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 Arden Wood runs 174 certified beds in Houston under corporate for-profit ownership, and its nurse staffing sits at 3.05 hours per resident day, roughly 21% under the national average, with weekends about 12% thinner than its own weekdays. That thin coverage shows up in the inspection record: 32 deficiencies, 12 of them at harm or jeopardy level, 2 abuse-related, and $130,388 in fines across two events, with the most recent inspection dated May 2026. The one clear strength is retention, where 25.6% turnover beats the 45.8% national figure, so the staff who are there tend to stay. Whether that offsets the survey history is the question a family has to weigh.
Beltline Healthcare Center runs 120 beds in Garland, and the numbers there are hard to dress up. Nurse staffing sits at 3.07 hours per resident day against a national average of 3.86, and weekends drop roughly 17% below the home's own weekday level, so the thinnest coverage lands when families tend to visit. Staff turnover is 93.9% a year, more than double the national figure, which means the aide who knows your mother this month may be gone by next. Inspectors have cited 24 deficiencies, four of them serious enough to put residents in harm's way, and CMS has placed the home in its Special Focus Facility program, with a $32,006 fine on record. The last inspection was November 2024.
Terrell Healthcare Center runs 94 certified beds under corporate for-profit ownership, and the staffing numbers are the first thing to notice: 3.52 nurse hours per resident day against a national average of 3.86, with weekends running about 10% leaner than weekdays already are. Turnover sits at 50.8%, above the 45.8% national figure, so the people caring for residents keep changing. The deficiency record is harder to look past: 93 total, 11 of them serious enough to put residents in harm's way, 6 tied to abuse. CMS has fined this home three times for $339,046 combined and placed it in the Special Focus Facility program, a designation reserved for homes with a pattern of persistent problems. If you're considering it, ask directly what's changed since the April 2026 inspection.
Avir At Caldwell runs on thin coverage. At 3.12 nurse hours per resident day, it sits roughly 19 percent under the national average of 3.86, and weekend staffing drops about 9 percent below its own weekday level, so the thinnest shifts get even thinner. The bigger red flag is turnover: 94.3 percent annually against a national average of 45.8 percent means the staff caring for your family member is, statistically, mostly new. Inspections tell a similar story, 30 deficiencies on record, two serious enough to involve harm or jeopardy, a one-star health inspection rating, and one fine of $10,036. The last inspection was January 8, 2026. Corporate-owned, 112 beds. Worth asking hard questions before you sign anything.
Gracy Woods is for-profit, corporate-owned, 118 beds, and sitting in CMS's Special Focus Facility program, the designation reserved for homes with a persistent record of serious problems. The numbers back that up: 64 deficiencies on the current record, 10 of them at harm or jeopardy level, five abuse-related, and four fines totaling $222,188. Staffing runs slightly under the national average at 3.79 hours per resident day, but the bigger issue is consistency, weekends drop about 16% below the home's own weekday level, and turnover sits at 54.5% against a 45.8% national figure. When roughly half the staff leaves in a year, care routines fray. The most recent inspection was June 2026, so the record is current.
Paradigm At Katy has 125 certified beds and a for-profit LLC owner. Its nurse staffing comes in at 4.41 hours per resident day, roughly 14% above the national average, but the workforce behind those hours is unstable: annual turnover runs 91.1% against a national 45.8%, and weekends already sit about 6% below weekday coverage. The inspection record is the harder problem, 51 deficiencies on file, 7 of them serious enough to involve harm or jeopardy and 2 tied to abuse, with $241,445 in fines across 5 penalties and a health inspection star rating of 1 out of 5. Quality measures score 4 out of 5, but that sits alongside a 1 out of 5 staffing rating despite the above-average hours.
Wells LTC Nursing & Rehabilitation has a staffing story that looks better than most, 4.82 nurse hours per resident day, roughly a quarter above the national average, but the rest of the record undercuts it. The home carries 36 deficiencies, including six at the harm or jeopardy level and five tied to abuse, and CMS has placed it in the Special Focus Facility program, a designation reserved for homes with a pattern of serious problems. Staff turnover sits at 52%, higher than the 45.8% national figure, and weekend coverage runs about 7% thinner than weekdays. Three fines totaling $34,428 are on record, with the last inspection in December 2025.
