facebook tracking Best and worst states for hospital quality: CMS star ratings ranked

Best and worst states for hospital quality

According to HospitalsInEachState.com's analysis of the October 2026 CMS release, the 3,150 U.S. hospitals Medicare rates average 3.21 overall stars; 383 hold 5 stars and 190 hold 1. In the HospitalsInEachState.com State Hospital Quality Rankings, Utah ranks #1 (4.24 stars on average) and Mississippi ranks last of 50 (2.31).

CMS data published October 20263,150 rated hospitals50 states ranked
Ranked #1 Utah 4.24 average stars
Ranked last (#50) Mississippi 2.31 average stars
U.S. average 3.21 stars Across 3,150 rated hospitals
5-star / 1-star 383 / 190 Hospitals at the top and bottom
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Report: 79% of Utah's rated hospitals have 4 or 5 CMS stars; 14% of Mississippi's do (Nov 13, 2026)

Key findings

  • Utah ranks #1. Its 29 rated hospitals average 4.24 stars. 15 of them earned the top 5-star rating, and 79% are rated 4 or 5 stars. Colorado (3.96), South Dakota (3.89), Wisconsin (3.78) and Minnesota (3.77) round out the top five.
  • Mississippi ranks last. Its 51 rated hospitals average 2.31 stars; 12 have the lowest 1-star rating and 61% score 1 or 2 stars. West Virginia, Kentucky, Alabama and New Mexico complete the bottom five.
  • Most 1-star hospitals: California (29), New York (21), Florida (16), Illinois (14).
  • Ownership matters. VA medical centers average 4.19 stars, nonprofit hospitals 3.31 and for-profit hospitals 2.81.
  • 2,193 of 5,343 hospitals (41%) have no star rating, usually because they report too few measures. That is common for small rural and specialty hospitals.

State Hospital Quality Rankings

Ranked by the average overall star rating of each state's rated hospitals. The bar shows the average out of 5; the tick marks the U.S. average. Pick a state to see every rated hospital there.

