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.
Silver Tree runs on 3.26 nursing hours per resident day, about sixteen percent under the national average, and weekend coverage dips another seven percent below its own weekday level. The number that stands out most is turnover: 93.3 percent of staff left over the past year, against a national rate of 45.8 percent, that's roughly a full replacement of the workforce annually, which makes consistent care hard to build. The record shows 60 deficiencies, four at harm or jeopardy level and two tied to abuse, plus three fines totaling $113,981. Ownership is a hospital district, and the last inspection was June 2026.
Town East Rehabilitation and Healthcare Center runs 130 certified beds in Mesquite under individual for-profit ownership, and the staffing numbers are where the trouble starts. At 3.40 nurse hours per resident day it sits about 12% under the national average, weekends drop roughly another 10% below its own weekdays, and annual turnover of 70.8% means most of the people caring for your family member will be gone within a year, against a national rate of 45.8%. The inspection record backs that up: 35 deficiencies, three serious enough to put residents in harm's way, one tied to abuse, plus two fines totaling $25,673. The 4/5 quality measure score is the bright spot, but quality measures are self-reported, and staffing is what actually delivers care.
Kingwood Rehabilitation runs 194 beds under hospital district ownership, and the numbers that stand out are staffing and inspection history. Nurses provide 3.40 hours per resident day, about 12% under the national average, and weekends drop roughly 15% below the home's own weekday levels, so the thinnest coverage lands when families tend to visit. Staff turnover sits at 72.8%, well above the 45.8% national figure, which means the people caring for residents are often new to the building. The current inspection record carries 29 deficiencies, seven involving harm or jeopardy and three tied to abuse, plus a $72,573 fine. The most recent inspection was June 2025.
Focused Care At Cedar Bayou carries 23 deficiencies on its current record, and 9 of those reached harm or jeopardy level, one tied to abuse. That's the kind of inspection history that put this for-profit, limited-liability home into CMS's Special Focus Facility program, a designation reserved for the homes regulators watch most closely. The health inspection rating sits at 1 out of 5, and the last full look came in February 2024. Staffing tells its own story: 3.01 nurse hours per resident day, about 22% under the national average, with weekends running roughly 7% thinner than weekdays. Turnover is 47.2%, slightly above the national 45.8%. Four fines total $99,485. The 4/5 quality measure rating reflects resident assessments, but it doesn't offset what inspections and staffing show.
College Park Rehabilitation and Care Center runs on 3.21 nurse hours per resident per day, roughly 17% under the national average, and weekends drop about 12% below what the home staffs on weekdays. That thin coverage shows up in the numbers: a 1-out-of-5 staffing rating, 56% annual turnover against a national 45.8%, and 15 deficiencies on the current record, two at the harm or jeopardy level, one abuse-related, plus a $38,675 fine. The last inspection was March 27, 2025. Corporate for-profit ownership, 120 certified beds. Inspections and quality measures each sit at 3 out of 5, so the weaker picture here isn't about care outcomes on paper; it's about whether enough consistent hands are there day to day.
Avir At Bandera runs on about 2.40 nurse staffing hours per resident day, roughly 38 percent under the national average of 3.86, and weekend coverage drops about 10 percent below its own weekday level. That thin staffing shows up in a 56.7 percent annual turnover rate, well above the 45.8 percent national figure, and in CMS's staffing rating of one star out of five even as its quality measure score sits at four. The inspection record is the harder problem: 20 deficiencies, two at harm or jeopardy level, one abuse-related, plus $100,293 in fines across two penalties. A for-profit corporation operates the 118-bed home. Two stars on health inspections, and that May 2026 inspection is recent.
Ganado Nursing and Rehabilitation Center runs on 3.03 nurse staffing hours per resident day, about 21 percent under the national average of 3.86, and weekends drop roughly another 20 percent below its own weekday levels, so the thinnest coverage lands when families tend to visit. The current record carries 20 deficiencies, one serious enough to reach harm or jeopardy level, plus a single fine of $8,422. State inspectors were last in on February 25, 2026, and the federal ratings land at one star for staffing, two for quality measures, and three for health inspections. It's a 91-bed for-profit corporation, and the staffing number is the one worth asking about directly.
Fort Worth Transitional Care Center runs on 3.09 nurse hours per resident day, roughly a fifth less than the national average, and weekend coverage drops about 14% below its own weekday level, so the thinnest staffing lands when families tend to visit. Annual turnover sits at 68.8% against a 45.8% national figure, meaning most of the people caring for your relative are relatively new to the building. The inspection record is the harder problem: 49 deficiencies, four at harm or jeopardy level and three tied to abuse, plus $64,771 in fines, with the most recent inspection dated April 2026. It's a hospital-district facility, and the quality measures score well, but the staffing and inspection numbers don't.
Avir At Orem runs lean on nursing staff, 2.97 hours per resident day against a national average of 3.86, with weekends about 11% thinner than weekdays. That gap shows up in the numbers: 61% annual turnover, well above the 45.8% national figure, and a staffing rating of 2 out of 5. The inspection record isn't clean either, with 21 deficiencies including one at the harm level and one abuse-related, and a $34,418 fine. The 4/5 health inspection rating and recent April 2025 survey suggest the home was in decent shape at its last look, and ownership changed within the past year, worth asking what that transition has meant for day-to-day care.
The numbers at West Houston Rehabilitation don't leave much room for interpretation. Nurse staffing sits at 3.26 hours per resident day against a national average of 3.86, and it thins out further on weekends, dropping roughly 15% below the home's own weekday level, so the stretch when families often visit is when coverage is lightest. On the inspection side, the record shows 30 deficiencies, including 7 at the harm or jeopardy level and 4 tied to abuse, with two fines totaling just over $205,000 and a survey as recent as January 2025. Staff turnover, at 43.1%, is actually a touch better than the national rate, which suggests the problems here aren't mainly about keeping people, they're about how the place is run.
