Austin, TX
· Travis County
★★★★★
CMS 5/5
110 beds
Government
Medicaid
- Nurse hours
-
3.50
/day
- Staff turnover
-
46%
- Serious cites
-
0
Gracy Woods II runs on 3.50 nurse hours per resident per day, about 9% under the national average, and weekends dip roughly 7% below its own weekday staffing. That thin margin is the main reason it lands where it does, despite steady turnover at 45.5%, essentially the national rate. What keeps it from sliding further is an inspection record with no harm-level or abuse-related deficiencies among its 16, and recent federal surveys from March 2025 that rated four out of five stars for health inspections and quality measures. The staffing star tells the more honest story. If your family member needs frequent hands-on help, ask how weekends are covered before deciding.
Cedar Park, TX
· Williamson County
★★★★☆
CMS 4/5
124 beds
For-profit
Medicaid
- Nurse hours
-
3.19
/day
- Staff turnover
-
51%
- Serious cites
-
0
Sagebrook runs on noticeably thinner staffing than most homes, 3.19 nurse hours per resident day against a national average of 3.86, with weekends about 7% leaner than weekdays. That's the number behind its low staffing rating, and it's the kind of gap families feel on a Saturday afternoon. Turnover sits at 50.7%, above the national 45.8%, so the aides and nurses cycling through are less likely to know your mother's routines.
The inspection side looks steadier: 21 deficiencies on record, none at harm or jeopardy level, though two are abuse-related and worth asking about directly. A May 2025 inspection is recent enough to trust. Corporate-owned and for-profit, this is a home that passes its surveys but may ask more of your own vigilance between them.
Kingsland, TX
· Llano County
★★☆☆☆
CMS 2/5
122 beds
Government
Medicaid
- Nurse hours
-
2.67
/day
- Staff turnover
-
43%
- Serious cites
-
0
Avir At Kingsland runs on thin nursing coverage: 2.67 hours per resident day against a national average of 3.86, and weekends drop roughly 11% below what the home manages on weekdays. That staffing level is the main reason the federal staffing rating lands at 1 out of 5, even though turnover at 42.5% is slightly better than the 45.8% national figure. The inspection record shows 20 deficiencies, including one at the harm or jeopardy level and two tied to abuse, with the most recent inspection dated May 2026. It's a hospital-district home with 122 certified beds, and its health inspection and quality measure ratings both sit at 3 out of 5.
Keene, TX
· Johnson County
★★★☆☆
CMS 3/5
126 beds
Non-profit
Medicaid
- Nurse hours
-
3.18
/day
- Staff turnover
-
46%
- Serious cites
-
0
Town Hall Estates Keene runs 126 certified beds as a nonprofit, and its nursing hours come in at 3.18 per resident day, roughly 18% under the national average of 3.86. That shortfall is the main reason its staffing rating sits at the bottom of CMS's scale, and weekends dip about 10% below what the home itself staffs on weekdays. Turnover is 45.6%, essentially level with the national figure, so retention isn't the standout problem here; coverage is. The inspection record shows 23 deficiencies, two of them serious enough to reach harm or jeopardy level, with no abuse citations, and $16,209 in fines across two penalties. Its most recent inspection came in July 2025.
San Antonio, TX
· Bexar County
★★★☆☆
CMS 3/5
126 beds
For-profit
Medicaid
- Nurse hours
-
3.62
/day
- Staff turnover
-
46%
- Serious cites
-
0
Legend Oaks runs 126 certified beds in San Antonio under individual for-profit ownership, and its nurse staffing sits at 3.62 hours per resident day, about 6% under the national figure of 3.86. Weekends run roughly 13% leaner than weekdays there, and annual turnover is 46.2%, which is right at the national average of 45.8%, so retention isn't the outlier here; the hours per resident are. The current record shows 32 deficiencies, none at the harm or jeopardy level and none abuse-related, with the last inspection on December 4, 2025. Quality measures score well above its staffing marks, a gap worth asking about directly.
