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
Auburn Nursing and Rehabilitation Center runs on 3.06 nurse hours per resident per day, about a fifth below the national average, and weekends drop roughly another 10% under its own weekday level. Staff turnover sits at 86.5% against a national 45.8%, meaning most of the people caring for residents weren't there a year ago. The current record carries 19 deficiencies, two of them serious enough to indicate harm or jeopardy, plus $24,850 in fines. All three CMS star ratings, health inspections, quality measures, staffing, sit at 1 out of 5. Ownership changed within the past year, and the most recent inspection was September 12, 2025.
Maplewood Center runs 120 certified beds in Amesbury, and the numbers behind its record are worth knowing before you visit. Nurse staffing sits at 2.99 hours per resident day, roughly a quarter below the national average of 3.86, with weekends running about 6% thinner than weekdays, and annual turnover at 55.2% against a national 45.8%. On the inspection side, CMS counts 67 deficiencies, including five at harm or jeopardy level and six tied to abuse, with two fines totaling $226,445. The home is in CMS's Special Focus Facility program, its last inspection was June 5, 2025, and it's owned by a for-profit limited liability company.
The Gardens Health and Rehab runs 120 beds in Potosi under for-profit partnership ownership, and the numbers that stand out most are on the staffing side. Nurses provide 3.46 hours per resident per day, roughly 10% under the national average, and weekends drop about 9% below the home's own weekday coverage, so the thinnest shifts come when families tend to visit. Staff turnover sits at 67.1%, well above the 45.8% national figure, which matters because consistent caregivers know residents' routines. Inspections in March 2025 turned up 34 deficiencies, including one at the harm level and two tied to abuse, plus an $8,021 fine. Quality and staffing measures both rate 1 out of 5.
Park Terrace runs on thin staffing even before you look closely: 3.74 nurse hours per resident day against a national average of 3.86, and weekends drop about 11% below its own weekday coverage, which is when families tend to visit and notice. The bigger issue is who's left to provide that care, turnover sits at 65.8%, well above the 45.8% national figure, meaning two out of three staff members cycle out in a year. The inspection record backs that up: 109 deficiencies, six serious enough to cause harm, twelve tied to abuse, and $121,954 in fines. State inspectors were last in on March 20, 2025.
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.
Rosewood at Tybee Island carries a federal Special Focus Facility designation, which CMS reserves for the homes with the most persistent problems. The inspection record backs that up: 25 deficiencies, five of them at a level where residents were actually harmed or put in immediate jeopardy, and two tied to abuse. Staffing sits at 2.76 nurse hours per resident per day against a national average of 3.86, and it thins out further on weekends, dropping about 13% below the home's own weekday level. Turnover runs 78.4% a year, well above the 45.8% norm, so the people caring for your family member are likely new and likely leaving soon. One fine on record totals $200,733.
Washington Senior Living runs 122 certified beds under for-profit LLC ownership, and the staffing numbers are the first thing worth noticing. At 3.42 nurse hours per resident day, it sits about 11% under the national average, and weekends drop roughly 19% below its own weekday level, so coverage thins out exactly when families tend to visit. Annual turnover of 67.5% is well above the 45.8% national figure, which means the people providing care keep changing. The inspection record backs that up: 64 deficiencies, 18 tied to abuse and 2 serious enough to reach harm or jeopardy, plus a $230,097 fine. The most recent inspection was December 2024.
La Bella Of Aurora runs 2.93 nurse hours per resident day against a national average of 3.86, roughly a quarter less hands-on time than the typical home, and weekends drop about 13% below its own weekday level. The inspection record is the bigger problem: 36 deficiencies, five of them serious enough to put residents in harm's way, one tied to abuse, and $274,921 in fines across three events. That April 2025 inspection was recent, so this isn't a stale file. It's a 68-bed for-profit LLC, the kind of operation where low staffing and repeated citations tend to reinforce each other rather than resolve.
Kenwood Vlge Nrsg And Rhb Ctr carries a record that should give any family pause. The home has been cited for 72 deficiencies, including 8 at the harm or jeopardy level and 10 tied to abuse, findings severe enough to trigger three federal fines totaling $236,838. Nurse staffing sits at 3.16 hours per resident day, roughly 18% under the national average, and weekend coverage drops another 17% below its own weekday level, meaning care thins out exactly when families often visit. Turnover is near the national norm, so the problem isn't churn, it's depth of coverage and a long, serious inspection history.
Appleton City Manor sits at 60 certified beds under for-profit LLC ownership, and every CMS star category comes back at one out of five, health inspections, quality measures, and staffing alike. The deficiency record tells the story behind those numbers: 63 total, including two at the harm or jeopardy level and four tied to abuse. Two fines totaling $92,020 are on file. Staffing falls short of what CMS expects for a home this size, which matters most when residents need hands-on help. The last inspection was June 27, 2025, so the record is current. Families considering this home should ask directly about the abuse-related findings and what's changed since that inspection.
El Paso Rehabilitation and Health Care Center carries 73 deficiencies on its current record, including 15 tied to abuse and three serious enough to put residents in immediate harm's way. That record, plus $227,266 in CMS fines and placement in the federal Special Focus Facility program, tells you regulators are watching this building closely. Nurse staffing sits at 2.91 hours per resident day, roughly a quarter below the national average, and weekends drop another 17 percent below the home's own weekday levels. Staff turnover runs 58.2 percent, well above the 45.8 percent national figure, so the people caring for residents keep changing. The most recent inspection was January 10, 2025.
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.
Nexus At Alton runs 181 beds under for-profit LLC ownership, and the staffing picture is stranger than the headline number suggests. Total nurse hours come in around 4.28 per resident day, roughly 11% above the national average, but weekends drop about 20% below the home's own weekday level, so coverage depends heavily on when you visit. Annual turnover sits at 81.5% against a national average near 45.8%, meaning most of the people caring for residents are new to the building. The inspection record is the harder problem: 87 deficiencies on file, 20 at harm or jeopardy level and 14 abuse-related, with five fines totaling $392,111 and a last inspection in May 2024.
Nurse staffing at The Creston runs 0.93 hours per resident day, about a quarter of what you'd see at the typical American nursing home. Nearly every worker who was there a year ago is gone now, with turnover at 95.4% against a national figure under 46%. That churn shows up in the inspection record: 61 deficiencies, four serious enough to cause harm, two tied to abuse, and $122,699 in fines across three penalties. The most recent inspection was February 27, 2026, so the picture is current. Nonprofit ownership hasn't translated into steadier care here, the staffing and quality stars sit at 1 and 2 out of 5. Families considering this one should ask hard questions about who's actually on the floor.
Tweeten Lutheran runs about 0.95 nurse hours per resident per day, roughly a quarter of the national average, and weekend coverage drops another 20% below its own weekday level. Annual turnover sits at 81%, well above the 45.8% norm, and its current inspection record carries 34 deficiencies, including 4 at the harm or jeopardy level and 4 tied to abuse. The most recent inspection was in April 2026.
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.
Troy Victorian runs 2.96 nurse staffing hours per resident day against a national average of 3.86, and weekends drop roughly 17% below what the home itself staffs on weekdays. Staff turnover sits at 57.4%, more than half the nursing staff leaving in a year, which matters even more at a place where CMS has flagged 11 abuse-related deficiencies. The home carries 73 deficiencies on its current record, three serious enough to cause harm, plus $269,574 in fines, and CMS has placed it in the Special Focus Facility program, reserved for the worst performers in the country. If you're considering this one for someone you love, ask what the turnover and weekend coverage look like on the specific unit and shift you're considering.
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?