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.
High Hope Care Center of Brenham is run by the local hospital district, which in theory can mean steadier resources than a for-profit chain. The numbers don't show that advantage. Nurse staffing sits at 3.51 hours per resident day, about 9% under the national average, and weekends run roughly 12% thinner than weekdays. Staff turnover is 62.2%, well above the national 45.8%, so the people caring for residents change often. Inspections turned up 18 deficiencies, one serious enough to reach harm or jeopardy level, plus a $20,699 fine. The last inspection was March 2026, and the quality and staffing ratings both sit at 2 out of 5.
Park Village runs 3.05 nurse hours per resident day against a national average of 3.86, and weekends drop another 15% below its own weekday levels, so the thinnest coverage lands when families tend to visit. The inspection record carries 52 deficiencies, eight at harm or jeopardy level and seven tied to abuse, with six fines totaling $221,389. CMS has placed it in the Special Focus Facility program, reserved for homes with a persistent pattern of poor care. Quality measures look strong at 5/5, but that score sits alongside a 1/5 on both inspections and staffing, a split worth asking about directly.
Swan Health At Wichita Falls runs 72 certified beds under for-profit LLC ownership, and its nurse staffing sits at 3.24 hours per resident day, about 16% under the national average of 3.86. Weekends dip roughly 6% below the home's own weekday coverage, so the thinnest hours come when families often visit. The record shows 27 deficiencies, none at harm or jeopardy level and none abuse-related, with the most recent inspection on March 20, 2025. CMS gives it 4 stars for health inspections but only 1 for staffing and 2 for quality measures. The tension is clear: surveyors found relatively few serious problems, yet the daily staffing numbers and quality metrics are where the weakness lives, especially on weekends.
River Oaks runs on a staffing model that doesn't hold. Nearly every employee who worked there a year ago is gone now, turnover sits at 95.6% against a national average of 45.8%, and the staffing star rating reflects it at 1 out of 5. That churn shows up in the record: 37 deficiencies, including three at the harm or jeopardy level and five tied to abuse, with two fines totaling $60,095. The health inspection rating is also 1 star, though the quality measure score of 4 suggests some clinical targets are being met on paper. Ownership is a for-profit limited liability company. The most recent inspection was April 17, 2026.
Hillside Medical Lodge runs on thinner staffing than most homes its size, 3.10 nurse hours per resident day against a national average of 3.86, with weekends dropping about 16% below its own weekday levels. That's the number families should weigh hardest, since it's the one that shapes daily care. Turnover sits at 46.7%, roughly in line with the national figure, and the home changed owners within the past year, which often means new management still settling in. The good news: 13 deficiencies on record with none at harm or jeopardy level and none abuse-related, plus a four-star health inspection rating and a recent December 2025 inspection. Quality measures land at two stars.
Larkspur runs 120 beds in Lufkin under corporate for-profit ownership, and the numbers tell a split story. The clinical side looks steady, four out of five stars on health inspections and quality measures, with the most recent inspection in April 2025. But staffing sits at 3.42 nurse hours per resident day, roughly 11% under the national average, and weekends drop about 16% below the home's own weekday coverage. Annual turnover hits 54%, well above the 45.8% national figure, and the record shows 26 deficiencies, including two at harm or jeopardy level and three tied to abuse, plus $30,928 in fines. Strong inspection results and thin, churning staffing don't cancel each other out. Ask how weekends and evenings are actually covered.
Heritage Plaza runs 3.15 nurse staffing hours per resident per day, roughly 19 percent under the national average of 3.86, and weekends drop about 16 percent below its own weekday levels. That thin coverage shows up in the numbers: 57.4 percent annual turnover against a national 45.8 percent, and 43 deficiencies on the current record, including three at the harm or jeopardy level and five tied to abuse. Three fines total $89,633, and the most recent inspection was April 23, 2025. Corporate-owned and certified for 95 beds, it scores well on quality measures but poorly on inspections and staffing, a pattern worth asking about directly before you visit.
Twin Pines runs 3.01 nurse staffing hours per resident day, roughly 22% under the national average of 3.86, and weekends dip about 8% below its own weekday levels. That thin coverage sits behind a one-star staffing rating and a one-star inspection record: 63 deficiencies on file, four serious enough to put residents in harm or jeopardy, one tied to abuse, plus three fines totaling $37,199. The most recent inspection was February 2026, so the record is current, not stale. With 200 beds under corporate for-profit ownership, families should ask directly who is on the floor overnight and on weekends, and request the latest inspection report before deciding.
Golden Estates runs 3.29 nurse hours per resident day, about 15% under the national average, and weekends drop roughly another 20% below its own weekday staffing. Nearly six in ten staff left over the past year, 58.5% turnover against a 45.8% national figure, which means the people caring for your relative are often new and still learning the building. The record shows 32 deficiencies, including six at harm or jeopardy level and two tied to abuse, plus three fines totaling $161,844. That inspection history and thin staffing sit behind the low marks, even though the quality measure score looks better on paper.
Ridgewood At The Woodlands is owned by a hospital district and holds 126 certified beds, but the numbers on its current record are hard to ignore. Nurse staffing sits at 3.63 hours per resident day, about 6% under the national average, and the gap widens on weekends, when coverage drops roughly 16% below its own weekday level. Annual turnover of 70.8% is well above the national 45.8%, which matters because constant churn makes consistent care harder to deliver.
The inspection history backs that up: 21 deficiencies on record, including two at the harm or jeopardy level and one tied to abuse, plus a $14,020 fine. Its last inspection was June 2025.
