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 Schertz runs on 2.93 nurse staffing hours per resident day, roughly a quarter below the national average of 3.86, and weekend coverage dips about 12% below its own weekday level. Staff turnover sits at 79.4% against a national average of 45.8%, so the people caring for residents change constantly. The inspection record shows 65 deficiencies, including three at the harm or jeopardy level and five tied to abuse, with $39,676 in fines and a most recent inspection dated February 27, 2026. Ownership is a for-profit limited liability company. The quality measure score looks strong on paper, but that number rests on a staffing and inspection picture that is far weaker.
San Gabriel Rehabilitation and Care Center runs 142 beds in Round Rock under for-profit LLC ownership. Nurse staffing sits at 3.18 hours per resident day, roughly 18% under the national average, and weekends run thinner still, about 7% below what the home staffs on weekdays. Turnover is 55.1%, close to ten points above the national rate, which means the aides and nurses your family member sees may keep changing.
The inspection record is the harder part: 32 deficiencies, three at harm or jeopardy level, six tied to abuse, and $19,393 in fines. CMS gave it one star each for health inspections and staffing. The most recent inspection was July 2025, so the record is current, not stale.
Magnolia Crossing runs on a government-hospital-district license and 128 beds, and its last inspection wrapped in May 2025 with a four-star health inspection rating, genuinely the strongest number here. The staffing numbers tell a different story. At 3.26 nurse hours per resident day, it sits about 16% under the national average, and weekends drop roughly 11% below its own weekday level, so the thinnest coverage lands when families tend to visit. Staff turnover hits 58.9% against a 45.8% national figure. Twenty deficiencies sit on record, none at harm level, though three are abuse-related. A strong inspection record is carrying a lot of weight for a building where people keep leaving.
St. Giles runs about 124 beds in El Paso, and the staffing numbers are where the trouble starts. At 3.61 nurse hours per resident day it sits roughly 7% under the national average, and weekend coverage drops another 9% below what it manages on weekdays. The bigger red flag is turnover: 93.9% of staff leave within a year, against a national average near 46%, that's an entirely new workforce roughly every twelve months. The current record carries 44 deficiencies, two tied to abuse, though none reached harm or jeopardy level and the last inspection was recent.
Big Spring Center For Skilled Care runs on thin nursing coverage: 3.43 hours per resident day against a national average of 3.86, with weekends dropping about 13% below its own weekday level. The bigger warning sign is turnover, 91.7% annually, roughly double the national rate, meaning nearly the entire nursing staff cycles through in a year. Inspections look decent on paper with a 4-star rating and a recent visit, but the record still carries 27 deficiencies, including one at the harm level and four tied to abuse, plus an $8,184 fine. Corporate-owned and certified for 120 beds, this is a home where you'd want to ask hard questions about who's actually on the floor at 2 a.m. on a Sunday.
Buena Vida Nursing and Rehab runs about 2.5 nurse hours per resident each day, roughly a third below the national average, and weekends dip even further. That thin coverage sits alongside a 94.2% annual turnover rate, more than double the national figure, meaning the people caring for residents are, more often than not, new to the building. Inspections turned up 15 deficiencies, one involving actual harm and one tied to abuse. The quality scores look strong, but those measure clinical outcomes, not whether enough hands are on deck. Ownership is corporate and for-profit.
Lakeshore Village runs on thinner staffing than most Texas nursing homes can claim as an excuse. At 3.19 nurse hours per resident day, it sits about 17% under the national average, and weekends drop roughly 15% below what the building itself manages Monday through Friday. That matters more than the quality measure score suggests, because 52 deficiencies sit on the current record, seven at harm or jeopardy level, two tied to abuse, with $107,407 in fines and a one-star inspection rating. Annual turnover of 52.1% means more than half the nursing staff leaves each year, against 45.8% nationally. Hospital district ownership hasn't translated into stability here, and the April 2026 inspection is the only recent look regulators have taken.
Southland Rehabilitation and Healthcare Center runs 150 certified beds in Lufkin under corporate, for-profit ownership, and the staffing numbers are where the trouble shows. At 3.24 nurse hours per resident day, it sits roughly 16% under the national average of 3.86, weekends drop about 17% below its own weekday level, and annual turnover hits 51.6% against a national 45.8%. That thin, churning coverage lines up with a 1-out-of-5 staffing rating and a 2-out-of-5 inspection rating. The record carries 22 deficiencies, three at harm or jeopardy level, one tied to abuse, and two fines totaling $188,884. Quality measures score 4 out of 5, but good marks on paper don't offset hands-on care that runs consistently short.
Focused Care At Orange runs 120 beds under for-profit LLC ownership, and the staffing numbers are where the trouble starts: 3.03 nurse hours per resident day against a national average of 3.86, with weekends about 16% thinner than weekdays. Turnover of 40.7% is actually better than the national 45.8%, so the issue isn't churn, it's raw coverage. The inspection record is heavier: 29 deficiencies, four at harm or jeopardy level, three tied to abuse, and $193,434 in fines across three penalties. A 1/5 inspection rating and 1/5 staffing rating sit alongside a more forgiving 3/5 on quality measures. The most recent inspection was April 2025, so this picture is current.
Broadway Nursing & Rehabilitation runs 237 certified beds in San Antonio under for-profit LLC ownership, and the staffing numbers are the first thing to look at: 3.65 nurse hours per resident day, under the national average, with weekends about 13% leaner than weekdays. Annual turnover sits at 51.4%, so more than half the nursing staff leaves each year. The inspection record shows 50 deficiencies, including 3 at harm or jeopardy level and 8 abuse-related, with two fines totaling $84,129. CMS rated staffing 1 out of 5 stars and health inspections 2 out of 5, though quality measures scored 4. Ask about weekend coverage and how they screen and supervise staff.
