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.
Pine Forest runs 4.87 nurse hours per resident per day, well above the national figure of 3.86, but that average hides a lot, since weekends drop roughly 27% below its own weekday coverage. Staff turnover sits at 63% against a national 45.8%, meaning the people providing that care are often new or on their way out. The inspection record is the harder problem: 41 deficiencies, 11 of them at harm or jeopardy level and 5 tied to abuse, plus six fines totaling $136,799. The most recent inspection was June 2025, so this is a current picture, not history. For-profit, limited liability ownership.
Delmar Gardens On The Green runs 120 certified beds in Chesterfield under corporate ownership, and the numbers tell a mixed story. Nurse staffing sits at 4.38 hours per resident day, roughly 13% above the national average, though weekends run about 4% thinner than weekdays and annual turnover hits 57.7% against a national 45.8%, meaning the people providing that above-average care are cycling through fast. The clinical record is harder to defend: 30 deficiencies, including 2 at harm or jeopardy level and 3 tied to abuse, plus one fine of $46,589. A recent October 2024 inspection gives you current information, but a 1/5 quality measure rating alongside that deficiency count suggests the extra staffing hours aren't translating into measured outcomes.
Kirksville Manor Care Center runs 119 certified beds under corporate for-profit ownership, and the numbers here are hard to read. Nurse staffing sits at 4.08 hours per resident day, roughly 6% above the national average, but that average hides a real drop on weekends, when coverage falls about 15% below the home's own weekday level. Meanwhile, annual turnover is 57.4%, well above the 45.8% national figure, so the people providing that care keep changing. The inspection record shows 54 deficiencies, seven at harm or jeopardy level, one tied to abuse, and $250,823 in fines across two penalties.
Gainesville Nursing runs 99 certified beds under corporate for-profit ownership, and its staffing is the number that stands out: 2.63 nurse hours per resident per day, roughly a third below the national average of 3.86. Weekend coverage drops about 12% below its own weekday level, so the thinnest shifts land when families tend to visit. Annual turnover sits at 48.6%, a bit above the national 45.8%. The inspection side looks strong on the surface, 4 of 5 stars, last survey in September 2024, but the record carries 25 deficiencies, six of them abuse-related, none flagged at harm or jeopardy level. Quality measures come in at 1 of 5 stars, which is where the gap between paperwork and daily care tends to show up.
Westchester House runs 159 beds in Chesterfield under corporate ownership, and its nurse staffing sits at 3.29 hours per resident day, roughly 15 percent under the national average, with weekends about 9 percent thinner than weekdays. On top of that, 69 percent of its nursing staff turns over in a year against a national rate near 46 percent, so the people providing hands-on care are constantly changing. The inspection record shows 43 deficiencies, including two at the harm level and three tied to abuse, with one fine of $83,824 and a health inspection rating of 2 out of 5. Its quality measure score is a bright spot at 4 out of 5, but quality numbers rest on the staffing that produces them.
River City Living Community has 50 deficiencies on its current record, including three at the harm or jeopardy level and nine tied to abuse. That's the part that matters most. Staffing sits at 3.87 hours per resident day, essentially identical to the national average of 3.86, but weekends run about 6% below the home's own weekday level, and annual turnover is 73.1%, well above the 45.8% national figure. The last inspection was October 2024, and there's one fine on record totaling $237,995. For-profit corporate ownership rounds out the picture. The staffing number looks fine on paper, but a 73% turnover rate suggests the people providing care keep changing.
Portageville Health Care Center has kept its health inspection record clean enough to earn four stars there, and its most recent survey was in May 2025. But the staffing picture is where things get shaky, CMS gives it one star, and annual turnover runs at 61.5%, well above the 45.8% national average. That churn matters more than any single inspection when you're thinking about who's actually at the bedside day to day. The facility also carries 25 deficiencies, one of them abuse-related, and a single fine of $240,603 on record. Nothing in the file points to immediate jeopardy, but the combination of thin staffing and high turnover is the real story here.
Wilshire at Lakewood runs 170 beds in Lee's Summit under limited-liability ownership, and its inspection history is the strongest part of the picture, a recent survey, a four-star health inspection rating, and no repeat of serious problems since. Staffing is where the trouble sits: 3.43 nurse hours per resident day, roughly 11% under the national average, with weekends about 12% thinner than weekdays. Turnover hits 66.5% against a national 45.8%, meaning most of the people caring for your family member are new to the building. The 34 deficiencies on record include one at harm level and two tied to abuse, which is worth asking about directly before you decide.
Creve Coeur Manor runs on 2.47 nurse hours per resident day, roughly a third less than the national average of 3.86, and weekend coverage drops further below its own weekday level. Staff turnover sits at 74.1% against a national 45.8%, meaning most of the people caring for residents this year likely won't be there next year. The current record carries 66 deficiencies, including one at the harm level and one abuse-related, with a single fine of $9,440. It's a for-profit limited liability company, 149 beds, last inspected November 2024.
Pioneer Care and Rehabilitation in Dillon is a for-profit limited liability company with 87 certified beds, and the numbers behind its record deserve a close look. The home has 53 deficiencies on file, including five at the harm or jeopardy level and four tied to abuse, along with six fines totaling $140,630. Its health inspection rating sits at 1 out of 5, and last May's inspection is recent. Nurse staffing runs 3.69 hours per resident day, about 4% under the national average, with weekends roughly 13% below its own weekday level. Annual staff turnover is 85.3% against a national average of 45.8%, a rate that makes consistent care hard to sustain.
