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.
Tomball Rehab & Nursing runs on 2.77 nurse hours per resident day, roughly 28% under the national average, and weekends drop another 8% below its own weekday coverage. That thin staffing shows up in the numbers: 68% annual turnover, well above the 45.8% national figure, and a one-star CMS staffing rating. The hospital district ownership doesn't change what the payroll looks like day to day.
Inspectors cited 26 deficiencies on the current record, two serious enough to involve harm or jeopardy, with $110,495 in fines across two penalties. The most recent inspection was February 2026. Quality measures score well at four stars, but that's a self-reported side of the ledger, and it sits against a two-star inspection history and staffing that's the real story here.
Focused Care At Webster runs a 120-bed for-profit operation in Harris County, and the staffing numbers are the first thing to look at. Nurse coverage sits at 3.56 hours per resident day, about 8% under the national average, and it thins out further on weekends. Annual turnover hits 66.3% against a national 45.8%, so you're looking at a building where two out of three caregivers left within the year.
The inspection record backs that up: 32 deficiencies on file, three at harm or jeopardy level, five tied to abuse, and $34,665 in fines across two penalties. The last inspection was January 30, 2025. Quality measure scores look strong, but that's largely charting, the direct-care hours and the harm-level findings are what a family will actually feel.
Georgia Manor runs on thin staffing, and the numbers show it: 3.01 nurse hours per resident day, roughly a fifth below the national average, with weekends dropping another 14% beneath its own weekday levels. Nearly every employee leaves within a year, turnover sits at 97.7% against a national average of 45.8%, so the people caring for residents are, more often than not, new to the building. The inspection record adds weight: 37 deficiencies, including one at the harm level and three tied to abuse, plus an $8,031 fine. A recent inspection date helps, but it doesn't erase a staffing pattern where continuity is nearly absent.
Reunion Plaza is run by a hospital district, and its inspection record is genuinely clean, five deficiencies on the books, none causing harm or involving abuse, and a recent survey from August 2025. The problem sits elsewhere. Nurse staffing runs 3.20 hours per resident day against a national average of 3.86, and weekends drop roughly 9% below the home's own weekday coverage, so the hours thin out exactly when families tend to visit. Annual turnover of 66.3% is well above the 45.8% national figure, which means aides and nurses are cycling through regularly. Good inspections, thin and unsettled staffing, that combination is what a C reflects here.
Matagorda Nursing & Rehabilitation Center runs a 100-bed for-profit operation in Bay City, and the staffing numbers are where the trouble shows. At 3.50 nurse hours per resident per day, it sits about 9% under the national average, and weekends drop roughly 14% below its own weekday coverage, so the thinnest shifts land when families tend to visit. Annual turnover of 87.8% is nearly double the national rate, meaning the people providing most of the daily care are, statistically, on their way out. Twelve deficiencies sit on the current record, one serious enough to involve harm or jeopardy, along with a $16,555 fine. A May 2025 inspection is recent, so the picture isn't stale.
Focused Care at Hogan Park runs on 2.37 nurse hours per resident day, well under the national average of 3.86, and weekend coverage drops further below its own weekday level. Staff turnover sits at 63% against a national 45.8%, so the people showing up are often new. The current inspection record carries 45 deficiencies, one serious enough to reach harm or jeopardy level, and a $9,110 fine; the last inspection was in January 2025. The government-hospital-district owner is a real distinction from a for-profit chain, but it hasn't translated into steady hands or enough of them. Ask how they hold staffing together on weekends before you decide.
Park Manor Of Cypress Station runs on thin nursing coverage: 3.09 hours per resident per day against a national average of 3.86, and weekends dip about 14% below its own weekday level. That staffing shortfall shows up in a 61% annual turnover rate, well above the 45.8% national figure, and in a one-out-of-five CMS staffing star. The inspection record is harder to look past: 27 deficiencies, seven at harm or jeopardy level, three tied to abuse, and $29,517 in fines, with the most recent inspection dated June 2025. Owned by a for-profit limited liability company, its quality measure star of four out of five stands out against everything else, though strong chart numbers don't change what happens on the floor.
Avir At Houston runs 148 certified beds as a for-profit corporation, and the numbers that matter most here are thin. Nurse staffing sits at 2.79 hours per resident day against a national average of 3.86, roughly 28% below, and weekends drop about 19% below the home's own weekday coverage, so the thinnest shifts are when families tend to visit. The inspection record carries 35 deficiencies, six of them serious enough to involve harm or jeopardy, plus four fines totaling $178,352. The most recent inspection was May 8, 2026. Federal quality measures score well, but that sits against a 1/5 staffing rating and a 1/5 inspection rating. If you're weighing this one, ask specifically how weekend coverage is handled.
Rockdale Estates runs about 2.7 nursing hours per resident each day, roughly 30% under the national average of 3.86, and weekends dip even lower. That thin coverage shows up against a one-star quality measure rating and 13 deficiencies on the current record, including one at the harm or jeopardy level, plus a single fine of $8,018. The inspection history is the bright spot: four stars and a recent April 2025 survey. Turnover at 42.6% is actually a bit better than the national 45.8%, so the problem isn't churn, it's how few hands are scheduled per resident, especially on weekends.
Avir At Sherman runs on 3.06 nurse hours per resident per day, roughly a fifth below the national figure, and weekends drop about 9% below what the home staffs on weekdays. That shortfall shows up in the numbers that matter: the federal staffing rating sits at 1 out of 5, with annual turnover at 87.1% against a national rate near 46%. Thirty-three deficiencies appear on the current record, three tied to abuse, though none reached harm or jeopardy. The last inspection was June 2025, and quality measures actually score well. A for-profit LLC runs the 132-bed home, so ask directly how they hold onto aides and who covers weekends.
