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.
Cherokee Rose runs lean on nurses. At 3.20 hours per resident day, its staffing sits about 17 percent under the national average, and weekends drop roughly another 20 percent below its own weekday level, so the thinnest coverage lands when families tend to visit. That shows up in the staffing star rating, which comes in at 1 out of 5, even as the health inspection rating holds at 4 out of 5. The current record carries 18 deficiencies, none tied to harm, jeopardy, or abuse, and the most recent inspection was March 2026. Quality measures rate 2 out of 5. Corporate-owned, 102 beds. Strong recent inspections, weak day-to-day staffing.
Arbor Lake runs on 3.11 nurse hours per resident per day, roughly 19 percent under the national average, and weekends drop another 11 percent below what the home itself staffs on weekdays. That thin coverage shows up in a 52.7 percent annual turnover rate, with more than half the nursing staff leaving each year. Inspectors cited 33 deficiencies on the current record, three of them serious enough to put residents in harm's way and two tied to abuse. The owner is a for-profit individual, and two fines totaling $14,676 are on file. One bright spot: the quality measures score well above average, and the most recent inspection was July 2025.
Colonial Manor runs on 3.42 nurse hours per resident per day, roughly 11% under the national average, and weekends dip another 7% below its own weekday numbers, so the thinnest coverage lands when families tend to visit. The inspection record is the harder problem: 43 deficiencies, six serious enough to reach harm or jeopardy, six tied to abuse, and four fines totaling $87,564, all from a for-profit LLC operating 123 beds. Staff turnover at 39.2% actually beats the national 45.8%, which tells you the building can hold workers, the trouble is how few of them there are and what inspectors keep finding.
Chisolm Trail runs a 96-bed for-profit home in Lockhart, and the numbers point in two directions at once. Resident outcomes look good on the federal quality measures, but staffing sits at 2.72 nurse hours per resident day, roughly 29 percent under the national average, and weekends drop about 16 percent below the home's own weekday coverage. The inspection record shows 24 deficiencies, including one at the harm level and two tied to abuse, plus a $37,541 fine; the most recent inspection was in August 2025. If you're weighing this one, ask how they cover weekends and what changed after that harm citation.
Windsor Healthcare Residence runs about 3.31 nurse hours per resident per day, roughly 14% under the national average, and weekend coverage dips another 8% below its own weekday levels, so the thinnest shifts land when families tend to visit. Staff turnover sits at 52.4%, above the 45.8% national figure, and that churn shows up in the inspection record: 13 deficiencies, three serious enough to flag harm or jeopardy, two tied to abuse, plus three fines totaling $34,232. The most recent inspection was August 2025. It's a for-profit, individually owned home with 90 certified beds. The quality measure score looks strong, but quality measures reflect resident health outcomes, not whether enough hands are on the floor or whether problems get fixed.
Kirkland Court runs on thin staffing. At 2.88 nurse hours per resident per day, it sits about a quarter below the national average, and weekend coverage drops further, so the thinnest shifts fall when families tend to visit. Staff turnover of 53.3% tops the national rate, meaning the people caring for your relative are often new to the building. The inspection record is the harder read: 37 deficiencies, three serious enough to put residents in harm or jeopardy, and six tied to abuse. Two fines total $16,810. The quality measures look strong, but those come from resident assessments, not from how the place is run day to day.
Val Verde runs lean on direct care: 3.24 nurse hours per resident day against a national average of 3.86, and weekends drop about 11% below its own weekday staffing. That's a real gap, not a rounding error, and it likely shows up on Saturday afternoons. Turnover is the bright spot, 31.1% versus 45.8% nationally, so the people who are there tend to stay. But the record holds 30 deficiencies, including two at harm level and three tied to abuse, plus a $138,908 fine. Inspectors were last in on June 6, 2025. Nonprofit ownership doesn't erase those numbers; staffing and past problems both matter when you weigh this one.
Focused Care Of Center is a for-profit limited liability company home with 92 certified beds, and the numbers tell a mixed story. Nurse staffing sits at 3.50 hours per resident day, about 9% under the national average, and weekends run roughly 13% below its own weekday level, so coverage thins out exactly when families tend to visit. Turnover, at 32.8%, is actually better than the 45.8% national figure, but the inspection record is where the real trouble sits: 37 deficiencies, including 4 at the harm or jeopardy level and 4 tied to abuse, plus two fines totaling $256,719. The most recent inspection was June 11, 2025.
Avir At Overton runs 100 certified beds under for-profit LLC ownership, and the staffing numbers tell a mixed story: 3.77 nurse hours per resident day sits just under the national average of 3.86, but weekends dip about 4% below weekdays, and annual turnover hits 58.3% against a national 45.8%. More concerning is the inspection record, 41 deficiencies, 13 of them at harm or jeopardy level, 10 abuse-related, and six fines totaling $363,446, with the most recent inspection dated April 2026. The quality measure rating is strong, but that reflects resident health metrics, not the safety and oversight record a family should weigh most heavily when choosing care.
Flatonia Healthcare Center runs 70 certified beds in Fayette County under corporate for-profit ownership, and its staffing is the one part of the picture that holds up: 4.04 nurse hours per resident day, about 5% above the national average, with weekend coverage dipping only slightly below weekdays. Turnover at 43.6% is a touch better than the national 45.8%. The trouble sits elsewhere. Fifteen deficiencies on the current record, two of them at harm or jeopardy level and two abuse-related, plus two fines totaling $15,098. The most recent inspection was December 4, 2025, so that record is recent. Staffing keeps residents attended to; the inspection history is what a family should ask about directly.
