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.
Landmark of Amarillo Rehabilitation and Nursing runs 99 certified beds under for-profit LLC ownership, and the inspection history is the place to start. The home carries 24 deficiencies on its current record, including two at the harm or jeopardy level and one tied to abuse. Two CMS fines total $160,948. That's a lot of enforcement activity for a building this size.
Staffing is the other pressure point. At 3.43 nurse hours per resident day, it sits about 11% under the national average, weekends drop roughly 13% below its own weekday levels, and annual turnover hits 97.6%, more than double the national figure of 45.8%. That churn makes consistent care hard to sustain.
The most recent inspection was January 15, 2025.
Spindletop Hill runs on 3.26 nurse hours per resident day, roughly 15 percent under the national average, and weekends drop about 11 percent below its own weekday staffing. Annual turnover sits at 60.6 percent against a national 45.8, so the aides and nurses in the building keep changing. The inspection record shows 34 deficiencies, six at harm or jeopardy level and six tied to abuse, with $128,948 in fines across three penalties and a survey as recent as June 2025. The quality measure score looks strong on paper, but that's resident data, not the building's own practices. Nonprofit ownership hasn't shielded this one.
Interlochen runs lean on the floor, and the numbers show it. Nurses give residents about 3.36 hours of care a day, roughly 13% under the national average, and weekends drop another 14% below the home's own weekday pace, so the thinnest coverage lands right when families tend to visit. On top of that, nearly everyone on staff left in the past year: 95.9% turnover against a national figure under half that, which means the people caring for residents are constantly new to the building. Its record carries 31 deficiencies, 6 serious enough to involve harm or jeopardy, 4 tied to abuse, and $54,137 in fines. An April 2025 inspection is recent, but the pattern behind it isn't reassuring.
Lake Lodge runs on 3.26 nurse hours per resident day, roughly sixteen percent under the national average, and weekends dip about eight percent below its own weekday staffing. That thin coverage shows up in a 93 percent annual turnover rate, double the national figure, meaning the aides and nurses at your mother's bedside are, statistically, likely to be gone within a year. The current record carries 33 deficiencies, five serious enough to cause harm or jeopardy and six tied to abuse, with $47,621 in fines across three cases. A January 2026 inspection is recent, at least, but a for-profit LLC with that staffing level and that churn is worth visiting unannounced, on a weekend, before you decide.
University Park Nursing and Rehabilitation runs on 2.97 nurse hours per resident per day, roughly a quarter below the national average of 3.86, and weekends drop about 12% below its own weekday staffing. The bigger warning sign is turnover: 86.9% of nursing staff left over the past year, nearly double the national rate of 45.8%, meaning the people at the bedside are constantly changing. Inspections look better than that picture, 23 deficiencies, none causing harm or involving abuse, and a recent June 2025 survey earned four stars. If you're considering this one, ask how they hold staffing steady on weekends and how they keep experienced nurses from walking out the door.
Avir At Hillsboro runs on 3.24 nurse hours per resident per day, roughly 16% under the national average of 3.86, and weekends dip about 8% below its own weekday levels, so the thinnest coverage lands when families tend to visit. Staff turnover is 90.4% a year against a national 45.8%, meaning most of the people caring for residents are new to the building. The inspection record carries 39 deficiencies, four at harm or jeopardy level and five tied to abuse, with two fines totaling $106,866; the most recent inspection was December 2025. Ownership is a for-profit corporation, and the quality measure score sits high while inspections and staffing sit at the bottom of the scale.
Countryview has 51 deficiencies on its current record, six of them serious enough to put residents in harm's way, and eight tied to abuse. That's an unusual concentration of the worst categories, and the one-star inspection rating reflects it. Staffing sits at 3.13 hours per resident per day, roughly 19% under the national average, with weekends running about 13% thinner than weekdays. The turnover number is the one that would worry me most: 94.4%, about double the national rate, meaning the aides who know your mother are mostly gone within a year. Five fines totaling just under $80,000 round out the record. It's a hospital-district home, inspected recently, in August 2025.
