10,187 Chain-Owned Nursing Homes in the United States
10,187 of the 14,697 Medicare-certified nursing homes in the United States (69%) are chain-owned, and all are listed below. 1307 of the 10167 graded homes earn an A and 743 earn a D or F. They average 3.7 nursing hours per resident per day, 0.16 hours below the 3.86 for every home in the United States. Deerfield Health Care Center in Urbandale grades highest at A (100 out of 100).
How chain-owned homes in the United States compare
This group set against every nursing home in the United States, from the current CMS release.
Capital Post Acute runs 121 beds in Sacramento under for-profit LLC ownership, and its nurse staffing sits at 4.06 hours per resident day, roughly 5% above the national average. Turnover is 38.2%, better than the 45.8% national figure, though weekend coverage drops about 11% below weekday levels, so care may thin out when families visit. What pulls the record down is the inspection side: a 2/5 health inspection rating and 71 deficiencies on file, 11 of them abuse-related, none at the harm level. The most recent inspection was February 2026. Quality measures score well at 4/5, but that paperwork strength doesn't erase 71 citations.
Gramercy Court runs 120 certified beds in Sacramento under for-profit LLC ownership, and its staffing numbers are genuinely strong: 4.16 nurse hours per resident day, roughly 8% above the national average, with weekend staffing dipping about 11% below its own weekday levels. Turnover sits at 43.1%, slightly better than the 45.8% national figure. The trouble is the inspection record, 49 deficiencies, 11 of them abuse-related, and a 2/5 health inspection rating, all as of a December 2025 survey. That's a lot of cited problems for a home this size, and the abuse category is the kind of thing families should ask about directly before touring. Strong staffing and a shaky inspection history can coexist, but they tell different stories.
Meadowood runs 4.13 nurse hours per resident day, about 7% above the national average, but that edge thins out on weekends, when staffing drops roughly 6% below its own weekday level. Turnover sits at 44.9%, essentially the national rate, so the crew is not unusually stable. The trouble is the inspection record: 64 deficiencies, including six at harm or jeopardy level and eight tied to abuse, with $91,067 in fines and a January 2026 inspection that earned one star out of five. Quality measures score five stars, but those are largely self-reported, and corporate ownership gives no reason to expect the pattern to change.
Pioneer House runs 4.13 nurse hours per resident day, which is about 7% above the national average, and turnover at 44.8% is basically in line with the country as a whole. The staffing picture isn't the problem. The current record shows 59 deficiencies, including one at the harm or jeopardy level and seven flagged as abuse-related, and the health inspection rating sits at 2 out of 5. Quality measures score 5 out of 5, so the day-to-day clinical numbers look strong even as the inspection history does not. Weekend staffing drops roughly 11% below its own weekday level, which is worth asking about directly. It's a 50-bed for-profit LLC, last inspected in December 2025.
San Diego Post-Acute Center runs 240 beds in El Cajon under for-profit LLC ownership, and its staffing is the strongest thing it has going: 4.16 nurse hours per resident day, about 8 percent above the national average, with turnover at 36.5 percent, meaningfully better than the 45.8 percent norm. Weekend coverage dips roughly 6 percent below weekdays, which is worth asking about. The inspection record is where the picture darkens. Eighty-seven deficiencies sit on the current record, three of them at harm or jeopardy level and seven tied to abuse, plus two fines totaling $46,495. The most recent inspection was February 27, 2025. Strong daily care numbers do not cancel out that history.
Santa Fe Heights sits in Compton with 99 certified beds and a for-profit LLC owner. The staffing numbers look solid on paper, 3.87 nurse hours per resident day, just a hair above the national average, and turnover at 27.8% is well below the 45.8% national figure. But weekends run about 7% thinner than weekdays, so coverage isn't as steady as the average suggests. What drags this home down is its record: 126 deficiencies, including 17 tied to abuse and 4 serious enough to put residents in harm's way, plus three fines totaling $113,169. The most recent inspection was February 9, 2026.
