247 of the 1,179 Medicare-certified nursing homes in Texas (21%) are government-run, and all are listed below. Nurse staff turnover runs 53.7%, 1.6 points lower than the 55.3% across all homes there. 11 of the 246 graded homes earn an A and 15 earn a D or F. Country View Living in Dimmitt grades highest at A (94 out of 100).
How government-run homes in Texas compare
This group set against every nursing home in Texas, from the current CMS release.
Nursing hours per resident per day
3.36
All homes in Texas: 3.39
Worse than the local average
Nurse staff turnover
53.7%
All homes in Texas: 55.3%
Better than the local average
Average ElderGrade score
67.8/100
All homes in Texas: 66.9/100
Better than the local average
Grade spread
B
C
11 grade A, 93 grade B, 127 grade C, 15 grade D,
The best-graded government-run home in Texas is
Country View Living
in Dimmitt, TX, grade A, 94/100.
Granbury Care Center runs on 2.71 nurse staffing hours per resident day, roughly 30% under the national average, and weekends drop another 13% below its own weekday level. That thin coverage shows up in the numbers: a staff turnover rate of 94.2%, where the national figure sits near 46%, meaning most of the people caring for residents this year likely won't be there next year. The home carries 37 deficiencies on its current record, including two at the harm or jeopardy level and one tied to abuse, plus $37,501 in fines. Inspectors were last out in February 2026, and the health inspection rating sits at 2 out of 5.
Trinity Nursing & Rehab Of Granbury runs on 3.12 nurse hours per resident day, roughly 19% under the national average, and weekends drop another 15% below what the home staffs on weekdays. Turnover sits at 69.6% against a national 45.8%, meaning most of the people caring for residents this year likely won't be there next year. The inspection record shows 28 deficiencies, including two at the harm or jeopardy level and two tied to abuse, plus a $66,367 fine. The last inspection was June 4, 2025. For-profit, LLC-owned, 90 beds. If you're considering this one, ask directly how they cover weekends and what's changed since that June inspection.
Coral Rehabilitation and Nursing of Austin runs on 2.82 nurse hours per resident day, roughly a quarter below the national average, and weekend coverage drops about 11% below its own weekday level. That thin margin shows up in staffing, where the home sits at the bottom of CMS's scale, and in a 57.6% annual turnover rate, well above the 45.8% national figure. The inspection record is heavier still: 86 deficiencies, 18 of them at harm or jeopardy level and 10 involving abuse, plus five fines totaling $294,911. CMS has placed it in the Special Focus Facility program, a designation reserved for homes with a persistent pattern of serious problems. The last inspection was September 30, 2025.
The Rio at Mission Trails runs 124 beds under hospital district ownership in San Antonio, and its nurse staffing sits just under the national average, 3.71 hours per resident day against 3.86. That small gap is not the real story. Weekend staffing drops roughly 16% below its own weekday level, and annual turnover hits 97.2%, more than double the national rate of 45.8%, meaning the aides and nurses at your mother's bedside are, statistically, almost certain to be new within the year. On inspections, the home carries 32 deficiencies, three at harm or jeopardy level and four abuse-related, with two fines totaling $153,825.
Buena Vida Nursing and Rehab in San Antonio runs 222 certified beds under hospital district ownership, and federal data shows it struggling on every measure CMS tracks. Nurse staffing sits at 2.93 hours per resident day, roughly a quarter below the national average of 3.86, and weekends drop about 9% below its own weekday level, so coverage thins out exactly when families tend to visit. The inspection record is the bigger concern: 49 deficiencies, five serious enough to put residents in harm's way, three tied to abuse, and $187,608 in fines. That combination landed it in CMS's Special Focus Facility program, a designation reserved for the country's most persistently troubled homes.
Avir At Rose Trail carries a record that should give any family pause. The Tyler home runs 3.04 nurse staffing hours per resident day against a national average of 3.86, and weekends drop about 16% below its own weekday level, so the thinnest coverage lands exactly when families tend to visit. Staff turnover sits at 69.6% against a national 45.8%, meaning most of the people caring for your relative will likely be gone within the year.
The inspection record is worse: 59 deficiencies, 10 of them at the harm or jeopardy level and 10 tied to abuse, with $442,321 in federal fines. CMS has placed it in the Special Focus Facility program, reserved for the country's most troubled homes.
How many government-run nursing homes are there in Texas?
There are 247 government-run Medicare-certified nursing homes in Texas, 21% of the 1,179 nursing homes there.
Are government-run nursing homes better staffed?
In Texas they average 3.36 total nursing hours per resident per day, against 3.39 for all nursing homes in Texas, a difference of -0.03 hours. Staff turnover averages 53.7% against 55.3%.
Which government-run nursing home grades best in Texas?