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.
The Frank M. Tejeda Texas State Veterans Home in Floresville runs lean on daily nursing hours, 3.09 per resident, roughly a fifth below the national average, and weekends dip about 13% below its own weekday coverage. What stands out instead is retention: turnover sits at 27.8%, well under the 45.8% national figure, which matters for familiar faces and consistent care. State-run, 160 beds, inspected in March 2026 and rated 4 of 5 on health inspections. The current record shows 22 deficiencies with none at the harm level, though 5 are abuse-related, worth asking about directly before you visit.
The Alfredo Gonzalez Texas State Veterans Home in McAllen runs on a stable workforce, 28.5% turnover is well below the national 45.8%, and that consistency shows up in its staffing score. But 3.58 nurse hours per resident day sits about 7% under the national average, and weekends drop roughly 15% below the home's own weekday coverage, so care thins out when families tend to visit.
The bigger concern is the inspection record: a 2-out-of-5 health inspection rating, 30 deficiencies including 3 at harm or jeopardy level and 5 abuse-related, plus two fines totaling $35,600. State-run ownership brings accountability, but this home's last survey in January 2026 flagged real problems.
Prestonwood runs on a hospital district's budget, and the nurse staffing shows it: 4.21 hours per resident day, roughly 9% above the national average. Weekends dip about 14% below its own weekday levels, worth asking about if your family visits Saturday or Sunday. The harder numbers are on the inspection side, 16 deficiencies on the current record, three of them at harm or jeopardy level and three abuse-related, with one fine totaling $14,433. Staff turnover sits at 46.8%, a hair above the national 45.8%. The last inspection was April 2025, so the record is recent. Strong staffing and quality scores, rough inspection history, that split is what the grade reflects.
Cibolo Creek runs on thinner nurse coverage than most homes in the country, 3.00 hours per resident day against a national average of 3.86, and it gets thinner on weekends, when staffing drops about 14% below its own weekday level. That's the kind of gap that shows up when a resident needs help on a Saturday night. The inspection record backs up the concern: 26 deficiencies, four of them at the harm or jeopardy level and three tied to abuse. Staff turnover sits at 60.8%, well above the 45.8% national average, meaning familiar faces are hard to keep. Hospital district ownership doesn't offset any of this. Quality measures score well, but the staffing and inspection numbers are what a family should weigh.
Memorial City runs on 3.20 nurse hours per resident day, about 17% under the national average, and weekends drop roughly 12% below its own weekday staffing. That thin schedule sits behind 32 deficiencies on the current record, six of them at harm or jeopardy level, one abuse-related, plus four fines totaling $70,554. Annual turnover of 53.6% means more than half the nursing staff leaves each year, well above the 45.8% national figure. The hospital district ownership is worth noting, but it hasn't kept the inspection record clean, the last survey was April 28, 2026, and the health inspection side scored 2 out of 5. Quality measures look strong at 5 out of 5, which raises the question of whether the day-to-day staffing can carry that.
Hidalgo Nursing and Rehabilitation Center runs on thinner nursing coverage than most homes, 3.32 hours per resident day against a national average of 3.86, and weekends dip about 11% below its own weekday levels, which is when families often visit and notice. The 25 deficiencies on its current record include one at the harm level and four tied to abuse, and the health inspection rating sits low. Staff turnover at 41.6% is slightly better than the national 45.8%, and its quality measure score is strong, but a government-hospital-district owner doesn't change the math: the daily staffing number is what your family will actually feel.
Lavaca Bay runs on 2.99 nursing hours per resident per day, roughly a fifth below the national average, and weekends drop another 14% below its own weekday staffing. That thin coverage shows up in the record: 37 deficiencies, including two at harm or jeopardy level and four tied to abuse, plus $21,720 in fines across two penalties. Turnover sits at 51.4%, higher than the 45.8% national figure, so residents see a rotating cast of caregivers. The hospital district ownership doesn't change the math here, the staffing rating reflects the hours actually worked, not who signs the paycheck.
The Tuskegee Airmen Texas State Veterans Home in Fort Worth is a 120-bed nonprofit, and its inspection record carries some weight worth knowing about. Eleven deficiencies show up on the current record, including three at the harm or jeopardy level and two tied to abuse, not the kind of findings a family should gloss over. One CMS fine of $14,280 is on file, and the most recent inspection was May 14, 2025, so the picture is fairly fresh. We don't have enough verified data here to compute a grade for this home, which means the deficiency pattern is the main thing you can actually judge. Ask about those harm-level findings and the abuse citations directly before deciding.
Lampasas Nursing And Rehabilitation Center runs on 3.43 nurse hours per resident day, about 11% under the national average, and weekend coverage drops roughly 13% below what it manages on weekdays. The current inspection record carries 15 deficiencies, two of them serious enough to put residents in harm's way, along with two fines totaling $33,198. It's a hospital-district-owned home with 68 beds, inspected recently in January 2026, and its federal ratings sit at two stars for health inspections, two for quality measures, and one for staffing. The pattern worth noticing is the staffing number: when a building runs lean every day and leaner on weekends, the inspection findings tend to follow.
Caraday Of Lampasas runs on 2.87 nurse hours per resident day, roughly a quarter below the national average of 3.86, and weekends drop about 6% below its own weekday level, so the thinnest coverage lands when families tend to visit. The health inspection record looks solid, but staffing sits at the bottom of CMS's scale, and 13 deficiencies include three at the harm level and one tied to abuse. Three fines totaling $16,426 are on file, with the last inspection dated February 2026. It's a hospital-district home with 76 beds, and the gap between its inspection results and its day-to-day staffing is the tension worth weighing.