Arlington, TX
· Tarrant County
★★★★☆
CMS 4/5
142 beds
For-profit
Medicaid
- Nurse hours
-
3.61
/day
- Staff turnover
-
49%
- Serious cites
-
0
Green Oaks runs 142 certified beds under corporate ownership, and its nurse staffing sits at 3.61 hours per resident day, roughly 7% under the national average of 3.86. Weekends drop about 13% below its own weekday coverage, and turnover is 48.5% against a national 45.8%, so the people caring for residents keep changing. The inspection record shows 17 deficiencies, including one at the harm or jeopardy level and one abuse-related, plus a single $83,850 fine; the last survey was in January 2025. The 5/5 quality measure star is genuinely strong, but staffing stars sit at 2/5 and health inspections at 3/5, worth asking how the good outcomes hold up when fewer nurses are on the floor.
Mansfield, TX
· Tarrant County
★★★★☆
CMS 4/5
118 beds
For-profit
Medicaid
- Nurse hours
-
3.17
/day
- Staff turnover
-
47%
- Serious cites
-
0
Mansfield Medical Lodge runs a 118-bed for-profit operation, and the numbers point to a home that inspects well but runs lean. Its last health inspection, in December 2025, came back clean on the serious stuff, 12 deficiencies on record, none at the harm level, none abuse-related, and a single $6,032 fine. Where it slips is staffing: 3.17 nurse hours per resident day against a national average of 3.86, with weekends roughly 11% thinner than weekdays. Annual turnover of 46.6% sits just above the national 45.8%. So you're looking at a place that keeps its record tidy but asks a relatively small crew to carry the load, which is worth asking about directly.
Pasadena, TX
· Harris County
★★★☆☆
CMS 3/5
196 beds
For-profit
Medicaid
- Nurse hours
-
3.26
/day
- Staff turnover
-
50%
- Serious cites
-
0
The Courtyards At Pasadena runs 196 beds under for-profit LLC ownership, and its nurse staffing sits at 3.26 hours per resident day, roughly 16% under the national average of 3.86. Weekends run about 7% leaner than weekdays, so coverage thins out right when families tend to visit. Annual turnover of 49.6% edges past the 45.8% national figure, meaning many of the aides and nurses you meet may not be there in a year. The current inspection record shows 17 deficiencies, one serious enough to reach harm or jeopardy level, with $8,827 in fines. No abuse citations appear. The last inspection was May 14, 2026. Ask how they staff weekends and what changed since that harm-level finding.
Abilene, TX
· Taylor County
★★★☆☆
CMS 3/5
120 beds
Government
Medicaid
- Nurse hours
-
3.30
/day
- Staff turnover
-
51%
- Serious cites
-
0
Windcrest runs lean on nursing hours, 3.30 per resident day against a national average of 3.86, and weekends drop roughly another 9% below its own weekday pace. Turnover sits at 50.5%, above the 45.8% national figure, so the staff covering those shifts is changing fairly often. The record shows 15 deficiencies, two of them serious enough to involve harm or jeopardy, plus one fine of $26,364; the most recent inspection was in May 2026. Quality measures score well, inspections and staffing land mid-range, and hospital-district ownership means public accountability rather than a chain. Ask how they staff weekends and what changed after those two harm-level citations.
Alvin, TX
· Brazoria County
★★★☆☆
CMS 3/5
94 beds
Government
Medicaid
- Nurse hours
-
2.98
/day
- Staff turnover
-
52%
- Serious cites
-
0
The Lev At Winchester is run by a hospital district, and its inspection record is the strongest thing going for it, a four-star health inspection score, no deficiencies at the harm or jeopardy level, no abuse citations, and a recent survey from August 2025. On the floor, though, the numbers tell a different story: 2.98 nurse hours per resident per day against a national average of 3.86, with weekends running roughly 12% thinner than weekdays. Staff turnover sits at 52.1%, above the 45.8% national figure, which matters most when the same aides aren't there week to week. Quality measures score well at four stars, and there's just one fine on record, $3,174. If your family member needs steady hands nearby, ask specifically about weekend coverage and how long the current staff have been there.
