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.
Avir At Monahans runs on a government-hospital-district license and 92 certified beds, and its nursing hours come in at 2.74 per resident day, roughly 29% under the national average of 3.86. That thin coverage thins further on weekends, when staffing drops about 9% below its own weekday level, and the aide and nurse turnover rate sits at 74% against a national 45.8%. The record shows 35 deficiencies, none at harm or jeopardy level and none abuse-related, with the most recent inspection in July 2025. Quality measures score well, but the staffing picture is what shapes daily life here.
Port Arthur Nursing and Rehabilitation Center runs 199 certified beds under for-profit partnership ownership, and its numbers split sharply depending on where you look. The quality measure score is perfect, yet nurse staffing sits at 3.06 hours per resident day, roughly 21% under the national average, and weekend coverage drops about 12% below its own weekday level. Turnover lands at 44.3%, close to the national figure, so retention isn't the outlier here. What is: 50 deficiencies on the current record, including five at harm or jeopardy level and 12 tied to abuse, plus four fines totaling $310,553. The last inspection was June 25, 2025. A strong quality score doesn't offset that inspection history.
Conroe Health Care Center runs 108 certified beds as a nonprofit, and the numbers tell a mixed story. Nurse staffing sits at 3.64 hours per resident day, about 6% under the national average of 3.86, and weekends dip roughly 5% below the home's own weekday coverage, so the hours get thinnest exactly when families tend to visit. Staff turnover is 52.6%, notably worse than the 45.8% national figure, which matters because constant churn makes consistent care harder. The current inspection record shows 20 deficiencies, two serious enough to involve harm or jeopardy, plus one fine of $12,860; the most recent inspection was April 11, 2025. Quality measures rate mid-range, but inspections and staffing are the weaker spots here.
Avir At Mineola runs on 3.45 nurse hours per resident day, roughly 11 percent under the national average, and weekends dip another 8 percent below its own weekday numbers, so the thinnest coverage lands when families tend to visit. The inspection record is heavier than that staffing gap alone would suggest: 54 deficiencies, including 8 tied to abuse and 3 serious enough to put residents in harm's way, plus three fines totaling $55,247. Ownership changed within the past year, which can mean new management or just a new name on the license. The most recent inspection was in December 2025. If you're considering this one, ask directly what changed after that inspection and who's actually on the floor on Saturdays.
Village Healthcare And Rehabilitation runs 114 certified beds in Mcallen under corporate for-profit ownership, and the staffing numbers are the main thing to know. At 3.49 nurse hours per resident day, it sits about 10% under the national average of 3.86, and weekends run roughly 15% lighter than its own weekdays, so coverage thins out exactly when families tend to visit. Turnover at 33.3% is actually better than the 45.8% national figure, which is a real point in its favor. The inspection record is the harder part: 16 deficiencies, three at harm or jeopardy level and one abuse-related, plus two fines totaling $28,970. The most recent inspection was April 2025. Ask about weekend staffing and that abuse citation directly.
Friendship Haven runs about 3.20 nurse hours per resident per day, roughly 17% under the national average, and weekends dip about 9% below its own weekday staffing. Employee turnover sits at 50.4%, above the 45.8% national figure. Texas records show 17 deficiencies, two serious enough to involve harm or jeopardy, one tied to abuse, plus an $8,018 fine; the last inspection was November 2024. The health inspection rating is strong at 4 out of 5, but that sits alongside a 2 out of 5 staffing rating. For a 150-bed for-profit home, the pattern is consistent: care standards look good on paper while the day-to-day staffing that delivers them runs thin.
The Villa at Mountain View runs 3.31 nurse staffing hours per resident day, roughly 14% under the national average of 3.86, and weekends drop about 9% below its own weekday levels. That matters when you consider the record: 36 deficiencies, four of them at the harm or jeopardy level, one tied to abuse, plus three fines totaling $33,580. Staff turnover sits at 48.3%, a few points above the national 45.8%, and the most recent inspection was May 2025. Ownership is for-profit corporate, with 120 certified beds. The quality measure score looks strong on paper, but the staffing and inspection numbers describe a building where care depends heavily on who happens to be working that day.
