Every Medicare- and Medicaid-certified nursing home in the country, graded A–F on its inspection record,
nurse staffing, staff turnover and enforcement history. No home pays to be listed and no grade is for sale.
See how we grade.
El Paso Rehabilitation and Health Care Center carries 73 deficiencies on its current record, including 15 tied to abuse and three serious enough to put residents in immediate harm's way. That record, plus $227,266 in CMS fines and placement in the federal Special Focus Facility program, tells you regulators are watching this building closely. Nurse staffing sits at 2.91 hours per resident day, roughly a quarter below the national average, and weekends drop another 17 percent below the home's own weekday levels. Staff turnover runs 58.2 percent, well above the 45.8 percent national figure, so the people caring for residents keep changing. The most recent inspection was January 10, 2025.
The Guest House in Shreveport runs on 2.67 nurse hours per resident per day, roughly a third below the national average, and weekends drop about another 10% below its own weekday pace. Staff turnover sits at 65.8% against a national rate of 45.8%, so the people left are often the newest. The current record carries 41 deficiencies, six of them at harm or jeopardy level and four tied to abuse, plus four fines totaling $267,179. Its last inspection was April 2025. For-profit, LLC-owned, 177 beds, with a one-star health inspection rating and a one-star staffing rating. That combination is what drives the grade down.
Four Seasons Living Center runs 239 certified beds in Sedalia under corporate for-profit ownership, and the staffing numbers tell the clearest story: 1.57 total nurse hours per resident day against a national average of 3.86. That's about 59% below what residents elsewhere typically receive, and weekends run roughly 9% thinner than the home's own weekdays. Staff turnover sits at 71.1%, well above the 45.8% national figure, meaning the people providing care are constantly changing. The inspection record shows 60 deficiencies, including 3 at harm or jeopardy level and 4 abuse-related, with two fines totaling $25,605 and the most recent inspection dated December 8, 2025.
Sarcoxie Health Care Center runs on nurse staffing that lands at 1.49 hours per resident day, a little over a third of the national figure, and weekends drop roughly another quarter below its own weekday level, so coverage thins out exactly when families tend to visit. Staff turnover sits at 84%. The current inspection record carries 24 deficiencies, including two at the harm or jeopardy level and five tied to abuse, and the most recent survey was in March 2025. With 40 beds and corporate for-profit ownership, the numbers point to a home where day-to-day care depends on a small, constantly changing staff.
Lawson Manor runs on about 3.02 nurse hours per resident per day, roughly 22 percent under the national average, and weekends drop another 9 percent below its own weekday level, so the thinnest coverage lands when families tend to visit. Staff turnover sits at 73.6 percent against a national 45.8, meaning most of the people caring for your relative are new to the building. The current record carries 62 deficiencies, three serious enough to involve harm or jeopardy and six tied to abuse, plus a $51,856 fine. Ownership is for-profit, through a limited liability company, and the last inspection was June 9, 2025.
Skyline Heights is a for-profit home in Billings with 150 beds, and the numbers behind its record are hard to argue with. Nurse staffing sits at 3.26 hours per resident day, about 16 percent under the national average, and weekends run roughly 11 percent thinner than weekdays. Staff turnover is 74.7 percent against a national average of 45.8 percent, most of the people caring for your relative likely won't be there in a year. The current inspection record carries 63 deficiencies, seven at the harm or jeopardy level and five tied to abuse, plus six fines totaling $418,996. CMS has placed it in the Special Focus Facility program, which is reserved for homes with a persistent pattern of poor care.
Mountain Ridge Center runs 86 certified beds in Franklin under Genesis Healthcare, a for-profit corporation, 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, and weekends dip roughly 15% below its own weekday level, so coverage thins out exactly when families tend to visit. Staff turnover of 67.5% is well above the 45.8% national figure, meaning many of the people caring for residents are still learning the building. Inspections in April 2025 turned up 16 deficiencies, one abuse-related, with a single fine of $16,702. No harm-level citations appear on the current record, but the quality measure rating of 1 out of 5 doesn't inspire confidence.
A family calling about Pembroke Center should know a few numbers before anything else. The home runs 3.37 nurse hours per resident per day, about 13% under the national average of 3.86, and weekend staffing drops roughly 9% below its own weekday level. Annual turnover is 68.4%, well above the 45.8% national figure, so the people caring for residents change often.
Its inspection record shows 41 deficiencies, including 4 at the harm or jeopardy level and 5 tied to abuse. Three fines total $37,339, and the most recent inspection was November 21, 2025. Corporate-owned and operating under a low-rated history across inspections, quality measures, and staffing, this home carries real risk on paper.
The Waters of Smyrna runs on 2.99 nurse staffing hours per resident day, roughly a quarter below the national average of 3.86, and weekend coverage dips further below its own weekday level. That thin staffing sits alongside 69.3% annual turnover, well above the 45.8% national figure, meaning most of the people caring for residents are new to the building. Its record shows 36 deficiencies, including three at the harm or jeopardy level and six tied to abuse, plus a $97,773 fine. The last inspection was in August 2022, so that record has had time to age without a fresh look.
Valley Grande Manor runs on 2.94 nursing hours per resident per day, roughly a quarter below the national average of 3.86. Weekends are thinner still, about 10% under the home's own weekday coverage, and 68.8% of staff left over the past year against a national rate near 46%, so the people providing care keep changing. Inspectors have logged 49 deficiencies, six involving actual harm or jeopardy, eleven tied to abuse, with four fines totaling $88,679; the most recent inspection was July 2025. This is a 147-bed for-profit home owned by an individual, and the pattern in these numbers, low staffing, high turnover, repeat serious findings, is what families should weigh before deciding.
