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.
The numbers here are hard to dress up. Nurse staffing sits at 3.63 hours per resident day against a national average of 3.86, and weekends run about 9% thinner than weekdays, meaning the shifts where families often visit are the ones with the least coverage. Staff turnover of 64.8% is well above the 45.8% national figure, so the people caring for residents change often. The inspection record shows 125 deficiencies, including 12 at harm or jeopardy level and 11 abuse-related, with $187,064 in fines. CMS has placed this corporate-owned home in its Special Focus Facility program, which is reserved for the homes with the most persistent problems.
Shepherd of the Valley runs 192 certified beds in Casper under corporate ownership that changed hands within the past year. The numbers that stand out: a one-star health inspection rating, 39 deficiencies on the current record, including seven serious enough to put residents in harm's way and three tied to abuse. Staffing sits at 3.26 nurse hours per resident day, roughly 16 percent under the national average, and weekends run about 18 percent thinner than weekdays. Add 47.4 percent annual turnover and $97,031 in fines across five penalties. When a home changes ownership while carrying that inspection record, families should ask who's actually running the building day to day.
Worland Health and Rehabilitation runs on thin nurse staffing, 3.25 hours per resident day against a national average of 3.86, and weekends dip roughly 9% below what the home manages on weekdays. The inspection record is the bigger concern: fifteen deficiencies, three of them at harm or jeopardy level and five tied to abuse, which is why CMS has placed it in the Special Focus Facility program. A single fine of $6,788 is on file, and the last inspection came in March 2025. For-profit corporate ownership, 87 certified beds. If you're considering this home for someone you love, ask pointed questions about weekend coverage and how the abuse-related findings were corrected.
Lakewood Healthcare Center in Downey is a 290-bed for-profit home with 4.15 total nurse staffing hours per resident day, roughly 8% above the national average, but that one bright spot is doing a lot of heavy lifting. The inspection record is where the trouble sits: 124 deficiencies, four at harm or jeopardy level, 16 abuse-related, and three fines totaling $128,597, which is why CMS has placed it in the Special Focus Facility program. Staffing also thins on weekends, dropping about 8% below its own weekday level, and the last inspection was December 18, 2025. If you're considering this home, ask specifically what the abuse-related findings involved and how the facility is addressing them.
Majestic Mountain Care Center runs on 3.48 nurse hours per resident per day, roughly 10% under the national average, and weekend coverage slips a bit further below its own weekday levels. That staffing gap shows up in a 69% annual turnover rate, well above the 45.8% national figure, and a two-star staffing rating. The inspection record is the harder read: 63 deficiencies, six at harm or jeopardy level, five tied to abuse, and $252,683 in fines. CMS has placed this for-profit, LLC-owned home in its Special Focus Facility program, and the most recent inspection was July 2025.
Valley Vista runs 72 beds in North Hollywood under for-profit LLC ownership, and the inspection record is the first thing that stands out: 114 deficiencies, including 2 at the harm or jeopardy level and 14 tied to abuse. The last inspection was this past July, so that record is current, not stale. Staffing looks decent on paper at 4.07 hours per resident day, about 5% above the national average, but weekends run roughly 12% below weekdays, and turnover sits at 60.6% against a national average of 45.8%, meaning the people caring for residents keep changing.
Riverside Postacute Care holds 188 certified beds and runs on nurse staffing that lands at 3.84 hours per resident day, essentially even with the national average, not above it in any meaningful way, and weekends dip about 4% below what the home staffs on weekdays. The bigger issue is who stays: annual turnover hits 61.3% against a national 45.8%, so a large share of the people providing care are new to the building. That instability shows up in the record: 170 deficiencies, five at harm or jeopardy level, 15 tied to abuse, and $76,211 in CMS fines. Federal regulators have placed it in the Special Focus Facility program, which is reserved for the homes with the most persistent problems.
