Methodology

For the list, U.S. News evaluated almost 15,000 nursing homes using publicly available data, primarily from CMS.

To be eligible for a rating, a facility must have sufficient data across staffing, process, and outcome measures. Nursing homes with certain negative indicators, like severe health deficiencies or recent CMS abuse designations, were restricted from earning a "High Performing" rating.

To be recognized as a "Best Nursing Home," a facility must achieve a "High Performing" rating in either short-term rehabilitation, long-term care, or both. A facility's overall rating is calculated as an average of the two care-type ratings, where applicable.

The ratings drew on a range of structural, process, and outcome measures, including:

• ED visits during stay
• Hospitalization during stay
• Total nurse staffing
• Total direct-care nurse staffing
• Weekend nurse staffing
• Weekend direct-care nurse staffing
• Total RN staffing
• Total direct-care RN staffing
• Physical therapist staffing
• RN staffing consistency
• Staff retention

Four additional measures were used for short-term rehab only:

• Residents able to return home
• Hospitalization after discharge
• Hospitalized infections
• Falls with major injury

Where the best nursing homes are located

According to U.S. News, the following 20 metropolitan areas, listed in alphabetical order, have the greatest number of Best Nursing Homes in the United States:

• Baltimore, MD
• Boston, MA
• Chicago, IL
• Cincinnati, OH
• Dallas-Fort Worth, TX
• Denver, CO
• Detroit, MI
• Miami-Fort Lauderdale, FL
• Minneapolis-St. Paul, MN
• New York, NY
• Orlando, FL
• Philadelphia, PA
• Phoenix, AZ
• Portland, OR
• Riverside-San Bernadino, CA
• San Diego, CA
• San Francisco-Oakland, CA
• Seattle, WA
• Tampa-St. Petersburg, FL
• Washington, D.C.

U.S. News also noted that, on average:

• Best Nursing Homes provide 20% more total staffing per resident per day compared to the national average.
• Top-performing skilled nursing facilities (SNFs) provide 80% more physical therapy per resident per day than the national average.
• Top-rated nursing homes have a 15% lower rate of hospitalizations for long-term residents compared to the national average. 
• Rehab patients at the highest-performing SNFs have a 33% lower rate of ED visits compared to the national average.

"Choosing a nursing facility, whether for post-acute rehabilitation — such as recovering from surgery like a hip replacement, a serious injury like a fracture or managing the aftermath of a stroke — or long-term residency, is one of the most crucial health care decisions a family can make," said Ben Harder, chief of health analysis and managing editor at U.S. News.

"This year's Best Nursing Homes ratings are the most comprehensive yet, with a significantly expanded portfolio of performance measures that offer families an even more holistic assessment of quality for both short-term rehab and long-term care," Harder added.

To see the full list, click here.