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.
Homestead Rehabilitation runs a for-profit partnership home in Newton with 128 certified beds, and the staffing picture is genuinely mixed. Total nurse coverage sits at 4.16 hours per resident day, about 8% above the national average, and turnover of 30.2% beats the national 45.8%, those are real positives. But weekends run roughly 14% leaner than weekdays, and the inspection record is where things fall apart: 40 deficiencies, two at harm or jeopardy level, one abuse-related, $111,754 in fines, and a spot in CMS's Special Focus Facility program. A 2025 inspection is recent, so this isn't stale data. Strong quality scores don't offset a harm-level citation and active federal monitoring.
Allaire Rehab & Nursing has the kind of staffing numbers most homes would envy, 4.87 nurse hours per resident day, well above the national average, but the inspection record tells a different story. Over 33 deficiencies, nine of them involving actual harm or jeopardy, five tied to abuse, and $198,526 in fines have landed this Freehold home in CMS's Special Focus Facility program, a designation reserved for the country's most persistently troubled nursing homes. Weekend staffing drops roughly 19% below weekday levels, and 50.8% of nursing staff turned over in a year, so the coverage on paper may not be what your family member experiences on a Saturday. The most recent inspection was November 2024.
The staffing numbers at this Piscataway home look decent on paper, 3.94 nurse hours per resident day, a bit above the national average, but weekends drop about 9% below weekday coverage, and a 1-out-of-5 inspection rating tells you the care isn't matching the payroll. Thirty-seven deficiencies sit on the current record, four of them serious enough to put residents in harm's way and five tied to abuse. CMS has placed it in the Special Focus Facility program, reserved for the country's poorest performers, and the most recent inspection was in December 2024. Ownership is for-profit, through a limited liability company. Staff turnover, at 41.9%, is actually slightly better than average, the problem here isn't retention, it's what's happening on the floor.
Sandia Ridge Center is a for-profit home in Albuquerque with 140 certified beds and a staffing picture that runs thinner than average, about 3.33 nurse hours per resident day against a national 3.86, with weekends roughly 12% below its own weekday levels. Annual turnover sits at 51%, above the national 45.8%, so the aides and nurses your relative sees may not be the same ones a year from now.
What stands out more is the record: 57 deficiencies, six at harm or jeopardy level, six abuse-related, and a $114,001 fine. CMS has placed it in the Special Focus Facility program. The last inspection was January 2023, which means the public picture may be well behind whatever is actually happening on the floor today.
Las Palomas Center carries 91 deficiencies on its current record, including seven that put residents in immediate harm or jeopardy and eight tied to abuse. That's why CMS placed it in the Special Focus Facility program, a designation reserved for the homes with the worst inspection histories. The health inspection rating sits at 1 out of 5, and the last full inspection was July 19, 2024. Staffing runs about 9% below the national average at 3.51 nurse hours per resident day, weekends drop roughly 14% below the home's own weekday levels, and annual turnover hits 67.9% against a national 45.8%. Three fines total $374,766. The quality measure score of 4 out of 5 stands out against everything else, but self-reported clinical data can look better than the day-to-day reality a low inspection rating reflects.
Casa Real runs 118 certified beds in Santa Fe under for-profit LLC ownership, and the numbers behind its record are worth knowing before you visit. Nurse staffing sits at 3.63 hours per resident day against a 3.86 national average, and weekends drop roughly 12% below its own weekday coverage, so the thinnest shifts land when families often can't be there. Staff turnover is 61.9% against a 45.8% national average, meaning most of the people caring for residents this year likely won't be there next year. Its current record carries 93 deficiencies, 7 at harm or jeopardy level, with 2 tied to abuse, and CMS has placed it in the Special Focus Facility program, a designation reserved for homes with a persistent pattern of serious problems. Three fines totaling $153,051 round out the picture.
