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.
Silver Tree runs on 3.26 nursing hours per resident day, about sixteen percent under the national average, and weekend coverage dips another seven percent below its own weekday level. The number that stands out most is turnover: 93.3 percent of staff left over the past year, against a national rate of 45.8 percent, that's roughly a full replacement of the workforce annually, which makes consistent care hard to build. The record shows 60 deficiencies, four at harm or jeopardy level and two tied to abuse, plus three fines totaling $113,981. Ownership is a hospital district, and the last inspection was June 2026.
Town East Rehabilitation and Healthcare Center runs 130 certified beds in Mesquite under individual for-profit ownership, and the staffing numbers are where the trouble starts. At 3.40 nurse hours per resident day it sits about 12% under the national average, weekends drop roughly another 10% below its own weekdays, and annual turnover of 70.8% means most of the people caring for your family member will be gone within a year, against a national rate of 45.8%. The inspection record backs that up: 35 deficiencies, three serious enough to put residents in harm's way, one tied to abuse, plus two fines totaling $25,673. The 4/5 quality measure score is the bright spot, but quality measures are self-reported, and staffing is what actually delivers care.
Kingwood Rehabilitation runs 194 beds under hospital district ownership, and the numbers that stand out are staffing and inspection history. Nurses provide 3.40 hours per resident day, about 12% under the national average, and weekends drop roughly 15% below the home's own weekday levels, so the thinnest coverage lands when families tend to visit. Staff turnover sits at 72.8%, well above the 45.8% national figure, which means the people caring for residents are often new to the building. The current inspection record carries 29 deficiencies, seven involving harm or jeopardy and three tied to abuse, plus a $72,573 fine. The most recent inspection was June 2025.
Focused Care At Cedar Bayou carries 23 deficiencies on its current record, and 9 of those reached harm or jeopardy level, one tied to abuse. That's the kind of inspection history that put this for-profit, limited-liability home into CMS's Special Focus Facility program, a designation reserved for the homes regulators watch most closely. The health inspection rating sits at 1 out of 5, and the last full look came in February 2024. Staffing tells its own story: 3.01 nurse hours per resident day, about 22% under the national average, with weekends running roughly 7% thinner than weekdays. Turnover is 47.2%, slightly above the national 45.8%. Four fines total $99,485. The 4/5 quality measure rating reflects resident assessments, but it doesn't offset what inspections and staffing show.
College Park Rehabilitation and Care Center runs on 3.21 nurse hours per resident per day, roughly 17% under the national average, and weekends drop about 12% below what the home staffs on weekdays. That thin coverage shows up in the numbers: a 1-out-of-5 staffing rating, 56% annual turnover against a national 45.8%, and 15 deficiencies on the current record, two at the harm or jeopardy level, one abuse-related, plus a $38,675 fine. The last inspection was March 27, 2025. Corporate for-profit ownership, 120 certified beds. Inspections and quality measures each sit at 3 out of 5, so the weaker picture here isn't about care outcomes on paper; it's about whether enough consistent hands are there day to day.
Avir At Bandera runs on about 2.40 nurse staffing hours per resident day, roughly 38 percent under the national average of 3.86, and weekend coverage drops about 10 percent below its own weekday level. That thin staffing shows up in a 56.7 percent annual turnover rate, well above the 45.8 percent national figure, and in CMS's staffing rating of one star out of five even as its quality measure score sits at four. The inspection record is the harder problem: 20 deficiencies, two at harm or jeopardy level, one abuse-related, plus $100,293 in fines across two penalties. A for-profit corporation operates the 118-bed home. Two stars on health inspections, and that May 2026 inspection is recent.
Ganado Nursing and Rehabilitation Center runs on 3.03 nurse staffing hours per resident day, about 21 percent under the national average of 3.86, and weekends drop roughly another 20 percent below its own weekday levels, so the thinnest coverage lands when families tend to visit. The current record carries 20 deficiencies, one serious enough to reach harm or jeopardy level, plus a single fine of $8,422. State inspectors were last in on February 25, 2026, and the federal ratings land at one star for staffing, two for quality measures, and three for health inspections. It's a 91-bed for-profit corporation, and the staffing number is the one worth asking about directly.
Fort Worth Transitional Care Center runs on 3.09 nurse hours per resident day, roughly a fifth less than the national average, and weekend coverage drops about 14% below its own weekday level, so the thinnest staffing lands when families tend to visit. Annual turnover sits at 68.8% against a 45.8% national figure, meaning most of the people caring for your relative are relatively new to the building. The inspection record is the harder problem: 49 deficiencies, four at harm or jeopardy level and three tied to abuse, plus $64,771 in fines, with the most recent inspection dated April 2026. It's a hospital-district facility, and the quality measures score well, but the staffing and inspection numbers don't.
Avir At Orem runs lean on nursing staff, 2.97 hours per resident day against a national average of 3.86, with weekends about 11% thinner than weekdays. That gap shows up in the numbers: 61% annual turnover, well above the 45.8% national figure, and a staffing rating of 2 out of 5. The inspection record isn't clean either, with 21 deficiencies including one at the harm level and one abuse-related, and a $34,418 fine. The 4/5 health inspection rating and recent April 2025 survey suggest the home was in decent shape at its last look, and ownership changed within the past year, worth asking what that transition has meant for day-to-day care.
The numbers at West Houston Rehabilitation don't leave much room for interpretation. Nurse staffing sits at 3.26 hours per resident day against a national average of 3.86, and it thins out further on weekends, dropping roughly 15% below the home's own weekday level, so the stretch when families often visit is when coverage is lightest. On the inspection side, the record shows 30 deficiencies, including 7 at the harm or jeopardy level and 4 tied to abuse, with two fines totaling just over $205,000 and a survey as recent as January 2025. Staff turnover, at 43.1%, is actually a touch better than the national rate, which suggests the problems here aren't mainly about keeping people, they're about how the place is run.