Austin, TX
· Travis County
★☆☆☆☆
CMS 1/5
125 beds
For-profit
Medicaid
- Nurse hours
-
3.09
/day
- Staff turnover
-
51%
- Serious cites
-
0
Onion Creek runs on thin staffing: 3.09 nurse hours per resident day, roughly a fifth below the national average, with weekends about 11% leaner than weekdays. The 1-out-of-5 staffing rating reflects that, and turnover at 50.5% means many of the aides and nurses currently on the floor weren't there a year ago. Its inspection history is the heavier concern, 26 deficiencies on record, including three at the harm or jeopardy level and one tied to abuse, plus two fines totaling $51,337. The 4-out-of-5 quality measure rating shows some clinical care is being tracked and scored well, but staffing is what families feel day to day, and the numbers there are hard to argue with.
Arlington, TX
· Tarrant County
★★☆☆☆
CMS 2/5
54 beds
For-profit
Medicaid
- Nurse hours
-
5.16
/day
- Staff turnover
-
62%
- Serious cites
-
0
Purehealth Transitional Care At Thr Arlington runs 54 certified beds as a for-profit LLC, and its nurse staffing sits at 5.16 hours per resident day, roughly a third above the national average of 3.86. That's the strongest card in its hand. Look at the rest, though: weekend staffing drops about 13% from weekday levels, annual turnover hits 62.1% against a national 45.8%, and the inspection record shows 10 deficiencies, four of them at harm or jeopardy level and one tied to abuse, with two fines totaling $118,148. The most recent inspection was May 2025. High staffing hours only go as far as the people staying long enough to deliver them.
El Paso, TX
· El Paso County
★★☆☆☆
CMS 2/5
124 beds
For-profit
Medicaid
- Nurse hours
-
3.18
/day
- Staff turnover
-
47%
- Serious cites
-
0
Avir At El Paso runs on 3.18 nurse hours per resident day, about 18% under the national average, and weekend coverage drops roughly 13% below its own weekday level. The inspection record is the real problem: 98 deficiencies, including 5 at harm or jeopardy level and 8 abuse-related, plus three fines totaling $192,681. Staff turnover sits at 46.8%, slightly above the national figure. Resident outcome measures score well, but a 1-out-of-5 inspection rating and 2-out-of-5 for staffing tell you where the trouble lives. It's a for-profit limited liability company, and the last inspection was March 2025.
Houston, TX
· Harris County
★★★☆☆
CMS 3/5
70 beds
For-profit
Medicaid
- Nurse hours
-
3.92
/day
- Staff turnover
-
71%
- Serious cites
-
0
North Houston Transitional Care runs 70 certified beds under for-profit LLC ownership, and its staffing picture is more strained than the raw number suggests. Total nurse staffing sits at 3.92 hours per resident day, technically above the national average of 3.86, but a 71.3% annual turnover rate means the people providing that care are constantly changing, and CMS's own staffing rating lands at just 1 out of 5 stars. Weekend coverage drops about 5% below weekday levels, so the hours tend to thin out when families are most likely to visit. The inspection record shows 8 deficiencies, 2 of them serious enough to involve harm or jeopardy, plus one fine of $11,508 from a last survey in April 2025. The 5-star quality measure rating stands out against all of this, but scores like that largely reflect reported clinical data rather than day-to-day staffing stability.
Madisonville, TX
· Madison County
★★☆☆☆
CMS 2/5
90 beds
For-profit
Medicaid
- Nurse hours
-
3.17
/day
- Staff turnover
-
56%
- Serious cites
-
0
The staffing numbers at Avir At Madisonville tell the clearest story: 3.17 nurse hours per resident day against a national average of 3.86, with weekends running roughly 15% leaner than weekdays. That's the kind of gap that shows up when aides are stretched thin, and a 56.1% annual turnover rate, well above the 45.8% national figure, means the people providing most of the hands-on care are often new or on their way out. The 49 deficiencies on record, three at harm or jeopardy level and one abuse-related, are worth asking the administrator about directly. The five-star quality measure score reflects chart-based outcomes; inspections, at two stars, reflect what surveyors actually found.
