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.
McAlester Nursing & Rehab runs on thin staffing margins, the lowest tier on CMS's staffing measure, and that's the number that should worry you most, since aides and nurses are who actually deliver daily care. Turnover sits at 64.4% against a national average of 45.8%, meaning roughly two of every three employees left within the year; that churn shows up as unfamiliar faces and inconsistent care. The current record carries 16 deficiencies, including two at the harm or jeopardy level and two tied to abuse, with $17,193 in fines. The last inspection was July 31, 2024, so that record is recent. For-profit, limited liability ownership is worth knowing too.
Chestnut Hill runs 180 certified beds in Wilkes Barre under corporate for-profit ownership, and the numbers that stand out most are on the staffing side. At 3.50 nurse hours per resident day, it sits about 9% under the national average of 3.86, and weekends dip roughly 11% below its own weekday levels, meaning coverage is thinnest exactly when families tend to visit. Turnover is 61.5% against a national 45.8%, so the aides and nurses caring for your relative are more likely than not to be new to the building within the year. The current record carries 66 deficiencies, four of them abuse-related, though none at the harm level, and the last inspection was February 2026.
Bethlehem South runs 227 certified beds as a for-profit corporation, and its staffing numbers are the clearest thing on the page: 3.30 nurse hours per resident day against a national average of 3.86, with weekends running about 12% thinner than weekdays. That shortfall shows up in CMS's staffing rating of 1 out of 5, and turnover sits at 52.2% versus 45.8% nationally, roughly half the nursing staff cycling through in a year. The inspection record holds 28 deficiencies, none at harm level but three tied to abuse, plus one fine of $27,378. A September 2025 inspection is recent, so the picture is current rather than stale.
Shenandoah Senior Living runs on 3.13 nurse hours per resident per day, roughly 19% under the national average, and weekends drop about 8% below what the home itself staffs during the week. That thinner coverage matters more given the inspection record: 39 deficiencies, including three at the harm level and four tied to abuse, with two fines totaling $76,285. Annual turnover sits at 46.9%, just above the national figure. The most recent inspection was in May 2026. A for-profit limited liability company owns the 119-bed home. Whatever the quality measures suggest, the health inspection history is where the real trouble shows.
Birchwood runs 3.34 total nurse hours per resident per day, roughly 14% under the national average of 3.86, and weekend staffing drops another 8% below its own weekday level. Turnover sits at 53.9%, well above the 45.8% national figure, so the aides and nurses at the bedside keep changing. The inspection record shows 52 deficiencies, including three at the harm or jeopardy level and three abuse-related, with two fines totaling $123,390; the last inspection was March 2026. It's a for-profit LLC with 121 beds, and its quality measure score stands out against a staffing picture that doesn't.
Kadima Rehabilitation & Nursing At Latrobe runs 107 certified beds as a for-profit LLC, and the numbers that stand out most are about people, not beds. Annual staff turnover hits 71.4 percent here against a national average of 45.8 percent, that's a building where most of the caregivers you meet this year likely won't be there next year. Federal inspectors have logged 70 deficiencies on the current record, including four serious enough to involve harm or jeopardy and seven tied to abuse. The staffing and health inspection ratings both sit at the lowest mark CMS gives, and the most recent inspection was March 19, 2026. That combination, thin, unstable staffing plus a long paper trail, is what drives the low grade.
Wyndmoor Hills runs on 3.10 nurse hours per resident day, roughly a fifth below the national average of 3.86, and weekend coverage slips another 5% below its own weekday levels. That thin staffing sits alongside a one-star inspection rating and 82 deficiencies on the current record, including four at the harm or jeopardy level and four tied to abuse. Staff turnover is 47.7%, a bit above the national 45.8%, and the home has paid three fines totaling $102,309. The most recent inspection was January 10, 2025. Ownership is for-profit, through a limited liability company. Quality measures score better than the rest, but they don't offset what the inspection and staffing numbers show.
