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.
Kendall House runs 40 certified beds as a nonprofit operation, and its most recent inspection in January 2026 earned four stars for health inspections and three for quality measures. The staffing picture is a different story: a one-star rating and 68.1% annual turnover, well above the 45.8% national average, meaning nearly seven in ten staff left within the year. The current record shows 22 deficiencies, including one at the harm or jeopardy level and one abuse-related citation, plus a single fine of $88,390. Turnover that high with a harm-level deficiency is what pulls the overall picture down despite decent inspection scores.
Los Arcos Del Norte runs on lean nursing hours, 3.31 per resident day, roughly 14% under the national average, and weekends are thinner still, about 7% below its own weekday pace. That shows up in the staffing rating, which sits at the bottom of CMS's scale. The inspection record is heavy: 72 deficiencies, including one at the harm level and two tied to abuse, with a $14,130 fine. Turnover at 40.8% is actually a little better than the 45.8% national figure, so the problem looks less like a churning workforce than like not enough hands on shift. A hospital district owns it, and its last inspection was March 2025, so the record is current.
Meridian Care of Alice runs 201 certified beds under individual for-profit ownership, and the staffing picture is mixed in a way worth understanding. Total nurse coverage sits at 3.21 hours per resident day, roughly 17 percent under the national average, and weekends drop about 14 percent below the home's own weekday level. The one number that looks better than average is turnover: 34.7 percent against a national 45.8 percent. But the inspection record is where the real concern lives: 18 deficiencies on file, four at harm or jeopardy level, three tied to abuse, and two fines totaling $211,990, with the most recent inspection dated March 2026. Strong quality measures and low turnover don't outweigh that harm-level history.
The Meadows runs on 2.90 nurse hours per resident day, roughly a quarter below the national average of 3.86, and weekend coverage dips even further below its own weekday levels. The current record shows 32 deficiencies, five of them at harm or jeopardy level and four tied to abuse, with $35,731 in fines across two penalties. Staff turnover sits at 58.1%, well above the 45.8% national figure, under for-profit LLC ownership. The quality measure score of 4 out of 5 may look reassuring, but it stands against a 1 out of 5 inspection rating and a 2 out of 5 on staffing, the numbers families weigh most heavily. The most recent inspection was January 15, 2025, so the record is current.
Cass Valley Healthcare Center runs 74 certified beds in Centerville under for-profit LLC ownership, and its nurse staffing comes in at 4.20 hours per resident day, roughly 9% above the national average of 3.86. That cushion thins on weekends, which run about 10% below the home's own weekday level, and annual turnover sits at 45%, essentially matching the national rate. The harder numbers are on the inspection side: 25 deficiencies on the current record, five of them at the harm or jeopardy level and four tied to abuse, with four fines totaling $54,592 and a two-out-of-five health inspection rating. The most recent inspection was November 24, 2025. Strong quality measure scores don't erase that record.
Willowcreek runs on 2.74 nurse hours per resident day, roughly 29% under the national average, and the weekend gap makes that thinner when families visit most. Staff turnover sits at 57.7% against a 45.8% national figure, so aides and nurses cycle through faster than residents can get used to them. The inspection record shows 24 deficiencies, including one at the harm level and one abuse-related, with a $23,794 fine and a 2-out-of-5 health inspection rating. Quality measures score well, but that's largely charting, and a 1-out-of-5 staffing rating tells you where the daily experience likely lands.
Uvalde Healthcare and Rehabilitation Center runs 115 certified beds under for-profit LLC ownership, and its staffing is the number that stands out for the wrong reason: 3.38 nurse hours per resident day against a national average of 3.86, with weekends dipping about 9% below its own weekday level. Turnover sits at 53.8%, well above the 45.8% national figure, meaning nearly six in ten staff left within the year. The current inspection record carries 33 deficiencies, six at harm or jeopardy level and three abuse-related, along with five fines totaling $96,040. The most recent inspection was June 11, 2026. Whatever the quality measure score suggests, thin and unstable staffing paired with that deficiency history is what families should weigh.
