237 of the 1,179 Medicare-certified nursing homes in Texas (20%) are independently owned, and all are listed below. They average 3.8 nursing hours per resident per day, 0.41 hours above the 3.39 for every home in Texas. Nurse staff turnover runs 50.9%, 4.4 points lower than the 55.3% across all homes there. The Legacy At Willow Bend in Plano grades highest at A (99 out of 100).
How independently owned homes in Texas compare
This group set against every nursing home in Texas, from the current CMS release.
Nursing hours per resident per day
3.8
All homes in Texas: 3.39
Better than the local average
Nurse staff turnover
50.9%
All homes in Texas: 55.3%
Better than the local average
Average ElderGrade score
70.7/100
All homes in Texas: 66.9/100
Better than the local average
Grade spread
A
B
C
D
32 grade A, 89 grade B, 83 grade C, 29 grade D,
The best-graded independently owned home in Texas is
The Legacy At Willow Bend
in Plano, TX, grade A, 99/100.
Le Reve runs on 3.06 nurse hours per resident day, roughly a fifth under the national average, and weekend coverage drops about 11% below what it manages on weekdays. Staff turnover sits at 64.7% against a national 45.8%, so the people caring for residents are, more often than not, new, and the health inspection record is where that shows: 26 deficiencies on the current record, six of them at harm or jeopardy level and three tied to abuse. Three fines totaling $120,553. Ownership is corporate and for-profit. One thing the numbers don't capture: CMS scored the quality measures 4 out of 5, which suggests some clinical care is being tracked well even as staffing and inspection results lag badly behind.
Heritage Convalescent Center runs 116 certified beds in Amarillo under corporate for-profit ownership, and its overall nurse staffing sits at 4.00 hours per resident day, modestly above the national average. That top-line number hides a couple of things worth knowing, though. Weekend staffing drops roughly 13% below its own weekday level, and annual turnover lands at 57% against a national rate of 45.8%, so the people covering those shifts are changing often. The current record shows 27 deficiencies, none at the harm or jeopardy level but one tied to abuse, and the last inspection was in December 2025. Federal ratings put staffing at 1 out of 5 stars and quality measures at 2.
Town Hall Estates runs on thinner nursing coverage than most homes, about 3.07 nurse hours per resident day against a national average near 3.86, with weekends dipping below its own weekday levels. That shortfall shows up in the staffing rating and in a turnover rate of 62.2%, well above the 45.8% national figure. The inspection record is the bigger concern: 29 deficiencies, five serious enough to involve harm or jeopardy, and one tied to abuse, plus eight fines totaling $83,494. A recent September 2025 inspection means the picture is current, not stale. Quality measures score well, but that's the one bright spot in an otherwise difficult record.
Nurse staffing at The Highlands runs 3.32 hours per resident day against a national average of 3.86, roughly 14% lighter, and weekends drop about 11% below the home's own weekday level, so coverage is thinnest exactly when families tend to visit and aides often work short. The inspection record shows 24 deficiencies, four of them serious enough to put residents at harm or jeopardy, plus four abuse-related citations and one fine of $47,726; the most recent inspection was December 30, 2025. This is a for-profit limited liability company with 116 certified beds, and its CMS staffing rating sits at 1 out of 5 while health inspections and quality measures each sit at 2.
Nurse staffing at The Bartlett runs about 3.58 hours per resident day, roughly 7 percent below the national average, and weekend coverage drops about 12 percent below the home's own weekday level, so care thins out exactly when families tend to visit. The current record shows 36 deficiencies, including 4 tied to abuse and 2 serious enough to put residents in harm's way, along with two fines totaling $34,613. A 1-out-of-5 staffing rating paired with 2s for health inspections and quality measures points to a pattern, not a one-time stumble. The last inspection was August 2025. The for-profit partnership has real ground to make up.
Brookhaven runs on thin staffing: 3.15 nurse hours per resident day against a national average of 3.86, with weekends about 9% leaner than weekdays. Turnover sits at 75.3%, well above the 45.8% national figure, so the people caring for residents keep changing. The inspection record is the bigger concern, 48 deficiencies, including four at harm or jeopardy level and two tied to abuse, with three fines totaling $24,739 and a survey as recent as July 2025. That combination of low staffing, high turnover, and repeat serious findings is what drives the low marks across all three CMS categories.
