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.
The Lev At San Antonio runs about 106 certified beds under for-profit LLC ownership, and the staffing numbers are the first thing to look at. At 3.09 nurse hours per resident per day, it sits roughly 20 percent under the national average of 3.86, and weekends drop about 12 percent below its own weekday level, so coverage thins out exactly when families tend to visit. Turnover lands at 41.5 percent, a bit better than the 45.8 percent national figure, but the inspection record carries more weight: 40 deficiencies, including one at harm or jeopardy level and one abuse-related, plus a single $174,496 fine. The most recent inspection was September 11, 2025.
Lily Springs runs a 116-bed for-profit home in Lampasas, and the numbers behind its federal record are worth walking through. Nurse staffing sits at 3.53 hours per resident per day, roughly 8% under the national average, and it drops another 9% on weekends, so the thinnest coverage lands exactly when families tend to visit. Staff turnover is 57.6% against a national 45.8%, meaning more than half the nursing workforce turns over in a year. The inspection record shows 56 deficiencies, six of them at harm or jeopardy level and three tied to abuse, with $86,207 in fines. The most recent inspection was May 2025.
Focused Care At Mount Pleasant runs 122 beds under for-profit LLC ownership, and the numbers that stand out aren't the quality measures, those actually rate well above average. The problem is everything around them. Nurse staffing sits at 3.16 hours per resident day, about 18% under the national figure, with weekends dipping roughly 8% below the home's own weekday level. Staff turnover hits 48.4%. The inspection record carries 82 deficiencies, including four at the harm level and six tied to abuse, plus five fines totaling $223,296, and the most recent inspection was July 2025. High quality scores can't offset thin coverage and that citation history.
Avir At River Valley is run by the hospital district, and its recent inspection history is the strongest part of the picture, a four-out-of-five health inspection rating with 25 deficiencies on record, none of them rising to actual harm or jeopardy. But staffing is where the numbers get thin. At 3.08 nurse hours per resident day, it sits roughly 20% under the national average of 3.86, weekend coverage drops about 8% below its own weekday level, and annual turnover runs 76% against a national 45.8%. Two abuse-related deficiencies also appear on the current record. The quality measure rating lands mid-range. If you're weighing this one, ask how they hold a shift together on a Sunday.
Gainesville Convalescent Center runs on thin nurse staffing, 3.08 hours per resident day against a national average near 3.86, and weekends are roughly 11% leaner than weekdays, so coverage thins exactly when families tend to visit. The county hospital district owns the 112-bed home, and its inspection record shows 50 deficiencies, four at harm or jeopardy level and four tied to abuse; two fines total $99,075. Staff turnover of 73.8% sits well above the 45.8% norm, meaning many caregivers are new. Quality measures score well, but surveys and staffing don't, which is where the trouble actually lives.
Riverview runs lean on nursing hours, 3.17 per resident day against a national average of 3.86, and weekends dip even further, about 9% below its own weekday coverage. That thinness shows up in the workforce itself: 67.7% annual turnover, well above the 45.8% norm, meaning roughly two of every three caregivers are new to the building each year. Inspectors have logged 38 deficiencies, eight serious enough to put residents in harm's way and seven tied to abuse, with $156,748 in fines across four actions. The last survey was March 2025, so the record is current. A for-profit limited liability company owns the place, and the inspection history is where the trouble concentrates.
Heritage Place Of Decatur runs 60 certified beds as a for-profit corporation, and its last inspection on November 21, 2025 sits fairly recent. The inspection history is the strong part: 13 deficiencies on record, none at harm or jeopardy level and none abuse-related, which lines up with a 4-out-of-5 health inspection rating. Staffing is where the picture shifts. At 2.99 nurse hours per resident day, it runs about 23% under the national average of 3.86, and weekends drop roughly 16% below its own weekday level, thin coverage getting thinner when families tend to visit. Quality measures come in at 2 out of 5. Ask how they cover weekends before you decide.
Hilltop Park runs 132 beds in Weatherford under limited-liability, for-profit ownership, and the staffing numbers are the first thing I'd flag. At 3.62 nurse hours per resident day, it sits about 6% under the national average, and weekends drop roughly another 10% below its own weekday levels, so the thinnest coverage lands exactly when families tend to visit. Turnover tells a related story: 73.3% of nursing staff leaving annually, against a national 45.8%. The record shows 22 deficiencies, including two at harm or jeopardy level and one tied to abuse, plus a $102,810 fine. Last inspection was September 2025. Resident care measures score well; staffing and inspection results do not.
Richmond Health Care Center runs about 3.66 nurse hours per resident day, roughly 5% under the national average, and weekend coverage dips another 8% below its own weekday level. Staff turnover sits at 65.5%, well above the 45.8% national figure, which is a lot of churn for a 92-bed nonprofit home. Its inspection record shows 23 deficiencies, including one at the harm level and one abuse-related, plus two fines totaling $78,036. Inspections were current as of September 2025, and the health and quality ratings hold at 4 stars each. The staffing number is where this one separates from the pack.
Avir At Meadow Creek runs on thin staffing: 3.11 nurse hours per resident day against a national average of 3.86, with weekends about 11% leaner than weekdays. Turnover sits at 45.9%, essentially identical to the national rate, so retention isn't the outlier here, the raw hours are. The inspection record is the bigger problem. Twenty-two deficiencies, six of them serious enough to involve harm or jeopardy, two tied to abuse, and $119,203 in fines across two events. The most recent inspection was April 2025, so the picture is current, not stale. Families should ask directly how those harm-level findings were corrected and who is on duty on Saturday and Sunday.
