Georgia Nursing Home Medicaid Statistics: Medicaid’s Share of Resident Days, and How Star Ratings, Nurse Staffing and Fines Compare
In the median Georgia nursing home certified for both Medicare and Medicaid, Medicaid paid for about 78% of resident days, and in about 4 in 10 of the 331 homes with a measured share it paid for 80% or more (shares as reported by the homes, mostly for state fiscal year 2025, which ran from July 2024 to June 2025).
You may be planning nursing home care for a parent or for yourself. If so, you may want to know how often Medicaid is the payer in Georgia nursing homes. You may also want to know whether homes with a higher Medicaid share are rated differently. In the median Georgia nursing home certified for both Medicare and Medicaid, Medicaid paid for about 78% of resident days, and in about 4 in 10 of the 331 homes with a measured share it paid for 80% or more (shares as reported by the homes, mostly for state fiscal year 2025, which ran from July 2024 to June 2025).
This report covers Georgia’s 356 certified nursing homes. For 331 of them, we worked out the share of resident days that Medicaid paid for. To do that, we matched two lists. One is the State of Georgia’s yearly survey of nursing homes. The other is the federal ratings file from the Centers for Medicare & Medicaid Services (CMS). For most homes the share comes from the state’s survey, and for 62 it comes from a federal Medicare cost report. Then we set CMS star ratings, nurse staffing, fines and ownership beside each home’s Medicaid share. Every figure is for Georgia unless it says otherwise. This report is part of The Hive Law’s Georgia elder law statistics, next to our Georgia long-term care statistics.
This report does not rate or name any nursing home. A star rating is CMS’s score, not a direct measure of the care a resident receives. The figures show which things go together. They do not show why.
Key Findings
In the median Georgia nursing home certified for both Medicare and Medicaid, Medicaid paid for about 78% of resident days, and in about 4 in 10 of the 331 homes with a measured share it paid for 80% or more (shares as reported by the homes, mostly for state fiscal year 2025, which ran from July 2024 to June 2025).How we got this Source: Georgia Department of Community Health (Annual Nursing Home Questionnaire); Centers for Medicare & Medicaid Services; analysis by The Hive Law
Georgia nursing homes where Medicaid paid for 80% or more of resident days averaged 2.54 of CMS’s five overall stars in August 2026, against 2.60 in homes at 70 to 79.9%, 2.50 at 60 to 69.9% and 2.98 at less than 60%: no established difference in CMS’s overall star rating by Medicaid share (330 rated homes; Medicaid shares mostly from state fiscal year 2025). In the U.S. as a whole, homes with a higher Medicaid share tend to have lower overall star ratings; in Georgia no link is established.How we got this Source: Centers for Medicare & Medicaid Services; Georgia Department of Community Health; analysis by The Hive Law
Georgia nursing homes where Medicaid paid for 80% or more of resident days reported 3.36 nurse hours per resident per day in January to March 2026, against 3.91 hours in homes where it paid for less than 60%, about 33 minutes less nurse time per resident per day (322 homes with staffing data; Medicaid shares mostly from state fiscal year 2025). Why is not measured. The difference is not established among rural homes, where few homes have a low Medicaid share.How we got this Source: Centers for Medicare & Medicaid Services; Georgia Department of Community Health; analysis by The Hive Law
Among Georgia nursing homes with a measured Medicaid share, non-profit homes averaged 3.37 of CMS’s five overall stars in August 2026 and for-profit homes 2.31, and Medicaid paid for at least as large a share of resident days in the non-profit homes: a median of 80.0% against 76.5% (84 non-profit and 233 for-profit homes; shares mostly from state fiscal year 2025). More than half of the non-profit homes are run by one operator; the rest averaged 3.14 stars. No cause is measured.How we got this Source: Centers for Medicare & Medicaid Services; Georgia Department of Community Health; analysis by The Hive Law
In Georgia, 31.1% of nursing homes where Medicaid paid for less than 60% of resident days were fined by federal regulators in the three years of CMS’s August 2026 penalty file, 40.0% of homes at 60 to 69.9%, 39.1% at 70 to 79.9% and 31.9% at 80% or more: no established difference by Medicaid share (331 homes; shares mostly from state fiscal year 2025).How we got this Source: Centers for Medicare & Medicaid Services; Georgia Department of Community Health; analysis by The Hive Law
Only 10 of Georgia’s 356 certified nursing homes are not certified for Medicaid; together they hold 437 of the state’s 39,494 certified beds (CMS data, August 2026). Nine of the ten are part of a retirement community.How we got this Source: Centers for Medicare & Medicaid Services; analysis by The Hive Law
15 of Georgia’s 159 counties have no Medicare- or Medicaid-certified nursing home (CMS and Georgia state data, 2025 and 2026); 26,108 Georgians aged 65 or older live in them (Census data, 2020 to 2024).How we got this Source: Centers for Medicare & Medicaid Services; Georgia Department of Community Health; U.S. Census Bureau; analysis by The Hive Law
How to Read These Figures
These points apply to every figure in this report.
Certified homes only. The 356 homes are the Georgia nursing homes certified by Medicare, Medicaid or both in the federal file for August 2026. That is not every licensed home.