Skies Healthcare & Rehabilitation Center runs 120 certified beds in Albuquerque under for-profit LLC ownership, and the numbers split in a way families should look at closely. The quality measure star sits at 4 out of 5, meaning the home's own reported data on things like pain and mobility looks good. But staffing is 1 out of 5, well below what CMS expects, and health inspections also come in at 1 out of 5, with 81 deficiencies on the current record, including one at the harm or jeopardy level and two tied to abuse. A single fine of $30,409 is on file, and the last inspection was January 8, 2026. Good self-reported outcomes mean little if there aren't enough hands on deck.
Las Cruces Village runs 3.67 nurse hours per resident day, roughly 5% under the national average, and weekend coverage drops about 10% below what it manages on weekdays. That thin margin matters because staff turnover is 64.6% a year, well above the 45.8% national figure, so the people providing most of the care are still relatively new. The inspection record shows 83 deficiencies, seven of them abuse-related, and CMS gave the health inspection domain its lowest rating; quality measures scored well, but that's largely a charting exercise. A recent June 2025 inspection means the findings are current, not stale. As a for-profit LLC with 94 beds, the numbers point to a building where care quality depends heavily on who happens to be on shift.
Hudson Hill runs 315 beds in Yonkers, and the numbers show a home stretched thin. Nurse staffing sits at 3.08 hours per resident day, roughly 20 percent under the national average, with weekends even leaner than weekdays, that's when call bells tend to go unanswered. The inspection record is the bigger worry: 50 deficiencies, three of them serious enough to put residents in harm's way and seven tied to abuse. A single fine of $56,044 is on file, and the last inspection was in December 2024. Turnover at 29.3 percent is actually better than the national figure, so the problem isn't keeping staff, it's having enough of them, and a record that keeps flagging the same risks.
Waterview Heights runs 229 beds in Rochester under for-profit partnership ownership, and the numbers here deserve real attention. Nurse staffing sits at 3.51 hours per resident day, about 9% under the national average, and weekends drop roughly 20% below what the home staffs on weekdays, so the hours when families visit aren't the hours when coverage is strongest. Staff turnover hits 67% against a national 45.8%, meaning most of the people caring for residents this year likely won't be there next year.
The record shows 86 deficiencies, 24 of them at harm or jeopardy level, with four tied to abuse. CMS has fined the home three times for $804,844 total and placed it in the Special Focus Facility program, which is reserved for the country's most troubled homes.
Humboldt House is a 173-bed for-profit home in Buffalo, and its record is one families should read carefully. The staffing numbers are the clearest issue: 3.04 nurse hours per resident per day, about a fifth below the national average, with weekends running thinner still, and turnover near 60 percent, well above the 45.8 percent typical nationally. On inspections, it holds 44 deficiencies, three of them at harm or jeopardy level and eight involving abuse, plus $270,858 in fines. CMS has placed it in the Special Focus Facility program, which is reserved for the homes with the most persistent problems. A strong quality-measure score doesn't offset that inspection history.
Van Duyn is one of the largest nursing homes in New York, and its record carries real weight: 91 deficiencies, 17 of them serious enough to put residents at risk of harm, plus nine tied to abuse. CMS has placed it in the Special Focus Facility program, which is reserved for homes with a pattern of persistent problems, and fines total just under $620,000. Nurse staffing sits slightly under the national average at 3.72 hours per resident day, and weekends run about 12 percent thinner than weekdays, when families often visit. Staff turnover, at 42.7 percent, is actually a touch better than average. Its most recent inspection was in December 2025.
The Grand Rehabilitation and Nursing at Utica holds 220 certified beds and a for-profit corporate owner, but the record is what stands out. Fifty-two deficiencies, including three at the level of actual harm or jeopardy and two tied to abuse, plus $132,759 in fines, have landed it in CMS's Special Focus Facility program, a designation reserved for the homes with the most persistent problems. Its one-star health inspection rating and two-star quality measures reflect that history, and staffing sits at 3.18 hours per resident day, roughly 18% under the national average, with weekends thinner still. One bright spot: turnover at 25.8% is well below the national 45.8%, suggesting a more stable core of workers than many peers.