Bayshire Riverwalk runs on a for-profit corporate model with 120 beds, and its staffing numbers are the strongest thing it has going: 4.51 nurse hours per resident day, roughly 17% above the national average, though weekend coverage drops about 9% below its own weekday level and annual turnover sits at 49%, a bit worse than the 45.8% national figure. The trouble is everything on the inspection side. Sixty-six deficiencies are on the current record, including three at the harm or jeopardy level and five tied to abuse. Two fines total $80,668, and the most recent inspection was December 4, 2025. A 1-out-of-5 health inspection rating against a 4-out-of-5 staffing rating tells you where the risk sits.
Sherwood Oaks Post Acute sits in Thousand Oaks with 99 certified beds, run by a for-profit limited liability company. The nursing hours tell a decent story on paper, 4.27 per resident day, roughly 11 percent above the national average, but weekends dip about 11 percent below the home's own weekday levels, so coverage isn't evenly spread across the week. Staff turnover runs 30.4 percent, noticeably better than the 45.8 percent national figure, which matters for familiarity with residents. Inspectors gave a 4-out-of-5 health inspection rating at the most recent visit in February 2025, with 49 deficiencies on record, none at harm or jeopardy level, though two are abuse-related.
Gordon Lane Care Center runs on 4.14 nurse hours per resident day, roughly 7% above the national average, and its staff turnover of 26% sits well under the 45.8% national figure, a real plus for consistency of care. The tradeoff shows up in the inspection history: 101 deficiencies on record, five of them abuse-related, though none at the harm or jeopardy level, and the health inspection rating sits at 2 out of 5. Weekend staffing drops about 8% below its own weekday level, so ask how coverage looks on Saturdays and Sundays. The last inspection was August 2025.
Cherokee Rose runs lean on nurses. At 3.20 hours per resident day, its staffing sits about 17 percent under the national average, and weekends drop roughly another 20 percent below its own weekday level, so the thinnest coverage lands when families tend to visit. That shows up in the staffing star rating, which comes in at 1 out of 5, even as the health inspection rating holds at 4 out of 5. The current record carries 18 deficiencies, none tied to harm, jeopardy, or abuse, and the most recent inspection was March 2026. Quality measures rate 2 out of 5. Corporate-owned, 102 beds. Strong recent inspections, weak day-to-day staffing.
Arbor Lake runs on 3.11 nurse hours per resident per day, roughly 19 percent under the national average, and weekends drop another 11 percent below what the home itself staffs on weekdays. That thin coverage shows up in a 52.7 percent annual turnover rate, with more than half the nursing staff leaving each year. Inspectors cited 33 deficiencies on the current record, three of them serious enough to put residents in harm's way and two tied to abuse. The owner is a for-profit individual, and two fines totaling $14,676 are on file. One bright spot: the quality measures score well above average, and the most recent inspection was July 2025.
Colonial Manor runs on 3.42 nurse hours per resident per day, roughly 11% under the national average, and weekends dip another 7% below its own weekday numbers, so the thinnest coverage lands when families tend to visit. The inspection record is the harder problem: 43 deficiencies, six serious enough to reach harm or jeopardy, six tied to abuse, and four fines totaling $87,564, all from a for-profit LLC operating 123 beds. Staff turnover at 39.2% actually beats the national 45.8%, which tells you the building can hold workers, the trouble is how few of them there are and what inspectors keep finding.
Chisolm Trail runs a 96-bed for-profit home in Lockhart, and the numbers point in two directions at once. Resident outcomes look good on the federal quality measures, but staffing sits at 2.72 nurse hours per resident day, roughly 29 percent under the national average, and weekends drop about 16 percent below the home's own weekday coverage. The inspection record shows 24 deficiencies, including one at the harm level and two tied to abuse, plus a $37,541 fine; the most recent inspection was in August 2025. If you're weighing this one, ask how they cover weekends and what changed after that harm citation.
Windsor Healthcare Residence runs about 3.31 nurse hours per resident per day, roughly 14% under the national average, and weekend coverage dips another 8% below its own weekday levels, so the thinnest shifts land when families tend to visit. Staff turnover sits at 52.4%, above the 45.8% national figure, and that churn shows up in the inspection record: 13 deficiencies, three serious enough to flag harm or jeopardy, two tied to abuse, plus three fines totaling $34,232. The most recent inspection was August 2025. It's a for-profit, individually owned home with 90 certified beds. The quality measure score looks strong, but quality measures reflect resident health outcomes, not whether enough hands are on the floor or whether problems get fixed.