Antelope Valley Care Center holds 199 certified beds in Lancaster under for-profit LLC ownership, and its record carries real weight: 170 deficiencies, five at harm or jeopardy level and eleven tied to abuse, with $124,690 in fines and a place in CMS's Special Focus Facility program. Staffing sits at 4.11 nurse hours per resident day, about 7% above the national average, but weekends run roughly 10% thinner than weekdays, and the staffing star rating is only 2 of 5. Annual turnover of 44.3% is slightly better than the 45.8% national figure, yet the inspection rating remains 1 of 5 despite a recent survey in August 2025.
Maclay Healthcare Center has 141 certified beds in Sylmar, and it's owned by a for-profit limited liability company. Nurse staffing runs about 4.10 hours per resident day, roughly 6% above the national average, with weekend coverage about 9% thinner than weekdays, and staff turnover at 43.5% sits just under the national figure. Those numbers aren't the problem. The inspection record is: 185 deficiencies, 12 at harm or jeopardy level, 23 abuse-related, and $384,678 in fines across seven penalties. CMS has placed this home in its Special Focus Facility program, a designation reserved for homes with a persistent pattern of serious problems. Its last inspection was January 16, 2026. Strong quality scores can't offset that inspection history.
Studio City Rehabilitation Center has real staffing strength: 4.60 nurse hours per resident day against a national average of 3.86, with turnover at 29.3% compared to 45.8% nationally. That's a workforce that mostly stays put, and it shows up in the quality measure rating.
The inspection record tells a different story. CMS has this for-profit, 181-bed home in its Special Focus Facility program, the designation reserved for the most persistently troubled homes, with 108 deficiencies on the current record, three at harm or jeopardy level and seven tied to abuse. Two fines totaling $45,604 are on file, and the last inspection was August 2025. Good staffing alone hasn't produced a safe building here.
Cottonwood runs about 3.24 nurse hours per resident per day, roughly 16% under the national average, and weekends dip a bit further below its own weekday numbers. The bigger issue is turnover: 98% annually, more than double the national rate, which means the aides and nurses caring for your relative are constantly new. Twenty-eight deficiencies sit on the current record, though none rose to harm or jeopardy and none involved abuse. A recent inspection in August 2025 is a point in its favor, as is the three-star health inspection rating. But for-profit corporate ownership, a one-star staffing rating, and a two-star quality measure rating all point the same direction: check actual caregiver presence on the shifts you'd visit.
Harmony Care At Giddings holds a federal Special Focus Facility designation, and the inspection record shows why: 48 deficiencies on file, including 9 at the harm or jeopardy level and 7 tied to abuse. Five fines total $237,415. Its health inspection rating sits at 1 out of 5 stars, and the most recent inspection was July 17, 2025. Ownership is a for-profit partnership. The one bright spot is quality measures at 4 stars, but that stands apart from how the home is actually run day to day. Nurse staffing averages 3.99 hours per resident day, only slightly above the national 3.86, and weekends run about 8% thinner than weekdays, worth asking about directly, since that's when families often visit.
Harmony Care At Beaumont is run by a hospital district, and it has 98 certified beds. The nurse staffing number looks strong on paper, 4.72 hours per resident day, roughly 22% above the national average, but weekends drop about 14% below the home's own weekday level, so coverage isn't steady across the week. The bigger issue sits in the inspection record: 77 deficiencies, 15 of them at harm or jeopardy level, 14 tied to abuse, plus 10 fines totaling $380,812. CMS has placed it in the Special Focus Facility program, which is reserved for homes with a persistent pattern of serious problems. The most recent inspection was April 15, 2026.
The numbers at Williamsburg Village in Desoto tell a split story: residents get good clinical outcomes on paper, but the day-to-day care and oversight don't hold up. Nurse staffing runs 2.81 hours per resident day, about 27% under the national average, and weekend coverage drops roughly 13% below its own weekday level, thinner help exactly when families can't be there. Behind that sit 79 deficiencies, nine serious enough to put residents in harm's way and ten tied to abuse, plus $195,541 in fines and a spot in CMS's Special Focus Facility program. Ownership is for-profit corporate, and turnover sits slightly better than average.
