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.
Adept Nursing & Rehab Of Waverly runs 54 beds under corporate ownership, and the staffing numbers are the first thing to look at. At 3.50 nurse hours per resident day, it sits about 9% under the national average, and weekends drop roughly 11% below its own weekday levels, so the thinnest coverage lands when families tend to visit. Turnover is the bigger flag: 78.1% of staff leaving annually, against a national 45.8%, meaning the people caring for residents are still learning the building. Behind the one-star inspection rating sit 41 deficiencies, including two at harm or jeopardy level and two tied to abuse, plus $25,642 in fines. The most recent inspection was December 2024.
Accura Healthcare of North Platte runs 71 certified beds under corporate ownership, and its last state inspection was in April 2025, recent enough that the findings still reflect how the place operates now. That inspection history is the strong part: 19 deficiencies on record, but none at the harm or jeopardy level and none tied to abuse. Where it gets thinner is staffing. At 3.35 nurse hours per resident day, it sits about 13% under the national average, weekend coverage dips below its own weekday level, and turnover near 65% means CNAs and nurses keep cycling through. High turnover and below-average hours are the combination families usually feel first.
The Subacute at Autumn Lake Healthcare has 124 beds and enough nursing hours per resident day to sit about 12% above the national average, which sounds reassuring until you notice weekends run roughly 12% thinner than weekdays and staff turnover hits 65.6%, well above the 45.8% national figure. A one-star health inspection rating sits alongside 26 deficiencies, four of them at harm or jeopardy level and one abuse-related, plus $130,206 in fines across two penalties. The five-star quality measure score doesn't offset that inspection record, and the most recent survey dates to March 2026. For-profit, individually owned, with a staffing rating that contradicts the raw hours.
Casa Arena runs on thin staffing: 2.92 nurse hours per resident day against a national average of 3.86, and weekends dip even further below its own weekday levels. With 60.8% annual turnover, aides and nurses are cycling out faster than most homes in the country, which makes consistent care hard to deliver. The inspection record is where the real trouble sits, 92 deficiencies, including three at harm or jeopardy level and eight tied to abuse, plus $124,375 in fines. A 4/5 on quality measures doesn't offset a 1/5 on inspections and staffing; those measures largely reflect what the home reports about its own residents. The last survey was recent, June 2025, so the picture is current.
The Pines at Utica runs on 3.56 nurse hours per resident per day, roughly 8% under the national average, and weekends drop about 14% below its own weekday staffing. That thin coverage shows up in a 49.5% annual turnover rate, above the national figure, and a one-out-of-five staffing rating. The inspection record is heavy: 28 deficiencies, three serious enough to cause harm or jeopardy, plus two fines totaling $55,708. State surveyors were last in on July 22, 2025. This is a for-profit LLC operation with 117 beds, and its quality measures rate two stars. Families should ask directly how weekend coverage is handled.
Liberty Commons runs 107 certified beds in Whiteville under corporate, for-profit ownership, and its nurse staffing sits at 3.86 hours per resident day, essentially matching the national average, not beating it. But weekends drop roughly 11% below its own weekday coverage, and annual turnover is 62% against a national 45.8%, so the people at the bedside change constantly. The inspection record is where the real weight sits: 27 deficiencies, 8 of them at harm or jeopardy level, four fines totaling $126,586, and a July 2025 inspection that landed at one star for health and one for quality measures. No abuse citations appear on record, but the harm-level findings and turnover together tell you why families here should ask hard questions before signing anything.
Litchford Falls runs on thinner nurse coverage than most homes, 3.55 hours per resident day against a national average of 3.86, and weekends dip even lower than its own weekday levels, which matters because that's when families often visit and when problems tend to surface. Staff turnover sits at 50.6%, meaning roughly half the nursing team leaves within a year, well above the 45.8% national figure. The inspection record backs this up: 19 deficiencies, three serious enough to put residents at risk of harm, and two fines totaling $181,873. The last full inspection was in May 2025, so the picture is fairly current. All three CMS star ratings, health inspections, quality measures, and staffing, come in at 2 out of 5.
