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.
Laredo West runs on 3.12 nurse hours per resident per day, roughly 19% under the national average of 3.86, and weekends drop about 13% below what the home itself staffs on weekdays. Turnover sits at 47.3%, slightly above the national 45.8%. Those numbers sit behind a one-star health inspection rating and a record of 31 deficiencies, three of them at harm or jeopardy level and four tied to abuse, with two fines totaling $49,719. The most recent inspection was April 2025, so the record is current, not stale. Government hospital district ownership doesn't change what the staffing and inspection data show. Families should ask direct questions about weekend coverage and the abuse-related findings before deciding.
Paradigm Northwest runs 148 beds in Houston under corporate for-profit ownership, and its nurse staffing sits at 2.96 hours per resident day, roughly a quarter below the national average of 3.86. Weekends dip about 11% below its own weekday levels, and annual turnover of 52.3% outpaces the national 45.8%, so the aides and nurses your family would see are cycling through steadily. Its inspection record carries 33 deficiencies, five serious enough to involve harm or jeopardy and one tied to abuse, with four fines totaling $51,400. The most recent inspection was December 2025, so that picture is current. CMS rates staffing and health inspections 1 out of 5; quality measures land at 3.
Guadalupe Valley runs 148 certified beds in Seguin under nonprofit ownership, which often signals stability, but the numbers here tell a more mixed story. Nurse staffing sits at 3.13 hours per resident day, roughly 19% under the national average of 3.86, and weekends drop about 12% below the home's own weekday levels, so coverage thins out exactly when families tend to visit. Staff turnover hits 48.1%, a bit above the national rate, while the inspection record shows 50 deficiencies, including two at the harm or jeopardy level and two tied to abuse, plus one $75,450 fine. The most recent inspection, in March 2026, is recent enough to reflect current conditions rather than old ones.
Desoto Nursing & Rehabilitation Center runs about 2.96 nurse hours per resident day, roughly a quarter below the national average of 3.86, and staffing thins out further on weekends. The bigger red flag is turnover: 96.6% of nursing staff leave within a year, against a national rate near 46%, which makes it hard to keep consistent caregivers who know the residents. The 18 deficiencies on record include one at the harm or jeopardy level, and a single fine of $12,740 has been levied. Quality measures look strong at 5/5 stars, but staffing sits at 1/5, and that gap between good outcomes on paper and thin, constantly changing staff is what drives the low overall score.
Grace Pointe Wellness Center runs 154 certified beds in El Paso under corporate for-profit ownership, and the numbers don't line up in the family's favor. Nurse staffing sits at 3.62 hours per resident day, roughly 6% under the national average, and weekends drop about 19% below what the home staffs on weekdays, so the coverage your relative gets on a Saturday is thinner than what the inspection record assumes. That record carries 53 deficiencies, including 5 at harm or jeopardy level and 8 tied to abuse, plus two fines totaling $76,770. The quality measure score looks strong, but quality measures are self-reported, and a 1-out-of-5 inspection rating alongside a 1-out-of-5 staffing rating is what the state actually found when it walked through the door in March 2026.
Focused Care At Humble runs 134 certified beds in Harris County under corporate for-profit ownership, and the staffing numbers are where the trouble shows. At 3.23 nurse hours per resident day, it sits about 16% under the national average of 3.86, and weekends drop roughly 12% below its own weekday level. Nearly half the staff turned over last year, 49.3% against a national 45.8%. The 17 deficiencies on record include 3 at harm or jeopardy level, with two fines totaling $19,410; the last inspection was in May 2025. Quality measures score well, but thin, churning staffing is the pattern a family should weigh hardest here.