Showing all 50 states

U.S. states ranked by the average CMS overall hospital star rating, October 2026
# State Avg stars Rated 5 ★ 1 ★ 4–5 ★ 1–2 ★
1 Utah 29 rated 15 five-star 0 one-star 7% rated 1–2 ★ 4.24 29 15 0 79% 7%
2 Colorado 49 rated 14 five-star 1 one-star 4% rated 1–2 ★ 3.96 49 14 1 73% 4%
3 South Dakota 18 rated 5 five-star 0 one-star 11% rated 1–2 ★ 3.89 18 5 0 72% 11%
4 Wisconsin 86 rated 21 five-star 2 one-star 8% rated 1–2 ★ 3.78 86 21 2 64% 8%
5 Minnesota 56 rated 13 five-star 1 one-star 7% rated 1–2 ★ 3.77 56 13 1 63% 7%
6 Virginia 76 rated 12 five-star 0 one-star 8% rated 1–2 ★ 3.68 76 12 0 61% 8%
7 Ohio 126 rated 18 five-star 0 one-star 8% rated 1–2 ★ 3.60 126 18 0 54% 8%
8 Rhode Island 11 rated 0 five-star 0 one-star 9% rated 1–2 ★ 3.55 11 0 0 64% 9%
9 Idaho 22 rated 5 five-star 0 one-star 14% rated 1–2 ★ 3.55 22 5 0 45% 14%
10 Nebraska 36 rated 0 five-star 0 one-star 14% rated 1–2 ★ 3.50 36 0 0 64% 14%
11 Pennsylvania 130 rated 20 five-star 3 one-star 19% rated 1–2 ★ 3.50 130 20 3 56% 19%
12 South Carolina 49 rated 7 five-star 0 one-star 20% rated 1–2 ★ 3.43 49 7 0 49% 20%
13 Connecticut 26 rated 4 five-star 0 one-star 19% rated 1–2 ★ 3.42 26 4 0 46% 19%
14 Texas 216 rated 29 five-star 7 one-star 20% rated 1–2 ★ 3.38 216 29 7 48% 20%
15 Wyoming 16 rated 2 five-star 0 one-star 19% rated 1–2 ★ 3.38 16 2 0 44% 19%
16 Indiana 91 rated 12 five-star 2 one-star 19% rated 1–2 ★ 3.36 91 12 2 44% 19%
17 Maryland 42 rated 7 five-star 2 one-star 19% rated 1–2 ★ 3.31 42 7 2 38% 19%
18 North Carolina 90 rated 12 five-star 4 one-star 23% rated 1–2 ★ 3.30 90 12 4 44% 23%
19 Oklahoma 62 rated 8 five-star 2 one-star 26% rated 1–2 ★ 3.29 62 8 2 45% 26%
20 Oregon 44 rated 3 five-star 2 one-star 23% rated 1–2 ★ 3.25 44 3 2 45% 23%
21 North Dakota 16 rated 2 five-star 1 one-star 25% rated 1–2 ★ 3.25 16 2 1 44% 25%
22 Montana 20 rated 4 five-star 1 one-star 30% rated 1–2 ★ 3.25 20 4 1 40% 30%
23 Vermont 12 rated 2 five-star 1 one-star 17% rated 1–2 ★ 3.25 12 2 1 33% 17%
24 Iowa 62 rated 7 five-star 2 one-star 29% rated 1–2 ★ 3.24 62 7 2 45% 29%
25 Washington 60 rated 6 five-star 1 one-star 25% rated 1–2 ★ 3.23 60 6 1 40% 25%
26 Maine 24 rated 1 five-star 1 one-star 21% rated 1–2 ★ 3.21 24 1 1 42% 21%
27 Massachusetts 54 rated 9 five-star 2 one-star 31% rated 1–2 ★ 3.20 54 9 2 39% 31%
28 Hawaii 11 rated 0 five-star 0 one-star 27% rated 1–2 ★ 3.18 11 0 0 45% 27%
29 New Hampshire 23 rated 0 five-star 1 one-star 22% rated 1–2 ★ 3.17 23 0 1 43% 22%
30 Kansas 54 rated 3 five-star 2 one-star 26% rated 1–2 ★ 3.17 54 3 2 41% 26%
31 New Jersey 61 rated 7 five-star 5 one-star 28% rated 1–2 ★ 3.15 61 7 5 39% 28%
32 Delaware 7 rated 0 five-star 0 one-star 14% rated 1–2 ★ 3.14 7 0 0 29% 14%
33 Missouri 79 rated 5 five-star 3 one-star 30% rated 1–2 ★ 3.14 79 5 3 42% 30%
34 Arizona 55 rated 8 five-star 1 one-star 35% rated 1–2 ★ 3.11 55 8 1 33% 35%
35 California 279 rated 29 five-star 29 one-star 32% rated 1–2 ★ 3.10 279 29 29 42% 32%
36 Michigan 94 rated 9 five-star 9 one-star 30% rated 1–2 ★ 3.09 94 9 9 38% 30%
37 Tennessee 72 rated 6 five-star 6 one-star 28% rated 1–2 ★ 3.08 72 6 6 36% 28%
38 Florida 168 rated 19 five-star 16 one-star 32% rated 1–2 ★ 3.06 168 19 16 36% 32%
39 Illinois 135 rated 14 five-star 14 one-star 32% rated 1–2 ★ 3.04 135 14 14 36% 32%
40 Nevada 25 rated 3 five-star 0 one-star 40% rated 1–2 ★ 3.00 25 3 0 28% 40%
41 Georgia 84 rated 6 five-star 8 one-star 36% rated 1–2 ★ 2.94 84 6 8 32% 36%
42 Alaska 10 rated 1 five-star 1 one-star 40% rated 1–2 ★ 2.90 10 1 1 30% 40%
43 Arkansas 43 rated 3 five-star 3 one-star 40% rated 1–2 ★ 2.86 43 3 3 26% 40%
44 Louisiana 59 rated 0 five-star 3 one-star 36% rated 1–2 ★ 2.81 59 0 3 22% 36%
45 New York 136 rated 20 five-star 21 one-star 49% rated 1–2 ★ 2.77 136 20 21 26% 49%
46 West Virginia 34 rated 5 five-star 6 one-star 47% rated 1–2 ★ 2.76 34 5 6 26% 47%
47 Kentucky 67 rated 5 five-star 8 one-star 43% rated 1–2 ★ 2.76 67 5 8 24% 43%
48 Alabama 57 rated 0 five-star 4 one-star 39% rated 1–2 ★ 2.74 57 0 4 19% 39%
49 New Mexico 23 rated 1 five-star 3 one-star 61% rated 1–2 ★ 2.48 23 1 3 17% 61%
50 Mississippi 51 rated 1 five-star 12 one-star 61% rated 1–2 ★ 2.31 51 1 12 14% 61%

Alaska, Delaware, Hawaii, Rhode Island, Vermont have fewer than 15 rated hospitals, so a single hospital's rating change can move them several places.