The Premier Snf Of Alice runs on thin staffing, 2.99 nurse hours per resident day against a national average of 3.86, with weekends dropping roughly 15% below its own weekday level. That's the number that matters most here, because 92.5% annual turnover means the people providing that care are constantly being replaced. The 14 deficiencies on record include nothing at the harm or jeopardy level and nothing abuse-related, which is a real distinction, and the last inspection was recent. Corporate ownership and a one-star CMS staffing rating sit alongside a four-star inspection rating. Families weighing this home should ask directly how many CNAs are on the floor on a Saturday night.
Sylan Shores runs on 3.00 nursing hours per resident day, roughly 22% under the national average of 3.86, and weekends drop about 14% below what it manages during the week. That thin coverage shows up in the numbers: a 69.5% annual turnover rate against a national 45.8%, and 16 deficiencies on the current record, including one at the harm level and two tied to abuse. The last inspection was July 2025, so the findings are recent rather than stale. Government hospital-district ownership doesn't change what the staffing star says. If you're weighing this one, ask how they cover weekends and what's changed since that inspection.
Five Points runs a 120-bed for-profit operation in DeSoto, and the staffing numbers are the first thing to look at. At 3.03 nurse hours per resident day, it's about a fifth below the national average, and weekends drop another 13% under its own weekday coverage, that's when problems tend to surface. The bigger concern is a 91% annual turnover rate, roughly double the national figure, which means the people caring for your relative are likely new and still learning the building. Twenty-eight deficiencies sit on the current record, including two at harm or jeopardy level and one tied to abuse. Inspectors were last there in May 2025.
Avir At Tierra Este runs on 3.05 nurse hours per resident per day, about 21% under the national average, and weekends drop roughly 7% below its own weekday staffing. That thin coverage shows up in a 56.9% annual turnover rate, well above the 45.8% national figure, and in a one-star CMS staffing rating. Inspectors have cited 65 deficiencies, three at harm or jeopardy level and two tied to abuse, with eight fines totaling $53,957; the last inspection was September 2025. This for-profit LLC home holds 120 certified beds, and its one-star health inspection rating sits against a three-star quality measure score.
Apex Secure Care Brownfield runs on 2.27 nurse staffing hours per resident day, roughly 41% under the national average of 3.86, and weekends drop about 17% below its own weekday levels. Staff turnover sits at 55.8% against a national 45.8%, so the people who remain are stretched thin and constantly changing. The inspection record shows 39 deficiencies, including two at the harm or jeopardy level and one tied to abuse, with $27,738 in fines across two penalties. Its most recent inspection was April 14, 2026, and the health inspection rating of 2 out of 5 reflects what surveyors found. A 4-out-of-5 quality measure score does not offset a 1-out-of-5 staffing rating.
Deerings runs on thin staffing, and the numbers show it. At 2.71 nurse hours per resident day, it sits about 30% under the national average of 3.86, and weekends drop roughly another 18% below its own weekday levels, so the thinnest coverage lands when families tend to visit. Annual turnover is 97.9%, more than double the national 45.8%, meaning the aides and nurses caring for residents are largely new or on their way out. Inspections look better: a 4/5 health inspection rating and a recent March 2025 visit, but the record still holds 30 deficiencies, including one at the harm level and three tied to abuse, plus $8,278 in fines. Good quality scores can't offset that kind of churn.
Hemphill Care Center runs on 2.96 nurse hours per resident per day, roughly a quarter below the national average, and its weekend staffing barely budges from weekdays, about 1% higher, which is unusual when most homes thin out on Saturdays and Sundays. That thin coverage shows up in the inspection record: 26 deficiencies, nine of them serious enough to put residents in harm's way, and five tied to abuse. Two fines totaling $29,226 round out the file. The last inspection was recent, September 2025, so this isn't stale history. Corporate-owned and operating well under typical staffing levels, this is a home where the numbers themselves tell you to look closely before deciding.
Shady Oak runs lean on staff. At 2.85 nurse hours per resident day, it sits about 26% under the national average, and weekends drop roughly another 15% below its own weekday coverage. Every nursing position turned over in the past year, 100%, against a national figure near 46%, which means the people caring for residents keep changing. Inspectors visited in September 2025 and logged 14 deficiencies, none at the harm level but one tied to abuse. The 5-star inspection rating looks strong on paper, but the 2-star quality and staffing marks tell you where the strain actually lands.
Copperas Cove Nursing & Rehabilitation runs on 2.88 nurse hours per resident day, roughly a quarter below the national average, and weekends dip even further below its own weekday numbers. That thin coverage sits behind a one-star staffing rating and a 60.9% annual turnover rate, well above the 45.8% national figure, meaning the people caring for residents are, more often than not, new to the building. The inspection record shows 28 deficiencies, two of them serious enough to involve harm or jeopardy, plus $24,242 in fines, though nothing abuse-related. The most recent inspection was in late November 2025, so the picture is current. For-profit corporate ownership, 123 beds, and low marks across staffing and quality.
Alvarado Meadows runs on thin staffing margins: 3.36 nurse hours per resident day against a national average of 3.86, with weekends dipping about 11% below its own weekdays. The turnover number is the harder one to get past, 95.7% annually, more than double the national rate, which means the aide helping your mother today is statistically unlikely to be there next year. The inspection record shows 19 deficiencies, three of them serious enough to cause harm or jeopardy and four tied to abuse, plus $85,479 in fines across five penalties. The most recent inspection was in May 2026. For-profit, limited liability ownership.