Houston, Texas's Harris County seat, has 61 Medicare-certified nursing homes with approximately 7,419 beds. Families have solid options to choose from.

Houston vs. Texas: Near State Average

Houston nursing homes perform near the state average on key quality metrics. The city's average CMS rating of 2.93 stars is close to Texas's statewide average of 2.79 stars.

12 of 61 facilities earn a B grade or better. Families should still research carefully, as 17 facilities have significant concerns.

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 — Recent deficiencies, their severity, and patterns over time
• Staffing Levels — RN hours, total nursing hours, and weekend staffing
• Quality Measures — Clinical outcomes like falls, pressure ulcers, and rehospitalizations
• Penalties — Fines, payment denials, and enforcement actions
• Complaints — Substantiated complaints and their severity

In Houston, 12 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.

Staffing: A Significant Concern in Houston

Staffing levels are among the most important predictors of nursing home quality. Research consistently shows that facilities with more nursing staff—especially registered nurses—have better outcomes for residents.

Houston facilities average 0.63 RN hours per resident day, which falls below the CMS-recommended threshold of 0.75 hours. The typical Houston resident receives approximately 38 minutes of RN attention daily—compared to the 45 minutes experts recommend.

14 Houston facilities exceed CMS staffing recommendations. Families prioritizing staffing should look for facilities with the "Top Staffing" badge and ask specifically about RN hours during facility visits.

Ownership: Mix of For-Profit and Non-Profit

Houston has 14 non-profit nursing homes and 40 for-profit facilities. 47 of 61 facilities are chain-owned, with the remainder independently operated.

Research suggests non-profit facilities often have higher staffing levels and fewer deficiencies on average, though ownership type alone does not guarantee quality. Families should evaluate each facility individually using inspection data, staffing levels, and recent deficiency reports.

Nearby Alternatives Worth Considering

Families may also want to consider nearby Texas cities for additional options. The following Texas cities offer multiple nursing home options:

• San Antonio — 59 facilities
• Dallas — 35 facilities
• Fort Worth — 30 facilities
• Austin — 25 facilities
• El Paso — 21 facilities
• Lubbock — 14 facilities