Arbor View runs 179 certified beds in Kerrville under for-profit LLC ownership, and the staffing numbers are where I'd start. At 3.39 nurse hours per resident day, it sits about 12% under the national average of 3.86, with weekends dipping roughly 5% below its own weekday levels. Annual turnover is 81.5% against a national 45.8%, nearly double, which means the people providing most of the daily care are still learning the residents. The inspection record is heavy: 76 deficiencies, six at harm or jeopardy level, nine abuse-related, and $154,617 in federal fines across five events. CMS has placed it in the Special Focus Facility program, reserved for the country's most persistently troubled homes. The most recent inspection was July 31, 2025.
Norfolk Health Care Center runs on 3.13 nursing hours per resident day, roughly 19% under the national average, and weekend coverage drops about 14% below what it manages on weekdays. That thin staffing sits alongside a 72.8% annual turnover rate, well above the 45.8% national figure, meaning most of the people caring for residents are new to the building. The inspection record shows 51 deficiencies, including one at the harm level and one tied to abuse, plus a $102,245 fine, and the last full inspection was in July 2021. Corporate-owned, 180 beds, and the federal stars land at one for health inspections and one for staffing.
Nurse staffing at Rivers Edge runs about 12% under the national average, and weekends are thinner still, roughly 15% below the home's own weekday coverage. That's a real problem when the same record shows 68.2% annual turnover, far above the 45.8% norm, because thin weekend shifts land on aides who may be new to the building. The inspection history is the louder signal: 107 deficiencies, six at harm or jeopardy level, 21 tied to abuse, and four fines totaling $406,985. For-profit corporate ownership, 58 beds, and a December 2025 inspection that's already on the books. Ask about weekend coverage, abuse-prevention training, and what's changed since that visit.
Focused Care At Pasadena runs on 2.95 nursing hours per resident per day, roughly a quarter below the national average, and weekends drop about 14% below what the home staffs on weekdays. That thin coverage shows up in the inspection record: 32 deficiencies, six of them serious enough to put residents in harm's way, three tied to abuse, and $131,012 in fines. Staff turnover sits at 76.6% against a national 45.8%, meaning most of the people caring for your family member this year likely won't be there next year. The corporation that owns it has drawn a 1-star inspection rating and a 1-star staffing rating, with the most recent survey dated February 2026.
Nexus At Alton runs 181 beds under for-profit LLC ownership, and the staffing picture is stranger than the headline number suggests. Total nurse hours come in around 4.28 per resident day, roughly 11% above the national average, but weekends drop about 20% below the home's own weekday level, so coverage depends heavily on when you visit. Annual turnover sits at 81.5% against a national average near 45.8%, meaning most of the people caring for residents are new to the building. The inspection record is the harder problem: 87 deficiencies on file, 20 at harm or jeopardy level and 14 abuse-related, with five fines totaling $392,111 and a last inspection in May 2024.
Carlinville Rehab & Hcc runs on 3.14 nurse hours per resident day, roughly 19% under the national average, and weekends drop about 15% below what the home already provides on weekdays. Turnover sits at 62.9% against a national 45.8%, so the aides and nurses who know your parent are often the ones walking out the door. The current record carries 38 deficiencies, six of them serious enough to put residents in harm's way and ten tied to abuse, plus two fines totaling $171,737. Inspectors were last in on June 26, 2025. This is a for-profit LLC, and the numbers say the money isn't going toward the bedside.
Lakeshore Manor runs on 2.90 nurse hours per resident day, roughly a quarter below the national average, and weekends drop about 24% below what the building manages Monday through Friday. Staff turnover sits at 56.6%, well above the 45.8% national figure. The inspection record shows 44 deficiencies, nine of them at harm or jeopardy level and four tied to abuse, with three fines totaling $259,803. CMS has placed it in the Special Focus Facility program, which is reserved for the poorest performers. A for-profit LLC owns the 110-bed building; its most recent inspection was December 10, 2025. If you're considering this one, ask what the correction plan actually looks like.
Athene Nursing and Rehabilitation runs 282 certified beds in Town and Country under for-profit LLC ownership, and the staffing numbers are the first thing that stands out. At 2.90 nurse hours per resident day, it sits about a quarter below the national average, and weekends drop another 16% below its own weekday level, so the thinnest coverage lands when families tend to visit. Turnover runs 61.2% against a national 45.8%, meaning the aides and nurses caring for residents are, more often than not, new to the building. The inspection record shows 111 deficiencies, including four at harm or jeopardy level and nine tied to abuse, with eight fines totaling $145,782. The most recent inspection was January 13, 2026, so the record is current, not old.
Jourdanton Nursing And Rehabilitation runs on 2.76 nurse hours per resident per day, about a quarter below the national average, and weekends are thinner still, roughly 17% less staff than weekdays. That staffing pattern sits behind a one-star CMS staffing rating, and the turnover number is the one that would worry me most: 90.5% annually against a national average of 45.8%, meaning most of the people caring for your relative are new, or about to be.
The inspection record shows 31 deficiencies, including two at the harm level and one abuse-related, with $28,334 in fines. Corporate-owned and for-profit, its most recent inspection was January 2026, so the record is current rather than dated.
Birchwood Park runs on thin staffing. At 3.06 nurse hours per resident per day, it's about 21% below the national average, and weekends drop roughly another 20% below its own weekday levels, so the thinnest coverage lands when families tend to visit. Turnover sits at 63.6% against a national 45.8%, which means the people caring for your relative are frequently new. The inspection record is heavier still: 114 deficiencies, seven at harm or jeopardy level, ten abuse-related, and a $131,178 fine. Virginia Beach has plenty of options; ask this one directly how it plans to fix staffing before you decide.