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.
Avir At Park Bend runs on thinner nursing coverage than most homes, 3.18 nurse hours per resident day against a national average of 3.86, and weekends drop another 12% below its own weekday levels. That's the kind of gap families feel on a Saturday afternoon when call lights take longer to answer. Turnover sits at 46.1%, essentially matching the national rate, so staffing instability here isn't an outlier problem. The inspection record is more concerning: 28 deficiencies, including 3 at harm or jeopardy level and 4 tied to abuse, with $38,155 in fines. A June 2025 inspection is recent, and the 3/5 health inspection rating reflects real citations. Government hospital district ownership doesn't erase any of this.
The Frank M. Tejeda Texas State Veterans Home in Floresville runs lean on daily nursing hours, 3.09 per resident, roughly a fifth below the national average, and weekends dip about 13% below its own weekday coverage. What stands out instead is retention: turnover sits at 27.8%, well under the 45.8% national figure, which matters for familiar faces and consistent care. State-run, 160 beds, inspected in March 2026 and rated 4 of 5 on health inspections. The current record shows 22 deficiencies with none at the harm level, though 5 are abuse-related, worth asking about directly before you visit.
River City Care Center runs 92 certified beds under individual for-profit ownership, and its nurse staffing sits at 3.22 hours per resident day, roughly 17% under the national average, with weekends about 13% thinner than weekdays. That shortfall shows up in the federal staffing rating, which lands at the lowest tier. The inspection record is the heavier concern: 36 deficiencies on file, including two at the level where residents were actually harmed or put in jeopardy, plus one tied to abuse, and $23,410 in fines across two penalties. Its quality measure score looks good on paper, but that's largely self-reported data, and the last full inspection was in July 2025. The families I'd tell to look hardest at this one are those needing consistent hands-on care, especially on weekends.
Avir At Dripping Springs runs 60 certified beds under corporate ownership, and the staffing numbers are the part that should get your attention. At 2.80 nurse hours per resident day, it sits about 27% under the national average of 3.86, and weekend coverage dips roughly 9% below its own weekday level. Annual turnover hits 68.6% against a national 45.8%, so the people caring for residents are cycling through fast. The inspection record is genuinely strong, a 5/5 star rating and a clean December 2025 survey, with no deficiencies at the harm level. But 13 deficiencies on file, one abuse-related, plus a 1/5 staffing star, means the day-to-day coverage is where the risk lives.
Avir At Magnolia runs on 2.86 nurse hours per resident day, roughly a quarter below the national average, and weekends drop further from an already thin weekday floor. That staffing gap sits behind 37 deficiencies on record, seven of them involving harm or jeopardy and three tied to abuse, plus five fines totaling $50,906, a pattern worth asking the administrator about directly. Nearly six in ten staff left over the past year, well above the 45.8% national rate, and with the last inspection in August 2025, the record is current rather than dated. The quality measure score looks better than the rest, but quality numbers reflect resident assessments, not whether enough hands are on the floor.
The Alfredo Gonzalez Texas State Veterans Home in McAllen runs on a stable workforce, 28.5% turnover is well below the national 45.8%, and that consistency shows up in its staffing score. But 3.58 nurse hours per resident day sits about 7% under the national average, and weekends drop roughly 15% below the home's own weekday coverage, so care thins out when families tend to visit.
The bigger concern is the inspection record: a 2-out-of-5 health inspection rating, 30 deficiencies including 3 at harm or jeopardy level and 5 abuse-related, plus two fines totaling $35,600. State-run ownership brings accountability, but this home's last survey in January 2026 flagged real problems.
Avir At Texarkana runs a for-profit LLC with 110 certified beds, and the numbers pull in different directions. Nurse staffing sits at 4.56 hours per resident day, roughly 18% above the national average of 3.86, but weekend coverage drops about 7% below its own weekday level, and annual turnover hits 61.7% against a national 45.8%, so the hours are there, the consistency isn't. What drags the record down is the inspection history: 33 deficiencies, three at harm or jeopardy level and five abuse-related, with two fines totaling $146,860 and a health inspection rating of 1 out of 5. Ownership changed within the last 12 months, and the most recent inspection was June 11, 2025.