Lone Star Ranch runs 146 beds in Kingsville under corporate ownership, and its numbers tell a mixed story. Nurse staffing sits at 3.22 hours per resident day, roughly 17% under the national average, and weekends dip about 12% below the home's own weekday coverage, so care thins out exactly when families tend to visit. Staff turnover is 43.8%, slightly better than the national rate. The inspection record is the real concern: 23 deficiencies, including one at the harm level and six tied to abuse, with a $8,190 fine and a survey completed in June 2025. Quality measures score well, but that coexists with a two-star inspection history.
Avir At Monahans runs on a government-hospital-district license and 92 certified beds, and its nursing hours come in at 2.74 per resident day, roughly 29% under the national average of 3.86. That thin coverage thins further on weekends, when staffing drops about 9% below its own weekday level, and the aide and nurse turnover rate sits at 74% against a national 45.8%. The record shows 35 deficiencies, none at harm or jeopardy level and none abuse-related, with the most recent inspection in July 2025. Quality measures score well, but the staffing picture is what shapes daily life here.
Port Arthur Nursing and Rehabilitation Center runs 199 certified beds under for-profit partnership ownership, and its numbers split sharply depending on where you look. The quality measure score is perfect, yet nurse staffing sits at 3.06 hours per resident day, roughly 21% under the national average, and weekend coverage drops about 12% below its own weekday level. Turnover lands at 44.3%, close to the national figure, so retention isn't the outlier here. What is: 50 deficiencies on the current record, including five at harm or jeopardy level and 12 tied to abuse, plus four fines totaling $310,553. The last inspection was June 25, 2025. A strong quality score doesn't offset that inspection history.
Conroe Health Care Center runs 108 certified beds as a nonprofit, and the numbers tell a mixed story. Nurse staffing sits at 3.64 hours per resident day, about 6% under the national average of 3.86, and weekends dip roughly 5% below the home's own weekday coverage, so the hours get thinnest exactly when families tend to visit. Staff turnover is 52.6%, notably worse than the 45.8% national figure, which matters because constant churn makes consistent care harder. The current inspection record shows 20 deficiencies, two serious enough to involve harm or jeopardy, plus one fine of $12,860; the most recent inspection was April 11, 2025. Quality measures rate mid-range, but inspections and staffing are the weaker spots here.
Avir At Mineola runs on 3.45 nurse hours per resident day, roughly 11 percent under the national average, and weekends dip another 8 percent below its own weekday numbers, so the thinnest coverage lands when families tend to visit. The inspection record is heavier than that staffing gap alone would suggest: 54 deficiencies, including 8 tied to abuse and 3 serious enough to put residents in harm's way, plus three fines totaling $55,247. Ownership changed within the past year, which can mean new management or just a new name on the license. The most recent inspection was in December 2025. If you're considering this one, ask directly what changed after that inspection and who's actually on the floor on Saturdays.
Village Healthcare And Rehabilitation runs 114 certified beds in Mcallen under corporate for-profit ownership, and the staffing numbers are the main thing to know. At 3.49 nurse hours per resident day, it sits about 10% under the national average of 3.86, and weekends run roughly 15% lighter than its own weekdays, so coverage thins out exactly when families tend to visit. Turnover at 33.3% is actually better than the 45.8% national figure, which is a real point in its favor. The inspection record is the harder part: 16 deficiencies, three at harm or jeopardy level and one abuse-related, plus two fines totaling $28,970. The most recent inspection was April 2025. Ask about weekend staffing and that abuse citation directly.
Friendship Haven runs about 3.20 nurse hours per resident per day, roughly 17% under the national average, and weekends dip about 9% below its own weekday staffing. Employee turnover sits at 50.4%, above the 45.8% national figure. Texas records show 17 deficiencies, two serious enough to involve harm or jeopardy, one tied to abuse, plus an $8,018 fine; the last inspection was November 2024. The health inspection rating is strong at 4 out of 5, but that sits alongside a 2 out of 5 staffing rating. For a 150-bed for-profit home, the pattern is consistent: care standards look good on paper while the day-to-day staffing that delivers them runs thin.
The Villa at Mountain View runs 3.31 nurse staffing hours per resident day, roughly 14% under the national average of 3.86, and weekends drop about 9% below its own weekday levels. That matters when you consider the record: 36 deficiencies, four of them at the harm or jeopardy level, one tied to abuse, plus three fines totaling $33,580. Staff turnover sits at 48.3%, a few points above the national 45.8%, and the most recent inspection was May 2025. Ownership is for-profit corporate, with 120 certified beds. The quality measure score looks strong on paper, but the staffing and inspection numbers describe a building where care depends heavily on who happens to be working that day.
Brenham Nursing and Rehabilitation Center runs on 2.71 nurse hours per resident day, roughly 30 percent under the national average of 3.86, and weekend coverage drops about 10 percent below its own weekday level. Staff turnover sits at 44.3 percent, close to the national figure of 45.8 percent, so this isn't a retention crisis so much as a thin floor of coverage that thins further on Saturdays and Sundays. The inspection record is where the real trouble shows: 28 deficiencies, two at harm or jeopardy level, one abuse-related, and two fines totaling $29,353. The most recent inspection was February 19, 2026. A five-star quality measure score doesn't offset a one-star inspection history at a home this size.
The state veterans home in Temple is a 160-bed for-profit operation, and its inspection record is the first thing to look at: 32 deficiencies on the current record, seven of them serious enough to cause harm or put residents in jeopardy, and five tied to abuse. Three fines totaling $53,476 followed. Staffing is the other concern, CMS rates it at the bottom of its scale, meaning the hours of direct care per resident fall well below what most Texas homes provide, even though the home's own quality measures score well. The last full inspection was March 2025, so the findings are recent. Ownership is a limited liability company. Families with a choice should ask hard questions here.
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?