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 Fort Worth runs on 3.06 nurse hours per resident day, roughly a fifth below the national average, and weekend coverage drops another 11% below what it manages on weekdays. Staff turnover sits at 71.6%, well above the 45.8% national figure, so the people providing most of the hands-on care are frequently new to the building. The inspection record is where the real weight sits: 42 deficiencies, nine serious enough to put residents in harm's way, six tied to abuse, and six fines totaling $272,419, with the most recent inspection in April 2025. High marks on quality measures don't offset a staffing and compliance picture like that.
The Crescent runs on thinner staffing than most homes in Texas and across the country, 3.61 nurse hours per resident day against a national average of 3.86, and it gets even thinner on weekends, when coverage drops about 13% below its own weekday level. That matters when you consider the inspection record: 41 deficiencies, seven of them serious enough to put residents in harm's way, seven tied to abuse, and $107,921 in fines across seven separate penalties. Annual staff turnover sits at 59.4%, well above the 45.8% national figure, so the people caring for your family member are probably new and likely to leave. The most recent inspection was February 26, 2026.
The Suites Pasadena runs on thinner nurse staffing than most homes nationally, 3.66 hours per resident day against a 3.86 average, and weekends drop about 13% below its own weekday coverage, which matters when a resident needs help on a Sunday. Turnover sits at 75.5% against a 45.8% national figure, so the people caring for your family member are likely to keep changing. Behind the numbers: 46 deficiencies on the current record, five at harm or jeopardy level and two tied to abuse, plus nine fines totaling $324,713. State inspectors were last in on January 16, 2026.
Willow Park Rehabilitation and Care Center runs 125 certified beds under corporate for-profit ownership, and its inspection record looks solid on paper: a 4-out-of-5 health inspection rating, a recent April 2025 survey, and 24 deficiencies with none at the harm or jeopardy level. Staffing is where the picture changes. At 3.49 nurse hours per resident day, it sits about 10% under the national average, and weekends drop roughly 9% below its own weekday coverage. Annual turnover hits 75%, well above the 45.8% national figure, and there's one abuse-related deficiency on record. Stable inspection results paired with thin, churning staffing is the pattern worth weighing if your family is considering this home.
Treviso Transitional Care runs 140 beds in Longview under for-profit LLC ownership, and the numbers tell a story worth hearing. Nurse staffing sits at 3.23 hours per resident day against a national average of 3.86, roughly 16% thinner, and weekends drop about 12% below what the home itself staffs on weekdays. Annual turnover of 53.4% outpaces the 45.8% national figure. Its inspection record carries 52 deficiencies, four at harm or jeopardy level and six abuse-related, plus a $150,705 fine; the most recent inspection was August 26, 2025. Resident outcome measures score well, but the hands-on care and safety picture is where the concern lives.
Avir At Johnson City runs 60 beds under corporate ownership, and the numbers tell a fairly consistent story. Nurse staffing sits at 3.44 hours per resident day, about 11% under the national average, and weekend coverage drops another 11% below its own weekday levels, so care is thinnest exactly when families tend to visit. Staff turnover of 65.5% is well above the 45.8% national figure, which matters because residents see a rotating cast rather than familiar faces.
The inspection record is the harder part: 28 deficiencies, six of them serious enough to reach harm or jeopardy level, and $74,691 in fines across three penalties. The most recent inspection was June 4, 2026. Quality measures score mid-range, but staffing and health inspections both sit at one star out of five.
Fortress Nursing and Rehabilitation runs 2.84 nurse hours per resident day, roughly 27% under the national average, and weekend coverage drops about 22% below its own weekday levels. That thin staffing sits alongside a 79.7% annual turnover rate, well above the 45.8% norm, so the people caring for residents change often. The current record carries 19 deficiencies, four of them at the harm or jeopardy level and three tied to abuse, plus a $17,014 fine; the most recent inspection was January 22, 2026. Ownership is a for-profit limited liability company. Quality measures score well, but staffing and inspection findings are where the trouble shows.
Honey Grove Nursing Center runs 102 certified beds under corporate for-profit ownership, and the staffing numbers are where things get uncomfortable. At 3.50 nurse hours per resident per day, it sits roughly 9% under the national average of 3.86, and weekends drop another 8% below its own weekday level, so the thinnest coverage lands exactly when families tend to visit. The inspection record backs that up: 40 deficiencies, four serious enough to reach harm or jeopardy level, and two fines totaling $213,797. No abuse citations appear on the current record, and the most recent inspection was in December 2025, so the picture is current rather than stale.
Heritage Gardens runs on thin staffing: 3.15 nurse hours per resident day against a national average of 3.86, and weekends drop about 17% below its own weekday levels. That's a real gap when a resident needs help on a Saturday. Annual turnover sits at 59.7%, well above the 45.8% national figure, so the aides and nurses in the building keep changing. The current inspection record shows 22 deficiencies, one at harm or jeopardy level and four abuse-related, with a $38,840 fine and the most recent inspection in November 2024. The quality measure score looks strong, but that's built from chart data, not from how the place is actually staffed day to day.
Highland Pines is run by a hospital district, and its 171 beds get 3.70 nursing hours per resident day, about 4% under the national average, with weekends running roughly 16% lighter than weekdays. Staff turnover sits at 46.2%, right at the national figure, so this isn't a retention crisis; it's thin coverage that thins further when you're most likely to visit. The inspection record is the harder read: 48 deficiencies, including one at harm or jeopardy level and four tied to abuse, with a $17,629 fine and a survey completed January 14, 2026. Two stars on health inspections and one on staffing tell you where the weight lands.