The Medicaid share counts days, not people. It is the part of a home’s resident days that the home reported as Medicaid days. The homes report these figures themselves, to the state or to Medicare.
A Medicaid day is not a person who spent down. A day paid by Medicaid does not mean the resident spent down savings first. The figures do not show how any resident came to be on Medicaid.
A star is CMS’s rating. It is not a direct measure of the care a resident receives.
Two time periods. Medicaid shares are mostly for the state’s fiscal year 2025, which ran from July 2024 to June 2025. Star ratings are from CMS’s file for August 2026. Staffing figures are for January to March 2026.
No cause. The figures show which things go together. They do not show why.
“Established” has a set meaning here. We call a difference established only when it passes the test described in how we worked this out. “No established difference” means the data do not show a clear difference. It is not proof that the homes rate alike.
Each home counts once. Every average is an average across homes, whatever their size.
No home is judged. Nothing here says that homes with a high Medicaid share are good homes or bad homes, and no home is named.
How Many Georgia Nursing Homes Are Certified for Medicaid
346 of Georgia’s 356 certified nursing homes are certified for Medicaid (CMS data, August 2026). Of the 356 homes, 344 are certified for both Medicare and Medicaid, 10 are certified for Medicare only, and 2 are certified for Medicaid only. The state runs those 2 homes.
Where this data comes from
This counts nursing homes certified by Medicare, Medicaid or both in the federal file for August 2026. It is not every licensed home.
The Medicaid share is the part of a home’s resident days it reported as Medicaid days, mostly for the state’s fiscal year 2025 (July 2024 to June 2025). The homes report these figures themselves. It counts days, not people.
For homes with figures from two sources, the state survey is used first. Under other choices the 80% or more group runs from 121 to 148 homes, so the fair summary is about 4 in 10.
A day paid by Medicaid does not mean the resident spent down savings first. The figures do not show how any resident came to be on Medicaid.
“Certified for Medicaid” is a status in CMS’s file. The file does not show whether a home has a bed open or will admit any one person.
Source: Centers for Medicare & Medicaid Services, Nursing Home Provider Information (file processed August 1, 2026) and cost reports for fiscal year 2024; Georgia Department of Community Health, Annual Nursing Home Questionnaire, state fiscal years 2025 and 2024. Analysis: The Hive Law.
Only 10 of Georgia’s 356 certified nursing homes are not certified for Medicaid; together they hold 437 of the state’s 39,494 certified beds (CMS data, August 2026). Nine of the ten are part of a retirement community.
That is 1.1% of the state’s certified beds. All ten homes are in metro counties. These 10 are not the only homes where people may pay privately. No source used here counts private-pay residents in any home.
We do not compare the ratings of these 10 homes with the rest. They are only ten homes, and nine of them are part of a retirement community.
“Certified for Medicaid” is a status in CMS’s file. The file does not show whether a home has a bed open or will admit any one person. For how Medicare and Medicaid differ on nursing home costs, see Medicare vs. Medicaid for nursing home costs in Georgia.
What Share of Resident Days Medicaid Paid For
A resident day is one person living in a nursing home for one day. Each home reports how many of its resident days were Medicaid days. The Medicaid share is those Medicaid days divided by all of the home’s resident days.
We could measure that share for 331 of the 344 Georgia homes certified for both Medicare and Medicaid (96.2%). For the other 13 homes, no usable figure exists.
In the median Georgia nursing home certified for both Medicare and Medicaid, Medicaid paid for about 78% of resident days, and in about 4 in 10 of the 331 homes with a measured share it paid for 80% or more (shares as reported by the homes, mostly for state fiscal year 2025, which ran from July 2024 to June 2025).
The median home is the middle one. Half of the measured homes had a higher share and half had a lower one.
We sort the 331 measured homes into four groups by Medicaid share. The same four groups are used throughout this report.
Group
Homes
Not certified for Medicaid (certified for Medicare only)
10
Medicaid paid for less than 60% of resident days
45
Medicaid paid for 60% to 69.9%
50
Medicaid paid for 70% to 79.9%
92
Medicaid paid for 80% or more
144
Certified for both, no usable figure
13
Certified for Medicaid only (run by the state)
2
All certified nursing homes
356
In 236 of the 331 measured homes, Medicaid paid for at least 70 percent of resident days.
These counts are as we built them. Where a home has figures from two sources, we used the state’s survey first. For 62 homes the share comes from a federal Medicare cost report. Under other choices, the 80% or more group runs from 121 to 148 homes, and the median changes a little. That is why we say “about 4 in 10” and “about 78%.”
Added up across the 331 measured homes, 74.4% of resident days were Medicaid days (shares mostly from state fiscal year 2025). Our long-term care report gives a different measure. In 2025, Medicaid was the primary payer for 71% of residents of Georgia’s certified nursing homes (KFF analysis of CMS data). That figure is explained in what share of Georgia nursing home residents rely on Medicaid. The first figure counts days in 331 homes. The second counts residents in all certified nursing homes. Why the two figures differ is not measured.
Neither figure counts people who spent down their savings. A day paid by Medicaid does not mean the resident spent down savings first. The figures do not show how any resident came to be on Medicaid.
Do Georgia Nursing Homes With More Medicaid Residents Have Lower Star Ratings?
