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.
If your family is looking at Sienna Nursing and Rehabilitation in Odessa, the staffing numbers are what you need to sit with. Nurses provide 2.91 hours of care per resident each day, about a quarter below the national average, and weekends run thinner than weekdays. Turnover is the number that should worry you most: 92.3% of staff leave or are replaced annually, roughly double the national rate, meaning the aide who knows your mother's routines today is probably gone within a year. The record shows 28 deficiencies, four of them serious enough to put residents at real risk, plus one abuse-related finding and a $241,722 fine. The state last inspected in January 2025.
Pebble Creek runs on thin staffing, and the numbers show it. At 3.38 nurse hours per resident per day, it sits about 13% under the national average, and weekends drop roughly another 11% below its own weekday level, so care gets thinnest exactly when families tend to visit. Meanwhile, annual turnover hits 97.4%, more than double the national rate, which means the people providing that care are constantly changing.
The inspection record is worse: 65 deficiencies, including 4 at harm or jeopardy level and 5 tied to abuse. Federal fines total $145,184 across two penalties, and the last inspection was May 2024, with a 1/5 health inspection rating and 1/5 staffing rating. For-profit, limited liability ownership. Ask direct questions about weekend coverage and turnover before considering this one.
Navasota Nursing & Rehabilitation runs 2.49 nursing hours per resident per day, roughly 36% under the national average of 3.86, and weekend staffing drops about 18% below its own weekday levels. The current inspection record carries 47 deficiencies, six of them serious enough to put residents in harm's or jeopardy's way, two tied to abuse, with six fines totaling $105,594. All three CMS star ratings, health inspections, quality measures, and staffing, sit at one out of five. Corporate for-profit ownership holds the license on 172 certified beds, and the most recent inspection was June 5, 2025.
Reunion Plaza runs on 3.01 nurse hours per resident day, roughly a fifth below the national average, and weekends dip another 14% below its own weekday numbers. Staff turnover sits at 64.5%, well above the 45.8% national figure, which means the people caring for your family member are often new and still learning the building. The inspection record shows 86 deficiencies, seven of them serious enough to put residents in harm's way, plus one tied to abuse. Three fines add up to $283,086, and the most recent inspection came in February 2026. For-profit corporate ownership, a one-star health inspection rating, and a one-star staffing rating all point the same direction.
If you're weighing Lancaster Nursing & Rehabilitation for someone you love, the federal numbers are worth sitting with. Nurse staffing runs about 3.30 hours per resident day, roughly 14% under the national average, and weekends dip another 14% below what the home itself staffs on weekdays. Staff turnover sits near 93%, more than double the national rate, meaning the aide who knows your mother this month may be gone the next. The inspection record shows 37 deficiencies, three involving actual harm or jeopardy and three tied to abuse, with $56,554 in fines and a survey as recent as October 2024. For-profit, LLC-owned, 120 beds. The pattern here is thin coverage and heavy churn, and that's what drives the low marks.
Whitesboro Health And Rehabilitation Center runs on 2.86 nurse hours per resident per day, roughly a quarter below the national average of 3.86, and weekends drop about another 10% below its own weekday levels. That thin coverage shows in the numbers: 90.9% annual staff turnover, double the national rate, with a 1-out-of-5 CMS staffing rating and 2-out-of-5 on quality measures. Inspectors last visited in May 2025 and cited 15 deficiencies, four of them serious enough to put residents at harm or jeopardy, including one abuse-related finding. Two fines totaling $30,253 are on record. For-profit corporate ownership, three inspection stars, and a resident population of up to 95, this is a home where you'd want to visit unannounced, on a weekend, and ask directly who's on the floor.
North Pointe runs on thin staffing. At 3.15 nurse hours per resident day, it sits about 18% under the national average, and weekends drop roughly another 11% below its own weekday level, so the thinnest coverage lands when families tend to visit. The bigger signal is turnover: 94.5% of nursing staff leaving in a year, against a national average of 45.8%. That's a building where almost everyone you meet is new. The inspection record backs it up, 27 deficiencies, 8 serious enough to cite harm or jeopardy, 7 tied to abuse, and three fines totaling $36,475. State inspectors were last in on April 17, 2025. For-profit, individually owned, 126 beds.
Brentwood Terrace runs on 3.04 nurse hours per resident per day, roughly a fifth below the national average, and weekends drop another 14% below its own weekday levels, so the thinnest coverage lands when families tend to visit. Staff turnover sits at 92.9%, more than double the national rate, which means the people caring for your relative are, statistically, likely to be gone within the year. The inspection record is the harder read: 51 deficiencies, eight serious enough to cause harm or jeopardy, seven tied to abuse, and a single $234,447 fine. The most recent inspection was June 2025.
Twin Oaks runs on thin staffing: 2.97 nurse hours per resident day against a national average of 3.86, and weekends drop roughly 18% below what the home already provides on weekdays. The bigger red flag is turnover, 98% annually, more than double the national figure, meaning the aide or nurse who knows your mother this month is statistically unlikely to be there next year. Its current record carries 34 deficiencies, including 2 at harm or jeopardy level and 4 abuse-related, plus a $174,431 fine. A December 2025 inspection is recent, so the picture isn't stale. The corporate owner is for-profit, and the numbers suggest a building where care depends heavily on who happens to be on shift.
Focused Care At Pasadena runs on 2.95 nursing hours per resident per day, roughly a quarter below the national average, and weekends drop about 14% below what the home staffs on weekdays. That thin coverage shows up in the inspection record: 32 deficiencies, six of them serious enough to put residents in harm's way, three tied to abuse, and $131,012 in fines. Staff turnover sits at 76.6% against a national 45.8%, meaning most of the people caring for your family member this year likely won't be there next year. The corporation that owns it has drawn a 1-star inspection rating and a 1-star staffing rating, with the most recent survey dated February 2026.