Brenham Nursing and Rehabilitation Center runs on 2.71 nurse hours per resident day, roughly 30 percent under the national average of 3.86, and weekend coverage drops about 10 percent below its own weekday level. Staff turnover sits at 44.3 percent, close to the national figure of 45.8 percent, so this isn't a retention crisis so much as a thin floor of coverage that thins further on Saturdays and Sundays. The inspection record is where the real trouble shows: 28 deficiencies, two at harm or jeopardy level, one abuse-related, and two fines totaling $29,353. The most recent inspection was February 19, 2026. A five-star quality measure score doesn't offset a one-star inspection history at a home this size.
The state veterans home in Temple is a 160-bed for-profit operation, and its inspection record is the first thing to look at: 32 deficiencies on the current record, seven of them serious enough to cause harm or put residents in jeopardy, and five tied to abuse. Three fines totaling $53,476 followed. Staffing is the other concern, CMS rates it at the bottom of its scale, meaning the hours of direct care per resident fall well below what most Texas homes provide, even though the home's own quality measures score well. The last full inspection was March 2025, so the findings are recent. Ownership is a limited liability company. Families with a choice should ask hard questions here.
Avir At Park Bend runs on thinner nursing coverage than most homes, 3.18 nurse hours per resident day against a national average of 3.86, and weekends drop another 12% below its own weekday levels. That's the kind of gap families feel on a Saturday afternoon when call lights take longer to answer. Turnover sits at 46.1%, essentially matching the national rate, so staffing instability here isn't an outlier problem. The inspection record is more concerning: 28 deficiencies, including 3 at harm or jeopardy level and 4 tied to abuse, with $38,155 in fines. A June 2025 inspection is recent, and the 3/5 health inspection rating reflects real citations. Government hospital district ownership doesn't erase any of this.
The Frank M. Tejeda Texas State Veterans Home in Floresville runs lean on daily nursing hours, 3.09 per resident, roughly a fifth below the national average, and weekends dip about 13% below its own weekday coverage. What stands out instead is retention: turnover sits at 27.8%, well under the 45.8% national figure, which matters for familiar faces and consistent care. State-run, 160 beds, inspected in March 2026 and rated 4 of 5 on health inspections. The current record shows 22 deficiencies with none at the harm level, though 5 are abuse-related, worth asking about directly before you visit.
River City Care Center runs 92 certified beds under individual for-profit ownership, and its nurse staffing sits at 3.22 hours per resident day, roughly 17% under the national average, with weekends about 13% thinner than weekdays. That shortfall shows up in the federal staffing rating, which lands at the lowest tier. The inspection record is the heavier concern: 36 deficiencies on file, including two at the level where residents were actually harmed or put in jeopardy, plus one tied to abuse, and $23,410 in fines across two penalties. Its quality measure score looks good on paper, but that's largely self-reported data, and the last full inspection was in July 2025. The families I'd tell to look hardest at this one are those needing consistent hands-on care, especially on weekends.
Avir At Dripping Springs runs 60 certified beds under corporate ownership, and the staffing numbers are the part that should get your attention. At 2.80 nurse hours per resident day, it sits about 27% under the national average of 3.86, and weekend coverage dips roughly 9% below its own weekday level. Annual turnover hits 68.6% against a national 45.8%, so the people caring for residents are cycling through fast. The inspection record is genuinely strong, a 5/5 star rating and a clean December 2025 survey, with no deficiencies at the harm level. But 13 deficiencies on file, one abuse-related, plus a 1/5 staffing star, means the day-to-day coverage is where the risk lives.