Briarcliff runs on about 3.25 nurse hours per resident per day, roughly 16% under the national average, and the weekend gap is real, weekends come in around 12% below what the building staffs on weekdays. Turnover sits at 53% against a national 45.8%, so nearly half the nursing staff leaves each year. The inspection record shows 46 deficiencies, including 5 at the harm or jeopardy level and 7 tied to abuse, with four fines totaling $63,129. The last inspection was May 2026. Ownership is a nonprofit corporation, and with 194 beds, there's plenty of room for the numbers to move. Right now, though, they aren't moving in the right direction.
Avir At Jefferson runs 116 certified beds under for-profit LLC ownership, and the staffing numbers are where the trouble starts. At 3.29 nurse hours per resident day, it sits roughly 15% under the national average of 3.86, and weekends drop about 14% below its own weekday level, meaning the thinnest coverage lands when families are most likely to visit.
Turnover tells a similar story: 58.8% annually against a national 45.8%, so more than half the nursing staff left within a year. Behind that churn sits an inspection record with 44 deficiencies, including two at the harm level and one tied to abuse, plus $16,498 in fines. The most recent inspection was December 2025. Three 2-out-of-5 stars across health, quality, and staffing round it out.
Sixty-one deficiencies sit on Focused Care At Linden's record, seven of them serious enough to involve harm or jeopardy, and four tied to abuse. Federal inspectors wrote four fines totaling $391,545. The company runs this 131-bed home for profit, and the health inspection rating is one out of five stars.
Staffing is the other trouble spot: 2.61 nurse hours per resident day, well under the national average of 3.86, with weekends about 12% thinner than weekdays. Turnover runs 53.6% a year against a 45.8% national figure, so caregivers keep cycling out. The quality measure score of four stars reflects charted clinical care, but that's measured on paper, the inspection record and thin staffing describe what happens on the floor.
Eagle Pass Nursing and Rehabilitation runs on 3.08 nurse staffing hours per resident day, roughly a fifth below the national average, and weekends drop about 17% below what the home staffs during the week. The record shows 26 deficiencies, three of them serious enough to reach harm or jeopardy, plus three abuse-related citations and $17,419 in fines. A recent inspection in May 2025 and a strong health inspection star rating suggest the home does get looked at closely, which makes the thin staffing harder to explain. Government hospital district ownership doesn't change the arithmetic here: fewer hands per resident, especially on weekends, is the number families will feel.
Heritage Trails is a 122-bed for-profit home in Cleburne, and its inspection history is genuinely decent, four out of five stars, with a survey done in August 2025. The staffing is where it comes apart. At 2.76 nurse hours per resident day, it runs about 28% under the national average, and weekend coverage drops roughly 13% below its own weekday level, which matters most when families visit and problems tend to surface. Turnover sits at 53.2%, higher than the 45.8% national figure. Twelve deficiencies are on the current record, three of them at the harm level and one tied to abuse, with seven fines totaling $67,124.
The Heights At Medical Center runs on 3.00 nurse hours per resident day, roughly 22% under the national average, and its own weekend coverage drops another 10% below weekdays. Staff turnover sits at 56.3%, well above the 45.8% national figure, so the people left covering those shifts are often new. Inspectors cited 44 deficiencies, three of them serious enough to put residents in harm's way, and fined the home twice for $22,052 combined. A for-profit LLC operates the 134-bed building, and its last inspection was August 2025. Resident outcome measures look better than the staffing does, but the hands-on care numbers are what families feel day to day.
Memphis Convalescent Center runs on 3.39 nursing hours per resident day, roughly 12% under the national average, and weekends dip about 9% below its own weekdays, so the thinnest coverage lands when families tend to visit. Every aide and nurse on staff turned over last year, against a national rate near 46%, which means the people caring for residents are largely new to the building and to each other. The record shows 20 deficiencies, including 3 at harm or jeopardy level and 4 tied to abuse, plus one fine of $19,754; the last inspection was November 2025. Hospital-district ownership doesn't change what those numbers say about daily care.