Maverick Nursing and Rehabilitation Center runs on a thin margin of nursing hours: 2.93 per resident day against a national average of 3.86, and weekends drop about 12% below its own weekday coverage. That staffing picture, not the inspection record, is what drags the home down, CMS gives it just one star for staffing even though inspections earned four and quality measures three. Turnover sits at 47.1%, slightly above the 45.8% national figure. Twenty-six deficiencies are on file, one serious enough to reach harm or jeopardy level, with a single fine of $15,642; the most recent inspection was December 12, 2025. If you're weighing this one, ask how they cover weekends.
Prestonwood runs on a hospital district's budget, and the nurse staffing shows it: 4.21 hours per resident day, roughly 9% above the national average. Weekends dip about 14% below its own weekday levels, worth asking about if your family visits Saturday or Sunday. The harder numbers are on the inspection side, 16 deficiencies on the current record, three of them at harm or jeopardy level and three abuse-related, with one fine totaling $14,433. Staff turnover sits at 46.8%, a hair above the national 45.8%. The last inspection was April 2025, so the record is recent. Strong staffing and quality scores, rough inspection history, that split is what the grade reflects.
Providence Park runs 3.24 nurse hours per resident per day, about 16 percent under the national average, and weekends drop another 13 percent below its own weekday staffing. The 125-bed for-profit has 23 deficiencies on its current record, two of them at the harm or jeopardy level, with two fines totaling $188,361. Its most recent inspection was June 18, 2025, and the health inspection rating sits at 2 of 5 stars. Staff turnover of 40.9 percent is slightly better than the 45.8 percent national figure, but a 2-star staffing rating paired with that many deficiencies is the real story here.
Heritage Park Of Katy runs on 2.86 nursing hours per resident per day, roughly a quarter below the national average of 3.86, and weekends drop about 7% below its own weekday staffing. That thin coverage sits behind a two-star CMS staffing rating, even though turnover at 43.5% is slightly better than the 45.8% national figure. The inspection record shows 17 deficiencies, including 2 at harm or jeopardy level and 1 abuse-related, with one fine of $25,508; the last inspection was November 2024. Owned by a hospital district, this home carries three stars each for health inspections and quality measures, middling marks that don't offset the low staffing.
Champions Healthcare At Willowbrook runs on tighter staffing than most Texas homes, and the numbers show it: 3.52 nurse hours per resident day against a national average of 3.86, with weekends dropping roughly 14% below its own weekday coverage. That thin weekend margin matters in a 98-bed building, and a 51.9% annual turnover rate, well above the 45.8% national figure, means the aides and nurses on that floor are often new to the job. The inspection record carries 19 deficiencies, three serious enough to reach harm or jeopardy, one tied to abuse, and $44,335 in fines across two penalties. The most recent inspection closed in April 2026, so the record is current rather than stale. For-profit individual ownership rounds out the picture.
Riverside Nursing and Rehabilitation Center is a 122-bed for-profit in Austin where the staffing numbers are the first thing to notice. At 3.38 nurse hours per resident day, it runs about 13 percent under the national average, and weekends drop roughly 17 percent below its own weekday levels, so coverage thins out exactly when families tend to visit. Annual turnover sits at 52.5 percent against a national 45.8 percent, which means caregivers cycle through faster than average. The inspection record backs that up: 28 deficiencies, five at harm or jeopardy level, two tied to abuse, and $88,227 in fines. The most recent inspection was January 15, 2026.