Kirkland Court runs on thin staffing. At 2.88 nurse hours per resident per day, it sits about a quarter below the national average, and weekend coverage drops further, so the thinnest shifts fall when families tend to visit. Staff turnover of 53.3% tops the national rate, meaning the people caring for your relative are often new to the building. The inspection record is the harder read: 37 deficiencies, three serious enough to put residents in harm or jeopardy, and six tied to abuse. Two fines total $16,810. The quality measures look strong, but those come from resident assessments, not from how the place is run day to day.
Val Verde runs lean on direct care: 3.24 nurse hours per resident day against a national average of 3.86, and weekends drop about 11% below its own weekday staffing. That's a real gap, not a rounding error, and it likely shows up on Saturday afternoons. Turnover is the bright spot, 31.1% versus 45.8% nationally, so the people who are there tend to stay. But the record holds 30 deficiencies, including two at harm level and three tied to abuse, plus a $138,908 fine. Inspectors were last in on June 6, 2025. Nonprofit ownership doesn't erase those numbers; staffing and past problems both matter when you weigh this one.
Focused Care Of Center is a for-profit limited liability company home with 92 certified beds, and the numbers tell a mixed story. Nurse staffing sits at 3.50 hours per resident day, about 9% under the national average, and weekends run roughly 13% below its own weekday level, so coverage thins out exactly when families tend to visit. Turnover, at 32.8%, is actually better than the 45.8% national figure, but the inspection record is where the real trouble sits: 37 deficiencies, including 4 at the harm or jeopardy level and 4 tied to abuse, plus two fines totaling $256,719. The most recent inspection was June 11, 2025.
Avir At Overton runs 100 certified beds under for-profit LLC ownership, and the staffing numbers tell a mixed story: 3.77 nurse hours per resident day sits just under the national average of 3.86, but weekends dip about 4% below weekdays, and annual turnover hits 58.3% against a national 45.8%. More concerning is the inspection record, 41 deficiencies, 13 of them at harm or jeopardy level, 10 abuse-related, and six fines totaling $363,446, with the most recent inspection dated April 2026. The quality measure rating is strong, but that reflects resident health metrics, not the safety and oversight record a family should weigh most heavily when choosing care.
Flatonia Healthcare Center runs 70 certified beds in Fayette County under corporate for-profit ownership, and its staffing is the one part of the picture that holds up: 4.04 nurse hours per resident day, about 5% above the national average, with weekend coverage dipping only slightly below weekdays. Turnover at 43.6% is a touch better than the national 45.8%. The trouble sits elsewhere. Fifteen deficiencies on the current record, two of them at harm or jeopardy level and two abuse-related, plus two fines totaling $15,098. The most recent inspection was December 4, 2025, so that record is recent. Staffing keeps residents attended to; the inspection history is what a family should ask about directly.
Lone Star Ranch runs 146 beds in Kingsville under corporate ownership, and its numbers tell a mixed story. Nurse staffing sits at 3.22 hours per resident day, roughly 17% under the national average, and weekends dip about 12% below the home's own weekday coverage, so care thins out exactly when families tend to visit. Staff turnover is 43.8%, slightly better than the national rate. The inspection record is the real concern: 23 deficiencies, including one at the harm level and six tied to abuse, with a $8,190 fine and a survey completed in June 2025. Quality measures score well, but that coexists with a two-star inspection history.
Frequently asked questions
How many chain-owned nursing homes are there in the United States?
There are 10,187 chain-owned Medicare-certified nursing homes in the United States, 69% of the 14,697 nursing homes there.
Are chain-owned nursing homes better staffed?
In the United States they average 3.7 total nursing hours per resident per day, against 3.86 for all nursing homes in the United States, a difference of -0.16 hours. Staff turnover averages 46.8% against 45.8%.
Which chain-owned nursing home grades best in the United States?