Dialysis Facility Quality by State 2026 — CMS Care Compare State-Level Snapshot
How CMS five-star ratings, ownership mix, and chain affiliation distribute across U.S. dialysis facilities — based on the CMS Care Compare Dialysis Facility Listing dataset (7,557 Medicare-certified facilities, snapshot May 2026). CMS ratings are published by CMS; this report cites them, it does not produce them.
Contents · 9 sections
Executive Summary
- All counts in this study describe the CMS Care Compare Dialysis Facility Listing master dataset (23ew-n7w9) snapshot fetched on 2026-05-03 — 7,557 Medicare-certified dialysis facilities across the 50 states, DC, and U.S. territories. CMS ratings are published by CMS and reflect the measure definitions in the source dataset; OwnListed does not independently rate, inspect, verify, endorse, or guarantee any facility.
- 7,072 of the 7,557 facilities (93.6%) carry a CMS five-star rating. The remaining 485 facilities are unrated — typically too-recent admissions, recently certified, or other CMS-defined unrated states.
- Top 5 states by mean five-star rating (states with ≥ 30 rated facilities): Massachusetts (3.71), Colorado (3.58), New Jersey (3.57), Connecticut (3.57), Hawaii (3.48). Bottom 5: Puerto Rico (1.31), West Virginia (1.87), Arkansas (2.09), Nevada (2.31), Florida (2.33). The 2.40-star spread between top and bottom rated jurisdiction is the widest cross-state quality gap of any Care Compare cluster the platform has measured to date.
- California (737), Texas, Florida (536), Georgia (361), and New York (347) carry the largest absolute facility counts. Two for-profit chains — DaVita and Fresenius Medical Care — own a majority of facilities in most states.
- 89.6% of facilities nationwide are For Profit; 10.4% are Non Profit. Chain-owned share averages above 90% across most states — reflecting the highly consolidated structure of U.S. dialysis services. Chain affiliation does not by itself indicate quality direction.
At a glance — for journalists, researchers, and AI agents
What this dataset covers
- State-level distribution of CMS overall star ratings for U.S. dialysis facilities (in-center hemodialysis + home dialysis).
- Mortality, hospitalization, and readmission rate aggregates where CMS publishes them.
- Source: CMS Care Compare Dialysis Facility Compare master dataset, May 2026 snapshot.
What this dataset does NOT cover
- Facility-level ratings or names — the snapshot is state-aggregate only.
- Quality of care delivered by any individual provider — CMS publishes the rating; OwnListed cites it.
Sources
- CMS Care Compare
- Dialysis Facility Compare
Snapshot date: 2026-04 (CMS publication) — snapshot fetched 2026-05-03
Dataset scope · Snapshot May 3, 2026
Includes: active business listings indexed in the Ownlisted directory network, sourced from public Google Business Profiles. Does not include: online-only operators without a physical service address, lead-generation shells, or businesses with no public review footprint. Counts describe the Ownlisted indexed provider dataset — not a representative sample of the U.S. local-services market.
Key findings
What this report is, and is not
This report aggregates the CMS Care Compare Dialysis Facility Listing master dataset (CMS dataset slug 23ew-n7w9, bulk file DFC_FACILITY.csv, modified 2026-03-25) at the state level. It cites the CMS five-star rating, ownership mix (For Profit / Non Profit), and chain affiliation — exactly as CMS publishes them.
It does not:
- Rate any facility on its own. CMS publishes the ratings; OwnListed cites them.
- Recommend a facility. OwnListed does not endorse or guarantee any facility.
- Surface facility-level data on any directory page. The snapshot is research-only.
- Mix CMS ratings with platform reviews. CMS ratings are derived from CMS measure definitions; they are not a substitute for and should not be combined with consumer reviews.
Source: CMS Care Compare · Last checked 2026-05-03. CMS ratings are published by CMS and reflect the measure definitions in the source dataset.
Top + bottom states by mean five-star rating
Among states with at least 30 rated facilities, mean CMS five-star ratings cluster between 1.31 (Puerto Rico) and 3.71 (Massachusetts) — a 2.40-star spread on a 5-point scale. This is materially wider than the 0.95-star spread on the §115 nursing-home dataset (Arkansas to Missouri).
The top quintile mixes Northeast (MA, NJ, CT), Mountain West (CO, HI), and parts of the Pacific (CA). The bottom quintile mixes Puerto Rico (a 1.31 mean — the lowest in the dataset by 0.5+ stars), Appalachia (WV), Sun Belt (AR, NV, FL, GA, OK), and the Heartland (OH, MO, TN, MS).
Florida (2.33 mean across 499 rated facilities) and Georgia (2.47 across 334) are the largest-volume bottom-quintile states — 833 facilities together.