Cedar Creek runs on thin staffing. At 3.35 nurse hours per resident day, it sits about 13 percent under the national average, and weekends drop roughly 18 percent below what the home manages during the week, so the thinnest coverage lands when families tend to visit. The bigger number is turnover: 94.4 percent of staff leaving in a year, more than double the national rate, which means the aides and nurses who know your mother's routines are constantly being replaced by people learning them for the first time. Forty total deficiencies on record, three tied to abuse, with the last inspection in May 2026. Corporate-owned, 62 beds. Ask to see weekday and weekend staffing schedules side by side before you decide.
Legacy At Jacksonville runs a 101-bed for-profit operation that just got through a health inspection with no findings at the harm or jeopardy level, which is worth something, 11 deficiencies on the record and only one tied to abuse, none serious enough to endanger a resident. But the nursing side tells a different story: 3.17 nurse hours per resident per day against a national average of 3.86, a staffing rating of 1 out of 5, and weekends running about 13% thinner than weekdays. Quality measures land at 2 out of 5, with two fines totaling $27,345 on the books. Inspection day looked fine; the daily staffing math is the part I'd ask about.
Brookdale Lakeway runs on thinner staffing than most homes its size, 3.37 nurse hours per resident day against a national average of 3.86, and weekends drop roughly 17% below what it manages Monday through Friday. That gap matters because care doesn't pause on Saturdays. Annual turnover sits at 55.3%, well above the 45.8% national figure, so the aides and nurses your family member sees are cycling through faster than average. The inspection record backs this up: 23 deficiencies, three serious enough to involve harm or jeopardy, two tied to abuse, and $91,420 in fines. The most recent inspection was in August 2025. Quality measures score well, but the staffing and oversight numbers are where the concern lives.
Legend Oaks in Waxahachie runs 121 certified beds under individual for-profit ownership, and the staffing picture is the first thing to notice: 3.55 nurse hours per resident day against a national average of 3.86, with weekends dropping roughly 19% below its own weekday levels. That thin weekend coverage matters, because turnover sits at 57.6%, well above the 45.8% national figure, meaning the aides and nurses at the bedside keep changing. The inspection record backs it up: 35 deficiencies, five serious enough to put residents in harm's way, one tied to abuse, and $41,215 in fines across three actions, with the most recent inspection in February 2026.
Cypress Creek runs 122 certified beds under individual for-profit ownership, and its staffing is the number that stands out: 3.23 nurse hours per resident day, roughly 16% under the national average, with weekends dipping about 16% below its own weekday levels. Annual turnover sits at 66.7% against a national average of 45.8%, so the aides and nurses in the building change often. The record shows 20 deficiencies, including 2 at harm or jeopardy level and 3 abuse-related, plus $74,263 in fines across two penalties; the most recent inspection was May 29, 2025.
Mineral Wells Nursing & Rehabilitation has a split personality in the federal data. Its last inspection was in April 2025, and it earned a top five-star health inspection rating with twelve deficiencies on record, one of which rose to the harm or jeopardy level and one tied to abuse. Where it struggles is staffing: 3.05 nurse hours per resident day sits about 21 percent under the national average, weekend coverage drops roughly 11 percent below its own weekdays, and annual turnover runs 95.6 percent against a national 45.8. That churn is the number that should worry you most, because it means the people caring for your relative are, more often than not, new to the building.
Paradigm At The Creek runs 120 certified beds in Wharton under for-profit LLC ownership, and the staffing numbers are the first thing to notice. Its 3.23 nurse hours per resident day sit well under the national average, weekend coverage drops further below its own weekday level, and more than half the nursing staff turned over in a year, a rate noticeably above the national figure. The inspection record backs that up: 38 deficiencies, seven serious enough to put residents in harm's way, four tied to abuse, and four fines adding up to just over $52,000. All three CMS star ratings sit at the lowest tier. If you're considering this one, ask hard questions about who's actually on the floor nights and weekends.
If you're considering Oakmont Healthcare And Rehabilitation Center Of Katy, the staffing numbers are what stand out first. Nurses provide 2.91 hours of care per resident per day, roughly a quarter below the national average, and weekend coverage drops about 10% below what the home staffs on weekdays. Annual turnover runs 92.6%, more than double the national rate of 45.8%, meaning most of the people caring for residents are new to the building.
The inspection record shows 23 deficiencies, including one at the harm or jeopardy level and one abuse-related, with a $12,740 fine. The last inspection was November 2024, so the record is reasonably current. Ownership is a for-profit corporation.
Avir At Stephenville runs 102 certified beds and leans on a nursing staff that logs 3.33 hours per resident day, roughly 14% under the national average, with weekends about 13% thinner than its own weekdays. That shortfall shows up in the numbers: 82.3% annual turnover against a national 45.8%, a one-star staffing rating, and 31 deficiencies on the current record, including two at harm or jeopardy level and four tied to abuse. A single fine of $204,614 sits on the books, and the most recent inspection, in July 2025, produced a two-star health inspection result. Ownership is corporate and for-profit, which may help explain the staffing math.
Avir At Western Hills runs on lean nurse staffing: 3.16 hours per resident day against a national average of 3.86, with weekends about 13% thinner than weekdays. That gap shows up in the payroll, 75% of staff turned over in a year, well above the 45.8% national figure, and it's a big reason the staffing rating sits at 1 out of 5 even though quality measures score 4. The inspection record carries 31 deficiencies, including three at harm or jeopardy level and two tied to abuse, plus $16,562 in fines. The most recent inspection was May 2025, so the picture is current, and this corporate-owned home is licensed for 120 beds.
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?