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.
Rockdale Estates runs about 2.7 nursing hours per resident each day, roughly 30% under the national average of 3.86, and weekends dip even lower. That thin coverage shows up against a one-star quality measure rating and 13 deficiencies on the current record, including one at the harm or jeopardy level, plus a single fine of $8,018. The inspection history is the bright spot: four stars and a recent April 2025 survey. Turnover at 42.6% is actually a bit better than the national 45.8%, so the problem isn't churn, it's how few hands are scheduled per resident, especially on weekends.
Avir At Sherman runs on 3.06 nurse hours per resident per day, roughly a fifth below the national figure, and weekends drop about 9% below what the home staffs on weekdays. That shortfall shows up in the numbers that matter: the federal staffing rating sits at 1 out of 5, with annual turnover at 87.1% against a national rate near 46%. Thirty-three deficiencies appear on the current record, three tied to abuse, though none reached harm or jeopardy. The last inspection was June 2025, and quality measures actually score well. A for-profit LLC runs the 132-bed home, so ask directly how they hold onto aides and who covers weekends.
Castro County Nursing & Rehabilitation runs on thin staffing: 2.93 nurse hours per resident day, roughly a quarter below the national average, and weekends dip even lower than its own weekdays. Turnover sits at 52.2%, so the people around your relative are frequently new. The inspection record backs up the concern, 53 deficiencies, four serious enough to involve harm or jeopardy, eight related to abuse, plus a $47,932 fine. The quality measure star rating is decent at 4/5, yet staffing earned just 1/5 and inspections 2/5 under CMS. The most recent inspection was May 2025, so this picture is current. This for-profit LLC has real problems filling shifts, and that shows up in the record.
Millbrook runs on thin staffing: 3.08 nurse hours per resident day against a national average of 3.86, and weekends drop about 10% below its own weekday level. The people who do show up don't stay, 69.7% turnover versus 45.8% nationally means most of the staff you'd meet today likely won't be there next year. Inspectors cited 22 deficiencies, one serious enough to involve harm or jeopardy, and fined the home $13,565; the most recent inspection was in February 2025. A for-profit limited liability company owns the place. The quality measures look better than the staffing numbers, but good scores on paper don't change how few hands are on the floor.
Avir At Dallas runs 136 beds under for-profit LLC ownership, and its inspection record is the first thing to notice: 29 deficiencies on file, two of them serious enough to cause harm or jeopardy, plus one abuse-related finding and an $8,018 fine. Staffing is the other trouble spot, 3.28 nurse hours per resident day sits about 15% under the national average, weekends run roughly 14% lighter than weekdays, and turnover hits 75.7% against a national 45.8%, so the people caring for your family member are likely new and often stretched thin. The most recent inspection was July 2025, so the picture is current.
Legend Oaks North runs 3.17 nurse hours per resident day against a national average of 3.86, and weekends drop roughly another 15% below what the home manages Monday through Friday. That thin coverage sits alongside 24 deficiencies on the current record, including two at the harm or jeopardy level and three tied to abuse. Federal inspectors also logged a $41,890 fine, and the most recent inspection is dated April 2026. Throw in for-profit LLC ownership and a 1/5 staffing star rating, and the pattern is consistent: this is a home regulators have cited repeatedly, with staffing that leaves little margin when something goes wrong.
The Heights of Tyler runs 3.13 nurse hours per resident day, roughly 19 percent under the national average, and weekend coverage dips about 12 percent below what it manages on weekdays. That thin margin sits behind a staffing rating of 1 out of 5 even though the home's last inspection in February 2026 produced a 4-star health inspection result. Turnover adds another layer: 56.1 percent of staff leave annually, well above the 45.8 percent national figure. The current record lists 21 deficiencies, one involving harm or jeopardy and one abuse-related, plus a $14,276 fine. Ownership is for-profit partnership. The inspection picture looks better than the day-to-day staffing reality.
Avir At Schertz runs on 2.93 nurse staffing hours per resident day, roughly a quarter below the national average of 3.86, and weekend coverage dips about 12% below its own weekday level. Staff turnover sits at 79.4% against a national average of 45.8%, so the people caring for residents change constantly. The inspection record shows 65 deficiencies, including three at the harm or jeopardy level and five tied to abuse, with $39,676 in fines and a most recent inspection dated February 27, 2026. Ownership is a for-profit limited liability company. The quality measure score looks strong on paper, but that number rests on a staffing and inspection picture that is far weaker.
San Gabriel Rehabilitation and Care Center runs 142 beds in Round Rock under for-profit LLC ownership. Nurse staffing sits at 3.18 hours per resident day, roughly 18% under the national average, and weekends run thinner still, about 7% below what the home staffs on weekdays. Turnover is 55.1%, close to ten points above the national rate, which means the aides and nurses your family member sees may keep changing.
The inspection record is the harder part: 32 deficiencies, three at harm or jeopardy level, six tied to abuse, and $19,393 in fines. CMS gave it one star each for health inspections and staffing. The most recent inspection was July 2025, so the record is current, not stale.
Magnolia Crossing runs on a government-hospital-district license and 128 beds, and its last inspection wrapped in May 2025 with a four-star health inspection rating, genuinely the strongest number here. The staffing numbers tell a different story. At 3.26 nurse hours per resident day, it sits about 16% under the national average, and weekends drop roughly 11% below its own weekday level, so the thinnest coverage lands when families tend to visit. Staff turnover hits 58.9% against a 45.8% national figure. Twenty deficiencies sit on record, none at harm level, though three are abuse-related. A strong inspection record is carrying a lot of weight for a building where people keep leaving.
