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.
Parkview runs about 2.87 nurse hours per resident day, roughly a quarter below the national average, and weekends drop another 19% under its own weekday numbers. That thin coverage shows up in the inspection record: 17 deficiencies, five of them at harm or jeopardy level and three tied to abuse, with four fines totaling $64,967 and a two-star health inspection rating. Staff turnover sits at 47.5%, slightly above the national figure. The quality measure score of 4/5 is the one bright spot, but it reflects reported care measures rather than the staffing and safety problems regulators have actually cited here.
La Vida Serena runs thin on nursing staff, 2.87 hours per resident per day against a national average of 3.86, roughly a quarter below it. Weekends are lighter still, about 11% under the home's own weekday coverage, so the thinnest shifts come when families often visit. The inspection record is a mixed picture: a four-star health inspection rating and a recent survey in September 2024, but 17 deficiencies on file, two of them at harm or jeopardy level and three tied to abuse. A single fine of $8,404 has been levied. The staffing star sits at one out of five, which tells you where the trouble concentrates.
Wellington Care Center runs on thin nursing coverage: 3.07 hours per resident day, roughly a fifth below the national average of 3.86, and weekends drop about 11% below its own weekday level. That shortfall is what drags its staffing rating down to 1 out of 5, even though its last inspection in January 2026 went reasonably well and produced a 4-out-of-5 inspection rating. The record shows 15 deficiencies, one serious enough to reach harm or jeopardy level, though none tied to abuse, plus a single $13,070 fine. Government hospital district ownership doesn't change the arithmetic, the quality measure rating sits at 3 out of 5, and the daily staffing numbers are the weakest part of this home's profile.
Village Creek runs on 3.27 nurse hours per resident day, roughly 15% under the national average, and weekend coverage dips about 15% below its own weekday level, so the thinnest staffing lands when families tend to visit. The inspection record is the bigger problem: 38 deficiencies, six of them at harm or jeopardy level and seven tied to abuse, with three fines totaling $125,838. A 1-out-of-5 inspection rating alongside a 4-out-of-5 quality measure score tells you the charted care metrics look better than the day-to-day compliance record. Turnover at 40.3% is slightly better than the 45.8% national figure, and the hospital district ownership is a point in its favor. Ask about the abuse-related findings directly before deciding.
Sonterra Health Center runs on thin nursing coverage, 3.53 hours per resident day, roughly 9% under the national average, and weekends are leaner still, about 19% below its own weekday level. That shortfall shows up in the federal staffing rating, which sits at the bottom of the scale, and in a turnover rate of 54.6%, nearly nine points above the national figure. Its current record carries 50 deficiencies, including five at the harm or jeopardy level and five tied to abuse, along with three fines totaling $80,964. A May 2025 inspection is recent, but the inspection rating is still below average. It's owned by a hospital district, which may explain some stability, but the numbers here are hard to read as reassuring.
Madison Medical Resort runs 3.57 nursing hours per resident day, roughly 8% under the national average of 3.86, and weekends drop about 16% below its own weekday staffing. That thin weekend coverage matters more than the overall number, since gaps show up when fewer people are watching. The 44.8% turnover rate is basically in line with the national 45.8%, so retention isn't the standout problem here. What is: ten deficiencies on the current record, two of them at harm or jeopardy level, plus a $32,445 fine. A 3/5 on health inspections and quality measures is middling, and the 1/5 staffing rating reflects the hours above. Ownership is for-profit corporate.
Rosewood Heights runs 64 beds in Killeen under corporate ownership, and its staffing is the number that stands out. At 3.81 nurse hours per resident day it sits just under the national average, but weekends drop roughly 12% below its own weekday level, and turnover runs 67.6% against a national 45.8%, meaning most of the people caring for residents this year likely won't be there next year. The inspection record shows 15 deficiencies, 5 of them at harm or jeopardy level, plus $42,298 in fines across three penalties. A recent August 2025 inspection and no abuse citations are the bright spots. Ask about weekend coverage and how they keep CNAs.
Magnolia Manor runs on 2.92 nurse staffing hours per resident day, roughly a quarter below the national average of 3.86, and weekends drop about 11% below its own weekday level. That thin coverage is where the real trouble sits: 24 deficiencies on the current record, four at harm or jeopardy level, three tied to abuse, and two fines totaling $230,279. Turnover at 39.7% is actually better than the national 45.8%, so the problem isn't retention, it's how few hands are on deck when they are there. The last inspection was July 2025, so the picture is current, not stale. For-profit corporate ownership, and a staffing star of 1 out of 5, tell you where the money goes.
Avir At Weatherford runs lean on nursing hours: 3.32 per resident day against a national average of 3.86, and weekends drop roughly another 12% below its own weekday level, so the thinnest coverage lands when families typically visit. Staff turnover sits at 70.4% against a national 45.8%, meaning most of the people caring for residents this year likely won't be there next year. The inspection record shows 18 deficiencies, two of them at harm or jeopardy level and three tied to abuse, with $22,356 in fines across two penalties. Ownership is a for-profit corporation, and the last inspection was in February 2026.
Avir At Enchanted Rock runs on a hospital district's budget out in Gillespie County, and the numbers show where that leaves residents. Nurses provide 3.44 hours of care per resident each day, roughly 11 percent under the national average, and weekends dip about 15 percent below the home's own weekday staffing. The bigger red flag is turnover: 78.9 percent of staff leave within a year, against a national average of 45.8, so the people providing that already-thin care are constantly new. Inspectors have cited 47 deficiencies, including 5 at the harm level and 8 tied to abuse, with $63,121 in fines. Quality scores look good on paper, but staffing and inspections tell the harder story.
