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.
Avir At Athens runs on 2.92 nurse hours per resident day, roughly a quarter below the national average, and weekends drop about 13% below what the home already provides during the week. That thin coverage shows up elsewhere: annual turnover is 57.5% against a national 45.8%, so the aides and nurses your family meets may not be there in six months. The inspection record carries 22 deficiencies, four serious enough to put residents in harm's way and four tied to abuse, with $243,325 in fines across four penalties. The most recent inspection was February 2026. A 112-bed for-profit partnership, it's licensed and it takes Medicare and Medicaid, but the staffing and inspection numbers are the ones to ask about directly.
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.
Meridian Care Monte Vista runs 4.74 nurse hours per resident day, roughly a quarter above the national average, but that raw number hides two problems: weekend staffing drops about 15% below its own weekday level, and annual turnover sits at 68.4% against a national 45.8%, meaning most of the people providing that care are new and likely to leave. The inspection record is where it gets harder to defend, 49 deficiencies, including two at the harm or jeopardy level and four tied to abuse, with fines totaling $28,345 and a February 2026 inspection still the most recent. The staffing ratio looks good on paper, but a home where two-thirds of caregivers turn over each year and inspectors keep finding serious problems isn't one where that number translates into steady care.
Coral Rehabilitation and Nursing of Austin runs on 2.82 nurse hours per resident day, roughly a quarter below the national average, and weekend coverage drops about 11% below its own weekday level. That thin margin shows up in staffing, where the home sits at the bottom of CMS's scale, and in a 57.6% annual turnover rate, well above the 45.8% national figure. The inspection record is heavier still: 86 deficiencies, 18 of them at harm or jeopardy level and 10 involving abuse, plus five fines totaling $294,911. CMS has placed it in the Special Focus Facility program, a designation reserved for homes with a persistent pattern of serious problems. The last inspection was September 30, 2025.
Ralls Nursing Home runs on 2.31 nurse hours per resident day, roughly 40% under the national average of 3.86, and weekend coverage drops another 14% below its own weekday levels. That thin staffing sits behind 29 deficiencies on the current record, nine of them at harm or jeopardy level and 13 abuse-related, with five fines totaling $303,179. Annual turnover of 72.4% means most of the aides and nurses working here last year aren't the ones working here now. The last inspection was September 2025, so the record is current, not stale. One bright spot: the quality measure rating is 4 out of 5, but quality scores are largely built from resident assessment data the facility itself reports, and they don't offset a 1-out-of-5 inspection and staffing picture.
Fall Creek runs on 3.25 nursing hours per resident day, about 16 percent under the national average, with weekends dropping roughly 14 percent below its own weekday staffing. That thin coverage shows up in the numbers: a 65.6 percent annual turnover rate, well above the 45.8 percent national figure, and a one-star CMS staffing rating. Inspectors have cited 21 deficiencies, seven of them serious enough to put residents in harm's way and three tied to abuse, with two fines totaling $48,555. The last inspection was in May 2025. For a 126-bed for-profit home, the pattern across staffing, turnover, and enforcement history is worth weighing carefully before you decide.
Arboretum Nursing And Rehabilitation Center Of Win runs on a nurse staffing level that's about a fifth below the national average, and weekends are thinner still, roughly 14% under its own weekday coverage. The bigger issue is the workforce itself: turnover sits at 98.4% a year, more than double the national rate, which tells you the aides and nurses in this building are largely new to it. On the current record are 28 deficiencies, including two at the harm or jeopardy level and two tied to abuse, along with two fines totaling $115,663. For a 120-bed for-profit home in Winnie, the pattern is a constant churn of caregivers paired with serious cited problems.
San Antonio West runs on 2.75 nurse staffing hours per resident day, about 29 percent under the national average, and weekends dip roughly 12 percent below its own weekday levels. Turnover sits at 63.6 percent against a national 45.8, most of the people caring for your family member will be new within a year. The inspection record backs this up: 73 deficiencies, six at harm or jeopardy level, four abuse-related, and $364,695 in fines. Its most recent inspection was April 2026, so the picture is current, and it includes one star each for health inspections and staffing. A for-profit corporation owns the 135-bed building.