Memorial City runs on 3.20 nurse hours per resident day, about 17% under the national average, and weekends drop roughly 12% below its own weekday staffing. That thin schedule sits behind 32 deficiencies on the current record, six of them at harm or jeopardy level, one abuse-related, plus four fines totaling $70,554. Annual turnover of 53.6% means more than half the nursing staff leaves each year, well above the 45.8% national figure. The hospital district ownership is worth noting, but it hasn't kept the inspection record clean, the last survey was April 28, 2026, and the health inspection side scored 2 out of 5. Quality measures look strong at 5 out of 5, which raises the question of whether the day-to-day staffing can carry that.
Hidalgo Nursing and Rehabilitation Center runs on thinner nursing coverage than most homes, 3.32 hours per resident day against a national average of 3.86, and weekends dip about 11% below its own weekday levels, which is when families often visit and notice. The 25 deficiencies on its current record include one at the harm level and four tied to abuse, and the health inspection rating sits low. Staff turnover at 41.6% is slightly better than the national 45.8%, and its quality measure score is strong, but a government-hospital-district owner doesn't change the math: the daily staffing number is what your family will actually feel.
The Villages On Macarthur runs leaner than most: 3.45 nurse hours per resident day against a national average of 3.86, and weekends drop about 12% below what the home staffs on weekdays. That matters because its inspection record carries 29 deficiencies, two of them at the harm or jeopardy level and one tied to abuse, with $25,259 in fines across two penalties. The health inspection rating sits at 2 out of 5, though quality measures score 4 and staffing 3. Turnover is 43%, slightly better than the 45.8% national figure, and the most recent inspection was July 2025. A nonprofit with recent eyes on it, but the harm-level findings are the part to ask about directly.
The Pavilion At Creekwood runs 126 certified beds under for-profit LLC ownership, and its nurse staffing sits at 3.21 hours per resident day, roughly 17% under the national average of 3.86. Weekends are thinner still, about 13% below its own weekday level, and turnover lands at 47%, slightly above the 45.8% national figure. The inspection record shows 24 deficiencies, four of them at harm or jeopardy level, with three fines totaling $39,674 and a 2/5 health inspection star. Quality measures score 4/5, but that doesn't offset the staffing and inspection picture. The most recent inspection was April 14, 2026, so the record is current.
The Healthcare Resort Of Plano runs 70 certified beds as a nonprofit, and its staffing sits just under the national average at 3.82 nurse hours per resident day. The bigger issue is consistency: weekends drop about 9% below its own weekday coverage, and annual turnover hits 54.8% against a national 45.8%, meaning more than half the nursing staff turns over each year. That churn shows up on the inspection side too, 25 deficiencies on the current record, two serious enough to involve harm or jeopardy, and $16,438 in fines across two events, with the most recent inspection in June 2025. Nothing here is catastrophic, but the pattern is a home running thin on staff and paying for it in citations.
Palomino Place runs 120 beds in Mesquite, and the staffing numbers are where I'd start. At 3.64 nurse hours per resident day, it sits about 6% under the national average, and weekends drop roughly 12% below its own weekday levels, so coverage thins out exactly when families tend to visit. Turnover is 52.7% against a national 45.8%, meaning more than half the nursing staff leaves within a year. The inspection record shows 32 deficiencies, five serious enough to involve harm or jeopardy, plus one tied to abuse, and $165,086 in fines across three penalties. The last inspection was December 11, 2025, so the record is current. For-profit corporate ownership rounds out the picture.
Cypress Springs runs 95 certified beds in Mount Vernon as a for-profit LLC, and the numbers a family should sit with are the workforce ones. Total nurse staffing sits at 3.57 hours per resident day, about 8% under the national figure, and weekends drop roughly another 11% below the home's own weekday coverage, so the thinnest shifts land when families tend to visit. Annual turnover is 81.1% against a national 45.8%, meaning most of the people caring for residents this year likely won't be there next year. Inspections in June 2025 turned up 22 deficiencies, including one at the harm or jeopardy level and one tied to abuse, with a $29,438 fine on record. Quality measures score well; consistent hands-on care is the open question.
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?