Longview Hill is a hospital-district home with 198 beds, and the numbers show a building under real strain. Nurse staffing sits at 3.36 hours per resident day, about 13% under the national average, and weekends drop roughly another 10% below what the home itself provides on weekdays, so the thinnest coverage lands exactly when families tend to visit. Staff turnover near 50% means the aides and nurses caring for residents are often new to the job. The inspection record backs that up: 60 deficiencies, four serious enough to put residents in harm's way, three tied to abuse, and more than $225,000 in fines.
Lily Springs runs a 116-bed for-profit home in Lampasas, and the numbers behind its federal record are worth walking through. Nurse staffing sits at 3.53 hours per resident per day, roughly 8% under the national average, and it drops another 9% on weekends, so the thinnest coverage lands exactly when families tend to visit. Staff turnover is 57.6% against a national 45.8%, meaning more than half the nursing workforce turns over in a year. The inspection record shows 56 deficiencies, six of them at harm or jeopardy level and three tied to abuse, with $86,207 in fines. The most recent inspection was May 2025.
Focused Care At Mount Pleasant runs 122 beds under for-profit LLC ownership, and the numbers that stand out aren't the quality measures, those actually rate well above average. The problem is everything around them. Nurse staffing sits at 3.16 hours per resident day, about 18% under the national figure, with weekends dipping roughly 8% below the home's own weekday level. Staff turnover hits 48.4%. The inspection record carries 82 deficiencies, including four at the harm level and six tied to abuse, plus five fines totaling $223,296, and the most recent inspection was July 2025. High quality scores can't offset thin coverage and that citation history.
Avir At River Valley is run by the hospital district, and its recent inspection history is the strongest part of the picture, a four-out-of-five health inspection rating with 25 deficiencies on record, none of them rising to actual harm or jeopardy. But staffing is where the numbers get thin. At 3.08 nurse hours per resident day, it sits roughly 20% under the national average of 3.86, weekend coverage drops about 8% below its own weekday level, and annual turnover runs 76% against a national 45.8%. Two abuse-related deficiencies also appear on the current record. The quality measure rating lands mid-range. If you're weighing this one, ask how they hold a shift together on a Sunday.
Gainesville Convalescent Center runs on thin nurse staffing, 3.08 hours per resident day against a national average near 3.86, and weekends are roughly 11% leaner than weekdays, so coverage thins exactly when families tend to visit. The county hospital district owns the 112-bed home, and its inspection record shows 50 deficiencies, four at harm or jeopardy level and four tied to abuse; two fines total $99,075. Staff turnover of 73.8% sits well above the 45.8% norm, meaning many caregivers are new. Quality measures score well, but surveys and staffing don't, which is where the trouble actually lives.
Riverview runs lean on nursing hours, 3.17 per resident day against a national average of 3.86, and weekends dip even further, about 9% below its own weekday coverage. That thinness shows up in the workforce itself: 67.7% annual turnover, well above the 45.8% norm, meaning roughly two of every three caregivers are new to the building each year. Inspectors have logged 38 deficiencies, eight serious enough to put residents in harm's way and seven tied to abuse, with $156,748 in fines across four actions. The last survey was March 2025, so the record is current. A for-profit limited liability company owns the place, and the inspection history is where the trouble concentrates.
Heritage Place Of Decatur runs 60 certified beds as a for-profit corporation, and its last inspection on November 21, 2025 sits fairly recent. The inspection history is the strong part: 13 deficiencies on record, none at harm or jeopardy level and none abuse-related, which lines up with a 4-out-of-5 health inspection rating. Staffing is where the picture shifts. At 2.99 nurse hours per resident day, it runs about 23% under the national average of 3.86, and weekends drop roughly 16% below its own weekday level, thin coverage getting thinner when families tend to visit. Quality measures come in at 2 out of 5. Ask how they cover weekends before you decide.
Hilltop Park runs 132 beds in Weatherford under limited-liability, for-profit ownership, and the staffing numbers are the first thing I'd flag. At 3.62 nurse hours per resident day, it sits about 6% under the national average, and weekends drop roughly another 10% below its own weekday levels, so the thinnest coverage lands exactly when families tend to visit. Turnover tells a related story: 73.3% of nursing staff leaving annually, against a national 45.8%. The record shows 22 deficiencies, including two at harm or jeopardy level and one tied to abuse, plus a $102,810 fine. Last inspection was September 2025. Resident care measures score well; staffing and inspection results do not.
Richmond Health Care Center runs about 3.66 nurse hours per resident day, roughly 5% under the national average, and weekend coverage dips another 8% below its own weekday level. Staff turnover sits at 65.5%, well above the 45.8% national figure, which is a lot of churn for a 92-bed nonprofit home. Its inspection record shows 23 deficiencies, including one at the harm level and one abuse-related, plus two fines totaling $78,036. Inspections were current as of September 2025, and the health and quality ratings hold at 4 stars each. The staffing number is where this one separates from the pack.
Avir At Meadow Creek runs on thin staffing: 3.11 nurse hours per resident day against a national average of 3.86, with weekends about 11% leaner than weekdays. Turnover sits at 45.9%, essentially identical to the national rate, so retention isn't the outlier here, the raw hours are. The inspection record is the bigger problem. Twenty-two deficiencies, six of them serious enough to involve harm or jeopardy, two tied to abuse, and $119,203 in fines across two events. The most recent inspection was April 2025, so the picture is current, not stale. Families should ask directly how those harm-level findings were corrected and who is on duty on Saturday and Sunday.
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?