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.
Arlington Heights runs 170 certified beds in Fort Worth, and the numbers that stand out are about people, not beds. Nurse staffing sits at 3.27 hours per resident day against a national average of 3.86, weekends drop about 11% below the home's own weekday level, and annual turnover hits 91.6% when the national figure is 45.8%, which means the aide or nurse your mother sees on Tuesday may not be there by spring. The inspection record shows 43 deficiencies, three at harm or jeopardy level and three abuse-related, with $31,539 in fines and a 2/5 health inspection rating. Ownership is for-profit, individual.
Treemont's staff turnover runs about 94 percent a year, roughly double the national average, which tells you the people caring for residents here are, more often than not, new to the building. That instability shows up in the numbers: 41 deficiencies on the current record, five serious enough to involve harm or jeopardy, six tied to abuse, and four fines totaling $63,262. Federal inspectors last visited in July 2025 and rated the home two stars for health inspections, two for quality measures, and one for staffing. It's a for-profit limited liability company with 130 certified beds.
Santa Fe Health & Rehabilitation Center runs 116 certified beds in Weatherford under for-profit LLC ownership, and its staffing is the number that stands out. At 2.89 nurse hours per resident per day, it's about a quarter below the national average of 3.86, and weekends dip roughly 15% below its own weekday level, which matters when families visit and needs don't pause. Annual turnover of 59.7% runs well above the national 45.8%, so familiar faces are hard to keep. The inspection record shows 19 deficiencies, none at harm or jeopardy level and none abuse-related, with the most recent survey in February 2025. CMS rates its staffing 1 out of 5 stars, while inspections and quality measures each land at 3.
Sunflower Park Health Care runs 3.24 nurse hours per resident day, roughly 16 percent under the national average, and weekends dip about 15 percent below its own weekday coverage. That thin staffing sits atop 100 percent annual turnover, every nurse replaced over a year, against a national rate near 46 percent. Inspectors cited 52 deficiencies on the current record, three at harm or jeopardy level and three abuse-related, with $190,538 in fines. The quality measure score looks strong, but it reflects charted care, not the hands available to deliver it. The most recent inspection was January 7, 2026.
Cypress Woods runs lean on nurses, 2.65 hours per resident day against a national average of 3.86, and weekends drop roughly another 10% below its own weekday coverage. That thin floor shows up in the numbers: annual turnover of 64.2% means most of the people caring for your family member are newer than the average aide elsewhere, and CMS itself rates staffing at just one star out of five.
The counterweight is inspection history. Twenty deficiencies on record, one serious enough to involve harm or jeopardy, and a single $22,104 fine, but a four-star health inspection rating and a recent survey from January 2025. This is a for-profit limited liability company where the care, when it happens, has generally satisfied state inspectors, even as the daily staffing margin stays slim. Ask about weekend coverage specifically.
Tomball Rehab & Nursing runs on 2.77 nurse hours per resident day, roughly 28% under the national average, and weekends drop another 8% below its own weekday coverage. That thin staffing shows up in the numbers: 68% annual turnover, well above the 45.8% national figure, and a one-star CMS staffing rating. The hospital district ownership doesn't change what the payroll looks like day to day.
Inspectors cited 26 deficiencies on the current record, two serious enough to involve harm or jeopardy, with $110,495 in fines across two penalties. The most recent inspection was February 2026. Quality measures score well at four stars, but that's a self-reported side of the ledger, and it sits against a two-star inspection history and staffing that's the real story here.
Focused Care At Webster runs a 120-bed for-profit operation in Harris County, and the staffing numbers are the first thing to look at. Nurse coverage sits at 3.56 hours per resident day, about 8% under the national average, and it thins out further on weekends. Annual turnover hits 66.3% against a national 45.8%, so you're looking at a building where two out of three caregivers left within the year.
The inspection record backs that up: 32 deficiencies on file, three at harm or jeopardy level, five tied to abuse, and $34,665 in fines across two penalties. The last inspection was January 30, 2025. Quality measure scores look strong, but that's largely charting, the direct-care hours and the harm-level findings are what a family will actually feel.
Georgia Manor runs on thin staffing, and the numbers show it: 3.01 nurse hours per resident day, roughly a fifth below the national average, with weekends dropping another 14% beneath its own weekday levels. Nearly every employee leaves within a year, turnover sits at 97.7% against a national average of 45.8%, so the people caring for residents are, more often than not, new to the building. The inspection record adds weight: 37 deficiencies, including one at the harm level and three tied to abuse, plus an $8,031 fine. A recent inspection date helps, but it doesn't erase a staffing pattern where continuity is nearly absent.
Reunion Plaza is run by a hospital district, and its inspection record is genuinely clean, five deficiencies on the books, none causing harm or involving abuse, and a recent survey from August 2025. The problem sits elsewhere. Nurse staffing runs 3.20 hours per resident day against a national average of 3.86, and weekends drop roughly 9% below the home's own weekday coverage, so the hours thin out exactly when families tend to visit. Annual turnover of 66.3% is well above the 45.8% national figure, which means aides and nurses are cycling through regularly. Good inspections, thin and unsettled staffing, that combination is what a C reflects here.
Matagorda Nursing & Rehabilitation Center runs a 100-bed for-profit operation in Bay City, and the staffing numbers are where the trouble shows. At 3.50 nurse hours per resident per day, it sits about 9% under the national average, and weekends drop roughly 14% below its own weekday coverage, so the thinnest shifts land when families tend to visit. Annual turnover of 87.8% is nearly double the national rate, meaning the people providing most of the daily care are, statistically, on their way out. Twelve deficiencies sit on the current record, one serious enough to involve harm or jeopardy, along with a $16,555 fine. A May 2025 inspection is recent, so the picture isn't stale.