Eddy Heritage House runs a nonprofit shop in Troy with 120 certified beds, and the staffing looks solid on paper, 3.90 nurse hours per resident day, just above the national average of 3.86. The catch is weekends, when coverage drops about 13% below the home's own weekday level, and turnover sits at 53% against a national 45.8%.
The inspection record is where this one gets harder to defend: 29 deficiencies on file, including two at harm or jeopardy level and four tied to abuse. That's a 1-star health inspection rating, with the most recent look coming in February 2024. Staffing earns 4 stars, quality measures 2. Families should ask directly how those abuse citations were resolved.
Affinity Skilled Living runs 280 beds in Oakdale under for-profit LLC ownership, and its record is genuinely mixed. The health inspection side is the weak spot: 29 deficiencies on file, three of them at harm or jeopardy level and two tied to abuse, with an $82,500 fine and a one-out-of-five inspection rating. Staffing sits at 3.73 nurse hours per resident day, a bit under the national average, and weekends run about 12 percent below weekdays, though turnover at 32.1 percent is better than the 45.8 percent norm. Resident outcome measures look strong on paper. Read the inspection history carefully before deciding.
Blumenthal Health and Rehabilitation Center is a for-profit LLC home in Greensboro with 134 certified beds, and the numbers behind its record are worth walking through slowly. Nurse staffing sits at 3.56 hours per resident day, roughly 8% under the national average, with weekends running about 12% thinner than weekdays, and an 82% annual turnover rate means the aides and nurses caring for residents are, more often than not, new to the building. Its inspection history shows 70 deficiencies, seven at harm or jeopardy level and three abuse-related, plus three fines totaling $210,325, and CMS has placed it in the Special Focus Facility program. The most recent inspection was September 13, 2025.
Surry Community Health Center By Harborview runs about 120 beds under corporate ownership, and the staffing numbers are the first thing I'd flag: 3.09 nurse hours per resident day against a national average of 3.86, with weekends running roughly 9% thinner than weekdays. Turnover at 36.6% is better than the 45.8% national figure, so that's a genuine bright spot. The inspection record is where it gets harder to explain away, 33 deficiencies on file, nine of them serious enough to involve harm or jeopardy, eight tied to abuse, and a $145,262 fine. The last inspection was June 2025. If you're considering this home, ask about those abuse-related findings directly.
Mary Gran Nursing Center runs 27 deficiencies on its current record, five of them serious enough to reach harm or jeopardy level, plus one tied to abuse. That's a lot of citations for a 212-bed for-profit home, and the most recent inspection only dates to August 2025, so this isn't old history. Nurse staffing sits at 3.29 hours per resident day against a national average of 3.86, weekends drop roughly 10% below the home's own weekday coverage, and annual turnover hits 51.3% versus 45.8% nationally. The pattern is consistent: thin coverage that thins further on weekends, with a workforce turning over faster than most.
Valley Nursing and Rehabilitation Center runs 183 certified beds in Taylorsville under corporate for-profit ownership, and its headline staffing number looks decent at first: 4.42 nurse hours per resident day, roughly 14 percent above the national average. Look closer and the picture changes. Weekend staffing drops about 9 percent below its own weekday level, so coverage thins exactly when families tend to visit, and annual turnover hits 67.6 percent against a national average of 45.8 percent, meaning most of the aides and nurses caring for residents are relatively new to the building. The inspection record is the harder problem: 28 deficiencies, nine of them serious enough to risk harm, five tied to abuse, and $88,557 in fines across three cases.
Vero Health & Rehab Of Sylva has 53 deficiencies on its current record, 13 of them serious enough to cause harm or put residents in jeopardy, and three tied to abuse. Federal fines total $359,818 across four penalties. The health inspection rating sits at 1 out of 5, and staffing doesn't help: 3.74 nurse hours per resident day, below the national average, with weekend coverage about 9 percent thinner than weekdays. This is a for-profit limited liability company operating 106 certified beds in Jackson County, and its last inspection was August 14, 2025. When a home carries that many harm-level findings, the question isn't whether the numbers look bad, it's whether you can get straight answers about what changed since.
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?