Nursing homes in Puerto Rico
Puerto Rico has 9 Medicare-certified nursing homes, with about 240 people living in them on an average day. 3 of them are rated one or two stars, the lowest two grades Medicare gives. Medicare grades inspections on a curve inside each state, so those stars are a rank inside Puerto Rico, not a national score.
Start with your town
1 town in Puerto Rico has two or more nursing homes. The number beside each one is how many.
Show the 6 towns with one nursing home
There is no town page for those, so each one goes straight to the home.
Or start with the municipio
Every home in Puerto Rico is in one of these 6, including the ones in towns too small for a page of their own.
How Puerto Rico is staffed
The national average is 3.86 hours. 4 of the 8 homes in Puerto Rico that report staffing are under 4.1 hours.
Registered nurses are the staff who notice a resident going downhill. The national average is 0.69 hours. 0 of the same 8 homes report less than 0.75 hours.
Turnover is how often the person who knows your mother's routine is replaced by someone who does not. This is the average across the 5 homes in Puerto Rico that report it.
Whether any of this is actually the law
Federal law does set some staffing rules: under 42 CFR 483.35 a home must have licensed nurses on duty 24 hours a day and a registered nurse for at least 8 consecutive hours a day, 7 days a week. What it does not set is a minimum number of nursing hours per resident. CMS wrote one into a 2024 rule, a federal court struck that rule down in April 2025, Public Law 119-21 barred its enforcement until 2034, and it was repealed in February 2026. So the 4.1 and 0.75 hour marks above are not law. They come from research CMS commissioned in 2001, which found that below those levels residents are more likely to be harmed. A home under them is not breaking a law. It is below the level that research tied to a higher risk of harm.
Where the benchmark comes from
Nursing hours are the number that shapes most of what happens in a home. These are the averages across Puerto Rico, against the level researchers found residents need.
The homes the government is watching
Medicare keeps a Special Focus Facility list, for homes with a persistent record of serious problems. No home in Puerto Rico is on that list or named as a candidate right now. That is worth knowing, and it is not the same as saying every home here is fine. What the findings below show is a separate question.
0 homes carry Medicare's abuse warning
Medicare puts a warning on a home when abuse was found and a resident was harmed, or when it happened twice. The warning comes off after a year.
3 homes have an abuse finding on record
Over the three inspection cycles on record, 3 homes were cited for abuse, the wrongful use of a resident's belongings or money, or involuntary seclusion. We count those three findings and nothing else. Medicare's words for the first of them: the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish.
2 homes were cited for putting a resident in immediate danger
Immediate jeopardy is the most serious thing an inspector can write down. It means a resident was in danger of serious harm or death right then. Medicare's words: noncompliance that has caused or is likely to cause serious injury, harm, impairment, or death.
A star in Puerto Rico is not a star in New Mexico. Medicare grades inspections on a curve, inside each state, one state at a time.
Inspectors add up points for what they find, and the more points a home has, the worse it did. Medicare then sorts every home in the state by that score and hands out stars by rank. So the score it takes to earn five stars depends entirely on the company a home keeps. In Puerto Rico, the worst score that still earned five stars this release was 45 points.
How Puerto Rico's 9 homes were graded overall. The inspection star is the curved ingredient in that overall grade, and it sets where a home starts. So this chart is not telling you Puerto Rico is average. It is telling you how homes here compare to each other.
Where these numbers come from
Everything on this page comes from the Centers for Medicare & Medicaid Services, from the Provider Information, Health Deficiencies, Penalties, Ownership and State US Averages files published on data.cms.gov. This page was built from the release dated August 1, 2026. CMS dates a release from the start of the month and puts it online on the last Wednesday of that month.
What these numbers do not say
Inspection findings cover the last three survey cycles. For some homes those cycles reach back to 2018, because routine inspections were suspended during the pandemic. Fines and payment denials cover April 9, 2024 to May 17, 2024. Staffing hours are payroll-based, reported quarterly by the homes themselves, and subject to audit by CMS.
A finding on a home's record does not mean the problem is still there, and the absence of one does not mean a home is safe. Inspectors visit about once a year and see one day of it. Use this page to know what to ask about, then go and look.