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.
La Hacienda De Paz is a 104-bed hospital-district home in Eagle Pass, and the numbers that stand out most are about who's there to care for residents. Nurse staffing runs 3.12 hours per resident day, roughly 19 percent under the national average, and weekends drop about 12 percent below the home's own weekday levels, so the thinnest coverage lands when families tend to visit. Staff turnover sits at 95.1 percent against a national 45.8 percent, meaning the aides and nurses you meet may not be there in six months. The inspection record shows 24 deficiencies, one at harm or jeopardy level and four tied to abuse, with a $14,069 fine. Ownership is government, through a hospital district.
Afton Oaks is a 169-bed for-profit home in Houston that CMS has placed in its Special Focus Facility program, a designation reserved for homes with a persistent record of serious problems. The numbers back that up: 37 deficiencies on the current record, 16 of them at the harm or jeopardy level and 5 tied to abuse, plus four fines totaling $115,512. Nurse staffing runs about 7% below the national average, and weekends drop roughly 8% below the home's own weekday levels, when residents still need care. Its last inspection was in April 2025. If you're considering this one, ask directly what's changed since CMS flagged it.
Gracy Woods is for-profit, corporate-owned, 118 beds, and sitting in CMS's Special Focus Facility program, the designation reserved for homes with a persistent record of serious problems. The numbers back that up: 64 deficiencies on the current record, 10 of them at harm or jeopardy level, five abuse-related, and four fines totaling $222,188. Staffing runs slightly under the national average at 3.79 hours per resident day, but the bigger issue is consistency, weekends drop about 16% below the home's own weekday level, and turnover sits at 54.5% against a 45.8% national figure. When roughly half the staff leaves in a year, care routines fray. The most recent inspection was June 2026, so the record is current.
Deerbrook runs on about 3.35 nursing hours per resident per day, roughly 13 percent under the national average, and weekends drop another 11 percent below its own weekday levels. That thin coverage shows up in the inspection record: 35 deficiencies, six serious enough to put residents in harm's way, two tied to abuse, and $196,911 in fines. CMS has placed it in the Special Focus Facility program, which is reserved for homes with a persistent pattern of poor care. Staff turnover sits at 60.7 percent against a 45.8 percent national average, so the people providing care keep changing. The 4/5 quality measure score reflects reported clinical data; the 1/5 inspection and staffing ratings reflect what surveyors actually found.
Legend Oaks Healthcare and Rehabilitation - Fort W runs 132 certified beds under for-profit LLC ownership, and its nurse staffing sits at 3.13 hours per resident day, roughly 19% under the national average. Weekends drop about 13% below its own weekday coverage, and annual turnover hits 67.8% against a national 45.8%, so the people providing care keep changing. The current inspection record shows 23 deficiencies, five at harm or jeopardy level, one abuse-related, with five fines totaling $65,583. Quality measures score well, but staffing and inspection results tell the harder story: thin coverage, high churn, and recent serious findings at a home where families should ask direct questions about who is on the floor at night and on weekends.
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.
Vidor Health & Rehabilitation Center runs 144 certified beds under for-profit LLC ownership, and its staffing numbers are the first thing to notice: 2.88 total nurse hours per resident per day, roughly a quarter below the national average of 3.86. Weekend coverage slips about 10% below the home's own weekday level, and annual turnover sits at 93.5% against a national rate near 46%, meaning most of the people caring for residents this year likely won't be there next year. The inspection record backs up the concern: 37 deficiencies on file, four at harm or jeopardy level, four abuse-related, and two fines totaling $58,904, with a one-star health inspection rating and a one-star staffing rating.
The Hillcrest of North Dallas runs on 2.66 nursing hours per resident day, roughly a third less than the national average of 3.86, and weekend coverage drops about 13% below what the home staffs on weekdays. Annual turnover sits at 68.3% against a national 45.8%, so the aides and nurses at the bedside keep changing. Its inspection record shows 44 deficiencies, including 6 at the harm or jeopardy level and 3 tied to abuse, with $221,052 in fines across three penalties and a 1-out-of-5 inspection rating; the most recent survey was July 31, 2025. Ownership is a for-profit corporation. The quality measure stars don't offset what staffing and inspections show.
If you're weighing Lakeside for someone you love, the staffing numbers are the place to start. At 3.13 nurse hours per resident day, this for-profit home runs roughly 19% below the national average, and weekends drop about 12% below its own weekday level. Annual turnover sits at 82.2% against a national average of 45.8%, which means the people caring for your family member are likely to change often. The record shows 44 deficiencies, three at harm or jeopardy level and six tied to abuse, with the most recent inspection in April 2025. That's a lot of history for a 93-bed building.
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.
Greenhill Villas runs on thin staffing even before the weekend squeeze: 3.10 nurse hours per resident day against a national average of 3.86, and weekends drop about 15% below its own weekday level. That's the kind of gap families notice as slower call-button response. Staff turnover sits at 95.2%, more than double the national 45.8%, so the aide who knows your mother's routine this month may be gone the next. The current record carries 47 deficiencies, including three at harm or jeopardy level and five tied to abuse, plus $154,116 in fines across three penalties. The last inspection was June 2025. Corporate-owned, 150 beds.
Heritage House of Marshall runs on thin staffing even before the weekends hit. At 3.29 nurse hours per resident day, it sits roughly 15% under the national average, and weekend coverage drops another 15% below its own weekday level, so the thinnest shifts are the ones families tend to visit. The bigger number is turnover: 91.7% of staff leave each year, double the national rate, which means the people caring for your relative are, more often than not, new. On its current record are 49 deficiencies, including one at the harm level and six tied to abuse, plus a $67,706 fine. Inspectors last came in July 2025, and the quality measures that track resident outcomes score low.
Woodway Nursing & Rehab in Houston runs on thinner staffing than most homes, with weekend coverage dropping further below its own weekday levels. The bigger red flag is turnover: 85.3% of nursing staff leaving annually, nearly double the national rate.
That churn shows up in the inspection record, 60 deficiencies, 18 serious enough to endanger residents, three tied to abuse, and four fines totaling more than $303,000. CMS has placed the home in its Special Focus Facility program, a designation reserved for the poorest performers. Inspectors were last on site in June 2025. For-profit, limited-liability ownership. Families considering this home should ask hard questions about who's actually on the floor nights and weekends.
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?