Riverview Healthcare Community runs 190 beds in Coventry under for-profit LLC ownership, and its staffing sits at 3.57 nurse hours per resident day, roughly 7% under the national average of 3.86. Weekends drop another 7% below the home's own weekday levels, so coverage thins out exactly when families tend to visit. Turnover is 40.1%, a bit better than the 45.8% national figure, but the inspection record is where things get serious: 31 deficiencies, two at harm or jeopardy level, and one abuse-related, with $63,518 in fines across two penalties. The most recent inspection was April 2, 2026, and CMS rated health inspections and staffing 2 out of 5.
Riverside Health And Rehab runs 160 certified beds in Charleston under for-profit LLC ownership, and its nurse staffing sits at 2.72 hours per resident day, roughly 30% under the national average of 3.86, with weekend coverage dipping about 10% below its own weekday level. Turnover is 46.2%, essentially tracking the national figure, so the shortfall isn't about constant churn; it's about how few hands are scheduled. The inspection record shows 21 deficiencies, including three at harm or jeopardy level and one tied to abuse, plus three fines totaling $27,788. The most recent inspection was April 21, 2026. Staffing star rating lands at 1 out of 5.
River Falls Post Acute runs 44 beds in Marietta under for-profit LLC ownership, and the staffing numbers are where the concern sits. At 3.12 nurse hours per resident day, it's roughly 19% under the national average, and weekends drop another 9% below its own weekday levels, so coverage thins out exactly when families tend to visit. Annual turnover of 59.5% is nearly 14 points above the national rate, meaning the aides and nurses caring for residents are frequently new. Inspections look better: a 4/5 health inspection rating, last survey in April 2026, 9 deficiencies with one at harm level and none abuse-related, plus a single $8,824 fine. The quality measures also rate 4/5. The gap between how care is documented and how consistently it's staffed is what pulls the overall picture down.
Nurse staffing at Huntsville Post-Acute runs 3.36 hours per resident day, about 13 percent under the national average, and weekends drop roughly 9 percent below the home's own weekday levels, so the thinnest coverage lands when families tend to visit. Annual turnover of 61.1 percent sits well above the 45.8 percent national figure, meaning many of the aides and nurses you meet may be new to the building. The current inspection record carries 28 deficiencies, four at harm or jeopardy level and one abuse-related, with a single $9,062 fine. Three straight two-star ratings on health inspections, quality measures, and staffing tell a consistent story rather than a fluke.
The Waters of Cheatham runs 80 certified beds in Ashland City under for-profit LLC ownership, and its staffing is the number that stands out: 3.09 nurse hours per resident day, roughly 20% under the national average of 3.86. Weekend coverage dips about 6% below its own weekday level, and annual turnover hit 67.5% against a national 45.8%, meaning most of the people caring for your family member are relatively new to the building. The inspection record carries 24 deficiencies, including one abuse-related citation, though none rose to harm or jeopardy level, and CMS fined the home twice for a total of $6,350. Its last inspection was March 26, 2026, so the record is current. Resident outcome measures score well; direct care hours per resident do not.
Nurse staffing at Waters of Memphis runs about 12% under the national average, and weekends get thinner still, roughly 13% below what the home staffs on weekdays. That gap matters, because care doesn't pause on Saturdays. Annual turnover sits near 60%, well above the 46% national figure, so the people at the bedside keep changing. The current record shows 13 deficiencies, four tied to abuse, though none rose to the level of actual harm or jeopardy; the last full inspection was in September 2023, and one fine totaling $5,293 has been levied. Quality measures score well, but staffing and inspections tell the more grounded story about daily conditions here.