Palo Pinto Nursing Center runs on 3.04 nurse hours per resident day, roughly a fifth below the national average, and weekends drop about 13% below what the home itself staffs on weekdays. Turnover sits at 45.6%, essentially the national rate, so the staffing shortfall isn't an exodus problem, it's how many hours the building puts on the floor. The inspection record shows 22 deficiencies, including two at the harm level and two tied to abuse, with a $41,036 fine and a survey completed in September 2025. The corporate owner operates it for profit across 106 certified beds. Families weighing this one against others nearby should ask how the weekend shifts are actually covered.
Greenville Health & Rehabilitation Center runs 120 certified beds under corporate ownership, and the numbers behind its record are worth knowing before you visit. Nurse staffing sits at 3.48 hours per resident day, roughly 10% under the national average, and weekends drop about 8% below what the home staffs on weekdays, so coverage thins out exactly when families tend to show up. Half the staff turned over in the past year, above the 45.8% national rate.
The inspection history is heavier: 68 deficiencies on the current record, including 5 at the harm or jeopardy level and 10 tied to abuse. Five fines total $96,065, and the last inspection was March 27, 2024.
Avir At Gonzales runs on 2.65 nursing hours per resident day, roughly a third below the national average of 3.86, and weekends drop about 14% below its own weekday staffing. That thin coverage shows up in the federal staffing rating: 1 out of 5. Annual turnover sits at 61.3% against a national 45.8%, meaning most of the people caring for residents weren't there a year ago. The inspection record shows 39 deficiencies, none at the harm or jeopardy level and none abuse-related, and the last survey was July 2025, so that picture is current. A for-profit corporation owns the 80-bed home. Inspection and quality scores land mid-range; the staffing numbers are where the concern sits.
Avir At Burleson runs a 120-bed for-profit building in Johnson County, and the split in its record is worth understanding before you tour. Inspectors have found this place in good shape, a 4-out-of-5 health inspection rating, 19 deficiencies on the current record with none reaching harm or jeopardy level and nothing abuse-related, and a survey as recent as November 2025.
The staffing side tells a different story. At 2.87 nurse hours per resident day, it sits roughly 26 percent under the national average of 3.86, and weekend coverage drops about 11 percent below its own weekday level. Annual turnover of 56.4 percent runs well above the 45.8 percent national figure. Good inspections, thin coverage, ask how they staff weekends.
Harmony Care At Golfcrest runs on 3.48 nurse hours per resident day, roughly 10% under the national average, and weekends drop another 8% below its own weekday staffing. That thin coverage shows up in the inspection record: 23 deficiencies, five of them serious enough to put residents in harm's way, two tied to abuse, and $71,472 in fines across three penalties. Staff turnover sits at 51.5%, well above the 45.8% national figure, which matters for a 120-bed for-profit where familiarity with residents is part of the safety net. The most recent inspection was July 2025, so the record is current. Ask the administrator what specifically has changed since then.
Greenbrier runs on 3.06 nurse hours per resident per day, roughly a fifth below the national average, and weekends drop another 14% under its own weekday level. That thin coverage shows up in the staffing rating, which sits at the bottom of CMS's scale. Annual turnover of 96.6%, more than double the national figure, means the people caring for residents are constantly new. Its current record carries 28 deficiencies, two tied to abuse, though none reached the harm or jeopardy level. The most recent inspection was March 2026. For-profit corporate ownership rounds out the picture. Ask about actual weekend coverage and how long aides tend to stay.
Avir At Heritage Oaks runs 159 certified beds under for-profit LLC ownership, and the staffing numbers are where your attention should go first. At 3.21 nurse hours per resident day, it sits about 17% under the national average of 3.86, and weekends drop roughly 11% below its own weekday levels, so coverage thins out exactly when families tend to visit. Annual turnover of 67.2% against a national 45.8% means many of the people caring for residents are still learning the building. The current record carries 28 deficiencies, two tied to abuse, though none reached harm or jeopardy level, and the last inspection was in May 2026.
Lake Village runs on 3.07 nurse hours per resident day, roughly a fifth below the national average of 3.86, and weekends drop about 18% below what the home staffs on weekdays. That thin coverage shows up in the inspection record: 33 deficiencies, including one at the harm or jeopardy level and one tied to abuse, with a $24,585 fine and a two-out-of-five health inspection rating. The four-out-of-five quality measure score reflects resident care metrics, but it sits alongside a one-out-of-five staffing rating, and the most recent inspection was in May 2026. For-profit corporate ownership out of Lewisville.
Avir At Adams runs 3.14 nurse hours per resident day, roughly 19% under the national average, and weekends drop about 12% below its own weekday coverage. That thin margin shows up in the numbers that matter most: a 66.2% annual turnover rate against a 45.8% national figure, meaning most of the people caring for your relative are new to the building. The current record carries 46 deficiencies, five at harm or jeopardy level and three tied to abuse, plus $24,819 in fines. The most recent inspection was June 19, 2025. For-profit corporate ownership, 118 certified beds, and a staffing rating that matches what those hours suggest.
Stonebridge Health Rehab runs 116 beds in Austin under for-profit LLC ownership, and its staffing sits about 15% under the national average at 3.28 nurse hours per resident day, with weekends roughly 10% thinner than weekdays. That thin coverage is the main story here. The current inspection record carries 20 deficiencies, two serious enough to involve harm or jeopardy, plus $39,258 in fines across two penalties. Turnover, at 35.3%, actually beats the national 45.8%, so retention isn't the problem, hours are. The most recent inspection was April 2026. If you're weighing this one, ask how they staff weekends and what those two harm-level citations involved.
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?