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.
San Saba Nursing & Rehabilitation runs on 2.26 nursing hours per resident per day, roughly 41 percent below the national average, and the staff it does have turns over at more than double the typical rate. Weekends are thinner still, about 17 percent leaner than weekdays. What keeps this home from looking worse on paper is its inspection record: three deficiencies, none involving harm or abuse, and a clean five-star history on health inspections and quality measures as recently as the end of 2025. That gap matters. The clinical care being documented looks steady, but the people delivering it keep leaving, and there simply aren't enough of them.
Bellway runs lean on the floor: 2.87 nurse hours per resident day against a national average of 3.86, roughly a quarter less hands-on time than most homes. Weekends dip even further below its own weekday levels, and nearly half the staff turns over each year, so the people caring for your relative may often be new. Twelve deficiencies sit on the current record, including one at the harm level and three tied to abuse, with a $203,450 fine. The last inspection was July 2024. Ownership is a for-profit corporation, and the staffing and health inspection ratings both land at 2 out of 5.
The Springs Of Red Oak runs 80 certified beds in Hot Springs under corporate for-profit ownership, and its staffing sits at 3.68 nurse hours per resident day, about 5% under the national average, with weekends running roughly 8% lighter than its own weekdays. That thin coverage gets harder to defend when you see turnover at 78.3% against a national 45.8%; most of the people caring for your relative are new, and the ones who stay are spread thin. The inspection record shows 18 deficiencies, including one at harm or jeopardy level and one tied to abuse, plus a $14,935 fine. The most recent inspection was May 2026, so the picture is current.
Gem Tcu has 75 certified beds in Pasadena and runs a for-profit operation under an LLC. Total nurse staffing comes in at 4.47 hours per resident day, roughly 16% above the national average, but that number looks less steady when you see weekends run about 12% below weekdays, and annual turnover hits 59.7% against a national average of 45.8%. More than half the nursing staff leaves each year. The inspection record is where this home really struggles: 87 deficiencies, including 2 at the harm or jeopardy level and 4 tied to abuse, drawing a $27,808 fine. CMS rated its last inspection 1 out of 5 stars, and that inspection was recent, November 2025.
Highline Post Acute runs 125 beds in Denver under for-profit LLC ownership, and its nurse staffing sits at 3.12 hours per resident day, about 19% under the national average of 3.86. Weekends dip roughly 7% below its own weekday coverage, so the thinnest shifts are the ones families tend to visit. Turnover is 43.3%, slightly better than the 45.8% national figure. The inspection record is the harder read: 36 deficiencies, five at harm or jeopardy level, one abuse-related, and $92,284 in fines across four penalties. The last inspection was August 15, 2024. Quality measures score mid-range, but the health inspection side is where the problems concentrate.
The staffing number looks fine on paper, 3.96 nurse hours per resident day, just above the national average, but that average hides a churn problem. Nearly 68% of staff turned over in a year, against a national rate around 46%, and weekend coverage drops about 7% below weekdays, so the people at the bedside keep changing. The inspection record is the harder read: 67 deficiencies, four serious enough to involve harm or jeopardy, four tied to abuse, and $153,884 in fines. A for-profit limited liability company runs it, and its last inspection was February 2026. Quality measures score well; staffing and inspections do not.
Aviata At Seminole runs on 3.37 nurse hours per resident day, roughly 13 percent under the national average, and weekend coverage dips slightly below its own weekday levels. The bigger signal is staffing churn: 71.2 percent annual turnover against a national average of 45.8 percent. That's a lot of new faces for 120 residents, and it shows up in a one-star staffing rating and a one-star health inspection record, 37 deficiencies, three tied to abuse, plus eight fines totaling $35,944, with the last inspection in May 2024. The four-star quality measures suggest some care processes are working. But steady caregivers matter more than charts, and this building struggles to keep them.
Fulton Center runs about 2.92 nurse hours per resident per day, roughly a quarter below the national average, and weekends drop another 13% below its own weekday level, so the thinnest coverage lands when families tend to visit. Turnover sits at 54.9%, well above the 45.8% national figure, which means the aides and nurses who know your mother may not be there in six months. The record shows 23 deficiencies, five at harm or jeopardy level, plus three abuse-related citations and a $105,368 fine. Quality measures score well; inspections and staffing do not. Ask the administrator directly who covers Saturday nights.
Paradise Creek runs 3.36 nurse hours per resident day, about 13% under the national average, and weekends dip another 13% below its own weekday level. That's the pattern families feel: thinner coverage on Saturdays and Sundays. Staff turnover is 70.9% against a national 45.8%, so the people helping your relative are frequently new. The inspection record shows 27 deficiencies, 3 serious enough to cause harm or jeopardy, 2 tied to abuse, and 9 fines totaling $63,834. Its most recent inspection was May 2026, so the record is current. The company is a for-profit LLC, and it has consistently scored low on federal staffing and inspection measures. If you're considering it, ask specifically how weekends are staffed.
Alden Lincoln runs 96 beds on Chicago's North Side, and the numbers that stand out first are the ones about people. Nurse staffing sits at 2.98 hours per resident per day, about a quarter below the national average, and weekends dip roughly 14% below what the home itself provides Monday through Friday. That's the stretch when families often visit and when coverage thins.
The inspection record carries 36 deficiencies, four of them serious enough to put a resident in harm's way and two tied to abuse. The most recent state visit was July 2024, so the picture is current, and one fine totaling $8,512 has been levied.
Staff turnover of 41.3% is slightly better than the 45.8% national figure, not a strong point, but not the worst of it either.