Georgia nursing homes where Medicaid paid for 80% or more of resident days averaged 2.54 of CMS’s five overall stars in August 2026, against 2.60 in homes at 70 to 79.9%, 2.50 at 60 to 69.9% and 2.98 at less than 60%: no established difference in CMS’s overall star rating by Medicaid share (330 rated homes; Medicaid shares mostly from state fiscal year 2025). In the U.S. as a whole, homes with a higher Medicaid share tend to have lower overall star ratings; in Georgia no link is established.
Where this data comes from
This covers 331 of the 344 Georgia nursing homes certified for both Medicare and Medicaid. For 13 homes no usable figure exists. One of the 331 has no overall star rating, so the bars rest on 330 rated homes: 45, 50, 91 and 144.
The Medicaid share is the part of a home’s resident days it reported as Medicaid days, mostly for the state’s fiscal year 2025 (July 2024 to June 2025). The homes report these figures themselves. It counts days, not people.
The star rating is the federal government’s overall rating for August 2026. It combines inspections, staffing and quality measures. It is not a direct measure of the care a resident receives.
The data do not show a clear difference between the bars. That is not proof the homes are the same. The last bar is 0.44 stars lower than the first, and the data would fit anything from 0.91 stars lower to 0.03 stars higher.
CMS’s quality-measure rating averaged 3.44 stars in homes where Medicaid paid for less than 60% of resident days and 2.69 to 2.76 in the three groups with higher Medicaid shares. The gap between the groups with the lowest and highest Medicaid shares is larger than chance would explain. Among homes at 60% or more, the data show no clear change in the rating as the Medicaid share rises, so The Hive Law does not count it as a steady trend.
Staffing does differ: homes with more Medicaid days report fewer nurse hours.
A day paid by Medicaid does not mean the resident spent down savings first. The figures do not show how any resident came to be on Medicaid.
Homes behind each figure: 330 rated homes (45, 50, 91 and 144 in the four groups), of 331 with a measured share
Source: Centers for Medicare & Medicaid Services, Nursing Home Provider Information (file processed August 1, 2026) and cost reports for fiscal year 2024; Georgia Department of Community Health, Annual Nursing Home Questionnaire, state fiscal years 2025 and 2024. Analysis: The Hive Law.
CMS’s health inspection rating shows no established difference by Medicaid share either. It averaged 2.96, 2.70, 2.81 and 2.79 stars across the four groups, from the lowest Medicaid share to the highest (August 2026 ratings).
“No established difference” means the data do not show a clear difference. It is not proof that the homes rate alike. Homes in the highest Medicaid group (80% or more) averaged 0.44 overall stars lower than homes in the lowest group (less than 60%). The data would fit anything from 0.91 stars lower to 0.03 stars higher, so a gap this size could be chance. One-star homes were 15.6% of homes at less than 60%, 34.0% of homes at 60 to 69.9%, 30.8% at 70 to 79.9% and 32.6% at 80% or more.
Staffing does differ. Homes where Medicaid paid for 80% or more of resident days reported about 33 minutes less nurse time per resident per day than homes where it paid for less than 60% (322 homes with staffing data, January to March 2026; Medicaid shares mostly from state fiscal year 2025). Why is not measured. The difference is not established among rural homes, where few homes have a low Medicaid share. The full figures are in nurse staffing hours by Medicaid share.
CMS’s quality-measure rating averaged 3.44 stars in homes where Medicaid paid for less than 60% of resident days and 2.69 to 2.76 in the three groups with higher Medicaid shares. The gap between the groups with the lowest and highest Medicaid shares is larger than chance would explain. Among homes at 60% or more, the data show no clear change in the rating as the Medicaid share rises, so The Hive Law does not count it as a steady trend.
Those are CMS’s August 2026 ratings. In figures, the highest Medicaid group averaged 0.76 quality-measure stars lower than the lowest group. The data would fit anything from 0.37 to 1.14 stars lower. For the health inspection rating, the highest group averaged 0.16 stars lower than the lowest group. The data would fit anything from 0.60 stars lower to 0.28 stars higher.
Medicaid share of resident days
Homes
Average overall rating
One-star homes
Four- or five-star homes
Average health inspection rating
Average quality-measure rating
Less than 60%
45
2.98
7 of 45 (15.6%)
16 (35.6%)
2.96
3.44
60% to 69.9%
50
2.50
17 of 50 (34.0%)
15 (30.0%)
2.70
2.76
70% to 79.9%
92
2.60
28 of 91 (30.8%)
26 (28.6%)
2.81
2.76
80% or more
144
2.54
47 of 144 (32.6%)
37 (25.7%)
2.79
2.69
All 331 measured homes
331
2.61
99 of 330 (30.0%)
94 (28.5%)
2.81
2.82
All 356 certified homes
356
2.64
104 of 355 (29.3%)
103 (29.0%)
2.83
2.86
Neither the one-star nor the four- or five-star column shows an established difference. One Georgia home has no star rating, so some counts are out of 91, 330 or 355 homes. Ratings are CMS’s for August 2026. Medicaid shares are mostly from state fiscal year 2025.