Edgewood Manor runs 80 certified beds in Port Clinton under for-profit partnership ownership, and the numbers that stand out most are on the staffing side. At 3.19 nurse hours per resident day, it sits about 17% under the national average, weekend coverage dips roughly 9% below its own weekday level, and 55.4% annual turnover means more than half the staff left within the year. The inspection record shows 33 deficiencies, including one at the harm level and five tied to abuse, with the most recent visit in July 2024.
Gardens Of Euclid Beach runs on thin nursing coverage: 3.42 hours per resident day against a national average of 3.86, with weekends dipping about 12% below its own weekday levels. That shortfall shows up in the workforce itself, 71.4% annual turnover, well above the 45.8% national figure. The inspection record is the harder read: 60 deficiencies, two at harm or jeopardy level, two tied to abuse, and a single $200,605 fine, with the most recent inspection in September 2025. A for-profit limited liability company operates the 99-bed home. Its quality measure score looks strong, but staffing and inspection results sit at the bottom of CMS's scale, and those are the measures families feel day to day.
Cardinal Woods runs on 3.02 nurse staffing hours per resident day, roughly 22 percent under the national average of 3.86, and weekends drop about 11 percent below what the home staffs on weekdays. That thin coverage sits alongside a 67 percent annual turnover rate, well above the 45.8 percent national figure, so the aides and nurses at the bedside keep changing. The current inspection record shows 42 deficiencies, five at harm or jeopardy level and eight tied to abuse, with $27,318 in fines and a survey that dates to August 2024. The quality measures look better than the rest, but they don't offset what's happening with staffing and oversight.
Continuing Healthcare At Forest Hill runs 88 certified beds in St. Clairsville under corporate ownership, and the staffing numbers are the first thing to look at. At 3.04 nurse hours per resident day, it sits roughly 21 percent under the national average of 3.86, and weekends drop about 11 percent below its own weekday level. That thin coverage shows up in the federal staffing rating of 1 out of 5, and turnover runs 56.3 percent against a national 45.8 percent, more than half the nursing staff leaving in a year. The current record carries 45 deficiencies, two of them serious enough to involve harm or jeopardy. Its last inspection was in January 2026.
University Manor runs on 3.01 nurse staffing hours per resident per day, about 22 percent under the national average of 3.86, and weekends dip roughly 6 percent below its own weekdays, so coverage is thinnest exactly when families tend to visit. Its inspection record carries 47 deficiencies, including two at the harm or jeopardy level and six tied to abuse, plus $32,394 in fines. Staff turnover sits at 47.8 percent against a national 45.8, and the last inspection was December 5, 2024. As a nonprofit corporation, it isn't chasing shareholder returns, but that structure hasn't translated into stronger numbers here.
Altercare Newark South runs 47 beds in Licking County under corporate ownership, and the staffing numbers are where the trouble shows. At 3.43 nurse hours per resident day, it sits about 11% under the national average, weekends dip another 11% below its own weekdays, and turnover hits 66.7% against a national 45.8%, so the people caring for residents keep changing, and there are fewer of them on Saturdays and Sundays. That staffing pattern earned a 1 out of 5 from CMS. Inspectors logged 24 deficiencies, two serious enough to involve harm or jeopardy, plus two fines totaling $252,477. The most recent inspection was in May 2025. Resident care measures score well; the workforce behind them is the open question.
Avenue Care and Rehabilitation Center is a for-profit, limited-liability operation in Warrensville Heights with 97 certified beds, and its staffing numbers tell a hard story. Nurses provide 3.58 hours per resident day, roughly 7% under the national average, and weekend coverage drops about 9% below the home's own weekday level. Annual turnover sits at 67.5%, well above the 45.8% national figure, meaning the people caring for residents are constantly changing. The inspection record is heavier still: 53 deficiencies, including 3 at harm or jeopardy level and 2 abuse-related, with $34,146 in fines across two penalties. Federal ratings put staffing and health inspections at 1 out of 5 stars each, though quality measures score 4. The last inspection was August 13, 2025.
