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.
Marquardt Memorial Manor runs 3.22 nurse staffing hours per resident day, about 16% under the national average, and weekends drop roughly 8% below its own weekday level. Turnover sits at 45.2%, essentially the national rate, so the problem here isn't retention, it's how thin the coverage is day to day. The inspection record shows 44 deficiencies, including 3 at the harm or jeopardy level and 4 tied to abuse, with one fine of $26,706 and a survey dated February 2026. All three CMS star ratings land at 2 out of 5. For a 140-bed nonprofit in Watertown, the numbers describe a home with real quality and safety problems, not just a staffing squeeze.
Avina Of Pewaukee runs 120 certified beds under corporate ownership, and the staffing numbers are the first thing to notice: 3.28 nurse hours per resident day, roughly 15 percent under the national average, with weekends dropping about 13 percent below its own weekday level. That thinner coverage matters more when you look at the inspection record, 55 deficiencies, two at harm or jeopardy level, and eight tied to abuse, plus a $95,791 fine. Staff turnover sits at 43.3 percent, slightly better than the national 45.8 percent, but the most recent inspection came in June 2025 and the health inspection rating remains 1 out of 5. Ask about weekend coverage and the abuse-related citations specifically.
Artesia Palms runs 296 beds under for-profit LLC ownership, and its nurse staffing sits at 4.00 hours per resident day, roughly 4% above the national average. That's the one number working in its favor. Everything else on the record pulls the other way: 70 deficiencies, 9 of them serious enough to risk harm or jeopardy, plus 12 tied to abuse. CMS has fined the home six times for a total of $267,056 and placed it in the Special Focus Facility program, the agency's watchlist for the country's most troubled homes. Weekend staffing also drops about 8% below weekday levels. Turnover, at 45.5%, is essentially the national norm, so it explains nothing here. The last inspection was May 29, 2026.
Avir At Hillsboro runs on 3.24 nurse hours per resident per day, roughly 16% under the national average of 3.86, and weekends dip about 8% below its own weekday levels, so the thinnest coverage lands when families tend to visit. Staff turnover is 90.4% a year against a national 45.8%, meaning most of the people caring for residents are new to the building. The inspection record carries 39 deficiencies, four at harm or jeopardy level and five tied to abuse, with two fines totaling $106,866; the most recent inspection was December 2025. Ownership is a for-profit corporation, and the quality measure score sits high while inspections and staffing sit at the bottom of the scale.
Countryview has 51 deficiencies on its current record, six of them serious enough to put residents in harm's way, and eight tied to abuse. That's an unusual concentration of the worst categories, and the one-star inspection rating reflects it. Staffing sits at 3.13 hours per resident per day, roughly 19% under the national average, with weekends running about 13% thinner than weekdays. The turnover number is the one that would worry me most: 94.4%, about double the national rate, meaning the aides who know your mother are mostly gone within a year. Five fines totaling just under $80,000 round out the record. It's a hospital-district home, inspected recently, in August 2025.
The Park In Plano runs on about 3.13 nurse hours per resident day, roughly 19 percent under the national average, and weekend coverage dips another 14 percent below its own weekday level. Staff turnover sits at 93.2 percent, about double the national figure, which means the aides and nurses in the building are, more often than not, still learning the residents. Inspections tell a different story: a 4 out of 5 federal rating, 36 deficiencies on record with none at the harm level, though two are abuse-related. It's a for-profit limited liability company with 120 beds, last inspected in April 2026. The pattern is a home that passes its surveys while running lean on the people who do the daily work.
Avir At Bradburn runs 3.39 nurse hours per resident per day, about 12% under the national average, and weekend coverage drops roughly 12% below its own weekday level, a pattern families often notice on Saturdays and Sundays. Staff turnover sits at 83.8% against a national average of 45.8%, so the aides and nurses caring for your relative are far more likely than average to be new or on their way out. Inspectors last visited in May 2025 and left 11 deficiencies, including two at the harm or jeopardy level and one tied to abuse, along with a $136,027 fine. Quality measures score well, but the corporation's own inspection and staffing ratings don't.