CMS gives each nursing home an overall rating of one to five stars. It combines inspections, staffing and quality measures. It is not a direct measure of the care a resident receives. CMS sets the health inspection rating by ranking each home against the other homes in its state.
These figures compare star ratings as CMS published them, with nothing else allowed for. They are not a finding that Medicaid share has no link to quality. Staffing differs. The quality-measure rating differs between the lowest and highest groups. And once ownership is allowed for, The Hive Law’s estimate is that the overall rating is lower where the Medicaid share is higher. That estimate rests on a small group of homes with low Medicaid shares. It is explained in for-profit and non-profit nursing homes by Medicaid share.
Georgia Next to the Country
In the U.S. as a whole, homes with a higher Medicaid share tend to have lower overall star ratings. In Georgia no link is established (330 rated homes; August 2026 ratings). Why is not measured.
We publish no rank among states on this link, and we make no claim that Georgia differs from them. Georgia’s Medicaid shares come mostly from the state’s own survey. Every other state’s shares come from federal cost reports. On federal cost reports alone, Georgia is not measurably different from the U.S. as a whole.
This is about a link, not a level. It asks whether ratings move with Medicaid share inside a state. It does not say Georgia’s homes rate well. Georgia’s rated nursing homes averaged 2.64 of five overall stars in August 2026, one of the five lowest averages among the 50 states and the District of Columbia. Read that comparison carefully. CMS sets the health inspection rating by ranking homes inside each state. So differences between states come mostly from the staffing and quality-measure parts of the rating.
Nurse Staffing Hours by Medicaid Share
Georgia nursing homes where Medicaid paid for 80% or more of resident days reported 3.36 nurse hours per resident per day in January to March 2026, against 3.91 hours in homes where it paid for less than 60%, about 33 minutes less nurse time per resident per day (322 homes with staffing data; Medicaid shares mostly from state fiscal year 2025). Why is not measured. The difference is not established among rural homes, where few homes have a low Medicaid share.
Where this data comes from
This covers 322 Georgia nursing homes: the 331 certified for both Medicare and Medicaid that have a usable Medicaid figure, less 9 with no staffing figures. For 13 more homes no usable Medicaid figure exists.
Hours are what each home reported from its payroll for January to March 2026. They measure staff time, not the care a resident received.
The Medicaid share is the part of a home’s resident days it reported as Medicaid days, mostly for the state’s fiscal year 2025 (July 2024 to June 2025). The homes report these figures themselves. It counts days, not people.
The chart shows a difference. It does not show why. Homes with more Medicaid days also have a smaller share of Medicare-paid days. Among rural homes the pattern is not clear, and few rural homes have a low Medicaid share.
A day paid by Medicaid does not mean the resident spent down savings first. The figures do not show how any resident came to be on Medicaid.
Homes behind each figure: 322 homes with staffing data, of 331 with a measured share
Source: Centers for Medicare & Medicaid Services, Nursing Home Provider Information (file processed August 1, 2026) and cost reports for fiscal year 2024; Georgia Department of Community Health, Annual Nursing Home Questionnaire, state fiscal years 2025 and 2024. Analysis: The Hive Law.
Where this data comes from
This covers 322 Georgia nursing homes: the 331 certified for both Medicare and Medicaid that have a usable Medicaid figure, less 9 with no staffing figures. For 13 more homes no usable Medicaid figure exists.
Minutes are what each home reported from its payroll for January to March 2026, for registered nurses only.
The Medicaid share is the part of a home’s resident days it reported as Medicaid days, mostly for the state’s fiscal year 2025 (July 2024 to June 2025). The homes report these figures themselves. It counts days, not people.
The chart shows a difference. It does not show why.
Homes behind each figure: 322 homes with staffing data, of 331 with a measured share
Source: Centers for Medicare & Medicaid Services, Nursing Home Provider Information (file processed August 1, 2026) and cost reports for fiscal year 2024; Georgia Department of Community Health, Annual Nursing Home Questionnaire, state fiscal years 2025 and 2024. Analysis: The Hive Law.
Reported registered-nurse time was 25.8 minutes per resident per day in homes at 80% or more, against 37.9 minutes in homes at less than 60% (January to March 2026).
Medicaid share of resident days
Homes with staffing data
Reported total nurse hours per resident per day
Reported registered-nurse minutes per resident per day
Less than 60%
44
3.91
37.9
60% to 69.9%
50
3.52
30.4
70% to 79.9%
89
3.45
27.4
80% or more
139
3.36
25.8
These hours are what each home reported from its payroll for January to March 2026. They measure staff time, not the care a resident received. 322 of the 331 measured homes have staffing data.
This difference is established. The data do not show why. Homes with a higher Medicaid share also have a smaller share of days paid by Medicare. They also score lower on CMS’s measure of resident mix, called the case-mix index. CMS publishes nurse hours adjusted for resident mix. On that adjusted measure, the gap between the lowest and highest groups is 0.37 hours, against 0.55 hours as reported.
The pattern holds inside for-profit homes and among urban homes. It also appears inside non-profit homes, but with 81 homes it is not established on its own. It is not established among rural homes, where few homes have a low Medicaid share. Only 12 of the 118 rural homes with staffing data were at less than 70 percent.