Twinsburg Post Acute runs 114 certified beds under corporate for-profit ownership, and the numbers that stand out most are on the staffing side. Nurse coverage sits at 3.56 hours per resident day, roughly 8% under the national average, and weekends drop about 10% below what the home staffs on weekdays, so coverage thins out right when families tend to visit. Annual turnover of 64.3% is well above the 45.8% national figure, which means aides and nurses are cycling through regularly. The inspection record is the heavier concern: 73 deficiencies, seven of them serious enough to involve harm or jeopardy, plus a $70,756 fine and a one-star health inspection rating. The most recent inspection was March 2024.
Sunny View runs a 57-bed for-profit home in Warwick, and the numbers worth your attention are the staffing and the inspection record. Nurse coverage sits at 3.66 hours per resident day, about 5% under the national average, and weekends drop roughly 6% below what the home itself staffs on weekdays, so the thinnest coverage lands when families tend to visit. Turnover is the bigger signal: 69.9% of staff leaving annually against a national 45.8% means caregivers rarely stay long enough to know your relative.
The current record carries 30 deficiencies, five serious enough to involve harm or jeopardy and one tied to abuse, plus three fines totaling $90,716. The last inspection was April 30, 2026. Ask what's changed since.
St Andrews Operator runs 108 certified beds in Columbia under individual for-profit ownership, and the numbers behind its F grade are worth walking through. Nurse staffing sits at 3.44 hours per resident day, roughly 11% under the national average, and weekends run about 11% thinner than weekdays, so coverage is lightest exactly when families tend to visit. Annual turnover of 79.3% is nearly double the national rate, meaning most of the people caring for residents are new to the building. The current record carries 40 deficiencies, including 4 at harm or jeopardy level and 8 tied to abuse, plus $52,910 in fines. Its last inspection was July 2025, so the picture is recent.
The Physical Rehabilitation and Wellness Center of Spa carries 27 deficiencies on its current record, including two at the harm or jeopardy level and one tied to abuse, that's a heavy citation load, and it's the main reason its inspection rating sits at the bottom of CMS's scale. Staffing runs thin here too: 3.23 nurse hours per resident day, roughly 16 percent under the national average, with weekends about 9 percent lighter than weekdays and turnover at 60.8 percent against a national 45.8. A for-profit LLC with 120 beds, this home was last inspected on January 16, 2026. Quality measures score better than its staffing and inspection numbers, but the pattern of low hours, high turnover, and repeated deficiencies tells the story.
Midtown Center runs 180 beds in Memphis under for-profit LLC ownership, and the staffing numbers are where the trouble shows. At 3.54 nurse hours per resident day, it sits roughly 8% under the national average, and weekends dip about 13% below its own weekday levels, so care gets thinnest exactly when families are most likely to visit. Annual turnover of 63.6% is well above the 45.8% national figure, meaning nearly two-thirds of the nursing staff leaves each year. On inspections, the record carries 18 deficiencies, including 2 at harm or jeopardy level and 2 tied to abuse, plus a $188,379 fine.
Signature Health of Portland runs 112 certified beds under corporate ownership, and the staffing numbers are where the trouble starts: 3.69 nurse hours per resident day sits below the national average of 3.86, and weekends drop roughly 15% below the home's own weekday coverage. Turnover tells a harder story than the hours alone, 67.9% of staff leaving annually against a 45.8% national rate means aides and nurses are cycling through constantly, which matters most for residents who need consistent hands. The inspection record backs that up: 24 deficiencies, including 9 at harm or jeopardy level and 3 abuse-related, with five fines totaling $171,234 and a health inspection rating of 1 out of 5. That combination, thin weekend coverage, high turnover, serious deficiencies, is what a family should weigh before choosing here.
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?