Every Medicare-certified nursing home in Texas, graded on inspections, staffing, turnover
and enforcement history.
37 homes
in the state sit in the federal Special Focus programme.
Caraday Of Lampasas runs on 2.87 nurse hours per resident day, roughly a quarter below the national average of 3.86, and weekends drop about 6% below its own weekday level, so the thinnest coverage lands when families tend to visit. The health inspection record looks solid, but staffing sits at the bottom of CMS's scale, and 13 deficiencies include three at the harm level and one tied to abuse. Three fines totaling $16,426 are on file, with the last inspection dated February 2026. It's a hospital-district home with 76 beds, and the gap between its inspection results and its day-to-day staffing is the tension worth weighing.
The Lakes at Texas City runs on 2.86 nurse hours per resident per day, roughly a quarter below the national average of 3.86, and weekends drop about 12% below its own weekday levels. That thin coverage sits alongside a 62% annual turnover rate, well above the 45.8% norm, so the aides and nurses in the building are often new to the job. Inspectors have logged 29 deficiencies, one serious enough to reach harm or jeopardy, though none abuse-related, with the most recent visit in December 2025 and $8,410 in fines. The quality measure score looks strong on paper, but it's built on top of staffing that CMS itself rates at the bottom.
Glenview Wellness & Rehabilitation runs on a leaner nurse staffing budget than most homes in the country, 2.40 hours per resident day against a national average of 3.86, and weekends dip even further below its own weekday coverage. That gap shows up in the federal staffing rating, which sits at the lowest tier, while annual turnover of 57.3% means the aides and nurses who are there keep changing.
The inspection record is where things get more concerning: 26 deficiencies on file, four of them at the level where a resident was actually harmed or put in jeopardy, and six tied to abuse. Two fines totaling $23,970 have been levied. The quality measure rating is strong at 4 out of 5, but that's a paper score next to the hands-on reality of who's available to answer a call light.
Richland Hills runs about 22% leaner on nursing hours than the typical American nursing home, and weekends drop roughly another 15% below its own weekday pace. That staffing math matters most when you consider the 72% annual turnover, nearly three-quarters of the nursing staff cycling out each year against a national average of 45.8%, on a corporate-owned, 92-bed building. The health inspection history shows 37 deficiencies, including two at the harm level and one abuse-related, with $8,190 in fines. CMS quality scores look strong, but those rely heavily on self-reported measures, while the staffing and inspection numbers reflect what surveys actually found.
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.
Ridgecrest runs 90 certified beds in Waco under for-profit LLC ownership, and the numbers families tend to ask about first are staffing and turnover. Staff turnover here sits at 82.1 percent against a national average of 45.8, meaning most of the people caring for residents in a given year are new to the building. The staffing star rating of 1 out of 5 reflects that churn, and the health inspection record shows 27 deficiencies, including one at the harm or jeopardy level and two tied to abuse. Quality measures score 4 out of 5, so clinical metrics look better than the day-to-day picture. One fine totaling $14,267 is on record, and the last inspection was June 15, 2025.
Ashford Hall runs 206 certified beds in Irving under corporate ownership, and the numbers behind its record are worth sitting with. State inspectors have logged 35 deficiencies, six of them serious enough to put residents in immediate harm or jeopardy, and six tied to abuse. Fines total $301,255 across four penalties. Staff turnover sits at 77.1%, well above the 45.8% national average, which means the people caring for residents are constantly changing. Nurse staffing runs 3.71 hours per resident day, slightly under the national figure, and weekends dip about 8% below the home's own weekday levels. Low turnover and steady weekend coverage are what keep residents safe; here, neither is holding.
Westward Trails runs lean on nursing hours, 3.27 per resident day against a national average of 3.86, and weekends drop roughly 21% below its own weekday coverage. That's the kind of gap that shows up when a resident needs help on a Saturday afternoon. Inspectors gave the place solid marks in June 2025, but the record still carries 24 deficiencies, including two tied to abuse and two serious enough to put residents in harm's way, plus $25,036 in fines across three penalties. Corporate ownership means decisions about staffing levels get made somewhere other than Nacogdoches. Ask about weekend coverage and how those abuse deficiencies were resolved before you decide.
Cedar Hill Healthcare Center runs on 2.95 nursing hours per resident per day, roughly a quarter below the national average of 3.86, and weekend coverage dips about 6% below its own weekday numbers. The inspection record shows 27 deficiencies, including two at the harm or jeopardy level and one tied to abuse, plus $22,503 in fines across two penalties; the last inspection was July 2, 2025. Staff turnover sits at 44.3%, slightly under the national 45.8%, so retention isn't the outlier here, thin daily staffing and the harm-level findings are. Corporate for-profit ownership, 110 certified beds in Dallas County.
Balch Springs Nursing Home runs on 2.72 nurse hours per resident day, roughly 29% under the national average, and weekend coverage drops about 15% below its own weekday level. That thin margin shows up in the numbers: a 1-out-of-5 staffing rating, 56.5% annual turnover against a national 45.8%, and 21 deficiencies on the current record, two of them serious enough to reach harm or jeopardy. Ownership is for-profit corporate, and there's one fine totaling $43,095. The last inspection was May 2026. Resident outcome measures look strong at 5 out of 5, which suggests the clinical care itself isn't the problem, the question is whether the staffing can hold that up.
