Nursing homes across Ellis County, Texas, graded on the federal inspection
record, nurse staffing and staff turnover. County rank is shown on each home's profile.
Legend Oaks in Ennis is run by the local hospital district and holds a five-star health inspection rating, which tells you the building itself is well-kept and the last inspection, in February 2025, went well. The trouble sits in the day-to-day staffing: 3.18 nurse hours per resident, roughly 18% under the national average, with weekends about 20% thinner than weekdays. That's a real gap when a resident needs help. Turnover is 36%, better than the national 45.8%, so the aides who are there tend to stay. Thirteen deficiencies on record, one at harm level, and a single $13,275 fine. Good oversight, thin coverage.
Midtowne Meadows runs a tight ship on inspections, a 5-star health inspection rating with just two deficiencies on record, neither of them causing harm or involving abuse. That's a genuinely clean survey history, and the most recent inspection came in September 2025, so the picture is current.
The staffing side tells a different story. At 3.77 nurse hours per resident per day, this home sits slightly under the national average, and its own weekend coverage drops about 7% below weekdays, when families tend to visit and residents need attention. CMS rates staffing 1 out of 5 stars.
Ownership changed hands within the past year, and five fines totaling $20,131 have accumulated. New operators sometimes mean reinvestment, sometimes disruption, worth asking about directly.
Renaissance Rehabilitation runs on a government hospital district's license in Italy, Texas, with 74 certified beds. The inspection record is the standout: a five-star federal rating, 11 deficiencies on file and none of them at the harm or jeopardy level, with the most recent survey done in September 2025. Staffing tells a different story. At 3.36 nurse hours per resident day, it sits about 13 percent under the national average of 3.86, weekends run roughly a tenth thinner than weekdays, and the government's staffing rating lands at two stars. Turnover, though, is genuinely low at 31.1 percent against a 45.8 percent national figure. Quality measures rate two stars.
Pleasant Manor runs about 3.31 nurse hours per resident per day, roughly 14% under the national average, and weekend coverage drops another 13% below its own weekday levels. Staff turnover sits at 57.7%, well above the 45.8% national figure, so the people caring for residents change often. The current inspection record carries 29 deficiencies, including two at the harm or jeopardy level and two tied to abuse, with $29,011 in fines across two penalties. Its quality measure score looks strong on paper, but that reflects charted clinical data, not the staffing and safety picture. The most recent inspection was March 2026. For-profit, LLC-owned, 132 beds.
Bluebonnet Rehab At Ennis runs 136 certified beds under for-profit LLC ownership, and its staffing is the first thing that stands out: 3.63 nurse hours per resident day, about 6% under the national average of 3.86, with weekend coverage dropping roughly 8% below its own weekday levels. Turnover sits at 56.9% against a national 45.8%, so that thinner staffing keeps getting rebuilt. The inspection record is comparatively clean, 17 deficiencies, none at harm or jeopardy level, none abuse-related, and a recent April 2026 survey. The split is real, though: steady survey results alongside staffing hours and retention that trail what most homes manage.
Focused Care Of Waxahachie runs on 2.68 nurse hours per resident day, roughly 31% under the national average, and weekends drop another 10% below its own weekday levels. That thin coverage shows up in the staffing picture, where turnover hits 58.9% against a national 45.8%, more than half the nursing staff leaving in a year. The inspection record is the harder problem: 40 deficiencies, five serious enough to involve harm or jeopardy, three tied to abuse, and $172,367 in fines across three penalties. A government hospital district owns the 152-bed building, and its most recent inspection was April 28, 2026. Quality measures score well; the hands-on care and oversight numbers do not.
Midlothian Healthcare Center runs 120 certified beds under corporate ownership, and its nurse staffing sits at 3.35 hours per resident day, roughly 13% under the national average, with weekends dropping another 11% below its own weekday level. That thin coverage shows up in a 64.1% annual turnover rate, well above the 45.8% national figure, meaning the people caring for your relative are often new and still learning the building. The record carries 17 deficiencies, including 5 at the harm or jeopardy level and 2 tied to abuse, plus four fines totaling $50,830. Its last inspection was December 2024. Before you decide, ask how they're addressing turnover and weekend coverage.
Legend Oaks in Waxahachie runs 121 certified beds under individual for-profit ownership, and the staffing picture is the first thing to notice: 3.55 nurse hours per resident day against a national average of 3.86, with weekends dropping roughly 19% below its own weekday levels. That thin weekend coverage matters, because turnover sits at 57.6%, well above the 45.8% national figure, meaning the aides and nurses at the bedside keep changing. The inspection record backs it up: 35 deficiencies, five serious enough to put residents in harm's way, one tied to abuse, and $41,215 in fines across three actions, with the most recent inspection in February 2026.
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.
Ennis Care Center runs on thin staffing: 3.23 nurse hours per resident day against a national average of 3.86, and weekends drop about 13% below what the home itself manages Monday through Friday. That shortfall shows up in turnover too, 58.2% of staff leave each year, well above the 45.8% national rate, which means caregivers are constantly new to residents who need consistency. The inspection record backs this up: 21 deficiencies, four serious enough to involve harm or jeopardy, one tied to abuse, and $187,220 in fines across three penalties. Corporate ownership is for-profit. The most recent inspection was March 2025, so the picture is current, not stale, and it's a hard one.