Avir At Arden Wood runs 174 certified beds in Houston under corporate for-profit ownership, and its nurse staffing sits at 3.05 hours per resident day, roughly 21% under the national average, with weekends about 12% thinner than its own weekdays. That thin coverage shows up in the inspection record: 32 deficiencies, 12 of them at harm or jeopardy level, 2 abuse-related, and $130,388 in fines across two events, with the most recent inspection dated May 2026. The one clear strength is retention, where 25.6% turnover beats the 45.8% national figure, so the staff who are there tend to stay. Whether that offsets the survey history is the question a family has to weigh.
Beltline Healthcare Center runs 120 beds in Garland, and the numbers there are hard to dress up. Nurse staffing sits at 3.07 hours per resident day against a national average of 3.86, and weekends drop roughly 17% below the home's own weekday level, so the thinnest coverage lands when families tend to visit. Staff turnover is 93.9% a year, more than double the national figure, which means the aide who knows your mother this month may be gone by next. Inspectors have cited 24 deficiencies, four of them serious enough to put residents in harm's way, and CMS has placed the home in its Special Focus Facility program, with a $32,006 fine on record. The last inspection was November 2024.
Terrell Healthcare Center runs 94 certified beds under corporate for-profit ownership, and the staffing numbers are the first thing to notice: 3.52 nurse hours per resident day against a national average of 3.86, with weekends running about 10% leaner than weekdays already are. Turnover sits at 50.8%, above the 45.8% national figure, so the people caring for residents keep changing. The deficiency record is harder to look past: 93 total, 11 of them serious enough to put residents in harm's way, 6 tied to abuse. CMS has fined this home three times for $339,046 combined and placed it in the Special Focus Facility program, a designation reserved for homes with a pattern of persistent problems. If you're considering it, ask directly what's changed since the April 2026 inspection.
Avir At Caldwell runs on thin coverage. At 3.12 nurse hours per resident day, it sits roughly 19 percent under the national average of 3.86, and weekend staffing drops about 9 percent below its own weekday level, so the thinnest shifts get even thinner. The bigger red flag is turnover: 94.3 percent annually against a national average of 45.8 percent means the staff caring for your family member is, statistically, mostly new. Inspections tell a similar story, 30 deficiencies on record, two serious enough to involve harm or jeopardy, a one-star health inspection rating, and one fine of $10,036. The last inspection was January 8, 2026. Corporate-owned, 112 beds. Worth asking hard questions before you sign anything.
Gracy Woods is for-profit, corporate-owned, 118 beds, and sitting in CMS's Special Focus Facility program, the designation reserved for homes with a persistent record of serious problems. The numbers back that up: 64 deficiencies on the current record, 10 of them at harm or jeopardy level, five abuse-related, and four fines totaling $222,188. Staffing runs slightly under the national average at 3.79 hours per resident day, but the bigger issue is consistency, weekends drop about 16% below the home's own weekday level, and turnover sits at 54.5% against a 45.8% national figure. When roughly half the staff leaves in a year, care routines fray. The most recent inspection was June 2026, so the record is current.
Paradigm At Katy has 125 certified beds and a for-profit LLC owner. Its nurse staffing comes in at 4.41 hours per resident day, roughly 14% above the national average, but the workforce behind those hours is unstable: annual turnover runs 91.1% against a national 45.8%, and weekends already sit about 6% below weekday coverage. The inspection record is the harder problem, 51 deficiencies on file, 7 of them serious enough to involve harm or jeopardy and 2 tied to abuse, with $241,445 in fines across 5 penalties and a health inspection star rating of 1 out of 5. Quality measures score 4 out of 5, but that sits alongside a 1 out of 5 staffing rating despite the above-average hours.
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?