Where Arizona ranks among states with the dirtiest (and cleanest) hospitals

Every year, up to 36 million Americans are hospitalized. However, roughly 1 in 31 patients contract at least one infection due to their health care every day. In 2024, U.S. hospitals reported 790,516 hospital-acquired infections (HAIs) linked to facility cleanliness.

With this in mind, the experts at per diem healthcare staffing platform Nursa analyzed hospital infection, inspection, and survey data to reveal the US states with the dirtiest and cleanest hospitals.

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Study highlights

• 8.73% of U.S. hospital patients reported their room and bathroom were “sometimes” or “never” clean.
• Delaware had the worst hospital hygiene in the nation, scoring 9.57/10 in Nursa’s Dirty Hospital Index.
• Utah ranked as the cleanest state, with a score of 3.09/10 on the same index.
• Nevada recorded the highest number of hospital-acquired infections per hospital, totaling 401 cases per hospital in 2024.

The states with the dirtiest hospitals 

Rank	State	Number of hospitals	Infection reports per hospital (2024)	No. of inspections mentioning unclean environment per hospital (2010-2025)	Cleanliness rating /5	Patients reporting their hospital room/bathroom as “Sometimes” or “Never” clean (2026)	Dirty Hospital Score /10
1	Delaware	19	368	2.53	2.43	12.86%	9.57
2	Alabama	129	284	2.70	2.69	10.80%	9.02
3	Michigan	182	283	2.03	2.74	11.19%	8.72
4	Missouri	169	321	2.63	3.17	9.56%	8.58
5	Maryland	72	288	1.49	2.86	10.77%	8.40
6 (tie)	North Dakota	56	264	2.57	2.27	8.86%	8.33
6 (tie)	Arizona	156	288	1.26	2.83	10.90%	8.33
8	Washington	119	337	2.37	3.25	8.36%	8.26
9 (tie)	Connecticut	52	292	3.13	3.31	9.23%	8.22
9 (tie)	Massachusetts	128	276	1.78	3.00	10.11%	8.22
11	Florida	361	328	1.24	3.16	10.06%	8.16
12	New Jersey	126	285	1.47	3.02	10.39%	8.15
13 (tie)	Nevada	68	401	1.32	3.19	9.21%	8.11
13 (tie)	New York	264	267	1.66	2.96	10.28%	8.11
15	Georgia	194	383	0.67	3.13	9.97	8.09

According to Nursa, U.S. hospitals reported 790,516 hospital-acquired infections (HAIs) linked to facility cleanliness in 2023. This makes up 2.20% of annual hospitalizations across the nation. As reporting is voluntary for each hospital, these results may not capture the full scope of hospital hygiene issues, and actual conditions could be more severe.

Nursa’s research also finds that 13,323 hospital inspection reports between 2010 and 2025 point towards an unclean environment for patients. These reports contain keywords such as biohazard, dirty, unsanitary, infected, and contaminated. 

Delaware’s hospitals are the dirtiest in the U.S.

With a score of 9.57/10, 2,664 hospital-acquired infections were reported across Delaware’s 19 hospitals in 2024, with 48 poor hospital hygiene inspections equating to 2.53 reports per hospital between 2010-2025. Recent patient survey results reveal that patients rate Delaware hospitals 2.43/5 stars for cleanliness, with 12.86% of respondents finding that their room and bathroom were either “sometimes” or “never” clean – the highest dissatisfaction rate nationwide. 

The second dirtiest hospitals are in Alabama, with a dirty hospital score of 9.02/10. In 2024, 2,253 hospital-acquired infections were reported across D.C.’s hospital facilities, with an astonishing 348 poor hospital hygiene inspections (2.7 per hospital) between 2010-2025. Patients rated hospital cleanliness at 2.43/5 stars, and 10.8%reported their room and bathroom were “sometimes” or “never” clean.

Michigan ranks third for poor hospital hygiene, with a dirty hospital score of 8.72/10. The state recorded 22,869 infections in 2024, and received 370 inspection reportsciting words such as “dirty”, “infected” or “cannot be disinfected” since 2010. Cleanliness received an average rating of 2.74/5 stars, while 11.19% of patients expressed dissatisfaction with room and bathroom cleanliness – the second highest dissatisfaction rate nationwide. 

The states with the most hygienic hospitals

Rank	State	Number of hospitals	Infection reports per hospital (2024)	No. of inspections mentioning unclean environment per hospital (2010-2025)	Cleanliness rating /5	Patients reporting their hospital room/bathroom as “Sometimes” or “Never” clean (2026)	Dirty Hospital Score /10
1	Utah	69	184	0.90	3.88	6.38	3.09
2	Hawaii	31	164	0.77	3.85	7.29	3.36
3	Wisconsin	179	226	2.09	3.85	6.12	4.91
4	Nebraska	103	247	1.99	3.89	5.75	4.92
5	Vermont	17	177	3.88	4.00	6.93	5.24
6	Wyoming	35	89	3.09	3.69	6.95	5.30
7	New Hampshire	35	251	1.63	3.71	6.88	5.34
8	Alaska	29	153	2.07	3.55	7.69	5.39
9	Kansas	165	247	2.25	3.74	5.86	5.41
10	Indiana	208	208	1.18	3.45	8.49	5.58
11	Iowa	132	218	2.81	3.57	6.05	5.72
12	South Dakota	70	216	3.26	3.67	6.48	5.88
13	Ohio	282	263	1.29	3.56	7.93	6.09
14	Rhode Island	17	273	1.59	3.73	7.82	6.10
15	West Virginia	73	256	1.81	3.61	7.55	6.15

Utah’s hospitals ranked as America’s most hygienic 

Utah ranks first for hospital cleanliness, achieving the lowest dirty hospital score of 3.09/10. In 2024, the state reported 6,233 hospital-acquired infections, averaging 184 per hospital. Patients rated hospital cleanliness at 3.88/5 stars, and only 6.38% said their room and bathroom were “sometimes” or “never” clean, among the lowest dissatisfaction rates nationwide.

Hawaii ranks second, with a dirty hospital score of 3.36/10. Hospitals reported 2,151 infections in 2023, or 164 per hospital. Cleanliness was rated 3.85/5 stars, and 7.29% of patients reported cleanliness concerns.

Wisconsin places third, scoring 4.91/10 on the index. The state recorded 14,884 infections in 2024, averaging 226 per hospital. Hospitals received a 3.85/5 cleanliness rating, with just 6.12% of patients expressing dissatisfaction, the fourth lowest rate in the U.S.