Glenview Wellness & Rehabilitation runs on a leaner nurse staffing budget than most homes in the country, 2.40 hours per resident day against a national average of 3.86, and weekends dip even further below its own weekday coverage. That gap shows up in the federal staffing rating, which sits at the lowest tier, while annual turnover of 57.3% means the aides and nurses who are there keep changing.
The inspection record is where things get more concerning: 26 deficiencies on file, four of them at the level where a resident was actually harmed or put in jeopardy, and six tied to abuse. Two fines totaling $23,970 have been levied. The quality measure rating is strong at 4 out of 5, but that's a paper score next to the hands-on reality of who's available to answer a call light.
Focused Care Of Waxahachie runs on 2.68 nurse hours per resident day, roughly 31% under the national average, and weekends drop another 10% below its own weekday levels. That thin coverage shows up in the staffing picture, where turnover hits 58.9% against a national 45.8%, more than half the nursing staff leaving in a year. The inspection record is the harder problem: 40 deficiencies, five serious enough to involve harm or jeopardy, three tied to abuse, and $172,367 in fines across three penalties. A government hospital district owns the 152-bed building, and its most recent inspection was April 28, 2026. Quality measures score well; the hands-on care and oversight numbers do not.
Paradigm At The Pines runs on 2.90 nurse hours per resident per day, about a quarter below the national average, and weekends drop roughly another 11% beneath its own weekday level. Turnover sits at 67.4% against a national 45.8%, and the staffing star rating reflects that: 1 out of 5. The inspection record shows 34 deficiencies, including one at the harm level and six tied to abuse, with a $8,281 fine. It's a hospital-district home, and the last inspection was recent. The quality measure score is strong, but that's largely self-reported data, the hands-on staffing and inspection findings tell a harder story.
College Street Health Care Center runs on thinner nursing coverage than most homes, 3.52 hours per resident day against a national average of 3.86, with weekends dipping about 10% below its own weekday level. Staff turnover sits at 55.6%, well above the 45.8% national figure, so the people caring for your family member are cycling through faster than usual. The current record shows 22 deficiencies, including one at the harm level and two related to abuse. A 4-star inspection rating from August 2025 suggests the survey process itself went reasonably well, but the quality measure rating of 2 stars points to weaker clinical outcomes. It's a small, government-run home with real staffing strain underneath a decent inspection score.
Carrollton Health and Rehabilitation Center runs about 3.12 nurse hours per resident each day, roughly 19 percent under the national average, and weekend staffing drops another 18 percent below its own weekday levels. That thin coverage helps explain the two-out-of-five rating on CMS's staffing measure. The inspection record shows 36 deficiencies, including two at the level where harm or jeopardy occurred and three tied to abuse, along with two fines totaling $19,185. Texas surveyors last visited in May 2025. This is a 120-bed for-profit corporate home where the daily aide and nurse presence is the real story.
Stonewall Living Center in Aspermont gets top marks on health inspections, a five-star rating there, but that's where the good news mostly stops. The staffing picture is thin, rated one star, and annual turnover runs 55.8% against a national average of 45.8%, meaning more than half the caregivers leave each year. Quality measures sit at two stars, and the current record shows ten deficiencies, one serious enough to reach harm or jeopardy level, plus an $8,281 fine. It's government-owned through the hospital district, which can offer stability, but stable ownership doesn't fix a workforce that keeps cycling through. The last inspection was in February 2026, so the record is recent. Families weighing this one should ask specifically how the home keeps consistent aides on the floor.
Wellington Care Center runs on thin nursing coverage: 3.07 hours per resident day, roughly a fifth below the national average of 3.86, and weekends drop about 11% below its own weekday level. That shortfall is what drags its staffing rating down to 1 out of 5, even though its last inspection in January 2026 went reasonably well and produced a 4-out-of-5 inspection rating. The record shows 15 deficiencies, one serious enough to reach harm or jeopardy level, though none tied to abuse, plus a single $13,070 fine. Government hospital district ownership doesn't change the arithmetic, the quality measure rating sits at 3 out of 5, and the daily staffing numbers are the weakest part of this home's profile.
Village Creek runs on 3.27 nurse hours per resident day, roughly 15% under the national average, and weekend coverage dips about 15% below its own weekday level, so the thinnest staffing lands when families tend to visit. The inspection record is the bigger problem: 38 deficiencies, six of them at harm or jeopardy level and seven tied to abuse, with three fines totaling $125,838. A 1-out-of-5 inspection rating alongside a 4-out-of-5 quality measure score tells you the charted care metrics look better than the day-to-day compliance record. Turnover at 40.3% is slightly better than the 45.8% national figure, and the hospital district ownership is a point in its favor. Ask about the abuse-related findings directly before deciding.
Avir At Enchanted Rock runs on a hospital district's budget out in Gillespie County, and the numbers show where that leaves residents. Nurses provide 3.44 hours of care per resident each day, roughly 11 percent under the national average, and weekends dip about 15 percent below the home's own weekday staffing. The bigger red flag is turnover: 78.9 percent of staff leave within a year, against a national average of 45.8, so the people providing that already-thin care are constantly new. Inspectors have cited 47 deficiencies, including 5 at the harm level and 8 tied to abuse, with $63,121 in fines. Quality scores look good on paper, but staffing and inspections tell the harder story.
Country Village Care runs 3.53 nurse hours per resident day against a national average of 3.86, and weekends dip about 12% below its own weekday staffing. That gap matters because the health inspection record is where this home struggles most, 18 deficiencies on file, four of them serious enough to cite harm or jeopardy, plus two fines totaling $61,425. Staff turnover sits at 56% versus 45.8% nationally, which means more than half the nursing staff leaves each year. It's government-owned, run by a hospital district, and its last inspection was October 2024. Nothing here suggests abuse; the problems are staffing consistency and a pattern of serious inspection findings.
Frequently asked questions
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?