Focused Care at Hogan Park runs on 2.37 nurse hours per resident day, well under the national average of 3.86, and weekend coverage drops further below its own weekday level. Staff turnover sits at 63% against a national 45.8%, so the people showing up are often new. The current inspection record carries 45 deficiencies, one serious enough to reach harm or jeopardy level, and a $9,110 fine; the last inspection was in January 2025. The government-hospital-district owner is a real distinction from a for-profit chain, but it hasn't translated into steady hands or enough of them. Ask how they hold staffing together on weekends before you decide.
Park Manor Of Cypress Station runs on thin nursing coverage: 3.09 hours per resident per day against a national average of 3.86, and weekends dip about 14% below its own weekday level. That staffing shortfall shows up in a 61% annual turnover rate, well above the 45.8% national figure, and in a one-out-of-five CMS staffing star. The inspection record is harder to look past: 27 deficiencies, seven at harm or jeopardy level, three tied to abuse, and $29,517 in fines, with the most recent inspection dated June 2025. Owned by a for-profit limited liability company, its quality measure star of four out of five stands out against everything else, though strong chart numbers don't change what happens on the floor.
Avir At Houston runs 148 certified beds as a for-profit corporation, and the numbers that matter most here are thin. Nurse staffing sits at 2.79 hours per resident day against a national average of 3.86, roughly 28% below, and weekends drop about 19% below the home's own weekday coverage, so the thinnest shifts are when families tend to visit. The inspection record carries 35 deficiencies, six of them serious enough to involve harm or jeopardy, plus four fines totaling $178,352. The most recent inspection was May 8, 2026. Federal quality measures score well, but that sits against a 1/5 staffing rating and a 1/5 inspection rating. If you're weighing this one, ask specifically how weekend coverage is handled.
Rockdale Estates runs about 2.7 nursing hours per resident each day, roughly 30% under the national average of 3.86, and weekends dip even lower. That thin coverage shows up against a one-star quality measure rating and 13 deficiencies on the current record, including one at the harm or jeopardy level, plus a single fine of $8,018. The inspection history is the bright spot: four stars and a recent April 2025 survey. Turnover at 42.6% is actually a bit better than the national 45.8%, so the problem isn't churn, it's how few hands are scheduled per resident, especially on weekends.
Avir At Sherman runs on 3.06 nurse hours per resident per day, roughly a fifth below the national figure, and weekends drop about 9% below what the home staffs on weekdays. That shortfall shows up in the numbers that matter: the federal staffing rating sits at 1 out of 5, with annual turnover at 87.1% against a national rate near 46%. Thirty-three deficiencies appear on the current record, three tied to abuse, though none reached harm or jeopardy. The last inspection was June 2025, and quality measures actually score well. A for-profit LLC runs the 132-bed home, so ask directly how they hold onto aides and who covers weekends.
Castro County Nursing & Rehabilitation runs on thin staffing: 2.93 nurse hours per resident day, roughly a quarter below the national average, and weekends dip even lower than its own weekdays. Turnover sits at 52.2%, so the people around your relative are frequently new. The inspection record backs up the concern, 53 deficiencies, four serious enough to involve harm or jeopardy, eight related to abuse, plus a $47,932 fine. The quality measure star rating is decent at 4/5, yet staffing earned just 1/5 and inspections 2/5 under CMS. The most recent inspection was May 2025, so this picture is current. This for-profit LLC has real problems filling shifts, and that shows up in the record.
Millbrook runs on thin staffing: 3.08 nurse hours per resident day against a national average of 3.86, and weekends drop about 10% below its own weekday level. The people who do show up don't stay, 69.7% turnover versus 45.8% nationally means most of the staff you'd meet today likely won't be there next year. Inspectors cited 22 deficiencies, one serious enough to involve harm or jeopardy, and fined the home $13,565; the most recent inspection was in February 2025. A for-profit limited liability company owns the place. The quality measures look better than the staffing numbers, but good scores on paper don't change how few hands are on the floor.
Avir At Dallas runs 136 beds under for-profit LLC ownership, and its inspection record is the first thing to notice: 29 deficiencies on file, two of them serious enough to cause harm or jeopardy, plus one abuse-related finding and an $8,018 fine. Staffing is the other trouble spot, 3.28 nurse hours per resident day sits about 15% under the national average, weekends run roughly 14% lighter than weekdays, and turnover hits 75.7% against a national 45.8%, so the people caring for your family member are likely new and often stretched thin. The most recent inspection was July 2025, so the picture is current.
Legend Oaks North runs 3.17 nurse hours per resident day against a national average of 3.86, and weekends drop roughly another 15% below what the home manages Monday through Friday. That thin coverage sits alongside 24 deficiencies on the current record, including two at the harm or jeopardy level and three tied to abuse. Federal inspectors also logged a $41,890 fine, and the most recent inspection is dated April 2026. Throw in for-profit LLC ownership and a 1/5 staffing star rating, and the pattern is consistent: this is a home regulators have cited repeatedly, with staffing that leaves little margin when something goes wrong.
The Heights of Tyler runs 3.13 nurse hours per resident day, roughly 19 percent under the national average, and weekend coverage dips about 12 percent below what it manages on weekdays. That thin margin sits behind a staffing rating of 1 out of 5 even though the home's last inspection in February 2026 produced a 4-star health inspection result. Turnover adds another layer: 56.1 percent of staff leave annually, well above the 45.8 percent national figure. The current record lists 21 deficiencies, one involving harm or jeopardy and one abuse-related, plus a $14,276 fine. Ownership is for-profit partnership. The inspection picture looks better than the day-to-day staffing reality.
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?