The Park In Plano runs on about 3.13 nurse hours per resident day, roughly 19 percent under the national average, and weekend coverage dips another 14 percent below its own weekday level. Staff turnover sits at 93.2 percent, about double the national figure, which means the aides and nurses in the building are, more often than not, still learning the residents. Inspections tell a different story: a 4 out of 5 federal rating, 36 deficiencies on record with none at the harm level, though two are abuse-related. It's a for-profit limited liability company with 120 beds, last inspected in April 2026. The pattern is a home that passes its surveys while running lean on the people who do the daily work.
Avir At Bradburn runs 3.39 nurse hours per resident per day, about 12% under the national average, and weekend coverage drops roughly 12% below its own weekday level, a pattern families often notice on Saturdays and Sundays. Staff turnover sits at 83.8% against a national average of 45.8%, so the aides and nurses caring for your relative are far more likely than average to be new or on their way out. Inspectors last visited in May 2025 and left 11 deficiencies, including two at the harm or jeopardy level and one tied to abuse, along with a $136,027 fine. Quality measures score well, but the corporation's own inspection and staffing ratings don't.
Central Texas Nursing & Rehabilitation runs 118 certified beds in Ballinger under for-profit LLC ownership, and its nurse staffing sits at 3.04 hours per resident day, about 21% under the national average of 3.86. Weekends drop roughly 17% below its own weekday level, so coverage thins exactly when families tend to visit. The inspection record shows 14 deficiencies, including one at the harm or jeopardy level and two tied to abuse, plus one fine of $8,936. A recent May 2025 inspection and a 4-star health inspection rating suggest the survey process is current and not entirely bleak, but a 1-star staffing rating and 2-star quality measures pull hard the other way. Ask about weekend nurse coverage and how the abuse-related findings were resolved.
The Manor At Seagoville runs on about 2.97 nurse hours per resident per day, roughly a quarter less than the national average of 3.86, and staffing thins further on weekends, dropping about 13% below its own weekday level. That shortfall shows up in the numbers: 59.1% annual turnover, well above the 45.8% national figure, and 33 deficiencies on the current record, two of them serious enough to involve harm or jeopardy, plus two abuse-related findings and $98,062 in fines. A 2/5 inspection rating and 2/5 staffing rating sit alongside a 4/5 quality measure score, which is worth asking about. This is a for-profit corporate home where the care reported on paper and the hands available to deliver it don't match.
Red Oak Health and Rehabilitation Center runs 144 certified beds under corporate ownership, and its inspection history is actually its strongest suit, a 4-out-of-5 federal rating there. The problem sits elsewhere. Nurse staffing works out to 2.93 hours per resident per day, roughly a quarter below the national average of 3.86, and weekends drop about 12% below the home's own weekday levels. Annual turnover hits 68.9% against a national 45.8%, meaning most of the aides and nurses your relative would see are relatively new. Sixteen deficiencies sit on the current record, including one at the harm level and one abuse-related, with a single $12,035 fine.
Pecan Tree runs on 2.57 nursing hours per resident day, roughly a third below the national average of 3.86, and weekends drop about 23% below what it manages on weekdays. That thin coverage sits behind a one-star staffing rating, and the inspection record is heavier still: 30 deficiencies, two of them serious enough to put residents in harm's way, plus two tied to abuse. The last full inspection was February 2026, so the findings are recent, not stale. Cooke County Hospital District owns the place, which means public ownership here hasn't translated into public accountability on care. One fine totaling $16,595 rounds out the record. If you're considering this home, ask directly how they staff weekends and what changed after those abuse citations.