Among homes at 60% or more, the averages keep falling as the Medicaid share rises: 3.52, 3.45 and 3.36 hours. But in that smaller group the link is not established on its own. So the homes at less than 60% supply part of the pattern.
The Hive Law also ran a model that allows for four other things. They are ownership, whether the home is part of a chain, whether it is urban or rural, and its number of beds. By The Hive Law’s estimate, after allowing for those four things, reported nurse time is 0.148 hours lower for each 10 points of Medicaid share. That is an estimate from a model. It shows no cause.
CMS also gives each home a staffing star rating. It averaged 2.62, 2.32, 2.22 and 2.17 stars across the four groups, from the lowest Medicaid share to the highest (August 2026 ratings). Whether that is an established difference depends on how the state survey filings are screened, so we make no call on it.
Across all Georgia nursing homes with staffing data, the average was 3.56 reported nurse hours per resident per day (January to March 2026). That is the fifth-lowest of the 50 states and the District of Columbia.
Fines by Medicaid Share
In Georgia, 31.1% of nursing homes where Medicaid paid for less than 60% of resident days were fined by federal regulators in the three years of CMS’s August 2026 penalty file, 40.0% of homes at 60 to 69.9%, 39.1% at 70 to 79.9% and 31.9% at 80% or more: no established difference by Medicaid share (331 homes; shares mostly from state fiscal year 2025).
The two middle groups are 7 to 9 points higher than the two end groups. That is why all four figures are always shown together.
Medicaid share of resident days
Homes
Fined at least once
Homes with CMS’s abuse icon
Less than 60%
45
14 (31.1%)
1 of 45
60% to 69.9%
50
20 (40.0%)
7 of 50
70% to 79.9%
92
36 (39.1%)
3 of 92
80% or more
144
46 (31.9%)
10 of 144
The fines are the ones in CMS’s penalty file, which covers three years. The Georgia fines in it are dated from August 2023 to May 2026. May 2026 is the date of the last Georgia fine in the file, not the end of the three years.
Fine dollars, CMS’s abuse icon and nursing staff turnover show no established difference by Medicaid share either. CMS puts an abuse icon on a home that inspectors cited for abuse or neglect at the levels CMS’s rules set out. Nursing staff turnover in 2025 was 49.5%, 46.1%, 45.8% and 45.3% across the four groups, from the lowest Medicaid share to the highest.
Statewide, 123 of Georgia’s 356 certified nursing homes were fined in the three years of CMS’s penalty file, for $4,742,821 in total (CMS data, August 2026).
A fine follows an inspection finding and an enforcement decision. Having no fine is not a measure of quality.
About 78%of resident days paid by Medicaid in the median Georgia nursing home certified for both programs (mostly fiscal year 2025)
10of Georgia's 356 certified nursing homes are not certified for Medicaid (August 2026)
15Georgia counties with no certified nursing home (August 2026)
For-Profit and Non-Profit Nursing Homes in Georgia, by Medicaid Share
CMS labels the operator of each nursing home as for-profit, non-profit or government. These figures use CMS’s labels.
Among Georgia nursing homes with a measured Medicaid share, non-profit homes averaged 3.37 of CMS’s five overall stars in August 2026 and for-profit homes 2.31, and Medicaid paid for at least as large a share of resident days in the non-profit homes: a median of 80.0% against 76.5% (84 non-profit and 233 for-profit homes; shares mostly from state fiscal year 2025). More than half of the non-profit homes are run by one operator; the rest averaged 3.14 stars. No cause is measured.
The gap is 1.06 stars. One operator runs 48 of the 84 measured non-profit homes, and those 48 homes averaged 3.54 stars. The other 36 non-profit homes averaged 3.14 stars, against 2.31 for for-profit homes. So the gap is not that one operator alone. We do not name operators.
Here are both kinds of home, split by Medicaid share. The number of homes is in brackets.
Less than 60%
60% to 69.9%
70% to 79.9%
80% or more
All groups
For-profit homes: average overall stars
2.68 (34)
2.125 (40)
2.28 (66)
2.27 (93)
2.31 (233)
Non-profit homes: average overall stars
Not shown (9)
4.00 (10)
3.48 (23)
3.02 (42)
3.37 (84)
For-profit homes: reported nurse hours per resident per day
3.751
3.455
3.346
3.224
3.375
Non-profit homes: reported nurse hours per resident per day
Not shown
3.755
3.622
3.508
3.684
“Not shown” means the group has fewer than 10 homes. The 14 government-run homes with a measured share are too few to split into groups. Star ratings are CMS’s for August 2026, staffing is for January to March 2026, and Medicaid shares are mostly from state fiscal year 2025.
Inside for-profit homes, the three groups at 60% or more averaged 2.125, 2.28 and 2.27 stars.
Inside non-profit homes, in this data, ratings fall as the Medicaid share rises: 4.00, 3.48 and 3.02 stars. That fall is not established on its own. Non-profit homes at 80% or more still averaged more stars than any for-profit group.
No cause is measured for the star gap between the two kinds of home, or for the fall inside non-profit homes.
The table also gives reported nurse hours inside for-profit homes and inside non-profit homes. Inside non-profit homes, the link between Medicaid share and reported nurse hours is not established on its own (81 homes). No cause is measured.
