Nursing Homes in Texas
Texas has 1,176 Medicare-certified nursing homes across 439 cities, with 133,685 total beds. 229 facilities (20%) earn a recommended rating for family consideration. The state performs -3.1% above the national average on quality metrics.
Compare 1,176 nursing homes ยท data
See all 229 recommended nursing homes in TexasWorth Considering
229
facilities earn a recommended rating
State Average
+-3.1% vs national
Coverage
439
cities with facilities
High Risk Facilities
344
166 with abuse citations
647 rated F grade
Cities with Best Care
1,176 facilities ยท Showing 1-10
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About Nursing Home Care in Texas
Texas's 1,176 Medicare-certified nursing homes serve residents across 439 cities, offering a combined capacity of 133,685 beds. The state's nursing home landscape performs notably well compared to national benchmarks, with facilities averaging -3.1% higher on quality metrics than the national average.
Of the state's facilities, 229 (20%) earn our recommended rating, indicating they meet quality thresholds across CMS star ratings, inspection results, staffing levels, and penalty history. This includes 176 five-star facilities that represent the highest tier of care quality.
However, families should exercise caution with 344 high-risk facilities in the state, including 166 with abuse citations and 647 rated F grade on our scoring system. Houston is the state's largest market with 61 facilities. for families in the state's largest city.
Texas at a Glance
Good News
- 20% of facilities earn recommended status
- State averages -3.1% above national quality metrics
- 30% of facilities have no recent fines
- 176 five-star CMS-rated facilities available
- Port Arthur leads the state with 1 recommended facilities and an average trust score of 90.
Be Aware
- 344 facilities (29%) are high-risk
- 166 facilities have abuse citations
- $67,694,087 in total fines over 3 years
- However, the city averages only 54 trust scoreโresearch facilities carefully.
- 70% of facilities are for-profit
What's Changing
- CMS staffing mandates taking effect 2024-2026
- 12% of facilities currently meet staffing benchmarks
- Quality reporting requirements expanding
- Infection control standards strengthened post-COVID
- State inspection frequency increasing
Questions to Ask When Visiting
Based on Texas's nursing home data, we recommend asking these questions during facility tours:
About Staffing
- What is the RN-to-resident ratio on each shift?
- How do you handle staffing on weekends?
- What is your staff turnover rate?
- Are staff trained in dementia care?
About Quality
- Can I see your most recent inspection report?
- Have you had any abuse citations in the past 3 years?
- What is your fall prevention protocol?
- How do you handle medication management?
About Costs
- What services are included in the daily rate?
- Do you accept Medicaid? What's the waitlist?
- Are there additional fees for therapies?
- What happens if my loved one runs out of private funds?
About Daily Life
- What activities are available for residents?
- What are the visiting hours and policies?
- How do you handle dietary restrictions?
- Can residents personalize their rooms?
Fines & Penalties in Texas
Over the past 3 years, Texas nursing homes have been assessed $$67,694,087 in federal fines and penalties. Here's how that breaks down:
$$67.7M
Total Fines (3yr)
$$57,563
Avg per Facility
175
No Recent Fines
49
Facilities Fined
Note: Fines data is based on CMS enforcement actions over the past 3 years. A facility with no fines may still have deficiencies; conversely, a fined facility may have corrected issues.
Most Common Deficiencies
30,014 total deficiencies ยท 25.5 avg per facility
Ownership Breakdown in Texas
Texas's nursing home industry is predominantly for-profit, with 825 facilities (70%) operated by for-profit companies.
For-Profit
70%825 of 1,176 facilities
Non-Profit
11%126 of 1,176 facilities
Government
19%225 of 1,176 facilities
Research suggests ownership type can influence care quality, though many factors affect outcomes. Non-profit facilities may reinvest surplus into care improvements, while for-profit facilities face investor return pressures. However, excellent and poor facilities exist in all ownership categories.
Finding Quality Nursing Home Care in Texas
Finding the right nursing home in Texas requires careful research. With 1,176 facilities spread across 439 cities, families have optionsโbut quality varies significantly. Our analysis shows that while Texas performs -3.1% above the national average, nearly one in four facilities (29%) carries a high-risk designation.
Understanding Our Trust Score System
The Trust Score is a 0-100 rating calculated from CMS's official nursing home database. The score combines five data categories:
- Health Inspection Results โ Recent deficiencies, their severity, and patterns over time
- Staffing Levels โ RN hours, total nursing hours, and weekend staffing
- Quality Measures โ Clinical outcomes like falls, pressure ulcers, and rehospitalizations
- Penalties โ Fines, payment denials, and enforcement actions
- Complaints โ Substantiated complaints and their severity
In Texas, 229 facilities score a B grade or better, indicating they meet quality benchmarks across these categories. We recommend families prioritize these facilities and carefully research any facility rated C or below before visiting.
Regional Considerations
Quality varies significantly by region. Port Arthur, Palestine, Crockett lead the state in quality metrics, with higher percentages of recommended facilities and lower rates of citations.
Frequently Asked Questions
Texas has 1,176 Medicare-certified nursing homes across 439 cities, offering a total of 133,685 beds. Of these, 229 facilities (20%) earn our recommended rating based on quality metrics including CMS star ratings, inspection results, staffing levels, and penalty history.
The largest cities for nursing home care in Texas are Houston, San Antonio, Dallas, Fort Worth, Austin. These cities consistently score above the state average on quality metrics.
Texas nursing homes score -3.1% above the national average on our Trust Score metric, with an average score of 50 compared to the national average of 53. The state has 176 five-star facilities (15%) and 30% of facilities have no recent fines.
The average cost of nursing home care in Texas varies by facility type and level of care. Medicare covers skilled nursing care for qualifying stays up to 100 days. Medicaid covers long-term care for eligible residents. Contact individual facilities for private pay rates and payment options.
All Medicare-certified nursing homes in Texas are inspected annually by the Texas Health and Human Services Commission. Inspections evaluate quality of care, safety, and compliance with federal regulations. Results are reported to CMS and factor into our Trust Score calculations.
Ready to Find Care?
Use our search above to filter Texas's 1,176 nursing homes by quality rating, location, and features. Start with our 229 recommended facilities for the best care options.