Princeton, TX
· Collin County
★★★☆☆
CMS 3/5
138 beds
Government
Medicaid
- Nurse hours
-
3.06
/day
- Staff turnover
-
51%
- Serious cites
-
0
Princeton Medical Lodge runs on a government hospital district license with 138 certified beds, and its inspection record is genuinely clean, a five-star health inspection rating, 11 deficiencies with none at harm or jeopardy level and nothing abuse-related, and a survey as recent as March 2026. Where the picture changes is daily care capacity. Nurse staffing sits at 3.06 hours per resident day against a national average of 3.86, roughly a fifth below it, and weekends drop about 15% below the home's own weekday coverage. Staff turnover of 51.1% tops the 45.8% national figure. Strong surveys, thin staffing, and a workforce that keeps cycling through, that combination is what pulls the overall grade down.
San Antonio, TX
· Bexar County
★☆☆☆☆
CMS 1/5
120 beds
Government
Medicaid
- Nurse hours
-
3.45
/day
- Staff turnover
-
42%
- Serious cites
-
0
Northeast Rehabilitation runs on 3.45 nursing hours per resident day, about 11% under the national average, and weekends drop roughly 15% below its own weekday staffing. Turnover sits at 41.8%, a bit better than the 45.8% national figure, but the inspection record is where the real trouble shows: 45 deficiencies, two at harm or jeopardy level, and five tied to abuse. Fines total $16,449 across two penalties, and the last inspection was March 2025. It's a government hospital-district home, so ownership isn't the issue here, the staffing shortfall and that deficiency count are what a family should weigh before deciding.
Lamesa, TX
· Dawson County
★★☆☆☆
CMS 2/5
80 beds
For-profit
Medicaid
- Nurse hours
-
2.87
/day
- Staff turnover
-
54%
- Serious cites
-
0
Focused Care At Lamesa runs lean on nurses: 2.87 hours per resident per day against a national average of 3.86, roughly a quarter less hands-on time, and weekends drop about 16% below its own weekday staffing. Annual turnover of 54.1% tops the national 45.8%, so the people providing that care keep changing. The 16 deficiencies on record include two at the harm or jeopardy level and two tied to abuse, though a May 2025 inspection means the picture is recent rather than stale. Resident outcome measures rate well, but staffing is where the gap shows.
Big Lake, TX
· Reagan County
★★★☆☆
CMS 3/5
36 beds
Government
Medicaid
- Nurse hours
-
4.78
/day
- Staff turnover
-
—
- Serious cites
-
0
Reagan County Care Center runs on unusually heavy staffing for a small Texas home, 4.78 nurse hours per resident day, roughly a quarter above the national average, though weekends dip about 9% below its own weekday levels. The tradeoff shows up elsewhere: a 1-out-of-5 quality measure rating and 12 deficiencies on record, none tied to harm, jeopardy, or abuse. Inspectors last visited in May 2025, and 19 fines totaling $123,755 have accumulated. The staffing number is real and worth asking about directly. So are the quality measures and that fine history.
Willis, TX
· Montgomery County
★★★★☆
CMS 4/5
114 beds
For-profit
Medicaid
- Nurse hours
-
2.77
/day
- Staff turnover
-
40%
- Serious cites
-
0
Willis Nursing and Rehabilitation runs 2.77 nurse hours per resident day, roughly 28% under the national average, and weekends drop about 20% below its own weekday coverage, so the thinnest staffing lands when families tend to visit. That gap is the main reason its staffing rating sits at the bottom of CMS's scale, even though inspections look strong: 13 deficiencies on record, one serious enough to cause harm, no abuse findings, and a $7,443 fine. Turnover at 40% is actually better than the 45.8% national figure. The licensed nursing home is for-profit, LLC-owned, with 114 certified beds and a clean inspection as recently as August 2025.