4,510 Independent Nursing Homes in the United States
4,510 of the 14,697 Medicare-certified nursing homes in the United States (31%) are independently owned, and all are listed below. 1309 of the 4490 graded homes earn an A and 280 earn a D or F. They average 4.25 nursing hours per resident per day, 0.39 hours above the 3.86 for every home in the United States. Mclean Health Center in Simsbury grades highest at A (100 out of 100).
How independently owned homes in the United States compare
This group set against every nursing home in the United States, from the current CMS release.
Nursing hours per resident per day
4.25
All homes in the United States: 3.86
Better than the local average
Nurse staff turnover
43.3%
All homes in the United States: 45.8%
Better than the local average
Average ElderGrade score
76.6/100
All homes in the United States: 73.5/100
Better than the local average
Grade spread
A
B
C
1,309 grade A, 1,865 grade B, 1,036 grade C, 279 grade D, 1 grade F
The best-graded independently owned home in the United States is
Mclean Health Center
in Simsbury, CT — grade A,
100/100.
Every independently owned nursing home in the United States
Valley of the Moon runs a small house, 27 beds, and staffs it well above average, about 5.05 nurse hours per resident day against a national 3.86. That's real coverage, though weekends thin out roughly 11% below the weekday level, and turnover sits at 47.2%, a touch worse than the national 45.8%.
The problem is the inspection record. Twenty-nine deficiencies, three serious enough to put a resident in harm's way, one tied to abuse, and a $13,065 fine. The state's last look was in October 2024.
So you have a home that's well staffed on paper and scores 5/5 on quality measures, but its last two years of inspections tell a messier story. Ask about staffing on Saturdays and what changed since that October visit.
Oroville Hospital Post-Acute Center runs 126 certified beds as a nonprofit, and its nurse staffing sits at 5.44 hours per resident day, roughly 41% above the national average of 3.86. That's a real strength, and it's why staffing earns a mid-tier rating. But look at what the extra hours are covering for: 46 deficiencies on the current record, including one at the harm or jeopardy level and two tied to abuse. Inspections and quality measures each land at the lowest star rating, and the most recent survey came in December 2024. One fine of $45,500 is on file. Weekend staffing also drops about 11% below its own weekday level, so the coverage thins out when families tend to visit.
Desert Springs Post Acute runs 178 beds in Palm Desert under for-profit LLC ownership, and the numbers tell a mixed story. Nurse staffing sits at 4.06 hours per resident day, about 5% above the national average, but weekends drop roughly 10% below the home's own weekday coverage, and annual turnover hits 49% against a national 45.8%. The health inspection record is where things get serious: 128 deficiencies on file, including 3 at harm or jeopardy level and 13 tied to abuse, with two fines totaling $74,424. Quality measures score well, but staffing and inspection ratings don't match. If you're considering this one, ask pointed questions about weekend coverage and how the abuse-related findings were resolved.
Alameda Hospital D/P SNF runs 5.11 nursing hours per resident day, roughly a third more than the national average, and its quality measure score sits at the top of CMS's scale. That part of the picture looks strong. What pulls it back is stability: annual staff turnover of 86.5% is nearly double the national rate, weekend coverage dips about 9% below weekdays, and the inspection history shows 17 deficiencies, including two tied to abuse, with a 2-out-of-5 inspection rating. County ownership means public accountability, but it doesn't fix a workforce that keeps cycling through. If you're considering this one, ask how they hold staffing steady on weekends and what's changed since September 2024.
Coalinga Regional Medical Center's skilled nursing unit runs 99 beds under for-profit LLC ownership, and the federal numbers show strain on multiple fronts. Staffing is the weakest area, CMS gives it one star out of five, well below what you'd want for a resident needing daily help. The inspection record carries 40 deficiencies, including four that caused actual harm or put residents in immediate jeopardy and two tied to abuse. That's a serious pattern, not a paperwork problem. The most recent inspection was April 10, 2025, so the findings are current, not stale. Quality measures also sit at two stars. If you're considering this home, ask directly what changed after those harm-level citations and how they're staffing the floor now.
River Walk Care Center reports 4.14 total nurse hours per resident day, about 7% above the national average of 3.86, but that staffing advantage thins on weekends, when hours drop roughly 10% below the home's own weekday levels. Turnover sits at 47.8%, slightly above the 45.8% national figure, and the limited liability company that owns the 99-bed home carries 51 deficiencies on its current record, including three at the harm or jeopardy level and two tied to abuse, plus $164,778 in fines across three penalties. The last inspection was February 26, 2026, so the record is recent. A 4/5 quality measure score stands out against 2/5 marks for staffing and health inspections.
Lawndale Healthcare & Wellness Centre runs 59 certified beds under for-profit, limited-liability ownership, and its nurse staffing sits at 4.73 hours per resident day, roughly 22 percent above the national average of 3.86. That's real coverage on paper. But weekends drop about 14 percent below the home's own weekday level, so the weekday numbers don't tell the whole story. The bigger problem is the inspection record: 68 deficiencies, including 2 at the harm or jeopardy level and 14 tied to abuse, plus two fines totaling $62,004. A 1-out-of-5 health inspection rating against 4-out-of-5 marks for staffing and quality measures is a wide gap, and with the last inspection dated January 2026, the record is recent. Ask about those 14 abuse-related deficiencies directly before you visit.
San Marino Healthcare Center runs on 4.10 nurse hours per resident day, about 6% above the national average, and its staff retention is unusually strong, turnover of 25.5% against a national average near 46%. Weekend coverage dips roughly 12% below weekday levels, so ask how that plays out on Saturdays. The inspection record is the weak spot: 45 deficiencies, 5 tied to abuse, though none reached harm or jeopardy level, and the most recent inspection was in January 2026. Quality measures score well and staffing holds up, but the compliance history is heavy for a 59-bed for-profit home.
Pasadena Nursing Center runs 52 beds as a for-profit LLC, and its nurse staffing averages 4.73 hours per resident day, about 22% above the national average of 3.86. That's a real strength, though weekends dip roughly 10% below the home's own weekday levels, and annual turnover sits at 60.7% against a national 45.8%. The inspection record is where the concern lives: 82 deficiencies, one at harm or jeopardy level, and 11 abuse-related, drawing three fines totaling $23,160. Its most recent inspection was in April 2026. High bedside hours paired with heavy turnover and that deficiency history is a mixed picture, worth asking about staff retention and how the abuse-related findings were resolved.
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.
Diamondback Healthcare Center runs 4.91 nurse hours per resident day, about 27% above the national average of 3.86. That's a lot of hands on deck during the week. But weekend staffing drops roughly 15% below its own weekday level, and annual turnover sits at 72.1% against a national 45.8%, meaning nearly three-quarters of the nursing staff leaves each year. Ten deficiencies sit on record, none at the harm level, though two are abuse-related, with $5,073 in fines across two incidents. Inspections are recent, and quality and health inspection ratings both land at 4 of 5. The pattern: good weekday coverage, churning staff, and a state survey that hasn't found serious harm.
Frequently asked questions
How many independently owned nursing homes are there in the United States?
There are 4,510 independently owned Medicare-certified nursing homes in the United States, 31% of the 14,697 nursing homes there.
Are independently owned nursing homes better staffed?
In the United States they average 4.25 total nursing hours per resident per day, against 3.86 for all nursing homes in the United States, a difference of +0.39 hours. Staff turnover averages 43.3% against 45.8%.
Which independently owned nursing home grades best in the United States?