The Hive Law also ran a model for star ratings. It allows for four things: ownership, whether the home is part of a chain, whether it is urban or rural, and its number of beds. By The Hive Law’s estimate, after allowing for those four things, CMS’s overall rating is 0.159 stars lower for each 10 points of Medicaid share. That estimate rests on the 21 homes where Medicaid paid for less than half of resident days. Without those 21 homes, the estimate is 0.131 stars and is not established. The estimate shows no cause.
Put together, there are three results. CMS’s overall star rating differs by about a star between non-profit and for-profit homes. Medicaid share alone does not show an established difference. And with ownership allowed for, there is an estimated link between a higher Medicaid share and a lower rating. That estimated link depends on a small group of homes with low Medicaid shares.
Counting all 356 certified nursing homes, with or without a measured Medicaid share, non-profit homes averaged 3.35 overall stars and for-profit homes 2.33 (August 2026 ratings). That gap can be read from CMS’s public file alone. What this report adds is each group’s Medicaid share beside it.
Georgia Counties With No Certified Nursing Home
15 of Georgia’s 159 counties have no Medicare- or Medicaid-certified nursing home (CMS and Georgia state data, 2025 and 2026); 26,108 Georgians aged 65 or older live in them (Census data, 2020 to 2024).
Where this data comes from
This counts nursing homes certified by Medicare, Medicaid or both in the federal file for August 2026, checked against Georgia’s own list of nursing homes and each home’s map location.
Three homes have two buildings under one federal certificate. Each building is counted in the county where it stands. That is why Pierce County, which has a building but no certificate of its own, is not among the 15.
The 15 counties are Atkinson, Baker, Banks, Chattahoochee, Dawson, Echols, Lincoln, McIntosh, Montgomery, Pike, Quitman, Schley, Talbot, Taliaferro and Webster.
26,108 Georgians aged 65 or older live in those 15 counties, by Census Bureau figures for 2020 to 2024.
The chart does not measure travel distance. Some of these counties border counties with several homes.
Source: Centers for Medicare & Medicaid Services, Nursing Home Provider Information (file processed August 1, 2026); Georgia Department of Community Health, nursing home inventory 2025; county names, map locations and population aged 65 and over from the U.S. Census Bureau (American Community Survey 2020 to 2024; Census geocoder). Analysis: The Hive Law.
The 15 counties are Atkinson, Baker, Banks, Chattahoochee, Dawson, Echols, Lincoln, McIntosh, Montgomery, Pike, Quitman, Schley, Talbot, Taliaferro and Webster.
Those 26,108 people are 1.6% of Georgia’s 1,636,809 residents aged 65 or older (Census data, 2020 to 2024).
This counts certified nursing homes only. It does not measure travel distance. Some of these counties border counties with several homes.
Certified nursing home locations in the county
Counties
None
15
One
69
Two
33
Three
21
Four
9
Five or more
12
A location is a building. Three certifications cover two buildings each, so the table counts 359 locations for 356 certified homes.
Pierce County is not on the list of 15. It has a 78-bed nursing home building that operates under a certification CMS lists at an address in the next county. CMS’s county field is also wrong for at least 5 Georgia homes. So we checked each home’s county three ways: CMS’s address, the home’s map location, and the state’s own list of nursing homes.
Medicaid Share by Area
Among measured homes, the median Medicaid share of resident days was 72.4% in the Atlanta area. It was 80.7% in Georgia’s micropolitan counties and 83.9% in counties outside any metro or micropolitan area. These shares are mostly from state fiscal year 2025. Micropolitan counties are smaller-town areas, as the federal government defines them.
In 59 Georgia counties, every measured home was at 80% or more. 46 of those 59 counties have a single measured home. These figures say nothing about how far a family would travel or what choices it has.
The Atlanta area has about 17 certified nursing home beds for every thousand people 65 or older. Micropolitan counties have about 39, and so do counties outside any metro or micropolitan area. These figures use August 2026 beds and the 2020 to 2024 Census population. This sets a count of beds beside a count of people. It does not measure need.
What Changed When We Added the State’s Survey
We answered the same questions twice. First we used federal cost reports alone. Then we added the state’s own survey. The answers changed, and the reason matters for anyone who uses this data.
Nursing homes file a yearly cost report with Medicare. The report has a place to show how many resident days Medicaid paid for. About 3 in 10 Georgia nursing homes file a federal cost report that does not break out Medicaid days. The count is 93 of the 308 Georgia homes certified for both programs that file the nursing-home cost report, or 30.2% (2024 cost reports). That is the second-highest share of the 50 states and the District of Columbia, after Vermont. In the U.S. as a whole it is 3.8%. Why a home leaves that part blank is not measured.
That is why we needed the state’s survey. Each year the Georgia Department of Community Health surveys the nursing homes on its list, and the homes report their Medicaid days and their other days.
On federal cost reports alone
With the state’s survey added
Homes certified for both programs with a measured Medicaid share
236 of 344
331 of 344
Homes where Medicaid paid for 80% or more of resident days, as built
71
144
Median Medicaid share
About 75%
About 78%
Average CMS overall rating of the 80% or more group
2.13
2.54
On federal cost reports alone, the 80% or more group averaged 2.13 overall stars, the lowest of the four groups. Even then, that difference was not established. With the state’s survey added, the group averages 2.54 stars and is not the lowest of the four.
