New York’s Nursing Home Accountability Index

New York is home to roughly 600 nursing homes caring for tens of thousands of vulnerable residents. The federal government rates each one on a five-star scale and tracks its staffing, inspection history, abuse findings, and fines. This analysis covers all 596 New York nursing homes in the June 2026 release of the Centers for Medicare and Medicaid Services data. It shows how uneven care is across the state and where the most troubled homes are concentrated.

The Syracuse problem

Onondaga County, home to Syracuse, leads the entire state in nursing-home fines, with $1.79 million in federal penalties across just 14 homes. Two of the state's largest single fines sit there, including $699,602 against Bishop Rehabilitation and Nursing Center and $619,590 against Van Duyn Center for Rehabilitation and Nursing.

Analysis. Van Duyn is more than a data point. In 2025 the New York Attorney General secured a $12 million settlement against the facility over chronic understaffing and the diversion of Medicaid funds, the largest nursing-home settlement in the office's history. The fines data flags exactly the kind of facility that later becomes a headline.

Understaffing runs through it all

Staffing is the clearest predictor of nursing-home quality, and New York's typical home reports just 0.57 hours of registered-nurse care per resident per day. At the bottom, a handful of homes report only 0.20 hours, roughly twelve minutes of registered-nurse time per resident across an entire day.

Analysis. Understaffing is the thread running through most enforcement actions, including the Van Duyn settlement. Low registered-nurse coverage correlates with missed care, falls, infections, and the kind of neglect that turns into litigation.

If your loved one was harmed in a nursing home

Nursing-home neglect and abuse can support claims for inadequate staffing, failure to prevent falls or pressure injuries, medication errors, and violations of residents' rights under New York Public Health Law. Families may be entitled to compensation for medical costs, pain and suffering, and in cases of gross neglect, punitive damages.

Methodology

Figures come from the Centers for Medicare and Medicaid Services Provider Information file, June 2026 release, covering all 596 certified nursing homes in New York. The overall rating is the CMS five-star measure, and below average means a rating of one or two stars. Fines are the total federal civil monetary penalties on record, which generally cover about three years. Staffing is reported registered-nurse hours per resident per day. Counties with fewer than eight rated homes are marked as small samples. Three homes lacked an overall rating and are excluded from the rating calculations.