River Hills runs on thin staffing: 3.11 nurse hours per resident day against a national average of 3.86, with weekends about 12% lighter than weekdays, and turnover at 75.9%, well above the 45.8% typical elsewhere, meaning the people caring for residents are constantly changing. The inspection record backs that up. Fifty-eight deficiencies, six serious enough to endanger residents, four tied to abuse, and three fines totaling $112,133, with the most recent inspection in June 2025. Quality measures score well, but that's a narrow bright spot. This is an individually owned for-profit home where the care depends heavily on who happens to be on shift.
Avir At Fort Worth runs on 3.06 nurse hours per resident day, roughly a fifth below the national average, and weekend coverage drops another 11% below what it manages on weekdays. Staff turnover sits at 71.6%, well above the 45.8% national figure, so the people providing most of the hands-on care are frequently new to the building. The inspection record is where the real weight sits: 42 deficiencies, nine serious enough to put residents in harm's way, six tied to abuse, and six fines totaling $272,419, with the most recent inspection in April 2025. High marks on quality measures don't offset a staffing and compliance picture like that.
The Crescent runs on thinner staffing than most homes in Texas and across the country, 3.61 nurse hours per resident day against a national average of 3.86, and it gets even thinner on weekends, when coverage drops about 13% below its own weekday level. That matters when you consider the inspection record: 41 deficiencies, seven of them serious enough to put residents in harm's way, seven tied to abuse, and $107,921 in fines across seven separate penalties. Annual staff turnover sits at 59.4%, well above the 45.8% national figure, so the people caring for your family member are probably new and likely to leave. The most recent inspection was February 26, 2026.
The Suites Pasadena runs on thinner nurse staffing than most homes nationally, 3.66 hours per resident day against a 3.86 average, and weekends drop about 13% below its own weekday coverage, which matters when a resident needs help on a Sunday. Turnover sits at 75.5% against a 45.8% national figure, so the people caring for your family member are likely to keep changing. Behind the numbers: 46 deficiencies on the current record, five at harm or jeopardy level and two tied to abuse, plus nine fines totaling $324,713. State inspectors were last in on January 16, 2026.
Chelsea Gardens runs about 3% below the national average for nurse staffing, and weekends dip roughly 11% below its own weekday levels, so coverage thins out exactly when families tend to visit. The bigger issue is consistency: 57.5% of staff turned over in a year against a national average of 45.8%, which means the people caring for residents keep changing. On inspections, 13 deficiencies sit on the current record, three at harm or jeopardy level and one tied to abuse, with two fines totaling $64,918. Inspectors were last there in October 2025. It's a for-profit partnership with 60 beds.
Willow Park Rehabilitation and Care Center runs 125 certified beds under corporate for-profit ownership, and its inspection record looks solid on paper: a 4-out-of-5 health inspection rating, a recent April 2025 survey, and 24 deficiencies with none at the harm or jeopardy level. Staffing is where the picture changes. At 3.49 nurse hours per resident day, it sits about 10% under the national average, and weekends drop roughly 9% below its own weekday coverage. Annual turnover hits 75%, well above the 45.8% national figure, and there's one abuse-related deficiency on record. Stable inspection results paired with thin, churning staffing is the pattern worth weighing if your family is considering this home.
Treviso Transitional Care runs 140 beds in Longview under for-profit LLC ownership, and the numbers tell a story worth hearing. Nurse staffing sits at 3.23 hours per resident day against a national average of 3.86, roughly 16% thinner, and weekends drop about 12% below what the home itself staffs on weekdays. Annual turnover of 53.4% outpaces the 45.8% national figure. Its inspection record carries 52 deficiencies, four at harm or jeopardy level and six abuse-related, plus a $150,705 fine; the most recent inspection was August 26, 2025. Resident outcome measures score well, but the hands-on care and safety picture is where the concern lives.
Avir At Johnson City runs 60 beds under corporate ownership, and the numbers tell a fairly consistent story. Nurse staffing sits at 3.44 hours per resident day, about 11% under the national average, and weekend coverage drops another 11% below its own weekday levels, so care is thinnest exactly when families tend to visit. Staff turnover of 65.5% is well above the 45.8% national figure, which matters because residents see a rotating cast rather than familiar faces.
The inspection record is the harder part: 28 deficiencies, six of them serious enough to reach harm or jeopardy level, and $74,691 in fines across three penalties. The most recent inspection was June 4, 2026. Quality measures score mid-range, but staffing and health inspections both sit at one star out of five.
Fortress Nursing and Rehabilitation runs 2.84 nurse hours per resident day, roughly 27% under the national average, and weekend coverage drops about 22% below its own weekday levels. That thin staffing sits alongside a 79.7% annual turnover rate, well above the 45.8% norm, so the people caring for residents change often. The current record carries 19 deficiencies, four of them at the harm or jeopardy level and three tied to abuse, plus a $17,014 fine; the most recent inspection was January 22, 2026. Ownership is a for-profit limited liability company. Quality measures score well, but staffing and inspection findings are where the trouble shows.
Dayton Nursing and Rehabilitation runs 4.37 nurse hours per resident per day, about 13% above the national average, and that's the best thing in its file. The rest is harder. Weekend staffing drops roughly 16% below its own weekday level, and annual turnover sits at 58.3% against a national 45.8%, so the faces change often. Inspectors have cited 36 deficiencies, four at harm or jeopardy level and three tied to abuse, with three fines totaling $131,714. The last inspection was September 2025. Federal ratings put health inspections and quality measures at 2 of 5 stars each. Individual ownership means one person answers for all of it. If you're considering this home, ask directly what changed after those abuse citations.