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.
Arbor Grace runs on thinner staffing than most homes, about 3.08 nurse hours per resident day against a national average near 3.86, and weekends dip roughly 6% below its own weekday levels. That shortfall shows up in the numbers: 58.6% annual turnover, well above the 45.8% national figure, plus 38 deficiencies on record, four serious enough to involve harm or jeopardy and one tied to abuse. Two fines totaling $44,434 round out the picture. The last inspection was February 2026, so the record is current, this isn't stale history. A for-profit LLC operating 80 beds with a 1/5 quality measure rating is a home where you'd want to ask hard questions about who's actually on the floor.
If you're weighing Brownsville Nursing and Rehabilitation Center for someone you love, the staffing numbers are the thing to sit with. Nurses provide 2.88 hours of care per resident per day, roughly a quarter below the national average, and weekends run about 13 percent thinner than weekdays. Staff turnover sits at 62 percent, well above the 45.8 percent national figure, which means caregivers cycle through fast and familiarity suffers. The inspection record is heavier still: 42 deficiencies, three serious enough to involve harm or jeopardy, two tied to abuse, plus $63,287 in fines. A recent August 2025 inspection and a strong quality-measure score don't offset a 1-out-of-5 staffing rating and a 1-out-of-5 inspection rating. Ask hard questions before choosing this one.
Corpus Christi Nursing and Rehabilitation Center runs on 3.00 nurse hours per resident day, roughly a fifth below the national average, and weekend coverage dips about 11% below its own weekday level. That thin margin matters because turnover sits at 59.8% against a national 45.8%, close to six in ten staff leaving in a year, which makes consistent care hard to hold onto. The inspection record shows 31 deficiencies, including two at the harm or jeopardy level and two tied to abuse, with one fine of $13,397 and a survey dated June 2025. Nonprofit ownership hasn't translated into stronger staffing here.
Groveton Nursing Home is a 47-bed for-profit in Trinity County, and the split in its federal ratings is the whole story. Inspectors rate it well, four stars, six deficiencies total, only one serious enough to cause harm, none tied to abuse, and the most recent visit was in September 2025. But staffing sits at one star, and that gap matters: a home can pass inspection on any given day while running thin the rest of the year. One fine has been levied, $56,378, which isn't small for a building this size. If you're considering it, ask how many direct-care hours residents actually get per day and how often they use agency or temporary staff.
Lakewest runs on thin nursing coverage, 3.20 hours per resident day against a national average of 3.86, and weekends dip about 14% below its own weekday level. That's the kind of gap families notice as slower call buttons and rushed meals. Staff turnover sits at 71.7% against a national 45.8%, meaning most of the people caring for your relative likely weren't there a year ago.
The inspection record carries 42 deficiencies, including one at the harm level and five tied to abuse. Two fines total $25,799, and the most recent inspection was January 2026. A government hospital district owns it. Strong quality scores don't offset staffing this thin and a record this long.
Caprock Nursing & Rehabilitation runs on 2.82 nurse hours per resident per day, roughly 27% under the national average, and weekends dip about 9% below its own weekday staffing. That thin coverage meets a workforce where 93.3% of staff turn over each year, more than double the national rate, so the people providing care keep changing. The current record holds 27 deficiencies, three at harm or jeopardy level and four abuse-related, plus one fine of $10,145. The most recent inspection was May 21, 2025. Quality scores look strong on paper, but the staffing and inspection record is where the real story sits.
Twin Pines North runs on 3.20 nurse staffing hours per resident day, roughly 17 percent under the national average, and weekends dip about 11 percent below its own weekday levels. That thin coverage shows in the numbers: 96.3 percent annual staff turnover, more than double the national rate, which means the aide or nurse caring for your relative this month is likely gone within the year. Twenty-six deficiencies sit on the current record, including two tied to abuse, though none reached the harm or jeopardy level, and the most recent inspection was April 2025. Corporate-owned and for-profit, the home rates one star for staffing and two for quality measures.
The Enclave runs on thinner nursing coverage than most homes, 3.63 nurse hours per resident day against a national average of 3.86, and weekends drop roughly 15% below what it manages on weekdays, so the thinnest shifts land when families tend to visit. Staff turnover sits at 60.9%, well above the 45.8% national figure, which means the people caring for residents keep changing. Inspectors cited 46 deficiencies on the current record, including three tied to abuse and one at the harm level, and the last inspection was in August 2025. That combination of low staffing, high turnover, and repeat citations is what drives the low rating here.
Skilled Care of Mexia is run by the local hospital district, and its inspection record is genuinely decent, a 4/5 health inspection rating, 17 deficiencies logged with three at the harm level and none tied to abuse. The problem sits almost entirely on the staffing side. At 3.17 nurse hours per resident day, this home runs about 18% under the national average, and weekends drop another 10% below its own weekday pace. Then there's turnover: 97.2% against a national average of 45.8%, meaning the aides and nurses around your relative are largely new to the building. Care can look fine on paper and still feel thin when the same faces never stay long enough to learn a resident's habits.
Avir At Patriot runs 3.18 nurse hours per resident day, roughly 18% under the national average, and weekends dip about 8% below its own weekday staffing. That thin coverage shows up in the numbers: a 52.7% annual turnover rate, more than 45.8% nationally, and a one-star CMS staffing rating. The inspection record carries 77 deficiencies, four of them at harm or jeopardy level and four abuse-related, with $153,192 in fines across three penalties. The most recent inspection was August 2025. Quality measures score better, but the staffing and inspection picture is what a family should weigh.