Avir At Portland runs 97 certified beds under corporate ownership, and the staffing numbers are the first thing a family should sit with. Nurses provide 3.25 hours of care per resident each day, roughly 16 percent under the national average, and weekend coverage drops about another 10 percent below the home's own weekday level. Annual turnover hits 63.9 percent, well above the 45.8 percent national figure, which means the people caring for your relative are likely to change often.
The inspection record shows 29 deficiencies, including three at the harm or jeopardy level and one tied to abuse, with $119,462 in fines across two penalties. The most recent inspection was September 2025.
Kerens Care Center runs on 2.95 nurse hours per resident per day, roughly a quarter below the national average of 3.86, and weekends dip about 9% below its own weekday levels. The bigger issue is turnover: 97.3% of staff leave annually, against a national average of 45.8%, which means the people caring for your family member are, more often than not, brand new. Fifteen deficiencies sit on the current record, two serious enough to involve harm or jeopardy, though none are abuse-related. The last inspection was April 2025, so the picture is fairly current. Corporate-owned, 70 beds, and staffing is where the trouble concentrates.
Five Points of Pflugerville runs on 3.08 nurse hours per resident per day, roughly a fifth under the national average, and it leans harder on weekdays than weekends, weekend coverage drops another 12% below its own weekday level. Staff turnover sits at 71.6% against a national 45.8%, so nearly three in four caregivers left over the past year, which matters more when the staffing rating is 1 out of 5. The current inspection record carries 41 deficiencies, 8 of them at harm or jeopardy level and 2 abuse-related, with five fines totaling $59,449; the last survey was March 19, 2025. Quality measures score well, but that's the one bright spot.
Avir At Cowhorn Creek runs 76 certified beds under hospital-district ownership, and the staffing numbers are where the trouble starts: 3.26 nurse hours per resident day against a national average of 3.86, with weekends running about 10 percent thinner than weekdays. Turnover sits at 68.2 percent, well above the 45.8 percent national figure, so residents see a lot of new faces. The inspection record shows 65 deficiencies, including two at the harm or jeopardy level and five tied to abuse, with one $30,105 fine and a survey date of February 2026. Quality measures score mid-range, but staffing and inspections both land at one star, and that combination is what drives the grade down.
Avir At Citizens Trail runs 114 certified beds under for-profit LLC ownership in Texarkana, and the numbers behind its record are worth a close look. Nurse staffing sits at 3.53 hours per resident day, roughly 9% under the national average, and weekends drop about 14% below the home's own weekday level, meaning coverage thins out exactly when families tend to visit. Annual turnover of 66.7% is well above the national 45.8%, so the people caring for residents keep changing. The current inspection record shows 52 deficiencies, including 7 at the harm or jeopardy level and 5 abuse-related, with two fines totaling $120,751 and the most recent inspection dated November 2025.
University Rehabilitation Center runs 146 certified beds in Denton under for-profit limited liability ownership, and the staffing numbers are where the trouble starts. At 3.36 nurse hours per resident day, it sits roughly 13% under the national average of 3.86, weekend coverage dips about 11% below its own weekday level, and annual turnover of 88.2% means most of the people caring for residents are new to the building, nearly double the national rate of 45.8%. The inspection record backs that up: 38 deficiencies, five of them serious enough to put residents in harm's way, one tied to abuse, plus two fines totaling $33,117. A 1-out-of-5 staffing rating and 2-out-of-5 on inspections tell the story plainly.
Legacy At Town Creek runs 199 certified beds in Palestine under hospital district ownership, and the numbers raise real questions. Nurse staffing sits at 3.37 hours per resident day, roughly 13 percent under the national average, with weekends about 9 percent thinner than weekdays, meaning your family member gets the least coverage exactly when other help is hardest to find. Staff turnover is 53.8 percent against a national 45.8, so caregivers cycle through quickly. On top of that, the current record shows 38 deficiencies, including 5 at harm or jeopardy level and 5 tied to abuse, with $294,608 in fines. The last inspection was August 2025. Ask about weekend coverage and turnover directly before deciding.
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?