Capstone Healthcare of Daingerfield runs a 106-bed for-profit operation where the staffing numbers look decent on paper, 3.95 nurse hours per resident day, a bit above the national average, but weekend coverage drops about 14% below what the home staffs on weekdays. Turnover sits at 33.9%, better than the 45.8% national figure, so the people who stay tend to stay. The trouble is the inspection record: 58 deficiencies, including 7 at harm or jeopardy level and 8 tied to abuse, plus six fines totaling $321,040. That history matters more than the staffing averages when you're deciding whether this is the right place for someone you love.
Meridian Care of Hebbronville runs 60 certified beds in Jim Hogg County, and its strongest numbers come from inspections: a clean recent record with nine deficiencies, none at the harm or jeopardy level and none related to abuse. The tradeoff shows up in daily staffing, which sits at 3.35 nurse hours per resident, roughly 13 percent under the national average, and thins out further on weekends. That's partly offset by turnover of 40.5 percent, better than the 45.8 percent national figure, meaning fewer caregivers cycling out than elsewhere. Quality measures hold at four stars. For a small rural home, the care outcomes look steady even though the day-to-day coverage runs lighter than average.
St. Dominic Village runs on a church-affiliated nonprofit model, and its quality scores are actually decent, four stars on CMS measures. The problem is the people side. Staffing sits at one star, well below what you'd want for 158 beds, and that gap shows up in the inspection record: 13 deficiencies, including one serious enough to reach harm or jeopardy level and two tied to abuse. Five fines totaling $42,031 have accumulated. The last inspection was in May 2025, so this isn't stale history. A nonprofit with good clinical metrics but thin staffing and abuse findings is a specific kind of risk, ask directly about direct-care hours per resident and how they've addressed those abuse citations.
Cibolo Creek runs on thinner nurse coverage than most homes in the country, 3.00 hours per resident day against a national average of 3.86, and it gets thinner on weekends, when staffing drops about 14% below its own weekday level. That's the kind of gap that shows up when a resident needs help on a Saturday night. The inspection record backs up the concern: 26 deficiencies, four of them at the harm or jeopardy level and three tied to abuse. Staff turnover sits at 60.8%, well above the 45.8% national average, meaning familiar faces are hard to keep. Hospital district ownership doesn't offset any of this. Quality measures score well, but the staffing and inspection numbers are what a family should weigh.
Fox Hollow Post Acute runs 126 beds in Brownsville under for-profit LLC ownership, and its nurse staffing sits at 3.02 hours per resident day, roughly 22% under the national average, with weekend coverage dropping another 14% below its own weekday level. The inspection record shows 28 deficiencies, including three at the harm or jeopardy level and one tied to abuse, plus four fines totaling $77,232 and a recent inspection date of January 22, 2026. Staff turnover lands at 47%, just above the 45.8% national figure. The quality measure rating of 4 out of 5 stands out against a 1 out of 5 on both health inspections and staffing, worth asking what's driving that gap before you decide.
James L West Center runs on a dementia-specific model in Fort Worth, and its staffing reflects that: 4.57 nurse hours per resident day, roughly 18% above the national average, with weekend coverage dipping about 6% below its own weekdays. Turnover sits at 33.9%, well under the national 45.8%, so the people caring for residents tend to stay. The trouble is on the inspection side. Seventeen deficiencies are on record, eight of them at harm or jeopardy level and eight abuse-related, with nine fines totaling $63,236 and a 2-out-of-5 health inspection rating. A recent June 2025 inspection means the picture is current. Strong daily care, but a documented history of serious safety problems.