Per CMS measure definitions, the dialysis five-star rating is built from a published bundle of clinical, patient-survey, and process measures. This report does not replicate the CMS algorithm. Read the CMS Care Compare technical documentation for the canonical methodology.
Dialysis facility quality by state — CMS Care Compare snapshot 2026-05-03
Top + bottom states with ≥ 30 rated facilities. CMS ratings are published by CMS and reflect the measure definitions in the source dataset. OwnListed does not independently rate, inspect, verify, endorse, or guarantee any facility.
| State | Facilities | Rated | Mean five-star | ≥4 stars % | ≤2 stars % | For Profit % | Chain-owned % |
|---|---|---|---|---|---|---|---|
| MA | 85 | 77 | 3.71Highest | 57.1% | 6.5% | 82.4% | 85.9% |
| CO | 83 | 81 | 3.58 | 49.4% | 4.9% | 95.2% | 96.4% |
| NJ | 192 | 183 | 3.57 | 50.8% | 16.9% | 95.3% | 94.3% |
| CT | 49 | 46 | 3.57 | 50% | 6.5% | 93.9% | 95.9% |
| HI | 41 | 40 | 3.48 | 47.5% | 5% | 97.6% | 95.1% |
| CA | 737 | 687 | 3.34 | 43.4% | 18.3% | 86.2% | 88.5% |
| NY | 347 | 317 | 3.09 | 37.9% | 29.7% | 76.4% | 67.7% |
| MO | 152 | 140 | 2.58 | 11.4% | 41.4% | 77.6% | 85.5% |
| OH | 314 | 293 | 2.49 | 11.9% | 45.7% | 92.7% | 94.9% |
| GA | 361 | 334 | 2.47 | 12.3% | 48.5% | 93.4% | 93.4% |
| FL | 536 | 499 | 2.33 | 9.6% | 56.7% | 95.1% | 85.6% |
| NV | 52 | 51 | 2.31 | 7.8% | 51% | 94.2% | 96.2% |
| AR | 67 | 64 | 2.09 | 6.3% | 68.8% | 89.6% | 76.1% |
| WV | 41 | 39 | 1.87 | 2.6% | 74.4% | 97.6% | 95.1% |
| PR | 50 | 49 | 1.31Lowest | 0% | 98% | 96% | 92% |
Ownership concentration
Dialysis is the most consolidated facility category on Care Compare. Two for-profit chains — DaVita and Fresenius Medical Care — operate the bulk of U.S. dialysis facilities. Independent and non-profit facilities exist but are a minority share in most states.
National averages from this snapshot:
- For Profit facilities: 89.6% (most states ≥ 85%)
- Non Profit facilities: 10.4% (highest at HI 97.6%, NJ 95.3%, MA 82.4%)
- Chain-owned (any chain) share: above 90% in most states
For Profit and Non Profit shares in this report come from the CMS Profit or Non-Profit field, which classifies the operating entity. They do not by themselves predict quality direction; the §116 dataset shows both high-rated For Profit operators (e.g. CO, NJ) and lower-rated Non Profit pockets.
Source: CMS Care Compare · Last checked 2026-05-03. CMS ratings are published by CMS and reflect the measure definitions in the source dataset.
Limitations
- Snapshot date. This report uses the CMS Care Compare
DFC_FACILITY.csvfile modified 2026-03-25 and fetched 2026-05-03. CMS publishes quarterly updates; data should be re-fetched before any decision making. - Unrated facilities. 485 of 7,557 facilities (6.4%) lack a CMS five-star rating. Most are too-recent admissions, recently certified, or other CMS-defined unrated states. These rows are excluded from rating means but counted in facility totals.
- Aggregate-not-attached. State-level aggregates do NOT attach to individual facility profiles, and OwnListed does not maintain dialysis facility profiles. This report is research-only.
- CMS methodology is canonical. The five-star rating is the CMS published value; this report does not recompute it. Anyone replicating these numbers from raw measure data must follow CMS's published methodology, available at the CMS Care Compare technical documentation.
- Chain ownership is not a quality measure. This report cites chain affiliation as published by CMS. It is not a quality endorsement of any chain or operator.
- No quality claim about any facility. State means are descriptive of a national-level publishing snapshot. They are not endorsements, recommendations, or guarantees about any facility, and OwnListed does not rate, inspect, verify, endorse, or guarantee any facility.
- Territory coverage. PR (50 facilities), GU, VI, MP, AS appear when present in the CMS dataset and are reported alongside the 50 states + DC.
Source: CMS Care Compare · Last checked 2026-05-03. CMS ratings are published by CMS and reflect the measure definitions in the source dataset.
