115 of the 1,179 Medicare-certified nursing homes in Texas (10%) are hospital-based, and all are listed below. 6 of the 114 graded homes earn an A and 13 earn a D or F. They average 3.5 nursing hours per resident per day, 0.11 hours above the 3.39 for every home in Texas. The Methodist Hospital Snf in Houston grades highest at A (99 out of 100).
How hospital-based homes in Texas compare
This group set against every nursing home in Texas, from the current CMS release.
Nursing hours per resident per day
3.5
All homes in Texas: 3.39
Better than the local average
Nurse staff turnover
56.6%
All homes in Texas: 55.3%
Worse than the local average
Average ElderGrade score
66.8/100
All homes in Texas: 66.9/100
Worse than the local average
Grade spread
B
C
D
6 grade A, 35 grade B, 60 grade C, 13 grade D,
The best-graded hospital-based home in Texas is
The Methodist Hospital Snf
in Houston, TX, grade A, 99/100.
Avir At Sealy runs on 2.91 nurse hours per resident per day, roughly a quarter below the national average, and weekends dip about 16% below its own weekday levels. Staff turnover sits at 78.9% against a national figure near 46%, which means many of the people caring for residents are still learning the building. The inspection record is thinner than those numbers might suggest: 18 deficiencies on file, none at harm or jeopardy level and none abuse-related, with the most recent inspection in March 2025. CMS rates the quality measures 5 out of 5 and inspections 4 out of 5, but staffing 1 out of 5. A for-profit corporation owns the 90-bed home.
Laredo West runs on 3.12 nurse hours per resident per day, roughly 19% under the national average of 3.86, and weekends drop about 13% below what the home itself staffs on weekdays. Turnover sits at 47.3%, slightly above the national 45.8%. Those numbers sit behind a one-star health inspection rating and a record of 31 deficiencies, three of them at harm or jeopardy level and four tied to abuse, with two fines totaling $49,719. The most recent inspection was April 2025, so the record is current, not stale. Government hospital district ownership doesn't change what the staffing and inspection data show. Families should ask direct questions about weekend coverage and the abuse-related findings before deciding.
Memphis Convalescent Center runs on 3.39 nursing hours per resident day, roughly 12% under the national average, and weekends dip about 9% below its own weekdays, so the thinnest coverage lands when families tend to visit. Every aide and nurse on staff turned over last year, against a national rate near 46%, which means the people caring for residents are largely new to the building and to each other. The record shows 20 deficiencies, including 3 at harm or jeopardy level and 4 tied to abuse, plus one fine of $19,754; the last inspection was November 2025. Hospital-district ownership doesn't change what those numbers say about daily care.
Twilight Home in Corsicana runs about 3.30 nurse hours per resident per day, roughly 14% under the national average, and weekends dip another 12% below its own weekday staffing. The bigger problem is turnover: 94.9% of staff leave each year, more than double the national rate, so the people providing that already-thin care are constantly new. Inspections look strong on paper, a 4 out of 5 star rating, with the most recent visit in May 2025, but the record still carries 10 deficiencies, one of them serious enough to involve harm or jeopardy, plus a $12,795 fine. CMS rates the staffing domain 1 out of 5 stars, and that's the number that matters most day to day.
Villa Toscana At Cypress Woods runs on 3.30 nurse hours per resident day, roughly 14 percent under the national average, and weekends drop another 11 percent below its own weekday staffing. The bigger problem is turnover: 91.4 percent of staff leave within a year, double the national rate, which means whoever is at the bedside is often new to the building. Inspectors have cited 39 deficiencies on the current record, including four at the harm level and four related to abuse, with $37,827 in fines across three penalties. The 4/5 quality measure score reflects resident care measures, not the safety record or the thin staffing that surrounds it.
Avir At Western Hills runs on lean nurse staffing: 3.16 hours per resident day against a national average of 3.86, with weekends about 13% thinner than weekdays. That gap shows up in the payroll, 75% of staff turned over in a year, well above the 45.8% national figure, and it's a big reason the staffing rating sits at 1 out of 5 even though quality measures score 4. The inspection record carries 31 deficiencies, including three at harm or jeopardy level and two tied to abuse, plus $16,562 in fines. The most recent inspection was May 2025, so the picture is current, and this corporate-owned home is licensed for 120 beds.