The Tuskegee Airmen Texas State Veterans Home in Fort Worth is a 120-bed nonprofit, and its inspection record carries some weight worth knowing about. Eleven deficiencies show up on the current record, including three at the harm or jeopardy level and two tied to abuse, not the kind of findings a family should gloss over. One CMS fine of $14,280 is on file, and the most recent inspection was May 14, 2025, so the picture is fairly fresh. We don't have enough verified data here to compute a grade for this home, which means the deficiency pattern is the main thing you can actually judge. Ask about those harm-level findings and the abuse citations directly before deciding.
Ridgecrest runs 90 certified beds in Waco under for-profit LLC ownership, and the numbers families tend to ask about first are staffing and turnover. Staff turnover here sits at 82.1 percent against a national average of 45.8, meaning most of the people caring for residents in a given year are new to the building. The staffing star rating of 1 out of 5 reflects that churn, and the health inspection record shows 27 deficiencies, including one at the harm or jeopardy level and two tied to abuse. Quality measures score 4 out of 5, so clinical metrics look better than the day-to-day picture. One fine totaling $14,267 is on record, and the last inspection was June 15, 2025.
Ashford Hall runs 206 certified beds in Irving under corporate ownership, and the numbers behind its record are worth sitting with. State inspectors have logged 35 deficiencies, six of them serious enough to put residents in immediate harm or jeopardy, and six tied to abuse. Fines total $301,255 across four penalties. Staff turnover sits at 77.1%, well above the 45.8% national average, which means the people caring for residents are constantly changing. Nurse staffing runs 3.71 hours per resident day, slightly under the national figure, and weekends dip about 8% below the home's own weekday levels. Low turnover and steady weekend coverage are what keep residents safe; here, neither is holding.
Parkview runs about 3.55 nurse hours per resident day, roughly 8% under the national average, and weekends dip another 9% below its own weekday coverage, so the thinnest shifts land when families tend to visit. Staff turnover sits at 57.6% against a national 45.8%, meaning more than half the nursing staff leaves in a year. The health inspection record is the strongest part here, a recent June 2025 survey with 18 deficiencies and none at harm or jeopardy level, though 5 are abuse-related and worth asking about directly. The 2/5 quality measure rating is where the day-to-day care concerns show up.
Stonewall Living Center in Aspermont gets top marks on health inspections, a five-star rating there, but that's where the good news mostly stops. The staffing picture is thin, rated one star, and annual turnover runs 55.8% against a national average of 45.8%, meaning more than half the caregivers leave each year. Quality measures sit at two stars, and the current record shows ten deficiencies, one serious enough to reach harm or jeopardy level, plus an $8,281 fine. It's government-owned through the hospital district, which can offer stability, but stable ownership doesn't fix a workforce that keeps cycling through. The last inspection was in February 2026, so the record is recent. Families weighing this one should ask specifically how the home keeps consistent aides on the floor.
The Estates at Shavano Park runs on thinner nursing coverage than most homes nationally, 3.67 nurse hours per resident day against a 3.86 average, and weekends get leaner still, dropping roughly 12% below its own weekday pace. That gap matters most when families visit on Saturdays and Sundays. Staff turnover sits at 63.4%, well above the 45.8% national figure, so the aides and nurses caring for residents are changing often. Inspectors cited 32 deficiencies, two tied to abuse, though none rose to the harm level; the most recent visit was March 2026, so the record is current. The for-profit LLC ownership structure adds no care capacity on its own.
Edgemere Estates runs 138 beds in El Paso under corporate ownership, and the staffing numbers are where I'd start. At 3.34 nurse hours per resident day, it sits about 13 percent under the national average, and weekends drop roughly 14 percent below its own weekday level, so the coverage you see midweek isn't what your family member gets on a Saturday. Turnover is 52.6 percent against a national 45.8. The inspection record carries 67 deficiencies, including four at harm or jeopardy level and five tied to abuse, with three fines totaling $49,292. The last inspection was April 30, 2025. Quality measures score well; staffing and inspections don't.
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?