942 of the 1,179 Medicare-certified nursing homes in Texas (80%) are chain-owned, and all are listed below. 22 of the 940 graded homes earn an A and 92 earn a D or F. They average 3.29 nursing hours per resident per day, 0.1 hours below the 3.39 for every home in Texas. Trinity Terrace in Fort Worth grades highest at A (94 out of 100).
How chain-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
3.29
All homes in Texas: 3.39
Worse than the local average
Nurse staff turnover
56.3%
All homes in Texas: 55.3%
Worse than the local average
Average ElderGrade score
65.9/100
All homes in Texas: 66.9/100
Worse than the local average
Grade spread
B
C
D
22 grade A, 316 grade B, 510 grade C, 92 grade D,
The best-graded chain-owned home in Texas is
Trinity Terrace
in Fort Worth, TX — grade A,
94/100.
Rollingbrook is owned by a hospital district, and its inspection record is genuinely solid, a 4/5 on health inspections, with the most recent visit in March 2026 and no abuse-related deficiencies. But the staffing side tells a different story. At 3.35 nurse hours per resident day, it runs about 13% under the national average, weekends dip roughly 10% below its own weekday levels, and annual turnover sits at 70.1% against a national average of 45.8%. Ten deficiencies are on the current record, one serious enough to involve harm or jeopardy, plus a $23,676 fine. Good inspections mean the home generally gets things right when surveyors arrive; thin, churning staffing is what families live with between visits.
Simpson Place runs about 3.18 nurse hours per resident day, roughly 18% under the national average, and weekends dip another 7% below its own weekday staffing. That thin coverage comes with 55.6% annual turnover, well above the 45.8% national figure, so the aides and nurses cycling through are stretched even when the numbers look adequate on paper. The record shows 34 deficiencies, none at harm or jeopardy level, though two are abuse-related, and the most recent inspection was April 30, 2026. State surveyors rated health inspections 3 out of 5 and quality measures 4 out of 5, but staffing 1 out of 5, which tells you where the trouble lives.
Renaissance Park runs 4.03 nurse hours per resident day, a bit above the national figure of 3.86, but that average hides a gap: weekends drop about 17% below the home's own weekday staffing. The bigger concern is retention, 63.2% annual turnover against a national average of 45.8%, which means many of the people caring for residents are new to the building. On the record side, 31 deficiencies include 4 at the harm or jeopardy level and 2 tied to abuse, with $106,478 in fines across 4 penalties. The most recent inspection closed in April 2026.
Diversicare Of Luling runs 60 certified beds under corporate ownership, and the staffing number is the one to watch: 2.96 nurse hours per resident per day against a national average of 3.86. That's roughly a quarter less hands-on nursing time than the typical home, and weekends dip about 9% below what the building manages on weekdays. The state inspection record is where it looks stronger, 13 deficiencies, none at the harm or jeopardy level, no abuse findings, and a survey as recent as May 2025. So the picture isn't dangerous care so much as thin coverage: 4 out of 5 on inspections, but 1 out of 5 on staffing, which is the number that shapes daily life.
Focused Care At Odessa runs about 3.06 nurse hours per resident per day against a national average of 3.86, roughly a fifth less hands-on time than the typical home. Weekends drop another 17% below its own weekday staffing, so the thinnest coverage lands when families tend to visit. The 28 deficiencies on record include one at the harm level and two tied to abuse, with the most recent inspection dated January 2026. A 45.9% turnover rate sits essentially at the national figure, meaning the staff it has turns over about as fast as everywhere else. Ownership is corporate for-profit across 75 certified beds. The federal staffing rating of 1 out of 5 is the number that explains the rest.
Cedar Lake passed its most recent inspection in September 2025 with no deficiencies at the harm level and none tied to abuse, which matters, that's the part families worry about most, and it's clean. Where the home struggles is everyday care capacity. Both its staffing and quality measure ratings sit at the bottom of CMS's five-point scale, meaning resident care hours and clinical outcomes lag what's typical nationally, even though the building holds 90 beds. Eight deficiencies and four fines totaling $27,270 point to recurring paperwork and process problems rather than dangerous conditions. A for-profit limited liability company runs it. The inspection record looks better than the day-to-day staffing numbers, so ask specifically about nurse and aide coverage on evenings and weekends.