Central Texas Nursing & Rehabilitation runs 118 certified beds in Ballinger under for-profit LLC ownership, and its nurse staffing sits at 3.04 hours per resident day, about 21% under the national average of 3.86. Weekends drop roughly 17% below its own weekday level, so coverage thins exactly when families tend to visit. The inspection record shows 14 deficiencies, including one at the harm or jeopardy level and two tied to abuse, plus one fine of $8,936. A recent May 2025 inspection and a 4-star health inspection rating suggest the survey process is current and not entirely bleak, but a 1-star staffing rating and 2-star quality measures pull hard the other way. Ask about weekend nurse coverage and how the abuse-related findings were resolved.
The Manor At Seagoville runs on about 2.97 nurse hours per resident per day, roughly a quarter less than the national average of 3.86, and staffing thins further on weekends, dropping about 13% below its own weekday level. That shortfall shows up in the numbers: 59.1% annual turnover, well above the 45.8% national figure, and 33 deficiencies on the current record, two of them serious enough to involve harm or jeopardy, plus two abuse-related findings and $98,062 in fines. A 2/5 inspection rating and 2/5 staffing rating sit alongside a 4/5 quality measure score, which is worth asking about. This is a for-profit corporate home where the care reported on paper and the hands available to deliver it don't match.
Red Oak Health and Rehabilitation Center runs 144 certified beds under corporate ownership, and its inspection history is actually its strongest suit, a 4-out-of-5 federal rating there. The problem sits elsewhere. Nurse staffing works out to 2.93 hours per resident per day, roughly a quarter below the national average of 3.86, and weekends drop about 12% below the home's own weekday levels. Annual turnover hits 68.9% against a national 45.8%, meaning most of the aides and nurses your relative would see are relatively new. Sixteen deficiencies sit on the current record, including one at the harm level and one abuse-related, with a single $12,035 fine.
Pecan Tree runs on 2.57 nursing hours per resident day, roughly a third below the national average of 3.86, and weekends drop about 23% below what it manages on weekdays. That thin coverage sits behind a one-star staffing rating, and the inspection record is heavier still: 30 deficiencies, two of them serious enough to put residents in harm's way, plus two tied to abuse. The last full inspection was February 2026, so the findings are recent, not stale. Cooke County Hospital District owns the place, which means public ownership here hasn't translated into public accountability on care. One fine totaling $16,595 rounds out the record. If you're considering this home, ask directly how they staff weekends and what changed after those abuse citations.
Avir At Portland runs 97 certified beds under corporate ownership, and the staffing numbers are the first thing a family should sit with. Nurses provide 3.25 hours of care per resident each day, roughly 16 percent under the national average, and weekend coverage drops about another 10 percent below the home's own weekday level. Annual turnover hits 63.9 percent, well above the 45.8 percent national figure, which means the people caring for your relative are likely to change often.
The inspection record shows 29 deficiencies, including three at the harm or jeopardy level and one tied to abuse, with $119,462 in fines across two penalties. The most recent inspection was September 2025.
Kerens Care Center runs on 2.95 nurse hours per resident per day, roughly a quarter below the national average of 3.86, and weekends dip about 9% below its own weekday levels. The bigger issue is turnover: 97.3% of staff leave annually, against a national average of 45.8%, which means the people caring for your family member are, more often than not, brand new. Fifteen deficiencies sit on the current record, two serious enough to involve harm or jeopardy, though none are abuse-related. The last inspection was April 2025, so the picture is fairly current. Corporate-owned, 70 beds, and staffing is where the trouble concentrates.
