By Lauren Giella

Copyright newsweek

One of the most important and emotional decisions a person can make is how to care for their aging family members. That’s why, for the last six years, Newsweek has provided reliable guidance for readers to make informed choices for finding the right nursing home to transition elderly loved ones.America’s Best Nursing Homes, in partnership with Statista, is Newsweek’s longest-running ranking.The 2026 ranking measures the top 1,200 individual nursing homes, not large chains, in over 30 states across the country. Nursing homes on this ranking are categorized by state and size – including small, medium and large facilities based on the number of beds.In addition to listing the top nursing homes, the ranking also includes whether Medicaid or Medicare is accepted and whether the facility has a resident or family councils, or both.Unsurprisingly, California, Florida and New York, states with some of the highest populations in the U.S., are the most represented on the 2026 list.In the latest ranking, here are the top 10 states with the most nursing homes:California – 122Florida – 107New York – 93Pennsylvania – 85Ohio – 74Texas – 74New Jersey – 65Illinois – 53Indiana – 52Michigan – 46When broken down by size, these are the top five states in each category:Facilities with 50-99 beds: Florida (48), Texas (40), Pennsylvania (28), California (25), Michigan (17)Facilities with 100-149 beds: California (52), Ohio (46), Indiana (22), Pennsylvania (17), Wisconsin (15)Facilities with over 150 beds: New York (74), New Jersey (50), Florida (45), California (45), Pennsylvania (40), Illinois (28)The ranking is determined by four main categories: performance, reputation, accreditation and resident satisfaction.“Excellence is defined above all by measurable quality: sufficient and stable staffing with low turnover, reliable weekend coverage, strong clinical outcomes and positive inspection results,” Statista told Newsweek. “Reputation among professionals, external accreditations, and the satisfaction of residents and their families also play a role. While in the past the focus often lay on basic care and comfort, the definition has shifted toward transparency, data-driven evaluation and verifiable quality indicators.”Performance score is comprised of staffing, quality measures and health inspections. Staffing includes hours, weekend hours and staff and administrative turnover. Quality metrics include long-stay and short-stay data like percentages of hospitalizations, vaccinations, falls, residents who need help with daily activities and catheter insertions and pressure ulcers. Finally, annual health inspections are collected and weighted based on the extent and severity of deficiencies. These inspections vary by state.The reputation score is derived from a nationwide survey of medical professionals, including nurses, administrators and physicians. Participants recommend nursing homes based on quality of medical care, nurse staffing, quality of services like dining and leisure activities and accommodations and amenities.The accreditation score reflects the range of structural and/or quality requirements from the Joint Commission and the Commission on Accreditation of Rehabilitation Facilities.Finally, the resident satisfaction score is based on Google reviews. Facilities must have at least 10 reviews to qualify.While there isn’t a specific metric for employee feedback, Statista said employee turnover rates are an indicator of staff satisfaction.“We assume that lower turnover rates are associated with higher overall satisfaction among employees, as they tend to remain longer at their workplace,” Statista said. “Accordingly, nursing homes with lower turnover rates receive better scores for this measure.”Having more time available per patient or resident also contributes to higher staff satisfaction and is closely linked to improved quality of care as well as greater resident satisfaction, Statista said.Nursing Homes RankingThroughout the last six years, the ranking has changed. Some of the biggest changes include the addition of facilities with 50-99 and 99-149 beds, COVID-19 score, resident satisfaction score and accreditation scoreSince the first ranking was published for 2020, America’s Best Nursing Homes has undergone several changes to better reflect the increased access to quality data.In 2020, the ranking only lists facilities with 150+ beds in the top 20 states, based on population. The scoring model was 85 percent performance data and 15 percent reputation.In subsequent rankings, more states and data sources were added.After the pandemic, the 2021 list included a COVID-19 response score that was evenly weighted with performance and reputation. This includes data on the total number of COVID-19 cases and deaths and other indicators like necessary medical supplies and staffing.The 2022…