The Homestead of Denison runs 140 certified beds under for-profit LLC ownership, and its nurse staffing sits at 3.31 hours per resident day, roughly 14% under the national average of 3.86. Weekend coverage drops about 11% below its own weekday level, and annual turnover hits 58.3% against a national 45.8%, meaning the aides and nurses your family member sees are likelier than average to be new or on their way out. The inspection record backs that up: 29 deficiencies, two at harm or jeopardy level and three abuse-related, with $29,991 in fines and a 2-out-of-5 inspection rating. Strong quality-measure scores don't offset thin, churning staffing.
Seven Oaks runs on 2.81 nurse hours per resident per day, roughly 27% under the national average of 3.86, and weekends dip about 10% below its own weekday staffing. That thin coverage lines up with a 100% annual turnover rate, more than double the national 45.8%, so the aide or nurse your family meets in January may be gone by summer. Inspections tell a different story: a 4/5 health inspection rating, a clean record on harm and abuse, and a visit as recent as July 2025, though 30 deficiencies sit on file. Ownership is corporate, for-profit. Strong clinical quality marks and weak staffing don't cancel each other out; they describe two different parts of the same building.
Homestead Nursing and Rehabilitation of Baird runs on thin staffing. At 2.88 nurse hours per resident per day, it sits about a quarter below the national average of 3.86, and weekends drop roughly another 13 percent below its own weekday levels, so the thinnest coverage lands when families tend to visit. Staff turnover is the bigger tell: 85.7 percent annually, nearly double the national rate, meaning most of the people caring for your relative will likely be gone within a year. The good news is real: a four-star health inspection with 14 deficiencies, none causing harm or involving abuse, five stars on quality measures, and a recent May 2025 inspection. Ask how the home holds those quality numbers with so much churn.
Paradigm At The Pines runs on 2.90 nurse hours per resident per day, about a quarter below the national average, and weekends drop roughly another 11% beneath its own weekday level. Turnover sits at 67.4% against a national 45.8%, and the staffing star rating reflects that: 1 out of 5. The inspection record shows 34 deficiencies, including one at the harm level and six tied to abuse, with a $8,281 fine. It's a hospital-district home, and the last inspection was recent. The quality measure score is strong, but that's largely self-reported data, the hands-on staffing and inspection findings tell a harder story.
Parkview runs about 3.55 nurse hours per resident day, roughly 8% under the national average, and weekends dip another 9% below its own weekday coverage, so the thinnest shifts land when families tend to visit. Staff turnover sits at 57.6% against a national 45.8%, meaning more than half the nursing staff leaves in a year. The health inspection record is the strongest part here, a recent June 2025 survey with 18 deficiencies and none at harm or jeopardy level, though 5 are abuse-related and worth asking about directly. The 2/5 quality measure rating is where the day-to-day care concerns show up.
Harmony Care At Floresville runs 2.90 nursing hours per resident day, roughly a quarter below the national figure of 3.86, and weekends dip about 12% below what the home staffs on weekdays. Turnover sits at 50.8%, above the 45.8% national average. The inspection record shows 39 deficiencies, two of them serious enough to reach harm or jeopardy level, plus one tied to abuse, and $87,066 in fines across three penalties. This is a for-profit corporate home with 144 beds; its most recent inspection was May 8, 2026. Low staffing and a heavy deficiency history are the two things worth weighing hardest if you're deciding.
Highland Park Care Center is a 120-bed nonprofit home in Houston where the direct-care numbers are thin. Nurses and aides give residents 3.65 hours of care per resident day, under the national average, and weekends drop about 15% below the home's own weekday staffing, so the coverage your family sees on a Tuesday isn't what shows up on a Saturday. Staff turnover sits at 56.9% against a national 45.8%, meaning more than half the workforce leaves each year. Eighteen deficiencies sit on the current record, two serious enough to involve harm or jeopardy, with one fine of $40,186. The quality measure score looks strong, but quality measures reflect resident health outcomes, not whether enough hands are present.
Hillside Heights runs about 3.09 nurse staffing hours per resident day, roughly 20 percent under the national average of 3.86, and weekends dip another 10 percent below its own weekday levels. Annual turnover sits at 56.5 percent against a national 45.8 percent, so the people around your family member change often. The inspection record shows 30 deficiencies, including one at the harm or jeopardy level and three tied to abuse, with a $14,901 fine on file; the most recent inspection was April 29, 2026. The state survey rating reflects that history, even though the quality measure score is stronger. Ownership is a for-profit limited liability company.
Willow Park runs 3.31 nursing hours per resident per day, roughly 14 percent under the national average, and weekends dip another 10 percent below its own weekday levels. The inspection record is the bigger concern: 27 deficiencies, three of them serious enough to put residents in harm's way, and three tied to abuse. Three fines totaling $59,972 have been levied, and the most recent inspection was December 2025, recent enough that the findings aren't stale. One bright spot: staff turnover at 36.9 percent beats the 45.8 percent national figure, which suggests people stay. Corporate-owned, 110 beds, and a one-star health inspection rating. Ask about the abuse citations and who supervises residents on weekends.
West Janisch runs on thin staffing margins, and it shows in the numbers. Nurse coverage sits just under the national average, but weekends drop about 11 percent below what the home manages on weekdays, and turnover runs at 69 percent against a national rate near 46 percent, meaning many of the people caring for residents are still learning the building. The inspection record is heavier: 22 deficiencies, three serious enough to put residents in harm's way, two tied to abuse, and one fine on file. A 1-out-of-5 inspection rating and a recent October 2025 survey give a current picture rather than an old one. Nonprofit ownership doesn't change what the data says about care.