The group’s rating rose because of which homes the federal file leaves out, not because any home changed. 108 homes had no usable federal figure in all. 95 of the 108 could be measured once the survey was added, and 50 of those 95 are in the 80% or more group. In every group, those 95 homes rate higher than the homes the federal file could measure.
The state’s survey has faults of its own. About 1 filing in 10 for fiscal year 2025 had a day total far from what CMS’s count of residents implies, or showed no days for any payer other than Medicaid. We left those filings out under a set rule.
For anyone working with this data: about 3 in 10 Georgia homes do not break out Medicaid days on their federal cost report, and the homes it leaves out that we could measure rate higher than the rest in every group.
Questions These Figures Do Not Answer
These figures describe Georgia’s nursing homes. They do not explain Medicaid’s rules, and they cannot tell you what to do. Our guides cover those questions.
The homes. We started with CMS’s Provider Information file, processed August 1, 2026. It lists 356 Georgia nursing homes certified by Medicare, Medicaid or both. Star ratings, staffing figures and fines all come from that file and its penalty file.
The Medicaid share. For each home certified for both programs, the Medicaid share is its Medicaid days divided by all of its resident days. We took each home’s days from the first of three sources that had a usable figure. The first is the Georgia Department of Community Health’s Annual Nursing Home Questionnaire for state fiscal year 2025 (263 homes). The second is a federal Medicare cost report (62 homes). The third is the same questionnaire for state fiscal year 2024 (6 homes). That gave a share for 331 of 344 homes. For 13 homes no usable figure exists.
Matching the two lists. Each home types its own Medicare number on the state’s survey, and 19 typed it wrongly in 2025. We matched on that number and checked every match against the home’s city. For 15 homes we made the match by hand. In all, 346 of the 356 CMS homes matched a facility in the state’s survey.
Screening the survey. For fiscal year 2025, 263 of 294 survey filings passed our check. We left out a filing for either of two reasons. One is that it showed no days for any payer other than Medicaid. The other is that its total days were far from what CMS’s count of residents implies.
How well the two sources agree. 201 homes have both a survey figure and a cost report figure. The two sources agree within 5 points for about 7 in 10 of those homes (145 of 201). The survey runs a median of 1.6 points higher. 63 of the 201 homes fall in a different 10-point group under the two sources. Both sources are reported by the homes themselves.
Why we say “about.” The median share and the size of the 80% or more group depend on which source is used first and how filings are screened. Across the choices we tried, the 80% or more group runs from 121 to 148 homes. So we give the median as “about 78%” and that group as “about 4 in 10.”
Stars, staffing and fines. CMS’s overall rating combines inspections, staffing and quality measures. Staffing hours come from payroll records that each home sends to CMS, here for January to March 2026. Fines are those in the three years of CMS’s penalty file.
Averages. Each home counts once, whatever its size. We also ran the averages weighted by number of residents, and no conclusion changed.
What “established” means. We compared 16 measures with Medicaid share. With that many comparisons, some will look different by chance. So we set a strict test. For each measure, we tested the link between Medicaid share and that measure across all measured homes. The test is a rank correlation. A p-value is the chance of seeing a link at least this strong in the data if there were really no link at all, so a smaller p-value means the link is harder to put down to chance. We call a link established only when its p-value is less than 0.0031. That is 0.05 divided by the 16 measures. Total nurse hours and registered-nurse hours pass that test. CMS’s overall rating and its health inspection rating do not. For the share of homes fined, we compared the four groups and found no established difference.
The comparison with the U.S. A rank correlation runs from -1 to 1. A figure less than zero means homes with a higher Medicaid share tend to have lower ratings. Across 12,367 U.S. homes, with shares from federal cost reports, it is -0.23. In the median of the 33 other states with 100 or more measured homes, it is -0.24. In Georgia, on our shares, it is -0.055 on 330 homes, and no link is established. On federal cost reports alone, Georgia’s figure is -0.146 on 214 homes, which is not measurably different from the U.S. figure. We publish no rank among states on this link.
The 13 homes we could not measure. If all 13 fell in any one group, that group’s average overall rating would move by no more than 0.12 stars.
What we did not measure. We did not count people who spent down their savings. We did not measure whether a home will admit a person who is on Medicaid. We did not measure any cause, any travel distance, or the quality of any single home.