Rockdale Estates runs about 2.7 nursing hours per resident each day, roughly 30% under the national average of 3.86, and weekends dip even lower. That thin coverage shows up against a one-star quality measure rating and 13 deficiencies on the current record, including one at the harm or jeopardy level, plus a single fine of $8,018. The inspection history is the bright spot: four stars and a recent April 2025 survey. Turnover at 42.6% is actually a bit better than the national 45.8%, so the problem isn't churn, it's how few hands are scheduled per resident, especially on weekends.
Gainesville Convalescent Center runs on thin nurse staffing, 3.08 hours per resident day against a national average near 3.86, and weekends are roughly 11% leaner than weekdays, so coverage thins exactly when families tend to visit. The county hospital district owns the 112-bed home, and its inspection record shows 50 deficiencies, four at harm or jeopardy level and four tied to abuse; two fines total $99,075. Staff turnover of 73.8% sits well above the 45.8% norm, meaning many caregivers are new. Quality measures score well, but surveys and staffing don't, which is where the trouble actually lives.
Park Manor of McKinney is owned by a hospital district, and its clinical quality scores look decent, four out of five stars on CMS's quality measures. The problem is the people doing the work. Nurse staffing sits at 3.25 hours per resident per day, about 16 percent under the national average, and weekends run roughly 19 percent thinner than weekdays, so your mother's Sunday care isn't the same as her Tuesday care. Staff turnover is 62.4 percent against a national 45.8 percent, meaning most of the aides who know her will be gone within a year. Eighteen deficiencies sit on the current record, two serious enough to involve harm, with one fine of $29,426.
Fair Park runs about 2.97 nurse hours per resident day, roughly a quarter below the national average of 3.86, and weekends drop another 20% beneath its own weekday level. That thin coverage is the big number here: staff turnover sits at 91.8% against a national average near 46%, so nearly the entire nursing staff turns over in a year. The current record shows 29 deficiencies, none at harm level but two tied to abuse, and the last inspection was in May 2025. For-profit corporate ownership and a 1-out-of-5 CMS staffing rating back up what the hours already suggest, ask who's actually on the floor on a Sunday.
Ballinger Healthcare and Rehabilitation Center runs on thin staffing. At 3.04 nurse hours per resident per day, it sits about 21% under the national average of 3.86, and weekends drop roughly another 11% below its own weekday level, so the thinnest coverage lands when families tend to visit. The bigger flag is turnover: 96.1% annually, meaning the aides and nurses caring for residents are, in large part, new to the building, against a national rate near 46%. Its 13 deficiencies include one abuse-related citation but none at the harm level, and the last inspection was November 2024. For-profit LLC ownership. Ask about weekend coverage and how long current staff have actually been there.
Lakewest runs on thin nursing coverage, 3.20 hours per resident day against a national average of 3.86, and weekends dip about 14% below its own weekday level. That's the kind of gap families notice as slower call buttons and rushed meals. Staff turnover sits at 71.7% against a national 45.8%, meaning most of the people caring for your relative likely weren't there a year ago.
The inspection record carries 42 deficiencies, including one at the harm level and five tied to abuse. Two fines total $25,799, and the most recent inspection was January 2026. A government hospital district owns it. Strong quality scores don't offset staffing this thin and a record this long.
The Manor At Seagoville runs on about 2.97 nurse hours per resident per day, roughly a quarter less than the national average of 3.86, and staffing thins further on weekends, dropping about 13% below its own weekday level. That shortfall shows up in the numbers: 59.1% annual turnover, well above the 45.8% national figure, and 33 deficiencies on the current record, two of them serious enough to involve harm or jeopardy, plus two abuse-related findings and $98,062 in fines. A 2/5 inspection rating and 2/5 staffing rating sit alongside a 4/5 quality measure score, which is worth asking about. This is a for-profit corporate home where the care reported on paper and the hands available to deliver it don't match.
Avir At Portland runs 97 certified beds under corporate ownership, and the staffing numbers are the first thing a family should sit with. Nurses provide 3.25 hours of care per resident each day, roughly 16 percent under the national average, and weekend coverage drops about another 10 percent below the home's own weekday level. Annual turnover hits 63.9 percent, well above the 45.8 percent national figure, which means the people caring for your relative are likely to change often.