Willow Ridge runs 265 beds in Fort Worth under a for-profit LLC, and the staffing numbers are the first thing that stands out: 3.05 nurse hours per resident day, roughly a fifth below the national average, with weekends dipping about 13% below its own weekday coverage. The inspection record backs that up, 39 deficiencies in total, 14 at harm or jeopardy level and 5 abuse-related, plus seven fines adding to $321,244. Quality measures score well, but the health inspection and staffing ratings both sit at the bottom of the federal scale, and the most recent survey was July 2025.
Oak Brook Health Care Center in Whitehouse is run by a hospital district, and its inspection record is genuinely strong, a five-star health inspection rating and only four deficiencies on the current record, with one at the harm level and none related to abuse. The problem sits with staffing. At 3.05 nurse hours per resident day, this home runs about 21 percent below the national average, and weekends dip roughly 17 percent below its own weekday coverage. Turnover is 66.4 percent against a national 45.8 percent. That combination, solid inspections, thin and churning staff, is what pulls the overall picture down to average.
Paradigm At Sweeny runs on thin staffing. At 2.89 nurse hours per resident day, it's about a quarter below the national average of 3.86, and weekends drop roughly 16% below what the home already provides on weekdays. Staff turnover sits at 75%, well above the 45.8% national figure, so the people caring for residents are cycling through fast. The inspection record backs that up: 21 deficiencies, four serious enough to cause harm or jeopardy, and four tied to abuse. A for-profit LLC operates the 90-bed home, and while its quality measure score looks good, the 1-star inspection and staffing ratings tell the more relevant story. One fine of $11,905 is on record.
Pleasanton North runs on thin staffing: 2.68 nurse hours per resident per day, roughly 31% below the national average of 3.86, and weekends drop another 16% below its own weekday levels. The inspection record is the bigger concern, 47 deficiencies, including 5 at the harm or jeopardy level and 7 tied to abuse, with two fines totaling $167,869 and a health inspection rating of 1 out of 5. Turnover at 42.3% is slightly better than the 45.8% national figure, but that's the one number here that isn't working against the home. The most recent inspection was July 2025, so the record is current.
Avir At Camp Wood runs 86 certified beds under corporate for-profit ownership, and its nurse staffing sits at 2.77 hours per resident day, roughly 28% under the national average of 3.86. That thin coverage gets thinner on weekends, when staffing drops about 9% below its own weekday level, which matters most when families are visiting and aides are stretched.
The inspection record shows 25 deficiencies, including one at the harm or jeopardy level and one abuse-related citation. CMS has fined the home twice, totaling $86,254, and the most recent inspection was July 31, 2025. Its health inspection rating lands at 3 out of 5, quality measures at 2, and staffing at 1, the numbers point to a home where care is being delivered, but with real strain.
Avir At Killeen runs on 3.18 nursing hours per resident day, about 18 percent under the national average, and weekend coverage drops roughly 15 percent below its own weekday level. Staff turnover sits at 52.1 percent against a national 45.8 percent, so the people caring for residents keep changing. The inspection record shows 60 deficiencies, ten of them at the harm or jeopardy level and six tied to abuse, with six fines totaling $137,749. The last inspection was April 17, 2025. Ownership is a for-profit corporation, and 120 beds are certified. The quality measure score looks better than the rest, but it's the staffing and inspection numbers a family should weigh.
Avir At New Braunfels runs 154 certified beds under for-profit LLC ownership that changed hands within the last year. Nurse staffing sits at 3.36 hours per resident day, roughly 13% below the national average, and weekends dip about 10% below its own weekday levels, meaning coverage is thinnest exactly when families tend to visit. The bigger concern is the inspection record: 53 deficiencies, including 5 at the harm or jeopardy level and 3 tied to abuse, with five fines totaling $163,819. Staff turnover of 73.7% is well above the 45.8% national average, so the people caring for residents are constantly changing.
Ivy Creek runs 162 certified beds in Waco under corporate for-profit ownership, and the staffing numbers are where the trouble starts. At 3.21 nurse hours per resident day, it sits about 17% under the national average, weekend coverage drops another 11% below its own weekday level, and 64.7% annual turnover means the aides and nurses in the building keep changing, a rate well above the 45.8% norm. The inspection record shows 15 deficiencies, including three at the harm or jeopardy level and two tied to abuse, with $149,039 in fines and a survey as recent as July 2025. Quality and health inspection scores land mid-range, so the real story is thin, unstable staffing layered over a record that has already flagged harm.
Pleasant Springs Healthcare Center runs about 2.99 nurse hours per resident day, roughly a quarter below the national average, and weekend coverage dips another 14% under its own weekday levels. The bigger red flag is turnover: 95.9% annually, more than double the national figure, meaning the aides and nurses caring for your relative are, statistically, almost certain to be new to the building within a year. Its inspection record shows 54 deficiencies, including three at the harm level and two tied to abuse, plus $70,837 in fines across four penalties. The most recent inspection was February 2025. Ownership is corporate for-profit. With 90 beds, that combination of thin staffing, constant churn, and a serious deficiency history is what a family should weigh carefully before choosing this home.
Windcrest Nursing and Rehabilitation runs 180 certified beds under corporate ownership, and the staffing numbers are the first thing that stands out. At 2.90 nurse hours per resident day, it sits roughly a quarter below the national average of 3.86, with weekends running about 6% thinner than its own weekdays. Turnover is 59.4% against a national 45.8%, meaning most of the people caring for residents weren't there a year ago. The inspection record shows 38 deficiencies, five at harm or jeopardy level and seven tied to abuse, plus four fines totaling $199,073. Quality measures rate well, but that's a narrow bright spot next to thin staffing and a 2/5 inspection rating.
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?