The Premier Snf Of Alice runs on thin staffing, 2.99 nurse hours per resident day against a national average of 3.86, with weekends dropping roughly 15% below its own weekday level. That's the number that matters most here, because 92.5% annual turnover means the people providing that care are constantly being replaced. The 14 deficiencies on record include nothing at the harm or jeopardy level and nothing abuse-related, which is a real distinction, and the last inspection was recent. Corporate ownership and a one-star CMS staffing rating sit alongside a four-star inspection rating. Families weighing this home should ask directly how many CNAs are on the floor on a Saturday night.
Sylan Shores runs on 3.00 nursing hours per resident day, roughly 22% under the national average of 3.86, and weekends drop about 14% below what it manages during the week. That thin coverage shows up in the numbers: a 69.5% annual turnover rate against a national 45.8%, and 16 deficiencies on the current record, including one at the harm level and two tied to abuse. The last inspection was July 2025, so the findings are recent rather than stale. Government hospital-district ownership doesn't change what the staffing star says. If you're weighing this one, ask how they cover weekends and what's changed since that inspection.
Five Points runs a 120-bed for-profit operation in DeSoto, and the staffing numbers are the first thing to look at. At 3.03 nurse hours per resident day, it's about a fifth below the national average, and weekends drop another 13% under its own weekday coverage, that's when problems tend to surface. The bigger concern is a 91% annual turnover rate, roughly double the national figure, which means the people caring for your relative are likely new and still learning the building. Twenty-eight deficiencies sit on the current record, including two at harm or jeopardy level and one tied to abuse. Inspectors were last there in May 2025.
Avir At Tierra Este runs on 3.05 nurse hours per resident per day, about 21% under the national average, and weekends drop roughly 7% below its own weekday staffing. That thin coverage shows up in a 56.9% annual turnover rate, well above the 45.8% national figure, and in a one-star CMS staffing rating. Inspectors have cited 65 deficiencies, three at harm or jeopardy level and two tied to abuse, with eight fines totaling $53,957; the last inspection was September 2025. This for-profit LLC home holds 120 certified beds, and its one-star health inspection rating sits against a three-star quality measure score.
Athens Post Acute runs about 3.48 nurse hours per resident day, roughly 10 percent under the national average, and weekend coverage drops another 19 percent below its own weekday schedule. Staff turnover sits at 58.5 percent against a national 45.8, which means more than half the nursing staff leaves each year. Inspections are a bright spot: a 4-out-of-5 health inspection rating with no deficiencies at the harm level and nothing abuse-related, though 16 deficiencies and ten fines totaling $61,744 sit on the record. The quality measure and staffing ratings both land at 2 out of 5. For-profit, limited liability ownership. If you tour, ask how they cover weekends and how long the current director of nursing has been in place.
Montezuma Health And Rehabilitation runs a hundred beds as a nonprofit, and its inspection history is genuinely the strongest part of the picture, a recent January 2026 survey and a four-out-of-five inspection rating. The trouble sits elsewhere. Nurse staffing of 3.39 hours per resident day falls roughly 12% under the national average, weekends dip about 16% below the home's own weekday coverage, and turnover among nursing staff hits 61.4% against a national 45.8%. Nine deficiencies are on record, two of them serious enough to involve harm or jeopardy, with $15,593 in fines across three penalties. Quality measures sit at one out of five stars, a sign the day-to-day care experience doesn't match the clean inspection sheet.
Nature Trail Health And Rehab runs about 3.33 nursing hours per resident day, roughly 14% under the national average, and weekends drop another 17% below its own weekday staffing. That thin coverage sits behind 28 deficiencies on the current record, including three at the harm or jeopardy level and two tied to abuse, along with one fine of $28,620. Inspectors were last in the building in December 2025, and the health inspection rating came back at 4 out of 5, so the state's most recent look wasn't the problem. Staff turnover is 49.2%, above the national 45.8%, which matters in a building this size.
Regency Care Center runs about 3.15 nurse hours per resident per day, roughly 18% under the national average of 3.86, and weekends are thinner still, about 14% below its own weekday staffing. The inspection record is heavy: 49 deficiencies, three of them at the level where residents were actually harmed or put in jeopardy, plus one tied to abuse, and a $78,497 fine. The most recent inspection was in April 2025. Ownership is a for-profit limited liability company, with 101 certified beds. Federal staffing and health inspection ratings both sit at one star out of five.
Harrington House runs 90 certified beds under corporate for-profit ownership, and the numbers around its nursing staff are worth your attention. Nurse staffing sits at 3.80 hours per resident day, just under the national average, but weekends drop roughly 23% below what the home staffs on weekdays, and annual turnover hits 57.9% against a national rate of 45.8%. Those two figures together mean less consistent coverage, especially when families tend to visit. The inspection record backs that up: 40 deficiencies, one serious enough to involve harm or jeopardy, two tied to abuse, and a $43,891 fine. The most recent inspection was in April 2025, so the picture is current.
Cornerstone runs 95 beds in Corinth under for-profit LLC ownership, and its inspection record is the place to start. The current file carries 33 deficiencies, four of them serious enough to involve harm or jeopardy, plus two tied to abuse. A single CMS fine of $90,844 came out of that history, and the most recent inspection is dated April 2026.
Nurse staffing sits at 3.74 hours per resident day, slightly under the national average of 3.86, and weekends run about 15% thinner than weekdays. Turnover is 55.4% against a national 45.8%. That combination, thin weekend coverage, high churn, and a heavy deficiency load, is what drives the low overall grade, not any one number alone.
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?