Castro County Nursing & Rehabilitation runs on thin staffing: 2.93 nurse hours per resident day, roughly a quarter below the national average, and weekends dip even lower than its own weekdays. Turnover sits at 52.2%, so the people around your relative are frequently new. The inspection record backs up the concern, 53 deficiencies, four serious enough to involve harm or jeopardy, eight related to abuse, plus a $47,932 fine. The quality measure star rating is decent at 4/5, yet staffing earned just 1/5 and inspections 2/5 under CMS. The most recent inspection was May 2025, so this picture is current. This for-profit LLC has real problems filling shifts, and that shows up in the record.
Millbrook runs on thin staffing: 3.08 nurse hours per resident day against a national average of 3.86, and weekends drop about 10% below its own weekday level. The people who do show up don't stay, 69.7% turnover versus 45.8% nationally means most of the staff you'd meet today likely won't be there next year. Inspectors cited 22 deficiencies, one serious enough to involve harm or jeopardy, and fined the home $13,565; the most recent inspection was in February 2025. A for-profit limited liability company owns the place. The quality measures look better than the staffing numbers, but good scores on paper don't change how few hands are on the floor.
Avir At Dallas runs 136 beds under for-profit LLC ownership, and its inspection record is the first thing to notice: 29 deficiencies on file, two of them serious enough to cause harm or jeopardy, plus one abuse-related finding and an $8,018 fine. Staffing is the other trouble spot, 3.28 nurse hours per resident day sits about 15% under the national average, weekends run roughly 14% lighter than weekdays, and turnover hits 75.7% against a national 45.8%, so the people caring for your family member are likely new and often stretched thin. The most recent inspection was July 2025, so the picture is current.
Legend Oaks North runs 3.17 nurse hours per resident day against a national average of 3.86, and weekends drop roughly another 15% below what the home manages Monday through Friday. That thin coverage sits alongside 24 deficiencies on the current record, including two at the harm or jeopardy level and three tied to abuse. Federal inspectors also logged a $41,890 fine, and the most recent inspection is dated April 2026. Throw in for-profit LLC ownership and a 1/5 staffing star rating, and the pattern is consistent: this is a home regulators have cited repeatedly, with staffing that leaves little margin when something goes wrong.
The Heights of Tyler runs 3.13 nurse hours per resident day, roughly 19 percent under the national average, and weekend coverage dips about 12 percent below what it manages on weekdays. That thin margin sits behind a staffing rating of 1 out of 5 even though the home's last inspection in February 2026 produced a 4-star health inspection result. Turnover adds another layer: 56.1 percent of staff leave annually, well above the 45.8 percent national figure. The current record lists 21 deficiencies, one involving harm or jeopardy and one abuse-related, plus a $14,276 fine. Ownership is for-profit partnership. The inspection picture looks better than the day-to-day staffing reality.
Avir At Schertz runs on 2.93 nurse staffing hours per resident day, roughly a quarter below the national average of 3.86, and weekend coverage dips about 12% below its own weekday level. Staff turnover sits at 79.4% against a national average of 45.8%, so the people caring for residents change constantly. The inspection record shows 65 deficiencies, including three at the harm or jeopardy level and five tied to abuse, with $39,676 in fines and a most recent inspection dated February 27, 2026. Ownership is a for-profit limited liability company. The quality measure score looks strong on paper, but that number rests on a staffing and inspection picture that is far weaker.
San Gabriel Rehabilitation and Care Center runs 142 beds in Round Rock under for-profit LLC ownership. Nurse staffing sits at 3.18 hours per resident day, roughly 18% under the national average, and weekends run thinner still, about 7% below what the home staffs on weekdays. Turnover is 55.1%, close to ten points above the national rate, which means the aides and nurses your family member sees may keep changing.
The inspection record is the harder part: 32 deficiencies, three at harm or jeopardy level, six tied to abuse, and $19,393 in fines. CMS gave it one star each for health inspections and staffing. The most recent inspection was July 2025, so the record is current, not stale.
Magnolia Crossing runs on a government-hospital-district license and 128 beds, and its last inspection wrapped in May 2025 with a four-star health inspection rating, genuinely the strongest number here. The staffing numbers tell a different story. At 3.26 nurse hours per resident day, it sits about 16% under the national average, and weekends drop roughly 11% below its own weekday level, so the thinnest coverage lands when families tend to visit. Staff turnover hits 58.9% against a 45.8% national figure. Twenty deficiencies sit on record, none at harm level, though three are abuse-related. A strong inspection record is carrying a lot of weight for a building where people keep leaving.
St. Giles runs about 124 beds in El Paso, and the staffing numbers are where the trouble starts. At 3.61 nurse hours per resident day it sits roughly 7% under the national average, and weekend coverage drops another 9% below what it manages on weekdays. The bigger red flag is turnover: 93.9% of staff leave within a year, against a national average near 46%, that's an entirely new workforce roughly every twelve months. The current record carries 44 deficiencies, two tied to abuse, though none reached harm or jeopardy level and the last inspection was recent.
Big Spring Center For Skilled Care runs on thin nursing coverage: 3.43 hours per resident day against a national average of 3.86, with weekends dropping about 13% below its own weekday level. The bigger warning sign is turnover, 91.7% annually, roughly double the national rate, meaning nearly the entire nursing staff cycles through in a year. Inspections look decent on paper with a 4-star rating and a recent visit, but the record still carries 27 deficiencies, including one at the harm level and four tied to abuse, plus an $8,184 fine. Corporate-owned and certified for 120 beds, this is a home where you'd want to ask hard questions about who's actually on the floor at 2 a.m. on a Sunday.
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?