Centers for Medicare & Medicaid Services, Provider Data Catalog, Nursing Homes Provider Information and Penalties files, Georgia and all states (files processed August 1, 2026)
Centers for Medicare & Medicaid Services, Five-Star Quality Rating System Technical Users’ Guide, July 2026
Georgia Department of Community Health, Office of Health Planning, Annual Nursing Home Questionnaire survey database, state fiscal years 2025 and 2024, and its 2025 nursing home inventory
Centers for Medicare & Medicaid Services, Medicare cost reports for fiscal year 2024 (the Skilled Nursing Facility Cost Report public use file and the hospital cost report file)
U.S. Census Bureau, American Community Survey 2020 to 2024 five-year estimates (population aged 65 and over by county), and the Census Geocoder (the county of each home’s map location)
U.S. Office of Management and Budget, list of metropolitan and micropolitan areas, July 2023, as distributed by the U.S. Census Bureau
KFF, State Health Facts, “Distribution of Certified Nursing Facility Residents by Primary Payer Source,” from CMS CASPER data, 2025
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Questions About Georgia Nursing Home Medicaid Statistics
346 of Georgia’s 356 certified nursing homes are certified for Medicaid (CMS data, August 2026). Only 10 of Georgia’s 356 certified nursing homes are not certified for Medicaid; together they hold 437 of the state’s 39,494 certified beds (CMS data, August 2026). Nine of the ten are part of a retirement community. “Certified for Medicaid” is a status in CMS’s file. The file does not show whether a home has a bed open or will admit any one person.
In the median Georgia nursing home certified for both Medicare and Medicaid, Medicaid paid for about 78% of resident days, and in about 4 in 10 of the 331 homes with a measured share it paid for 80% or more (shares as reported by the homes, mostly for state fiscal year 2025, which ran from July 2024 to June 2025). Added up across the 331 measured homes, 74.4% of resident days were Medicaid days. A different measure counts residents and not days. In 2025, Medicaid was the primary payer for 71% of residents of Georgia’s certified nursing homes (KFF analysis of CMS data). Why the two figures differ is not measured. A day paid by Medicaid does not mean the resident spent down savings first. The figures do not show how any resident came to be on Medicaid.
Georgia nursing homes where Medicaid paid for 80% or more of resident days averaged 2.54 of CMS’s five overall stars in August 2026, against 2.60 in homes at 70 to 79.9%, 2.50 at 60 to 69.9% and 2.98 at less than 60%: no established difference in CMS’s overall star rating by Medicaid share (330 rated homes; Medicaid shares mostly from state fiscal year 2025). In the U.S. as a whole, homes with a higher Medicaid share tend to have lower overall star ratings; in Georgia no link is established. CMS’s health inspection rating shows no established difference by Medicaid share either. Staffing does differ: Georgia homes where Medicaid paid for 80% or more of resident days reported about 33 minutes less nurse time per resident per day than homes where it paid for less than 60% (322 homes with staffing data, January to March 2026). Why is not measured. The difference is not established among rural homes, where few homes have a low Medicaid share. CMS’s quality-measure rating averaged 3.44 stars in homes where Medicaid paid for less than 60% of resident days and 2.69 to 2.76 in the three groups with higher Medicaid shares. The gap between the groups with the lowest and highest Medicaid shares is larger than chance would explain. Among homes at 60% or more, the data show no clear change in the rating as the Medicaid share rises, so The Hive Law does not count it as a steady trend.
Georgia nursing homes where Medicaid paid for 80% or more of resident days reported 3.36 nurse hours per resident per day in January to March 2026, against 3.91 hours in homes where it paid for less than 60%, about 33 minutes less nurse time per resident per day (322 homes with staffing data; Medicaid shares mostly from state fiscal year 2025). Why is not measured. The difference is not established among rural homes, where few homes have a low Medicaid share. These hours are what each home reported from its payroll. They measure staff time, not the care a resident received.
Among Georgia nursing homes with a measured Medicaid share, non-profit homes averaged 3.37 of CMS’s five overall stars in August 2026 and for-profit homes 2.31, and Medicaid paid for at least as large a share of resident days in the non-profit homes: a median of 80.0% against 76.5% (84 non-profit and 233 for-profit homes; shares mostly from state fiscal year 2025). More than half of the non-profit homes are run by one operator; the rest averaged 3.14 stars. No cause is measured.
In Georgia, 31.1% of nursing homes where Medicaid paid for less than 60% of resident days were fined by federal regulators in the three years of CMS’s August 2026 penalty file, 40.0% of homes at 60 to 69.9%, 39.1% at 70 to 79.9% and 31.9% at 80% or more: no established difference by Medicaid share (331 homes; shares mostly from state fiscal year 2025). The two middle groups are 7 to 9 points higher than the two end groups. That is why all four figures are always shown together. Having no fine is not a measure of quality.
15 of Georgia’s 159 counties have no Medicare- or Medicaid-certified nursing home (CMS and Georgia state data, 2025 and 2026); 26,108 Georgians aged 65 or older live in them (Census data, 2020 to 2024). The 15 counties are Atkinson, Baker, Banks, Chattahoochee, Dawson, Echols, Lincoln, McIntosh, Montgomery, Pike, Quitman, Schley, Talbot, Taliaferro and Webster. The count does not measure travel distance, and some of these counties border counties with several homes.
The Hive Law’s Georgia nursing home Medicaid figures come from mainly two public sources matched home by home. One is the Centers for Medicare & Medicaid Services file of certified nursing homes, with its star ratings, staffing figures and fines, for August 2026. The other is the Georgia Department of Community Health’s Annual Nursing Home Questionnaire, in which homes report their Medicaid days, mostly for state fiscal year 2025. For 62 homes the share comes from a federal Medicare cost report. The homes report the day counts and the staffing figures themselves. A Medicaid share could be measured for 331 of the 344 Georgia homes certified for both Medicare and Medicaid.
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