Columbus Oaks runs 137 certified beds as a for-profit corporation, and the numbers show strain in a few places. Staff turnover sits at 56.5% against a national average of 45.8%, and the federal staffing and quality ratings both come in at one star out of five. The health inspection record shows 30 deficiencies, two of them serious enough to reach harm or jeopardy level, though none tied to abuse. Fines total $8,412 from a single penalty, and the most recent inspection was July 9, 2025. Nothing here suggests a home in crisis, but the combination of high turnover and low staffing marks is worth asking about directly.
Kent County Nursing Home runs on thinner staffing than most: 3.56 nurse hours per resident day against a national average of 3.86, with weekends dropping about 9% below its own weekday coverage. That matters in a 60-bed county-run home, because turnover sits at 55.1% while the national figure is 45.8%, more than half the nursing staff cycling out in a year. The inspection record is heavier still: 27 deficiencies, four serious enough to reach harm or jeopardy, five tied to abuse, and seven fines adding up to $187,081. The most recent inspection was December 2025. If you're weighing this one, ask about weekend coverage and how they've addressed the abuse findings.
Colonial Nursing & Rehabilitation Center runs 90 certified beds in Lindale under individual for-profit ownership, and its staffing sits at 3.51 nurse hours per resident day, roughly 9% under the national average of 3.86. Weekends drop about 7% below the home's own weekday coverage, so the thinnest shifts get thinner.
The inspection record is the bigger concern. Twenty-three deficiencies are on file, three of them serious enough to involve harm or jeopardy, and two tied to abuse. One federal fine totals $247,572, a figure usually reserved for repeat or high-severity problems. The last inspection was March 18, 2026, so the record is recent, not stale.
If you're weighing this one, ask the administrator directly how those abuse deficiencies were resolved and what weekend nurse coverage looks like on a typical Saturday.
The Lev At San Antonio runs about 106 certified beds under for-profit LLC ownership, and the staffing numbers are the first thing to look at. At 3.09 nurse hours per resident per day, it sits roughly 20 percent under the national average of 3.86, and weekends drop about 12 percent below its own weekday level, so coverage thins out exactly when families tend to visit. Turnover lands at 41.5 percent, a bit better than the 45.8 percent national figure, but the inspection record carries more weight: 40 deficiencies, including one at harm or jeopardy level and one abuse-related, plus a single $174,496 fine. The most recent inspection was September 11, 2025.
River Hills runs on thin staffing: 3.11 nurse hours per resident day against a national average of 3.86, with weekends about 12% lighter than weekdays, and turnover at 75.9%, well above the 45.8% typical elsewhere, meaning the people caring for residents are constantly changing. The inspection record backs that up. Fifty-eight deficiencies, six serious enough to endanger residents, four tied to abuse, and three fines totaling $112,133, with the most recent inspection in June 2025. Quality measures score well, but that's a narrow bright spot. This is an individually owned for-profit home where the care depends heavily on who happens to be on shift.
Chelsea Gardens runs about 3% below the national average for nurse staffing, and weekends dip roughly 11% below its own weekday levels, so coverage thins out exactly when families tend to visit. The bigger issue is consistency: 57.5% of staff turned over in a year against a national average of 45.8%, which means the people caring for residents keep changing. On inspections, 13 deficiencies sit on the current record, three at harm or jeopardy level and one tied to abuse, with two fines totaling $64,918. Inspectors were last there in October 2025. It's a for-profit partnership with 60 beds.
Dayton Nursing and Rehabilitation runs 4.37 nurse hours per resident per day, about 13% above the national average, and that's the best thing in its file. The rest is harder. Weekend staffing drops roughly 16% below its own weekday level, and annual turnover sits at 58.3% against a national 45.8%, so the faces change often. Inspectors have cited 36 deficiencies, four at harm or jeopardy level and three tied to abuse, with three fines totaling $131,714. The last inspection was September 2025. Federal ratings put health inspections and quality measures at 2 of 5 stars each. Individual ownership means one person answers for all of it. If you're considering this home, ask directly what changed after those abuse citations.