Fort Worth Wellness & Rehabilitation runs on 2.80 nurse hours per resident day, roughly 27% under the national average of 3.86, and weekends drop about 14% below its own weekday staffing. That thin coverage is the main thing behind its one-star staffing rating, and it shows up alongside 19 deficiencies on the current record, including one at the harm level, plus a single fine of $122,336. The inspection history sits at two stars, most recently surveyed July 17, 2025, so nothing here is stale. Turnover of 46.7% is close to the national 45.8%, but with this staffing level, even average churn means less continuity for residents.
Avir At Petal Hill runs 3.50 nurse hours per resident day, about 9% under the national average, and weekend coverage drops roughly 14% below what the home staffs on weekdays. Its record shows 33 deficiencies, four of them at the harm or jeopardy level and two tied to abuse, with $31,256 in fines across two penalties. Staff turnover sits at 43.9%, a touch better than the 45.8% national figure. All three CMS ratings, health inspection, quality measures, staffing, land at 2 out of 5, and the most recent inspection was March 5, 2026. For a 120-bed for-profit corporate home, the pattern is thin staffing, repeated serious findings, and middle-to-low marks across the board.
Laredo West runs on 3.12 nurse hours per resident per day, roughly 19% under the national average of 3.86, and weekends drop about 13% below what the home itself staffs on weekdays. Turnover sits at 47.3%, slightly above the national 45.8%. Those numbers sit behind a one-star health inspection rating and a record of 31 deficiencies, three of them at harm or jeopardy level and four tied to abuse, with two fines totaling $49,719. The most recent inspection was April 2025, so the record is current, not stale. Government hospital district ownership doesn't change what the staffing and inspection data show. Families should ask direct questions about weekend coverage and the abuse-related findings before deciding.
Paradigm Northwest runs 148 beds in Houston under corporate for-profit ownership, and its nurse staffing sits at 2.96 hours per resident day, roughly a quarter below the national average of 3.86. Weekends dip about 11% below its own weekday levels, and annual turnover of 52.3% outpaces the national 45.8%, so the aides and nurses your family would see are cycling through steadily. Its inspection record carries 33 deficiencies, five serious enough to involve harm or jeopardy and one tied to abuse, with four fines totaling $51,400. The most recent inspection was December 2025, so that picture is current. CMS rates staffing and health inspections 1 out of 5; quality measures land at 3.
Guadalupe Valley runs 148 certified beds in Seguin under nonprofit ownership, which often signals stability, but the numbers here tell a more mixed story. Nurse staffing sits at 3.13 hours per resident day, roughly 19% under the national average of 3.86, and weekends drop about 12% below the home's own weekday levels, so coverage thins out exactly when families tend to visit. Staff turnover hits 48.1%, a bit above the national rate, while the inspection record shows 50 deficiencies, including two at the harm or jeopardy level and two tied to abuse, plus one $75,450 fine. The most recent inspection, in March 2026, is recent enough to reflect current conditions rather than old ones.
Desoto Nursing & Rehabilitation Center runs about 2.96 nurse hours per resident day, roughly a quarter below the national average of 3.86, and staffing thins out further on weekends. The bigger red flag is turnover: 96.6% of nursing staff leave within a year, against a national rate near 46%, which makes it hard to keep consistent caregivers who know the residents. The 18 deficiencies on record include one at the harm or jeopardy level, and a single fine of $12,740 has been levied. Quality measures look strong at 5/5 stars, but staffing sits at 1/5, and that gap between good outcomes on paper and thin, constantly changing staff is what drives the low overall score.
Crestwood runs on notably thin nursing coverage: 2.95 hours per resident day, roughly a quarter below the national average, and weekends drop about 10% below what the home already provides on weekdays. Inspectors have cited 45 deficiencies, including two at the harm or jeopardy level and three tied to abuse, with one fine of $10,839 and a health inspection rating of 1 out of 5; the last inspection was January 2024. Staff turnover sits at 59% against a national 45.8%, so the people providing care change often. The quality measure score of 5 out of 5 stands out against all of this, a gap worth asking the administrator about directly.
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?