Avir At Magnolia runs on 2.86 nurse hours per resident day, roughly a quarter below the national average, and weekends drop further from an already thin weekday floor. That staffing gap sits behind 37 deficiencies on record, seven of them involving harm or jeopardy and three tied to abuse, plus five fines totaling $50,906, a pattern worth asking the administrator about directly. Nearly six in ten staff left over the past year, well above the 45.8% national rate, and with the last inspection in August 2025, the record is current rather than dated. The quality measure score looks better than the rest, but quality numbers reflect resident assessments, not whether enough hands are on the floor.
The Alfredo Gonzalez Texas State Veterans Home in McAllen runs on a stable workforce, 28.5% turnover is well below the national 45.8%, and that consistency shows up in its staffing score. But 3.58 nurse hours per resident day sits about 7% under the national average, and weekends drop roughly 15% below the home's own weekday coverage, so care thins out when families tend to visit.
The bigger concern is the inspection record: a 2-out-of-5 health inspection rating, 30 deficiencies including 3 at harm or jeopardy level and 5 abuse-related, plus two fines totaling $35,600. State-run ownership brings accountability, but this home's last survey in January 2026 flagged real problems.
Avir At Texarkana runs a for-profit LLC with 110 certified beds, and the numbers pull in different directions. Nurse staffing sits at 4.56 hours per resident day, roughly 18% above the national average of 3.86, but weekend coverage drops about 7% below its own weekday level, and annual turnover hits 61.7% against a national 45.8%, so the hours are there, the consistency isn't. What drags the record down is the inspection history: 33 deficiencies, three at harm or jeopardy level and five abuse-related, with two fines totaling $146,860 and a health inspection rating of 1 out of 5. Ownership changed within the last 12 months, and the most recent inspection was June 11, 2025.
Maverick Nursing and Rehabilitation Center runs on a thin margin of nursing hours: 2.93 per resident day against a national average of 3.86, and weekends drop about 12% below its own weekday coverage. That staffing picture, not the inspection record, is what drags the home down, CMS gives it just one star for staffing even though inspections earned four and quality measures three. Turnover sits at 47.1%, slightly above the 45.8% national figure. Twenty-six deficiencies are on file, one serious enough to reach harm or jeopardy level, with a single fine of $15,642; the most recent inspection was December 12, 2025. If you're weighing this one, ask how they cover weekends.
Prestonwood runs on a hospital district's budget, and the nurse staffing shows it: 4.21 hours per resident day, roughly 9% above the national average. Weekends dip about 14% below its own weekday levels, worth asking about if your family visits Saturday or Sunday. The harder numbers are on the inspection side, 16 deficiencies on the current record, three of them at harm or jeopardy level and three abuse-related, with one fine totaling $14,433. Staff turnover sits at 46.8%, a hair above the national 45.8%. The last inspection was April 2025, so the record is recent. Strong staffing and quality scores, rough inspection history, that split is what the grade reflects.
Providence Park runs 3.24 nurse hours per resident per day, about 16 percent under the national average, and weekends drop another 13 percent below its own weekday staffing. The 125-bed for-profit has 23 deficiencies on its current record, two of them at the harm or jeopardy level, with two fines totaling $188,361. Its most recent inspection was June 18, 2025, and the health inspection rating sits at 2 of 5 stars. Staff turnover of 40.9 percent is slightly better than the 45.8 percent national figure, but a 2-star staffing rating paired with that many deficiencies is the real story here.
Heritage Park Of Katy runs on 2.86 nursing hours per resident per day, roughly a quarter below the national average of 3.86, and weekends drop about 7% below its own weekday staffing. That thin coverage sits behind a two-star CMS staffing rating, even though turnover at 43.5% is slightly better than the 45.8% national figure. The inspection record shows 17 deficiencies, including 2 at harm or jeopardy level and 1 abuse-related, with one fine of $25,508; the last inspection was November 2024. Owned by a hospital district, this home carries three stars each for health inspections and quality measures, middling marks that don't offset the low staffing.
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?