Jourdanton Nursing And Rehabilitation runs on 2.76 nurse hours per resident per day, about a quarter below the national average, and weekends are thinner still, roughly 17% less staff than weekdays. That staffing pattern sits behind a one-star CMS staffing rating, and the turnover number is the one that would worry me most: 90.5% annually against a national average of 45.8%, meaning most of the people caring for your relative are new, or about to be.
The inspection record shows 31 deficiencies, including two at the harm level and one abuse-related, with $28,334 in fines. Corporate-owned and for-profit, its most recent inspection was January 2026, so the record is current rather than dated.
Whispering Pines Lodge runs leaner on nursing hours than most homes in Texas and nationwide, and weekends are thinner still, roughly one-sixth less coverage than a weekday. Staff turnover is the number that should stop you: more than nine in ten caregivers left over the past year, against a national rate under half that. The inspection record backs it up, 60 deficiencies, a dozen serious enough to put residents in harm's way, and five tied to abuse, with over half a million dollars in fines. CMS has placed it in the Special Focus Facility program, its most intensive monitoring tier, following a January 2026 inspection.
Avir At Converse runs on 3.00 nurse hours per resident day, roughly 22% under the national average, and weekends drop about 17% below its own weekday level, so the thinnest coverage lands when families tend to visit. Staff turnover sits at 67.2% against a 45.8% national figure, which means caregivers are cycling out faster than residents can get used to them. The inspection record shows 50 deficiencies, four serious enough to put residents at harm or jeopardy, plus one tied to abuse, and $43,845 in fines. State inspectors were last on site in June 2026.
Mountain View runs 187 certified beds under limited-liability, for-profit ownership, and the staffing numbers are where things get uncomfortable. At 3.37 nurse hours per resident day, it sits about 13% under the national average, and weekend coverage drops roughly 15% below its own weekday level, so the thinnest shifts are also the least supervised. Staff turnover is 95.9% against a national figure of 45.8%, meaning nearly the entire nursing workforce cycles out annually. On the current record: 68 deficiencies, five of them serious enough to put residents in harm's way, seven tied to abuse, and three fines totaling $127,645. The most recent inspection was March 2026, recent enough that these problems are current, not historical.
Woodway Nursing & Rehab in Houston runs on thinner staffing than most homes, with weekend coverage dropping further below its own weekday levels. The bigger red flag is turnover: 85.3% of nursing staff leaving annually, nearly double the national rate.
That churn shows up in the inspection record, 60 deficiencies, 18 serious enough to endanger residents, three tied to abuse, and four fines totaling more than $303,000. CMS has placed the home in its Special Focus Facility program, a designation reserved for the poorest performers. Inspectors were last on site in June 2025. For-profit, limited-liability ownership. Families considering this home should ask hard questions about who's actually on the floor nights and weekends.
If you're considering Cascades At Galveston for someone you love, the numbers here are hard to get past. The home runs 2.74 nursing hours per resident per day, roughly a third below the national average, and weekends drop about 23% below its own weekday staffing. Annual turnover sits at 70.7% against a national average of 45.8%, so the people caring for residents are cycling out fast.
The inspection record shows 41 deficiencies, nine at harm or jeopardy level and one abuse-related, with four fines totaling $241,516. CMS has placed it in the Special Focus Facility program, which is reserved for homes with a persistent pattern of serious problems. The last inspection was May 2025.
Bluebonnet Point Wellness runs on 2.80 nurse hours per resident day, roughly 27% under the national average, and weekends drop about 12% below its own weekday level, so the thinnest coverage lands when families tend to visit. Staff turnover sits at 97.8% against a national 45.8%, meaning nearly the entire nursing workforce cycles out each year. The current record shows 34 deficiencies, six serious enough to cause harm or jeopardy and one tied to abuse, with five fines totaling $181,947. Inspectors last visited in August 2025. With 119 certified beds under corporate for-profit ownership, ask specifically who is on duty nights and weekends before you decide.
Greenview runs on 2.86 nurse hours per resident day, well under the 3.86 national average, and weekends drop about 9% below what the home already provides on weekdays. Nearly 70% of nursing staff turned over in a year, against a 45.8% national figure, with a for-profit LLC operating the 128 beds. The current inspection record carries 45 deficiencies, nine of them at harm or jeopardy level and six tied to abuse, and the home has been fined five times for $73,108 total. Its last inspection was March 19, 2025.
Lampstand runs 140 beds in Bryan under for-profit LLC ownership, and the staffing numbers are the first thing to sit with. At 3.33 nurse hours per resident day, it's roughly 14% under the national average, and weekends drop about 17% below its own weekday level, so coverage thins out exactly when families tend to visit. Turnover is the harder fact: 97.3% annually against a national average of 45.8%, meaning the aides and nurses caring for your relative are, statistically, almost certain to change within the year. Behind those numbers sit 48 deficiencies on the current record, four of them serious enough to reach harm or jeopardy level, plus $31,460 in fines. The most recent inspection was April 2026.
Vintage Health Care Center runs on 3.23 nurse hours per resident day, roughly 16 percent under the national average, and weekends drop about 13 percent below its own weekday staffing. Annual turnover sits at 96.6 percent, more than double the national figure, meaning the aides and nurses caring for your relative are, statistically, likely to be new or on their way out. The inspection record backs that up: 57 deficiencies, seven serious enough to put residents in harm's way, one tied to abuse, and four fines totaling $252,370. Federal regulators have placed it in the Special Focus Facility program, a designation reserved for the country's most persistently troubled homes.
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?