St. Giles runs about 124 beds in El Paso, and the staffing numbers are where the trouble starts. At 3.61 nurse hours per resident day it sits roughly 7% under the national average, and weekend coverage drops another 9% below what it manages on weekdays. The bigger red flag is turnover: 93.9% of staff leave within a year, against a national average near 46%, that's an entirely new workforce roughly every twelve months. The current record carries 44 deficiencies, two tied to abuse, though none reached harm or jeopardy level and the last inspection was recent.
Big Spring Center For Skilled Care runs on thin nursing coverage: 3.43 hours per resident day against a national average of 3.86, with weekends dropping about 13% below its own weekday level. The bigger warning sign is turnover, 91.7% annually, roughly double the national rate, meaning nearly the entire nursing staff cycles through in a year. Inspections look decent on paper with a 4-star rating and a recent visit, but the record still carries 27 deficiencies, including one at the harm level and four tied to abuse, plus an $8,184 fine. Corporate-owned and certified for 120 beds, this is a home where you'd want to ask hard questions about who's actually on the floor at 2 a.m. on a Sunday.
Kent County Nursing Home runs on thinner staffing than most: 3.56 nurse hours per resident day against a national average of 3.86, with weekends dropping about 9% below its own weekday coverage. That matters in a 60-bed county-run home, because turnover sits at 55.1% while the national figure is 45.8%, more than half the nursing staff cycling out in a year. The inspection record is heavier still: 27 deficiencies, four serious enough to reach harm or jeopardy, five tied to abuse, and seven fines adding up to $187,081. The most recent inspection was December 2025. If you're weighing this one, ask about weekend coverage and how they've addressed the abuse findings.
Buena Vida Nursing and Rehab runs about 2.5 nurse hours per resident each day, roughly a third below the national average, and weekends dip even further. That thin coverage sits alongside a 94.2% annual turnover rate, more than double the national figure, meaning the people caring for residents are, more often than not, new to the building. Inspections turned up 15 deficiencies, one involving actual harm and one tied to abuse. The quality scores look strong, but those measure clinical outcomes, not whether enough hands are on deck. Ownership is corporate and for-profit.
Lakeshore Village runs on thinner staffing than most Texas nursing homes can claim as an excuse. At 3.19 nurse hours per resident day, it sits about 17% under the national average, and weekends drop roughly 15% below what the building itself manages Monday through Friday. That matters more than the quality measure score suggests, because 52 deficiencies sit on the current record, seven at harm or jeopardy level, two tied to abuse, with $107,407 in fines and a one-star inspection rating. Annual turnover of 52.1% means more than half the nursing staff leaves each year, against 45.8% nationally. Hospital district ownership hasn't translated into stability here, and the April 2026 inspection is the only recent look regulators have taken.
Colonial Nursing & Rehabilitation Center runs 90 certified beds in Lindale under individual for-profit ownership, and its staffing sits at 3.51 nurse hours per resident day, roughly 9% under the national average of 3.86. Weekends drop about 7% below the home's own weekday coverage, so the thinnest shifts get thinner.
The inspection record is the bigger concern. Twenty-three deficiencies are on file, three of them serious enough to involve harm or jeopardy, and two tied to abuse. One federal fine totals $247,572, a figure usually reserved for repeat or high-severity problems. The last inspection was March 18, 2026, so the record is recent, not stale.
If you're weighing this one, ask the administrator directly how those abuse deficiencies were resolved and what weekend nurse coverage looks like on a typical Saturday.
Southland Rehabilitation and Healthcare Center runs 150 certified beds in Lufkin under corporate, for-profit ownership, and the staffing numbers are where the trouble shows. At 3.24 nurse hours per resident day, it sits roughly 16% under the national average of 3.86, weekends drop about 17% below its own weekday level, and annual turnover hits 51.6% against a national 45.8%. That thin, churning coverage lines up with a 1-out-of-5 staffing rating and a 2-out-of-5 inspection rating. The record carries 22 deficiencies, three at harm or jeopardy level, one tied to abuse, and two fines totaling $188,884. Quality measures score 4 out of 5, but good marks on paper don't offset hands-on care that runs consistently short.
Focused Care At Orange runs 120 beds under for-profit LLC ownership, and the staffing numbers are where the trouble starts: 3.03 nurse hours per resident day against a national average of 3.86, with weekends about 16% thinner than weekdays. Turnover of 40.7% is actually better than the national 45.8%, so the issue isn't churn, it's raw coverage. The inspection record is heavier: 29 deficiencies, four at harm or jeopardy level, three tied to abuse, and $193,434 in fines across three penalties. A 1/5 inspection rating and 1/5 staffing rating sit alongside a more forgiving 3/5 on quality measures. The most recent inspection was April 2025, so this picture is current.
Broadway Nursing & Rehabilitation runs 237 certified beds in San Antonio under for-profit LLC ownership, and the staffing numbers are the first thing to look at: 3.65 nurse hours per resident day, under the national average, with weekends about 13% leaner than weekdays. Annual turnover sits at 51.4%, so more than half the nursing staff leaves each year. The inspection record shows 50 deficiencies, including 3 at harm or jeopardy level and 8 abuse-related, with two fines totaling $84,129. CMS rated staffing 1 out of 5 stars and health inspections 2 out of 5, though quality measures scored 4. Ask about weekend coverage and how they screen and supervise staff.
Longview Hill is a hospital-district home with 198 beds, and the numbers show a building under real strain. Nurse staffing sits at 3.36 hours per resident day, about 13% under the national average, and weekends drop roughly another 10% below what the home itself provides on weekdays, so the thinnest coverage lands exactly when families tend to visit. Staff turnover near 50% means the aides and nurses caring for residents are often new to the job. The inspection record backs that up: 60 deficiencies, four serious enough to put residents in harm's way, three tied to abuse, and more than $225,000 in fines.