Misty Willow runs 3.30 nurse hours per resident day against a national average of 3.86, and weekends drop about 13% below its own weekday numbers, so the thinnest coverage lands when families are most likely to visit. The inspection record is the harder problem: 30 deficiencies, 8 of them at harm or jeopardy level, 3 tied to abuse, and $79,412 in fines across three penalties. CMS has placed it in the Special Focus Facility program, which is reserved for homes with a persistent pattern of poor care, and its health inspection rating sits at 1 out of 5. Quality measures score well, but that's a narrow slice of the picture.
Deerbrook runs on about 3.35 nursing hours per resident per day, roughly 13 percent under the national average, and weekends drop another 11 percent below its own weekday levels. That thin coverage shows up in the inspection record: 35 deficiencies, six serious enough to put residents in harm's way, two tied to abuse, and $196,911 in fines. CMS has placed it in the Special Focus Facility program, which is reserved for homes with a persistent pattern of poor care. Staff turnover sits at 60.7 percent against a 45.8 percent national average, so the people providing care keep changing. The 4/5 quality measure score reflects reported clinical data; the 1/5 inspection and staffing ratings reflect what surveyors actually found.
If you're considering Epic Nursing & Rehabilitation in Corsicana, the numbers are hard to get around. Nurse staffing sits at 2.89 hours per resident per day, roughly a quarter below the national average, and it thins out further on weekends, not what you want at a 119-bed home. The record shows 45 deficiencies, five of them serious enough to involve harm or jeopardy, eight tied to abuse. Staff turnover runs 54.5%, well above the national figure, which means the people caring for residents are often new. CMS has placed this home in its Special Focus Facility program, reserved for the poorest performers. Two fines totaling $31,233 are on file, with the most recent inspection in February 2025.
Legend Oaks Healthcare and Rehabilitation - Fort W runs 132 certified beds under for-profit LLC ownership, and its nurse staffing sits at 3.13 hours per resident day, roughly 19% under the national average. Weekends drop about 13% below its own weekday coverage, and annual turnover hits 67.8% against a national 45.8%, so the people providing care keep changing. The current inspection record shows 23 deficiencies, five at harm or jeopardy level, one abuse-related, with five fines totaling $65,583. Quality measures score well, but staffing and inspection results tell the harder story: thin coverage, high churn, and recent serious findings at a home where families should ask direct questions about who is on the floor at night and on weekends.
Ignite Medical Resort El Paso runs 60 certified beds under corporate for-profit ownership, and the numbers worth knowing sit in two places. Nurse staffing averages 3.24 hours per resident day against a national average of 3.86, and weekends run about 12% thinner than the home's own weekdays, so the thinnest coverage lands when families tend to visit. The inspection record carries 45 deficiencies, three at harm or jeopardy level and one abuse-related, plus a $67,425 fine. CMS has placed this home in its Special Focus Facility program, a designation reserved for the poorest performers, and the most recent inspection dates to June 2024. Ask about weekend coverage and the correction plan before deciding.
Terra Bella runs about 3.36 nurse staffing hours per resident day, roughly 13 percent under the national average, and it leans thinner on weekends than weekdays. Staff turnover sits at 61.6 percent, well above the 45.8 percent national figure, so the people caring for residents keep changing. On inspections, CMS has cited 44 deficiencies, including 12 at the harm or jeopardy level and 3 tied to abuse, with six fines totaling $181,644 and a spot in the Special Focus Facility program, which CMS reserves for homes with a persistent record of serious problems. The most recent inspection was March 26, 2026.
