SNF Wound Care Rankings by State: What CMS Quality Measures Actually Show

We scored 14,591 skilled nursing facilities on wound care need. Star ratings — even low ones — don't tell you which facilities need wound care the most.

What We Looked At

CMS publishes quality measures on every Medicare-certified skilled nursing facility in the country. Among those measures are indicators directly relevant to wound care: pressure ulcer prevalence, skin integrity quality measures, and related clinical outcomes tracked through the Minimum Data Set (MDS).

Rehinged scores each facility on a 0–100 wound care ICP (Ideal Customer Profile) scale that combines these measures into a single composite indicator. A higher score indicates a greater concentration of wound-care-relevant clinical signals — meaning the facility has more indicators suggesting unmet wound care need. This is not a quality judgment. It is a measure of clinical signal density for a specific product category.

We scored 14,591 facilities. The national average wound care score is 36.56. Scores range from 14.68 to 100.00.

Finding 1: Star Ratings Don't Predict Wound Care Need — In Any Direction

At the aggregate level, facilities with lower star ratings have slightly higher average wound care need scores, and facilities with the highest star ratings have the lowest. But the averages are misleading — the variance within every star tier is so wide that a facility's star rating tells you almost nothing about its wound care need.

91 facilities in the scored universe do not have a CMS overall star rating and are excluded from this breakdown. They are included in the state-level and full rankings tables.

Higher scores indicate greater wound care need.

But the averages mask the real story. Look at the ranges within each star tier. A 5-star facility can score as high as 79.91 on wound care need. A 1-star facility can score as low as 15.48. The spread within any single star tier is so wide that the star rating has almost no predictive value for wound care specifically.

An important caveat on this finding: facilities with higher-acuity patient populations tend to receive lower CMS star ratings and may also show elevated wound care signals due to the clinical complexity of their residents. The inverse relationship between star ratings and wound care scores likely reflects differences in case mix and patient acuity in addition to differences in unmet clinical need. This is one reason we emphasize that a high wound care ICP score is not a quality judgment — it is a measure of clinical signal density that may reflect patient complexity as much as care gaps. For commercial targeting purposes, the practical implication remains the same: star ratings alone do not identify which facilities have the highest wound care signal, regardless of whether that signal is driven by acuity or by unmet need.

5-Star Facilities with High Wound Care Need

These facilities carry CMS's highest overall rating but score among the highest for wound care need indicators. These are facilities where wound care products and services may be relevant despite an otherwise strong quality profile.

Higher scores indicate greater wound care need.

Notice that these facilities also show wide variation across other clinical dimensions. Panorama City scores 79.9 for wound care but only 42.5 for fall prevention. Casa Bonita scores high across all three dimensions. Each facility has a distinct clinical profile that a single star rating cannot capture.

Finding 2: The Facilities at the Top of One Dimension Are Almost Never at the Top of Another

We compared the top-ranked facilities across wound care, fall prevention, and infection prevention. The overlap is close to zero.

Finding 3: State-Level Variation Is Substantial

Average wound care scores vary by nearly 60% between the highest and lowest states. Rhode Island averages 43.91. Arkansas averages 27.55. For a wound care company planning territory strategy, this means the density of opportunity is not distributed evenly — it clusters geographically.

Top 10 States by Average Wound Care Score

Higher scores indicate greater wound care need.

Bottom 10 States by Average Wound Care Score

Higher scores indicate greater wound care need.

Note the large states in the bottom 10: Texas (1,165 facilities, avg 31.19) stands out as the second-largest SNF state in the country, yet ranks 47th for average wound care scores. However, Texas still has 9 facilities scoring 70 or above in absolute terms — more than most small states. Iowa (387 facilities) and Alabama (224) are also high-volume territories with below-average wound care signals. Territory strategy requires looking at both the average and the distribution.

Full State-by-State Rankings

Below is the complete ranking of all 53 states and territories by average wound care ICP score. The "High Need" column shows facilities scoring 70 or above, representing the most concentrated wound care opportunity indicators. Click any column header to sort.

Higher scores indicate greater wound care need.

What This Means for Wound Care Sales Teams

Three implications stand out from this data.

First, sorting facilities by star rating to build a wound care call list doesn't work. The data shows the relationship is inverse at the aggregate level, but the variance within every star tier is so wide that star ratings are a poor predictor of any individual facility's wound care need.

Second, state-level averages matter for territory planning, but they can mislead if used alone. Texas has a low average wound care score (31.19) but still has 9 facilities scoring 70 or above — more than most small states. The absolute number of high-need facilities, not just the average, should drive territory allocation.

Third, cross-dimensional scoring reveals that wound care targeting requires wound-care-specific data. The zero overlap between wound care and fall prevention top-ranked facilities means a generic "high-need" list will produce a fundamentally different call list than one built for wound care specifically.

What This Doesn't Mean

Methodology

Frequently Asked Questions

Which states have the highest wound care need in skilled nursing facilities?

Based on CMS quality measures scored across 14,591 SNFs, Rhode Island (43.91 avg score), Michigan (43.53), Connecticut (42.38), Illinois (42.14), and Virginia (42.00) have the highest average wound care ICP scores, indicating the greatest concentration of wound-care-relevant clinical signals.

Do CMS star ratings predict wound care need in nursing homes?

No. The relationship is inverse. 1-star facilities have the highest average wound care need scores (41.74), meaning they show the greatest concentration of clinical signals indicating unmet wound care need. 5-star facilities have the lowest average need scores (31.43). However, the variance within any star tier is so wide that star ratings have almost no predictive value for identifying which facilities have the most wound care need.

How many skilled nursing facilities were scored for wound care?

Rehinged Healthcare scored 14,591 Medicare-certified skilled nursing facilities on wound care need using CMS quality measures. The top scoring drivers include MDS QM S_038_02 (the pressure ulcer quality measure tracking percentage of residents with new or worsened pressure ulcers), skin integrity citations, and F686 pressure ulcer deficiency violations. Scores range from 14.68 to 100 on a 0-100 scale.

Is there overlap between top-ranked wound care and fall prevention facilities?

Almost none. The top 10 facilities for wound care and the top 10 for fall prevention share zero facilities. Even at the top 100 level, only 1 facility appears on both lists, confirming that each clinical dimension requires its own targeted ranking.