604 Hospital-Based Nursing Homes in the United States
604 of the 14,697 Medicare-certified nursing homes in the United States (4%) are hospital-based, and all are listed below. 228 of the 602 graded homes earn an A and 21 earn a D or F. They average 4.94 nursing hours per resident per day, 1.08 hours above the 3.86 for every home in the United States. Transitional Sub-Acute Unit in Wyomissing grades highest at A (100 out of 100).
How hospital-based homes in the United States compare
This group set against every nursing home in the United States, from the current CMS release.
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.
Plumas District Hospital's skilled nursing unit is small, 36 certified beds, and it's run by the hospital district rather than a for-profit chain, which shapes how it operates. The current record shows four deficiencies, none of them at the harm or jeopardy level, though one is abuse-related, so it's worth asking staff directly what happened and what changed afterward. The most recent inspection came in February 2026, so the picture here is fairly current rather than stale. With a unit this size, staffing often tracks closely to hospital coverage, which can mean steadier nurse presence than a standalone nursing home of similar bed count.
One thing to note: ElderGrade doesn't have a computed grade for this home yet, so there's no score to lean on. That means the federal inspection and staffing data are what you have to work with, ask about the abuse-related finding, and ask how many residents are typically on the unit at once.
How many hospital-based nursing homes are there in the United States?
There are 604 hospital-based Medicare-certified nursing homes in the United States, 4% of the 14,697 nursing homes there.
Are hospital-based nursing homes better staffed?
In the United States they average 4.94 total nursing hours per resident per day, against 3.86 for all nursing homes in the United States, a difference of +1.08 hours. Staff turnover averages 41.7% against 45.8%.
Which hospital-based nursing home grades best in the United States?