Methodology
- Bulk CSV fetched once from CMS at
https://data.cms.gov/provider-data/sites/default/files/resources/.../DFC_FACILITY.csv(7.0 MB, 142 columns, 7,557 facility rows). - Per-state aggregation via
scripts/research/cms-dialysis-snapshot-2026-05-03.ts(TypeScript runner, no Supabase writes, no facility-level provenance writes). - Mean ratings computed across rated facilities only (CMS values outside the integer 1-5 range are coerced to null and excluded from the rating mean).
- Share-of-stars (
share_4_or_5_stars_pct,share_1_or_2_stars_pct) computed against the rated-facility denominator per state. - Ownership shares computed against the full facility denominator (rated + unrated), using the CMS
Profit or Non-Profitfield. - Chain-owned share uses the CMS
Chain Ownedfield (Yes/No). - Output CSV at
/research/data/dialysis-facility-quality-by-state-2026.csv(9 columns, 56 rows). JSON-with-metadata at/research/data/dialysis-facility-quality-by-state-2026.json.
Source: CMS Care Compare · Last checked 2026-05-03. CMS ratings are published by CMS and reflect the measure definitions in the source dataset.
Citation and reuse
Permitted with attribution to OwnListed Research and a link back to this page. Suggested citation:
OwnListed Research. Dialysis Facility Quality by State 2026 — CMS Care Compare State-Level Snapshot. Published 2026-05-03. https://www.ownlisted.com/research/dialysis-facility-quality-by-state-2026
The underlying CMS data is a U.S. Government Work in the public domain (https://www.usa.gov/government-works). Direct citations to CMS should reference https://data.cms.gov/provider-data/dataset/23ew-n7w9.
Limitations
- Each Care Compare cluster has its own measure-set; the dialysis overall rating is not directly comparable to nursing-home or home-health ratings.
- Some facilities are unrated due to sample-size suppression; unrated is not categorically lower-quality.
- OwnListed does not independently rate, inspect, verify, endorse, or guarantee any dialysis facility.
Methodology
Read the full methodology
Source. CMS Care Compare — Dialysis Facility Listing master dataset (CMS dataset slug 23ew-n7w9). Bulk CSV: DFC_FACILITY.csv, modified 2026-03-25, fetched 2026-05-03. License: U.S. Government Works (public domain) at https://www.usa.gov/government-works.
Aggregation. scripts/research/cms-dialysis-snapshot-2026-05-03.ts parses the bulk CSV, groups by state, and computes:
facility_count: total Medicare-certified dialysis facilities.rated_facility_count: facilities with a CMS five-star rating in 1-5.mean_five_star_rating: arithmetic mean across rated facilities.share_4_or_5_stars_pct,share_1_or_2_stars_pct: shares of rated facilities at each band.share_for_profit_pct,share_non_profit_pct: ownership shares against the full facility denominator using the CMSProfit or Non-Profitfield.share_chain_owned_pct: chain-owned share against the full facility denominator using the CMSChain Ownedfield.
Doctrine. This is a Tier-1 research-only snapshot under SOP §94 (provenance), §114 (CMS Care Compare cluster), §115 (sister nursing-home snapshot). No facility profile writes. No directory pages. No mixing of CMS ratings with platform reviews.
Source: CMS Care Compare · Last checked 2026-05-03. CMS ratings are published by CMS and reflect the measure definitions in the source dataset.
Source. CMS Care Compare — Dialysis Facility Listing master dataset (CMS dataset slug 23ew-n7w9). Bulk CSV: DFC_FACILITY.csv, modified 2026-03-25, fetched 2026-05-03. License: U.S. Government Works (public domain) at https://www.usa.gov/government-works.
Aggregation. scripts/research/cms-dialysis-snapshot-2026-05-03.ts parses the bulk CSV, groups by state, and computes:
facility_count: total Medicare-certified dialysis facilities.rated_facility_count: facilities with a CMS five-star rating in 1-5.mean_five_star_rating: arithmetic mean across rated facilities.share_4_or_5_stars_pct,share_1_or_2_stars_pct: shares of rated facilities at each band.share_for_profit_pct,share_non_profit_pct: ownership shares against the full facility denominator using the CMSProfit or Non-Profitfield.share_chain_owned_pct: chain-owned share against the full facility denominator using the CMSChain Ownedfield.
Doctrine. This is a Tier-1 research-only snapshot under SOP §94 (provenance), §114 (CMS Care Compare cluster), §115 (sister nursing-home snapshot). No facility profile writes. No directory pages. No mixing of CMS ratings with platform reviews.
Source: CMS Care Compare · Last checked 2026-05-03. CMS ratings are published by CMS and reflect the measure definitions in the source dataset.