San Rafael runs on 3.08 nurse hours per resident day, roughly a fifth below the national average, and weekends drop about 15% below its own weekday staffing. That thin coverage shows up in the record: 59 deficiencies, including six at the harm or jeopardy level and five tied to abuse, with four fines totaling $80,132. Turnover at 38.2% is actually better than the 45.8% national average, and the hospital district ownership means public accountability rather than a private operator. But a one-star inspection rating and a March 2025 inspection leave little room to argue the care is well-supervised. If you're considering this one, ask specifically how weekends are covered and how abuse allegations get handled.
Park Place runs lean on the people who actually deliver care. At 3.41 nurse hours per resident day, it sits about 12 percent under the national average, and weekends drop roughly another 18 percent below its own weekday coverage. The staffing picture gets harder when you look at turnover: 63.8 percent of staff left last year, against a national rate near 46 percent, meaning the aides and nurses caring for your relative are, statistically, likely to be new to the building. The government's own inspectors rated staffing and health inspections each 1 out of 5, and the record shows 32 deficiencies, three of them serious enough to put residents in harm's way and three tied to abuse. Two fines total $287,159. Texas corporate ownership, 120 beds, last inspected May 2025.
Park View is a 74-bed hospital-district home in Muleshoe, and the numbers behind its record deserve a close look. Nurse staffing sits at 3.49 hours per resident per day, about 10% under the national average, and it thins out further on weekends, roughly 15% below the home's own weekday level. Annual turnover runs 66.7% against a national 45.8%, meaning most of the people caring for residents are relatively new.
Inspections tell the harder story: 26 deficiencies on the current record, including 2 at harm or jeopardy level and 4 abuse-related, with one fine of $21,645. The most recent inspection was January 15, 2026.
Grace Care Center Of Henrietta runs 60 certified beds under for-profit LLC ownership, and the federal numbers are hard to get past. Its staffing rating sits at the lowest tier, meaning nurse hours per resident fall well short of the national average, and the health inspection rating matches it. The deficiency record shows 54 citations, four of them serious enough to put residents in harm or jeopardy, four tied to abuse. Two fines add up to $204,137. The quality measure rating is slightly better at two stars, but that's the outlier here. A July 2025 inspection is recent, so this isn't a stale file, the problems are current.
The Hilltop On Main runs lean on nursing staff, 2.83 hours per resident day against a national average of 3.86, with weekends about 15% thinner than weekdays. Half the staff turned over in the past year, and the most recent inspection, in March 2026, left 15 deficiencies on the record, three of them serious enough to involve harm or jeopardy, plus one fine of $29,243. This is a for-profit limited liability company operating 94 certified beds, and its federal ratings sit at 2 for health inspections, 2 for quality measures, and 1 for staffing. If you're weighing this one, ask what specifically was cited at those harm-level deficiencies and how the home plans to hold onto direct-care staff.
Apex Secure Care Brownfield runs on 2.27 nurse staffing hours per resident day, roughly 41% under the national average of 3.86, and weekends drop about 17% below its own weekday levels. Staff turnover sits at 55.8% against a national 45.8%, so the people who remain are stretched thin and constantly changing. The inspection record shows 39 deficiencies, including two at the harm or jeopardy level and one tied to abuse, with $27,738 in fines across two penalties. Its most recent inspection was April 14, 2026, and the health inspection rating of 2 out of 5 reflects what surveyors found. A 4-out-of-5 quality measure score does not offset a 1-out-of-5 staffing rating.
Knopp Nursing & Rehab Center runs on noticeably thinner nurse coverage than most homes, 3.09 hours per resident day against a national average of 3.86, and weekends dip even further below its own weekday level. That shortfall matters more when you consider the staff turnover of 62.5%, well above the 45.8% national figure, meaning the people providing that care are frequently new or on their way out. The record backs it up: 34 deficiencies, two serious enough to put residents in harm's way, three tied to abuse, and two fines totaling $32,094. With a for-profit corporate owner and the most recent inspection in January 2026, this is a home where the numbers themselves tell the story.
Frequently asked questions
How many independently owned nursing homes are there in Texas?
There are 237 independently owned Medicare-certified nursing homes in Texas, 20% of the 1,179 nursing homes there.
Are independently owned nursing homes better staffed?
In Texas they average 3.8 total nursing hours per resident per day, against 3.39 for all nursing homes in Texas, a difference of +0.41 hours. Staff turnover averages 50.9% against 55.3%.
Which independently owned nursing home grades best in Texas?