Mission Ridge runs on 3.19 nurse hours per resident day, roughly 17% under the national average, and weekends dip about 9% below its own weekday numbers. That's thin coverage even before you factor in turnover near 97%, more than double the national rate, meaning most of the people caring for your family member probably weren't there a year ago. The inspection record backs this up: 25 deficiencies, three of them serious enough to put residents in harm's way, one abuse-related, and $37,698 in fines. A for-profit LLC in Refugio County, 90 beds, last inspected February 2026. The quality measures look average on paper, but staffing is where this home falls apart.
Lakeside Health and Wellness runs 124 certified beds in Kemp under for-profit LLC ownership, and the staffing numbers are the first thing I'd want you to see. Total nurse staffing sits at 2.66 hours per resident day, roughly a third below the national average, and weekends run thinner still. Annual turnover of 75.4% means most of the people caring for residents weren't there a year ago, compare that to the national rate of about 46%.
Then there's the inspection record: 59 deficiencies, including 8 at the harm or jeopardy level and 10 tied to abuse, with five fines totaling $195,593. The most recent inspection was in January 2026.
The quality measure score is high, but strong numbers on paper don't fix a thin, constantly changing staff.
Texoma Healthcare Center runs 179 certified beds in Sherman under corporate for-profit ownership, and the numbers that stand out most are about people. Nurse staffing sits at 3.24 hours per resident per day, roughly 16 percent under the national average, and it thins out further on weekends, dropping about 17 percent below the home's own weekday level. Annual turnover is 93.7 percent, more than double the national rate of 45.8 percent, which means the aides and nurses caring for residents are, on average, not there for long. The inspection record shows 36 deficiencies, including two at harm or jeopardy level and one tied to abuse, with $16,441 in fines. The last inspection was March 19, 2026; the health and quality ratings each land at 3 out of 5, staffing at 1.
Longmeadow Healthcare Center runs on 2.70 nurse hours per resident day, roughly 30% under the national average of 3.86, and weekends drop about 17% below its own weekday staffing. That thin coverage shows up in the numbers: 85.9% annual turnover, nearly double the national rate, plus 35 deficiencies on record, eight serious enough to cause harm or jeopardy and five tied to abuse, with $50,595 in fines across three penalties. The 120-bed for-profit home, owned by a limited liability company, was last inspected May 6, 2025, and its health inspection score sits at the bottom of CMS's scale. Ask about weekend nurse coverage and how they've corrected the abuse-related findings before you decide.
The Oaks At Radford Hills runs a 116-bed for-profit operation in Abilene, and the numbers that matter most here are staffing and turnover. Nurses provide 2.82 hours of care per resident per day against a national average of 3.86, and weekend coverage drops roughly another 17% below the home's own weekday level. Staff turnover sits at 79.7%, more than seven in ten workers leaving annually, compared with 45.8% nationally. On the inspection side, the record shows 53 deficiencies, four at harm or jeopardy level and four tied to abuse, with $163,651 in fines across two penalties. The most recent inspection was March 2026. Low staffing and high turnover tend to matter more day to day than a favorable quality-measure score.
Castle Pines runs 3.35 nurse hours per resident day, roughly 13% under the national average, and weekends drop about 14% below its own weekday staffing. That thin coverage shows up in the federal ratings: one star for staffing, two for quality measures, three on health inspections. The current record carries 19 deficiencies, three of them serious enough to put residents at harm or jeopardy, along with three fines totaling $53,155. The last inspection was May 2025, so the picture is recent. Corporate-owned and certified for 120 beds, this is a home where the numbers point to a persistent staffing gap rather than a one-time slip.
The nurse staffing numbers at Downtown Health and Rehabilitation Center run about 16% under the national average, and weekends drop roughly another 13% below the home's own weekday level. That matters because more than nine in ten caregivers left over the past year, a 93.6% turnover rate against a national figure near 46%. The current inspection record carries 50 deficiencies, including three at the harm or jeopardy level and 11 tied to abuse; fines total $36,418. Fort Worth's hospital district operates the 161-bed home, and its last inspection was March 12, 2026. Low staffing stars and repeated turnover rarely sit apart from inspection trouble.
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?