Focused Care At Midland runs about 2.95 nursing hours per resident each day, roughly a quarter below the national average of 3.86, and weekends dip another 13% under its own weekday numbers. That thin coverage shows up on the record: 45 deficiencies, one serious enough to reach harm or jeopardy level, with a $9,281 fine and a June 2025 inspection. Staff turnover sits at 41.2%, a bit better than the 45.8% national figure, though the CMS star ratings land at 2 out of 5 across health inspections, quality measures, and staffing. For-profit corporate ownership and 106 beds. Ask about weekend coverage specifically, and request the plan of correction for that harm-level finding.
Twilight Home in Corsicana runs about 3.30 nurse hours per resident per day, roughly 14% under the national average, and weekends dip another 12% below its own weekday staffing. The bigger problem is turnover: 94.9% of staff leave each year, more than double the national rate, so the people providing that already-thin care are constantly new. Inspections look strong on paper, a 4 out of 5 star rating, with the most recent visit in May 2025, but the record still carries 10 deficiencies, one of them serious enough to involve harm or jeopardy, plus a $12,795 fine. CMS rates the staffing domain 1 out of 5 stars, and that's the number that matters most day to day.
Winnie L Nursing & Rehabilitation runs on thin staffing and high turnover, and both numbers are worth sitting with. Nurses provide 3.27 hours per resident day against a national average of 3.86, and weekends drop about 13% below what the home manages on weekdays. Staff turnover sits at 87.5%, nearly double the national rate, which means the people caring for residents are constantly new. The inspection record shows 34 deficiencies, five serious enough to involve harm or jeopardy, plus one abuse-related finding and $51,479 in fines; the last inspection was May 2025. Ownership is a for-profit corporation. Quality measure scores look strong, but that's the part of the record least connected to how the building is actually run day to day.
Huebner Creek runs on thin nursing coverage. At 2.52 nurse hours per resident day, it sits about 35% under the national average of 3.86, and weekends drop roughly 24% below what the home already staffs on weekdays. That matters when you're thinking about who answers a call light on a Saturday.
The inspection record is heavier than the staffing picture alone would suggest: 54 deficiencies, including one at the harm or jeopardy level and two tied to abuse. The last inspection was March 2026, so the findings are recent, not stale. A single fine of $14,327 is on file. Limited liability ownership, 146 beds, and quality measures that rate better than the staffing and inspection scores, a gap worth asking about directly.
Wesley Woods in Waco runs 120 certified beds under corporate ownership, and the staffing numbers tell a story worth paying attention to. Nurses provide 3.51 hours per resident per day, roughly 9% under the national average, and weekend coverage drops another 7% below the home's own weekday level, so care thins out exactly when families tend to visit. Staff turnover hits 56.3%, well above the 45.8% national figure, which means fewer familiar faces and more training burden. The current inspection record carries 26 deficiencies, including three at the harm or jeopardy level and one abuse-related finding. All three CMS star ratings, health inspections, quality measures, staffing, sit at 2 out of 5.
Bastrop Lost Pines is run by a hospital district, which you might expect to mean steadier resources, but the numbers don't show that. Nurses give about 3.10 hours of care per resident each day against a national average of 3.86, and weekends run roughly 13 percent thinner than weekdays, so coverage depends heavily on when you visit. The current inspection record carries 27 deficiencies, three of them serious enough to put residents in harm's way and two tied to abuse, with $101,156 in fines across three cases. Turnover sits at 46.8 percent, slightly worse than the national figure, and the most recent inspection was January 30, 2026.
Villa Toscana At Cypress Woods runs on 3.30 nurse hours per resident day, roughly 14 percent under the national average, and weekends drop another 11 percent below its own weekday staffing. The bigger problem is turnover: 91.4 percent of staff leave within a year, double the national rate, which means whoever is at the bedside is often new to the building. Inspectors have cited 39 deficiencies on the current record, including four at the harm level and four related to abuse, with $37,827 in fines across three penalties. The 4/5 quality measure score reflects resident care measures, not the safety record or the thin staffing that surrounds it.
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?