Crestway runs on thin staffing, 3.57 nurse hours per resident day, about 8% under the national average, and weekends dip another 7% below its own weekday levels. Turnover is the bigger red flag: 100% of nursing staff leaving annually, against a national average near 46%, which means the people caring for your family member are, on average, brand new to the building.
The inspection record is heavy, 65 deficiencies, five serious enough to cause harm, three tied to abuse, and five fines totaling nearly $74,000, with the most recent inspection in July 2025. This is a for-profit LLC where every federal staffing and inspection measure sits near the bottom. Worth asking hard questions before admission.
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.
Valley Grande Manor runs on 2.94 nursing hours per resident per day, roughly a quarter below the national average of 3.86. Weekends are thinner still, about 10% under the home's own weekday coverage, and 68.8% of staff left over the past year against a national rate near 46%, so the people providing care keep changing. Inspectors have logged 49 deficiencies, six involving actual harm or jeopardy, eleven tied to abuse, with four fines totaling $88,679; the most recent inspection was July 2025. This is a 147-bed for-profit home owned by an individual, and the pattern in these numbers, low staffing, high turnover, repeat serious findings, is what families should weigh before deciding.
Arbor View runs 179 certified beds in Kerrville under for-profit LLC ownership, and the staffing numbers are where I'd start. At 3.39 nurse hours per resident day, it sits about 12% under the national average of 3.86, with weekends dipping roughly 5% below its own weekday levels. Annual turnover is 81.5% against a national 45.8%, nearly double, which means the people providing most of the daily care are still learning the residents. The inspection record is heavy: 76 deficiencies, six at harm or jeopardy level, nine abuse-related, and $154,617 in federal fines across five events. CMS has placed it in the Special Focus Facility program, reserved for the country's most persistently troubled homes. The most recent inspection was July 31, 2025.
Avir At San Augustine runs on thin staffing: 3.54 nurse hours per resident day, about 8% under the national average, and weekends drop roughly 7% below its own weekday levels. That's a real problem when turnover hits 82%, nearly double the national 45.8%, because new hires cycle through faster than they can learn residents' needs. The inspection history backs this up: 20 deficiencies on the current record, including 3 at harm or jeopardy level and 3 tied to abuse, with $102,752 in fines across three penalties. A 4/5 inspection rating and recent May 2026 survey suggest the home can pass a walkthrough, but a 1/5 staffing score and 2/5 quality measures tell you what day-to-day care actually looks like.
Rolling Meadows is a small non-profit home in Wichita Falls, certified for just two beds, and its record is clean on the federal measures that matter most: no deficiencies of any kind, nothing at the harm or jeopardy level, and no abuse-related citations. The most recent inspection was July 24, 2025, so the picture is current rather than stale. With a bed count that low, there's also no meaningful staffing average to weigh against the national figure, the usual comparison doesn't apply here. What you're looking at is a very small operation with a spotless recent survey history and no for-profit owner pushing the numbers. Call and ask how those two beds are actually used.
St. Joseph's Care Center runs 100 certified beds in McGregor under for-profit partnership ownership. Its record shows two deficiencies, one serious enough to reach the harm or jeopardy level, meaning inspectors found a problem that had already hurt or endangered a resident, not just a paperwork gap. One CMS fine totals $12,735. No abuse-related citations are on file, and the most recent inspection, dated June 12, 2025, is recent enough that the findings still describe the home as it operates now. A single harm-level deficiency in a 100-bed building is not a pattern, but it is not nothing either. Ask what happened and what changed afterward.
St. Juanita Retirement and Rehab is a 90-bed for-profit corporate home in San Angelo, and its inspection record is mild enough on its face: five deficiencies, none of them at the harm or jeopardy level, none abuse-related, with a very recent survey dated December 23, 2025. What stands out is what isn't there. The home has no computed ElderGrade score, which typically means the underlying CMS data needed to grade it, star ratings, staffing figures, isn't available or complete enough to judge. So a clean deficiency count tells you only that inspectors found little to flag on one visit; it can't tell you whether nurse staffing sits above or below the national average, because that number isn't in the record. Worth asking the administrator directly.
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?