Care Nursing & Rehabilitation runs 97 certified beds in Brownwood under corporate for-profit ownership, and its inspection record is genuinely good, a 4-out-of-5 health inspection rating, last survey in March 2025, and 17 deficiencies on file with none at the harm or jeopardy level and nothing abuse-related. The staffing side tells a different story. At 2.98 nurse hours per resident day, it sits roughly 23 percent under the national average of 3.86, weekends run about 13 percent thinner than weekdays, and CMS gives it just 1 out of 5 stars for staffing. Quality measures land at 3. So: clean inspections, thin coverage. Ask about weekend and evening nurse presence before deciding.
Legend Oaks in Gladewater runs on 3.11 nursing hours per resident day, roughly a fifth below the national average, and weekends drop about 17% below what the home staffs on weekdays. Turnover sits at 42.6%, a touch better than the 45.8% national figure, so the problem isn't retention so much as how few hands are scheduled to begin with. The inspection record is where it gets harder to explain away: 39 deficiencies, 7 of them at harm or jeopardy level, 8 abuse-related, and six fines totaling $124,559, with the most recent inspection on April 15, 2026. Hospital district ownership doesn't change what those numbers describe.
Bertram Nursing and Rehabilitation runs on a thin nursing margin. At 2.73 hours per resident day, the home sits about 29 percent under the national staffing average, and weekends slip roughly 19 percent below its own weekday level, you can guess when problems tend to surface. The bigger signal is turnover: 95.6 percent of nursing staff leave within a year, against a national rate near half that, which means the people caring for residents are, more often than not, still learning the building. Inspections look strong on paper, including two abuse-related deficiencies and two at harm level, and one $10,135 fine. The pattern is a home that can score well on paper while the workforce underneath it keeps churning.
Midland Medical Lodge runs about 3.13 nurse hours per resident per day, roughly 19 percent under the national average of 3.86, and weekends drop another 17 percent below its own weekday numbers. Staff turnover sits at 46.9 percent, slightly above the national 45.8 percent, so the people around your family member may change often. The inspection record is the stronger side: 17 deficiencies on file, none at the harm or jeopardy level and none abuse-related, with the most recent inspection in August 2025. With 125 beds under for-profit partnership ownership, ask specifically how weekend coverage is handled on the unit your relative would live on.
Avir At Beaumont runs 214 certified beds under hospital district ownership, and the numbers show a building under real strain. Nurse staffing sits at 3.33 hours per resident day, roughly 14 percent under the national average, and weekends run about 9 percent thinner than weekdays, so coverage gaps tend to land when families visit most. Staff turnover of 49.5 percent tops the national rate, which means the people caring for residents are often new to the job.
The current inspection record carries 41 deficiencies, including two at the harm or jeopardy level and three tied to abuse, with $39,563 in fines across three penalties. The most recent inspection was June 20, 2025.
Legacy Nursing and Rehabilitation runs about 3.00 nurse hours per resident day, roughly 22% under the national average, and weekends dip about 15% below what the home staffs on weekdays. That thin coverage shows up in the federal staffing rating, which sits at the lowest mark, while annual turnover of 46.8% means close to half the nursing staff leaves each year, a bit above the national rate. Inspectors cited 38 deficiencies on the current record, including one at the harm level and one abuse-related, with a single fine of $12,375. The most recent inspection was in May 2025. Brazos County families comparing options should weigh that record against the home's mid-range quality scores.
Windsor Nursing and Rehabilitation Center of Morga runs 176 certified beds under nonprofit ownership, and the staffing numbers are the first thing to notice. At 2.91 nurse hours per resident per day, it sits about 25% under the national average of 3.86, and weekends drop roughly 15% below its own weekday level, so the thinnest coverage lands when families tend to visit. Turnover is 45.5%, essentially the national rate, so that's not the outlier here. The inspection record is heavier: 26 deficiencies, 7 at harm or jeopardy level, 5 tied to abuse, and three fines totaling $32,353. The most recent inspection was July 8, 2025. Quality measures score well; staffing and inspections are where the concerns sit.