Five Points of Pflugerville runs on 3.08 nurse hours per resident per day, roughly a fifth under the national average, and it leans harder on weekdays than weekends, weekend coverage drops another 12% below its own weekday level. Staff turnover sits at 71.6% against a national 45.8%, so nearly three in four caregivers left over the past year, which matters more when the staffing rating is 1 out of 5. The current inspection record carries 41 deficiencies, 8 of them at harm or jeopardy level and 2 abuse-related, with five fines totaling $59,449; the last survey was March 19, 2025. Quality measures score well, but that's the one bright spot.
Avir At Cowhorn Creek runs 76 certified beds under hospital-district ownership, and the staffing numbers are where the trouble starts: 3.26 nurse hours per resident day against a national average of 3.86, with weekends running about 10 percent thinner than weekdays. Turnover sits at 68.2 percent, well above the 45.8 percent national figure, so residents see a lot of new faces. The inspection record shows 65 deficiencies, including two at the harm or jeopardy level and five tied to abuse, with one $30,105 fine and a survey date of February 2026. Quality measures score mid-range, but staffing and inspections both land at one star, and that combination is what drives the grade down.
Avir At Citizens Trail runs 114 certified beds under for-profit LLC ownership in Texarkana, and the numbers behind its record are worth a close look. Nurse staffing sits at 3.53 hours per resident day, roughly 9% under the national average, and weekends drop about 14% below the home's own weekday level, meaning coverage thins out exactly when families tend to visit. Annual turnover of 66.7% is well above the national 45.8%, so the people caring for residents keep changing. The current inspection record shows 52 deficiencies, including 7 at the harm or jeopardy level and 5 abuse-related, with two fines totaling $120,751 and the most recent inspection dated November 2025.
University Rehabilitation Center runs 146 certified beds in Denton under for-profit limited liability ownership, and the staffing numbers are where the trouble starts. At 3.36 nurse hours per resident day, it sits roughly 13% under the national average of 3.86, weekend coverage dips about 11% below its own weekday level, and annual turnover of 88.2% means most of the people caring for residents are new to the building, nearly double the national rate of 45.8%. The inspection record backs that up: 38 deficiencies, five of them serious enough to put residents in harm's way, one tied to abuse, plus two fines totaling $33,117. A 1-out-of-5 staffing rating and 2-out-of-5 on inspections tell the story plainly.
Legacy At Town Creek runs 199 certified beds in Palestine under hospital district ownership, and the numbers raise real questions. Nurse staffing sits at 3.37 hours per resident day, roughly 13 percent under the national average, with weekends about 9 percent thinner than weekdays, meaning your family member gets the least coverage exactly when other help is hardest to find. Staff turnover is 53.8 percent against a national 45.8, so caregivers cycle through quickly. On top of that, the current record shows 38 deficiencies, including 5 at harm or jeopardy level and 5 tied to abuse, with $294,608 in fines. The last inspection was August 2025. Ask about weekend coverage and turnover directly before deciding.
Corrigan LTC Nursing & Rehabilitation runs 86 certified beds under a hospital district, and the numbers on record are worth a careful look. Nurse staffing sits at 3.71 hours per resident day, a bit under the national average, and it dips further on weekends, roughly 10% below the home's own weekday level. Staff turnover is the bigger concern: 63.6% annually against a national average of 45.8%, meaning a large share of the people caring for residents are relatively new. The inspection record shows 30 deficiencies, four at harm or jeopardy level and seven abuse-related, with $91,839 in fines across four events. The most recent inspection was September 2025, so the picture is current.
Cimarron Place runs on thin staffing. At 3.19 nurse hours per resident per day, it sits about 17% under the national average, and weekends drop roughly another 12% below its own weekday level, so the thinnest coverage lands when families tend to visit. Annual turnover of 65.6% against a 45.8% national average means aides and nurses cycle through quickly, which matters for anyone who needs consistent hands-on care. The inspection history is mixed: a recent June 2025 survey and a four-star health inspection rating, but 19 deficiencies on record including one at the harm level and one abuse-related, plus two fines totaling $19,143. Limited liability ownership, 120 beds. Worth asking about weekend coverage and how long direct-care staff typically stay.
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?