Lakeland Rehab runs 154 beds in Effingham under corporate ownership, and its staffing is the weak spot: 3.39 nurse hours per resident day, roughly 12% under the national average, with weekends about 12% thinner than weekdays. The inspection history is the real concern, 27 deficiencies on record, including 4 at the harm or jeopardy level and 7 tied to abuse, plus three fines totaling $86,553. Turnover at 38.6% is actually better than the national 45.8%, and the 4-star health inspection and July 2025 visit are recent positives. But thin daily staffing against that deficiency record is what pulls this home's overall picture down.
Aperion Care Wilmington runs on 2.15 nursing hours per resident day, roughly 44% under the national average of 3.86, and weekends dip about 10% below its own weekday numbers. That thin coverage shows up in the inspection record: 47 deficiencies, including 5 at harm or jeopardy level and 13 tied to abuse, with four fines totaling $293,067. Turnover sits at 43.3%, slightly better than the 45.8% national figure, but stable-ish staffing doesn't offset a 1-out-of-5 CMS staffing rating or a 2-out-of-5 on health inspections. The most recent inspection was April 2025, so the record is current. For-profit, limited liability ownership.
Accolade Hc Of Paxton On Pells carries a for-profit, limited-liability ownership and a record that should give any family pause before signing. The home has 59 deficiencies on file, including 10 at the harm or jeopardy level and 6 tied to abuse, plus seven fines totaling $153,560, and its most recent health inspection earned a single star out of five. Nurse staffing sits at 3.55 hours per resident day, roughly 8% under the national average, with weekends about 3% leaner than weekdays. Annual turnover of 48% tops the national 45.8% figure, meaning the people caring for your relative are likely to keep changing. Ask hard questions about that abuse history and what's changed since January 2025.
Pearl of Elk Grove runs 190 beds under corporate ownership, and its nurse staffing sits at 3.20 hours per resident day, roughly 17% under the national average of 3.86. Weekends drop about 9% below its own weekday levels, so the thinnest coverage lands when families tend to visit. The inspection record is where the real weight sits: 56 deficiencies, 10 of them at harm or jeopardy level and 7 tied to abuse, plus five fines totaling $144,133. Staff turnover of 47.3% runs slightly above the national 45.8%. The most recent inspection was December 19, 2025. Quality measures score well; staffing and inspections do not.
St. Clara's runs leaner than most homes on the floor: 2.95 nurse hours per resident day, roughly a quarter below the national average, and weekends dip further below its own weekday numbers. That thin coverage is the core issue behind its low staffing rating, and it's worth asking how the home handles a Saturday night. Turnover is better than average at 34.6%, and there are no abuse deficiencies, which matters. But 19 deficiencies with two at harm level, two fines totaling nearly $71,000, and a February 2025 inspection point to real compliance problems. The nonprofit owner doesn't change what the numbers show.
The Grove of Northbrook runs lean on nurses, 2.20 hours per resident day against a national average of 3.86, roughly 43% below. Weekend coverage barely dips from its own weekday level, so the thinness is consistent rather than a weekend problem. What stands out in the other direction is turnover: 18.8% against a national 45.8%, meaning the staff who are there tend to stay. Inspections, though, are where this home gets exposed. Nineteen deficiencies on the current record, four of them at harm or jeopardy level and two tied to abuse, plus three fines totaling $83,860. The most recent inspection was June 2024, so that record is current.
Pearl of Hillside runs 198 certified beds under for-profit LLC ownership, and its nurse staffing sits at 3.15 hours per resident day, roughly 19% under the national average of 3.86. Weekends drop another 12% below what the home staffs on weekdays, so coverage thins out exactly when families tend to visit. The inspection record is where the real weight sits: 52 deficiencies, six of them at harm or jeopardy level and two tied to abuse, plus three fines totaling $131,810. Turnover at 41.1% is slightly better than the 45.8% national figure, but that's the one number working in its favor. The most recent inspection was March 2025.
Alden Estates of Orland Park runs 200 beds under corporate ownership, and the staffing numbers are the first thing worth noticing. At 3.65 nurse hours per resident day it sits about 5% under the national average, and weekends drop roughly 13% below its own weekday levels, so coverage thins out exactly when families tend to visit. Annual turnover of 50.3% runs above the 45.8% national figure, which means the aides and nurses caring for residents are often new to the building. The inspection record backs that up: 53 deficiencies, seven serious enough to reach harm or jeopardy level, one tied to abuse, and five fines totaling $87,510.
Elevate Care Country Club Hill runs 200 certified beds in Cook County under corporate ownership, and its nurse staffing sits at 3.28 hours per resident day, roughly 15% under the national average of 3.86. Weekends dip about 11% below its own weekday coverage, so the thinnest shifts land when families tend to visit. The inspection record is the bigger concern: 54 deficiencies, 14 of them serious enough to put residents at harm or jeopardy, six tied to abuse, and seven fines totaling $436,375. Turnover, at 45.1%, is basically average. Quality measures score well, but staffing and inspections don't.
Elevate Care Windsor Park is a 240-bed for-profit home on Chicago's southwest side, and the number that stands out is nurse staffing: 2.97 hours per resident day, roughly 23% under the national average of 3.86. Weekends run about 14% thinner than weekdays, so coverage gets lightest exactly when families tend to visit. Turnover sits at 42.1%, a bit better than the national 45.8%, but that's cold comfort next to 72 deficiencies on the current record, 8 at harm or jeopardy level and 3 abuse-related, plus four fines totaling $84,764. The last inspection was April 3, 2026, and the health inspection rating is 2 out of 5. Ask about weekday-to-weekend staffing and how abuse-related issues were resolved.
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?