Park View Care Center runs 179 certified beds in Fort Worth under corporate for-profit ownership, and its staffing sits at 4.02 nurse hours per resident day, a bit above the national average, though weekends drop roughly 10 percent below its own weekday coverage. That's the strongest part of the picture. The inspection record is where it gets harder to explain away: 62 deficiencies on file, including six at the harm or jeopardy level and seven tied to abuse, with six fines totaling $299,019. Annual staff turnover runs 51.9 percent against a national average of 45.8 percent, so the people providing care keep changing. The most recent inspection was February 2026, recent enough that this record reflects current conditions, not an old one.
Denton Village by Purehealth runs 88 certified beds under for-profit LLC ownership, and its nurse staffing sits at 3.55 hours per resident day, about 8% under the national average of 3.86. Weekend coverage drops roughly 11% below its own weekday level, so the thinnest shifts are the ones families tend to visit. The inspection record is the harder read: 26 deficiencies, including one at the harm level and one abuse-related, plus a $55,112 fine, with the most recent inspection in September 2025. Staff turnover at 41.3% is slightly better than the 45.8% national figure, and the 5/5 quality measure rating stands out against a 2/5 inspection score. The gap between those two numbers is worth asking about directly.
Colonial Manor runs about 3.78 nursing hours per resident per day, a bit under the national average, and weekends drop roughly 11% below its own weekday staffing. That thinner weekend coverage matters more when turnover sits at 52.8%, well above the 45.8% national figure, because a changing roster makes it harder to know who's on the floor. The record shows 26 deficiencies, including three at harm or jeopardy level and three tied to abuse, with $51,594 in fines and a February 2025 inspection. The quality measure stars look strong, but the inspection and staffing numbers tell a different story.
Skyline Nursing Center is a 204-bed hospital-district home in Dallas, and the numbers behind its federal record are hard to read kindly. Nurse staffing runs about 3.05 hours per resident day, roughly a fifth below the national average, and it drops another 10% on weekends, when families often visit and coverage matters most. Annual turnover sits at 50%. The inspection history is heavier still: 39 deficiencies on the current record, including 5 at the level where residents were actually harmed or put in jeopardy, plus 6 tied to abuse. One fine of $96,817 has been levied, and the most recent inspection was April 2026.
Advanced Health & Rehab Center of Garland runs on 2.97 nursing hours per resident per day, roughly a quarter below the national average, and weekends drop about 10% below its own weekday staffing. That thin coverage shows up in the inspection record: 41 deficiencies, four serious enough to cause harm or jeopardy, two tied to abuse, and three fines totaling $237,224. Staff turnover of 43.5% is slightly better than the national 45.8%, and the quality measure score is strong, but the staffing and inspection scores sit at the bottom. It's hospital-district owned and was inspected in April 2025. Ask about weekend nurse coverage and what changed since that inspection.
Patriot Heights runs 3.46 nurse hours per resident day, roughly 11% under the national average, and weekends dip about 15% below what the home itself staffs Monday through Friday. That thin weekend coverage matters more when you look at the record: 25 deficiencies, three at harm or jeopardy level, two tied to abuse, and $28,033 in fines across two penalties. Annual turnover sits at 50%, above the 45.8% national figure, so the people providing care keep changing. The quality measure score looks strong, but that reflects charted clinical outcomes, not whether enough hands are present on a Saturday. The last inspection was September 5, 2025.
Henderson Health & Rehabilitation Center runs 173 certified beds under for-profit LLC ownership, and its nurse staffing sits at 3.27 hours per resident day, roughly 15% under the national average of 3.86. Weekends dip about 5% below its own weekday levels, and annual turnover hits 52.5% against a national 45.8%, meaning more than half the nursing staff turns over each year. The inspection record shows 30 deficiencies, four of them serious enough to cause harm or jeopardy, plus one abuse-related finding and a $10,546 fine. The last inspection was May 2025. Quality measures score well, but staffing and inspection results are where the real story sits.
Frequently asked questions
How many chain-owned nursing homes are there in Texas?
There are 942 chain-owned Medicare-certified nursing homes in Texas, 80% of the 1,179 nursing homes there.
Are chain-owned nursing homes better staffed?
In Texas they average 3.29 total nursing hours per resident per day, against 3.39 for all nursing homes in Texas, a difference of -0.1 hours. Staff turnover averages 56.3% against 55.3%.
Which chain-owned nursing home grades best in Texas?