Carthage Center runs about 3.25 nursing hours per resident day, roughly 16% under the national average, and its weekends dip about 26% below its own weekday coverage, so the aide or nurse available Monday may not be there Saturday. Staff turnover sits at 68.6% against a national 45.8%, which means more than two-thirds of the nursing staff turned over in a year. The 31 deficiencies on record include none flagged for harm or abuse, and the last inspection was in September 2024. The quality measure score is high, but that reflects charted care, not the hands on the floor.
Davidson Health & Rehab Center runs on 3.50 nursing hours per resident day, about 9% under the national average, and weekend staffing drops roughly 12% below its own weekday level, so the thinnest coverage lands when families tend to visit. Staff turnover sits at 72% against a national 45.8%, which means the people caring for your relative are often brand new. The current inspection record carries 43 deficiencies, including six at harm or jeopardy level and two abuse-related, plus $54,389 in fines across three penalties. Its last inspection was August 2025, so the record is recent. Corporate ownership, a one-star inspection rating, and one-star staffing tell the same story.
Elevate Health and Rehabilitation runs 3.25 nursing hours per resident per day, roughly 16% under the national average, and weekends drop about 10% below its own weekday levels. Turnover sits at 72.8% against a national 45.8%, so the people providing care keep changing. Inspection history is the harder problem: 30 deficiencies on the current record, six at harm or jeopardy level and one abuse-related, plus three fines totaling $174,346. The September 2025 inspection is recent, and the one-star inspection and staffing ratings reflect what surveyors found. Quality measures score well, but that's a narrow slice of the picture.
Redwood Health & Rehab runs 116 beds in Charlotte under for-profit limited liability ownership, and the staffing numbers are the main thing to know. At 3.43 nurse hours per resident day, it sits about 11% under the national average of 3.86, and weekends drop roughly another 5% below its own weekday level. Turnover is 55.6% against a national 45.8%, so aides and nurses are cycling through faster than usual. The current inspection record shows 16 deficiencies, none at the harm or jeopardy level and none abuse-related, with two fines totaling $7,742 and a survey dated May 2026. Quality and staffing measures both land at 2 out of 5 stars.
Smoky Ridge runs on thinner nursing coverage than most homes, 3.08 nurse hours per resident day against a national average of 3.86, with weekends dipping about 11% below its own weekday levels. That staffing pattern sits behind a CMS staffing rating of 3, but the inspection record is the bigger concern: 21 deficiencies, including one at the harm level and two tied to abuse. Add a $59,631 fine and a 51.6% annual turnover rate that outpaces the national figure of 45.8%, and you get a home where consistency is hard to maintain. The most recent inspection was in March 2025, so the picture is current.
Village Care of King runs 96 beds under for-profit LLC ownership, and the staffing numbers are where the trouble starts. At 3.58 nurse hours per resident day, it sits under the national average, and weekends drop about 11% below its own weekday level, meaning the thinnest coverage lands when families tend to visit. Turnover tells a related story: 77.8% of staff leave annually, well above the 45.8% national rate. The current record carries 15 deficiencies, four at harm or jeopardy level and two abuse-related, plus three fines totaling $110,113. A recent inspection in January 2026 and a 1/5 staffing star confirm the pattern.
Pisgah Manor runs on 2.86 nurse hours per resident per day, roughly a quarter below the national average of 3.86, and weekend coverage dips about 6% below its own weekday level, so the thinnest shifts come when families tend to visit. Staff turnover sits at 59.1% against a national 45.8%, which means CNAs and nurses are cycling out faster than residents can get used to them. The inspection record shows 12 deficiencies, one serious enough to put a resident in harm's way, plus a $59,391 fine. A 2/5 on health inspections and 2/5 on staffing tell you the same story the numbers do.
Liberty Commons runs on 3.17 nurse hours per resident per day, roughly 18% under the national average, and weekends dip about 7% below its own weekday level. That thin staffing shows up in a 70.5% annual turnover rate, well above the 45.8% national figure, so the people caring for your relative are often new. The health inspection record is recent (May 2025) and rated well, but the home carries 36 deficiencies, six at harm or jeopardy level and two abuse-related. A four-star inspection rating and a one-star staffing rating can coexist; here they do, which tells you the problems aren't in paperwork but in daily coverage.
Brunswick Health & Rehab Center runs 100 certified beds in Ash under corporate for-profit ownership, and its nurse staffing sits at 3.47 hours per resident day, about ten percent under the national average of 3.86. Weekend coverage drops another twelve percent below its own weekday level, and turnover runs 55.1 percent against a national 45.8. The current inspection record carries 32 deficiencies, six at harm or jeopardy level and two tied to abuse, with four fines totaling $252,827 and a one-star health inspection rating. Quality and staffing each earned three stars, but the last inspection was April 2026, so the record is recent. Ask about weekend nurse coverage and what's changed since that citation history.
Inniswood runs lean on nursing staff, 3.17 hours per resident day against a national average of 3.86, and the gap widens on weekends, when coverage drops about 10% below its own weekday level. That thinness shows up in turnover, too: 59.3% of staff left last year, well above the 45.8% national figure. The inspection record is heavy: 47 deficiencies, five serious enough to involve harm or jeopardy, four tied to abuse, and a $169,562 fine. Ownership is for-profit corporate, and the last full inspection was July 2025. Quality measures score well, but the staffing and inspection numbers are what a family should weigh.
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?