The inspection record shows 29 deficiencies, including three at the harm or jeopardy level and one tied to abuse, with $119,462 in fines across two penalties. The most recent inspection was September 2025.
Avir At Bandera runs on about 2.40 nurse staffing hours per resident day, roughly 38 percent under the national average of 3.86, and weekend coverage drops about 10 percent below its own weekday level. That thin staffing shows up in a 56.7 percent annual turnover rate, well above the 45.8 percent national figure, and in CMS's staffing rating of one star out of five even as its quality measure score sits at four. The inspection record is the harder problem: 20 deficiencies, two at harm or jeopardy level, one abuse-related, plus $100,293 in fines across two penalties. A for-profit corporation operates the 118-bed home. Two stars on health inspections, and that May 2026 inspection is recent.
Avir At Arbor Terrace runs 126 certified beds in San Angelo, and the staffing numbers are where I'd start. At 3.05 nurse hours per resident day, it sits about 21% under the national average of 3.86, weekends dip roughly 7% below its own weekdays, and turnover hits 75.3% against a national 45.8%, that's a lot of churn on top of thin coverage. The inspection record backs it up: 38 deficiencies, three at harm or jeopardy level, one abuse-related, and $121,840 in fines across three events. A 2/5 inspection rating and 3/5 on quality measures don't offset a 1/5 staffing score. Ask about weekend coverage and how they hold staff before you tour.
The Heights of League City runs on thin nursing coverage: 3.38 hours per resident day against a national average of 3.86, and weekends dip about 9% below its own weekday numbers. That gap matters most on Saturdays and Sundays, when families often visit and when problems tend to surface. Staff turnover sits at 69.7%, well above the 45.8% national figure, so the people caring for residents are frequently new to the building. The inspection record backs this up: 28 deficiencies, nine at harm or jeopardy level, six fines totaling $144,668. A hospital district owns it, which might suggest stability, but the numbers here tell a different story.
Five Points At Lake Highlands runs 280 certified beds in Dallas under for-profit LLC ownership, and the staffing numbers are where the trouble starts. At 3.36 nurse hours per resident day, it sits about 13% under the national average of 3.86, and weekends dip roughly 14% below its own weekday levels, so the thinnest coverage lands when families tend to visit. Turnover is 64% 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 is heavier still: 53 deficiencies, five at harm or jeopardy level, one abuse-related, and $58,149 in fines across five penalties. The most recent inspection was March 31, 2026, so the picture is current, not stale.
Advanced Rehabilitation and Healthcare of Athens carries 120 certified beds and is run by a hospital district, which you might expect to mean steadier oversight. The numbers say otherwise. Nurse staffing sits at 3.19 hours per resident day, roughly 17% under the national average, and weekends drop about 8% below the home's own weekday levels. Staff turnover hits 58% against a national 45.8%. The inspection record shows 31 deficiencies, seven at harm or jeopardy level and seven abuse-related, with two fines totaling $210,588, and CMS has placed the home in its Special Focus Facility program. Its last inspection was March 2026. Quality measures score well; staffing and inspections do not.
The Atrium of Bellmead runs on 3.25 nursing hours per resident day, roughly 16% under the national average, and weekends drop about 14% below its own weekday numbers. Staff turnover is the number that should stop you: 95.3% a year against a national average of 45.8%, meaning the aides and nurses at the bedside are largely new faces. Inspections look strong on paper, a recent February 2026 survey and no deficiencies at the harm level, but six deficiencies are on record, two of them abuse-related, and the government's own staffing rating lands at the bottom. Government hospital district ownership doesn't change any of that arithmetic.
Frequently asked questions
How many hospital-based nursing homes are there in Texas?
There are 115 hospital-based Medicare-certified nursing homes in Texas, 10% of the 1,179 nursing homes there.
Are hospital-based nursing homes better staffed?
In Texas they average 3.5 total nursing hours per resident per day, against 3.39 for all nursing homes in Texas, a difference of +0.11 hours. Staff turnover averages 56.6% against 55.3%.
Which hospital-based nursing home grades best in Texas?