Park Manor of McKinney is owned by a hospital district, and its clinical quality scores look decent, four out of five stars on CMS's quality measures. The problem is the people doing the work. Nurse staffing sits at 3.25 hours per resident per day, about 16 percent under the national average, and weekends run roughly 19 percent thinner than weekdays, so your mother's Sunday care isn't the same as her Tuesday care. Staff turnover is 62.4 percent against a national 45.8 percent, meaning most of the aides who know her will be gone within a year. Eighteen deficiencies sit on the current record, two serious enough to involve harm, with one fine of $29,426.
Fair Park runs about 2.97 nurse hours per resident day, roughly a quarter below the national average of 3.86, and weekends drop another 20% beneath its own weekday level. That thin coverage is the big number here: staff turnover sits at 91.8% against a national average near 46%, so nearly the entire nursing staff turns over in a year. The current record shows 29 deficiencies, none at harm level but two tied to abuse, and the last inspection was in May 2025. For-profit corporate ownership and a 1-out-of-5 CMS staffing rating back up what the hours already suggest, ask who's actually on the floor on a Sunday.
The Chateau Waco, a 123-bed hospital-district home, has a staffing problem that runs deeper than its 3.48 nurse hours per resident day, roughly 10% under the national average. Weekend coverage drops about 15% below the home's own weekday level, and 73.6% of staff left over the past year, well above the 45.8% national rate. On inspections, the record shows 33 deficiencies, six at harm or jeopardy level and one abuse-related, with four fines totaling $72,056 and a one-star health inspection rating. The quality measure score of four stars stands out against a one-star staffing rating, which tells you the clinical numbers look better on paper than the floor coverage suggests.
Vista Hills runs on thin staffing: 3.44 nurse hours per resident day, about 11% under the national average, and weekends drop roughly 15% below what the home manages on weekdays. The bigger problem is retention, 95.8% annual turnover means the aides and nurses caring for residents are, on average, gone within about a year, against a national rate near 46%. Inspectors have cited 72 deficiencies, including five tied to abuse and one at the harm level, and fined the corporate owner $40,465. The quality measure score looks good on paper, but that's family-reported data, and it sits alongside a one-star staffing rating.
Bay Ridge Healthcare Center runs 58 certified beds in La Porte under corporate for-profit ownership, and the numbers on its current record are worth a close look. Nurse staffing sits at 3.71 hours per resident day, a bit under the national average, and weekend coverage drops roughly 13% below the home's own weekday level, the stretch when families often can't visit. Staff turnover runs 57.7% against a national 45.8%, so the people caring for your relative may keep changing. The inspection record shows 32 deficiencies, six at harm or jeopardy level and six abuse-related, with $18,054 in fines. The most recent inspection was February 2025.
Avir At Azalea Heights runs 120 certified beds in Tyler under for-profit LLC ownership, and its nurse staffing sits at 2.60 hours per resident day, roughly a third below the national average of 3.86. Weekends dip about 11% below its own weekday levels, so coverage thins out exactly when families tend to visit. The inspection record shows 25 deficiencies, three of them serious enough to put residents at harm or jeopardy, with two fines totaling $27,550 and a December 2025 inspection. Staff turnover of 43.8% is close to the national 45.8%, so the problem isn't retention so much as how few hands are scheduled per resident.
Ballinger Healthcare and Rehabilitation Center runs on thin staffing. At 3.04 nurse hours per resident per day, it sits about 21% under the national average of 3.86, and weekends drop roughly another 11% below its own weekday level, so the thinnest coverage lands when families tend to visit. The bigger flag is turnover: 96.1% annually, meaning the aides and nurses caring for residents are, in large part, new to the building, against a national rate near 46%. Its 13 deficiencies include one abuse-related citation but none at the harm level, and the last inspection was November 2024. For-profit LLC ownership. Ask about weekend coverage and how long current staff have actually been there.
Avir At Winnsboro runs a 112-bed for-profit home, and its nurse staffing sits at 2.71 hours per resident day, roughly 30 percent under the national average. Weekends drop another 14 percent below its own weekday levels, and staff turnover hits 59.4 percent against a national figure of 45.8. That combination matters more than any single number here, because thin coverage and constant turnover tend to reinforce each other. The current inspection record carries 50 deficiencies, including two at the harm or jeopardy level and four tied to abuse, with $21,554 in fines. The most recent inspection was June 25, 2025. If you're considering this one, ask directly how they cover weekends and what they've changed since that inspection.
Regency Village runs 122 certified beds in Webster under for-profit LLC ownership, and the staffing numbers are the place to start. At 3.33 nurse hours per resident day, it sits about 14% under the national average of 3.86, and weekends dip roughly 10% below its own weekday levels, so coverage thins out exactly when families tend to visit. Annual turnover of 68.8% is well above the 45.8% national figure, meaning the aides and nurses caring for residents are often new to the building.
The inspection record is heavier still: 28 deficiencies, including 5 at harm or jeopardy level and 4 tied to abuse, with two fines totaling $22,718. State inspectors last visited in May 2025.
Winfield Rehab & Nursing runs about 3.2 nurse hours per resident per day, roughly 17% under the national average, and weekend coverage dips another 11% below its own weekday level. Staff turnover sits at 62.1%, well above the 45.8% national figure, that's a lot of unfamiliar faces cycling through an 83-bed building. The inspection record is where things get serious: 48 deficiencies, nine at harm or jeopardy level, ten tied to abuse, and five fines totaling $355,773. The quality measure score looks fine on paper, but that reflects charted care processes, not the staffing and safety problems inspectors keep documenting. For-profit individual ownership, and the last inspection was December 2025.
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?