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Star ratings by hospital ownership

Average overall rating by who owns the hospital. Groups with fewer than 10 rated hospitals are left out.

OwnershipRated hospitalsAvg stars
VA (Veterans Health Administration) 110 4.19
Physician-owned 18 3.50
Nonprofit (church) 216 3.37
Nonprofit 1,860 3.31
Government (local or district) 404 2.93
Government (state or federal) 49 2.92
For-profit 490 2.81

Every 5-star hospital, by state

383 hospitals earned the top rating. Open a state to see them.

Alaska 1 five-star hospital
Arizona 8 five-star hospitals
Arkansas 3 five-star hospitals
California 29 five-star hospitals
Colorado 14 five-star hospitals
Connecticut 4 five-star hospitals
Florida 19 five-star hospitals
Georgia 6 five-star hospitals
Idaho 5 five-star hospitals
Illinois 14 five-star hospitals
Indiana 12 five-star hospitals
Iowa 7 five-star hospitals
Kansas 3 five-star hospitals
Kentucky 5 five-star hospitals
Maine 1 five-star hospital
Maryland 7 five-star hospitals
Massachusetts 9 five-star hospitals
Michigan 9 five-star hospitals
Minnesota 13 five-star hospitals
Mississippi 1 five-star hospital
Missouri 5 five-star hospitals
Montana 4 five-star hospitals
Nevada 3 five-star hospitals
New Jersey 7 five-star hospitals
New Mexico 1 five-star hospital
New York 20 five-star hospitals
North Carolina 12 five-star hospitals
North Dakota 2 five-star hospitals
Ohio 18 five-star hospitals
Oklahoma 8 five-star hospitals
Oregon 3 five-star hospitals
Pennsylvania 20 five-star hospitals
South Carolina 7 five-star hospitals
South Dakota 5 five-star hospitals
Tennessee 6 five-star hospitals
Texas 29 five-star hospitals
Utah 15 five-star hospitals
Vermont 2 five-star hospitals
Virginia 12 five-star hospitals
Washington 6 five-star hospitals
West Virginia 5 five-star hospitals
Wisconsin 21 five-star hospitals
Wyoming 2 five-star hospitals

Questions about hospital star ratings

Which state has the best hospitals?

Utah ranks first. Its 29 hospitals with a Medicare star rating average 4.24 stars, and 79% are rated 4 or 5 stars. Colorado, South Dakota, Wisconsin and Minnesota complete the top five.

Which state has the lowest-rated hospitals?

Mississippi ranks last of 50. Its 51 rated hospitals average 2.31 stars, and 61% are rated 1 or 2 stars.

What is the CMS hospital star rating?

The Centers for Medicare & Medicaid Services (CMS) gives hospitals an overall rating of 1 to 5 stars, combining measures of mortality, safety of care, readmissions, patient experience and timely and effective care. The U.S. average is 3.21 stars across 3,150 rated hospitals.

Why do some hospitals have no star rating?

2,193 of 5,343 hospitals (41%) have no overall rating, usually because they report too few measures. That is common for small rural, critical access and specialty hospitals. A missing rating is not a bad rating.

How often are these rankings updated?

This page uses CMS data published October 2026. The site checks CMS for new data every day and updates the rankings automatically when CMS publishes a new release.

Cite this data

Journalists, researchers and site owners are welcome to quote and chart these figures. They are free to use under CC BY 4.0: please credit HospitalsInEachState.com and link to this page.

Figures as of the October 2026 CMS release Updated automatically when CMS publishes new data Permanent link: hospitalsineachstate.com/hospital-ratings/

Download the data (CSV)

Methodology: Data is the CMS Hospital General Information file (Care Compare, October 2026 release). Each facility is counted once by its CMS Certification Number. 3,150 of 5,343 hospitals have an overall star rating; hospitals without one are left out of the averages. A state's rank is the mean overall rating of its rated hospitals, with ties broken by the share rated 4 or 5 stars. Washington, D.C. and U.S. territories are not ranked.

A star rating summarizes many measures and does not capture every service. Talk to your doctor about which hospital is right for your care. About the data. Not affiliated with CMS. For a medical emergency, call 911.