AARP Nursing Home Quality and Safety Dashboard

This release of AARP’s new Nursing Home Quality and Safety Dashboard covers the second quarter (April through June) of 2026.      

All areas covered by the Dashboard show continued wide variation in performance between states. Those areas include staffing, quality measures and other characteristics, and respiratory illnesses and vaccination.

Approximately 15% of long-stay nursing home residents (stays longer than 100 days) received an antipsychotic medication (state range 8% in Washington D.C., to 25% in South Dakota), and 1.6% of short-stay residents (100 day stays or shorter) received an antipsychotic medication for the first time (state range from 0.7% in Washington D.C., to 3.3% in Louisiana).  Antipsychotics can have dangerous side effects in the older population and are often used inappropriately.  Additionally, 5% of residents had pressure ulcers (state range from 3% in Idaho to 8% in Washington D.C.).  Pressure ulcers are often associated with poor care and inadequate staffing. 

Nearly three-quarters of nursing homes (74%) are privately-owned, for-profit entities, with the greatest share, 90%, in Arkansas and the lowest share, only 6%, in North Dakota.  In 44 states, more than half of facilities are for-profit.  In addition to North Dakota, the exceptions are Alaska, Minnesota, Nebraska, South Dakota, Wyoming, and Washington D.C.  The nursing home occupancy rate averaged about 80% across the country, with a high of 92% in Alaska and a low of 62% in Oklahoma.  Nearly all nursing homes had a resident council (95% nationally), including 100% of facilities in Alaska, New Hampshire, Vermont, and Wyoming.  About 12% of facilities also had a family council, with the percentage ranging from only 3% in Arizona to 53% in Minnesota.

Following established seasonal patterns, respiratory illness cases and hospitalizations dropped significantly from Q1 2026 (winter) to Q2 2026 (spring).  Compared to the previous quarter, COVID-19 cases dropped by 83% and hospitalizations dropped by 77%; influenza cases dropped 95% and hospitalizations dropped by 94%; and RSV cases declined by 61% and by 57%.  There were some exceptions to the trend; a few states with very low COVID-19 rates in the winter showed an increase in cases (Arizona, Oregon, Washington D.C.) or hospitalizations (California, Nevada, Utah) in the spring.  An additional nine states had an increase in RSV cases, and five states had an increase in hospitalizations due to flu during the spring quarter.

Vaccination rates for all three illnesses remain much lower than needed to protect vulnerable residents.  As of late June, just 32% of nursing home residents were up to date on COVID-19 vaccination, and only 24% were vaccinated for RSV.  Seasonal influenza vaccination rates were not tracked in Q2 but averaged 58% at the end of Q1. This represents a continued decline in the rates of COVID-19 and flu vaccination: Recent vaccination rates peaked for flu in 2009 at 78%, and for COVID-19 in October 2021 at 86%.  Only 6% of health care staff were up to date with COVID-19 vaccination, down from 74% in October 2021.