Nursing Homes in Texas
1,177 Medicare- and Medicaid-certified facilities · TX · ranked on CMS Five-Star ratings, staffing, and penalties
Texas's 1,177 Medicare- and Medicaid-certified nursing homes average 2.6 of 5 CMS overall stars, below the 3.0-star national average, ranking #47 of 51 states/territories with ≥15 homes by average overall rating; 134 hold the top 5-star rating while 321 sit at the 1-star floor (CMS Nursing Home Compare, August 2026).
Ratings are force-curved within each state, so Texas's averages are best read against its own facilities and the national mean, not used to rank one state's 3-star home against another's.
- 2.6 / 5
- Below average · nat'l 3.0
- #47 of 51
- State rank by avg CMS overall (≥15 homes)
- 1,177
- Certified facilities
- 134
- Five-star homes (11.4%)
The state picture
Texas's 1,165 rated nursing homes average 2.6 CMS overall stars, below the 3.0-star national mean, ranking #47 of 51 states on average overall rating. 134 homes sit at 5 stars and 321 at 1 star; the state beats the U.S. average on 0 of 4 staffing-and-rating metrics.
- 2.6 / 5
- Mean CMS overall · national 3.0
- #47 of 51
- State rank by average overall rating
- 134
- Five-star homes in Texas
- 0 / 4
- Metrics beating the national average
CMS overall stars are force-curved within each state · August 2026. Compare homes against Texas peers, not only the U.S. mean.
State registry desk · lower-band mean · floor-heavy
Texas's mean sits in the lower third of ≥15-home states
Texas's 2.6 mean sits at or below the 3.0 lower-tercile cut across 51 ≥15-home peers. The curve is floor-heavy: 321 one-star facilities (27.3%) outnumber 134 five-star records (11.4%) by more than 1.5×.
Largest absolute gap vs the U.S. mean is Nursing staff turnover (lower is better): Texas 55.3% vs national 45.8% (national side of the marker on the four-metric board).
Ownership desk: For-profit holds 834 of 1,177 certified homes (71%). Mean certified beds per home ≈ 113 · published federal fines average $45K per certified home statewide.
CMS Nursing Home Compare registry fields only · August 2026. Not care-placement advice.
CMS care plate
Sheet TX · Texas 2.65★ mean
STAR-LAG · BOTTOM-DECILE · PHOTO-FINISH · FP-HEAVY · BOOK-DENSE · STAFF-STRAIN
- STAR-LAG -0.33★ vs U.S.
- BOTTOM-DECILE #47/51
- PHOTO-FINISH -0.01★ peer
- FP-HEAVY 71% for-profit
- BOOK-DENSE 1177 homes
- STAFF-STRAIN 0.43 RN · 55% turn
Nearest average-rating peer: Georgia (-0.01★)
Instrument codes from this state’s CMS Nursing Home Compare sheet: star lead, peer rank, photo-finish gap, ownership sector, certified book size, and RN/turnover staffing. Not a placement score.
Average-rating neighbourhood around Texas
Lowest and highest poles plus nearest average-CMS-overall peers, not a full 50-state board reprint.
How Texas's nursing homes are rated
Texas's 1,165 rated facilities lean toward the CMS floor: 321 one-star records (27.3%) vs 134 five-star (11.4%). The bars below are Texas's force-curved distribution, not a national absolute.
Texas vs all states by nursing-home facility count
Where this state's CMS-certified nursing-home inventory sits among every tracked state and territory (inventory signal, not a quality ranking)
1,177 1st of 53 the highest of 53 states
States and territories, banded by CMS-certified nursing-home count
Each bar is a band; taller bars hold more states. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count and share, and where it sits relative to this entry.
Source CMS Nursing Home Compare · August 2026
Ownership sector · state inventory
For-profit dominates Texas's 1,177-home book
For-profit accounts for 71% of certified homes in Texas. CMS ownership sectors (For-profit, Nonprofit, Government) are exclusive inventory labels, separate from the star-rating curve. Source: CMS Nursing Home Compare, August 2026.
Texas vs the national average
Metrics ordered by largest absolute gap from the U.S. mean. Texas sits on the better side of the marker on 0 of 4. Opening gap: Nursing staff turnover (lower is better) (55.3% vs 45.8%).
National average: 45.8%
National average: 3.86
National average: 2.98 ★
National average: 0.69
Bar = Texas average · vertical marker = U.S. average. Source: CMS Nursing Home Compare · August 2026.
What the Texas Nursing Home Record Reveals
Texas hosts 1,177 Medicare- and Medicaid-certified nursing facilities operating 133,408 total certified beds (113 beds/home mean), with a statewide average CMS overall rating of 2.6 out of 5 stars - lower-tercile among ≥15-home peers (cut 3.0). The tip is floor-heavy: 321 one-star (27%) vs 134 five-star (11%). CMS ratings are state-normalized, so the same absolute inspection record may place differently in Texas than in a state with a different facility mix.
Statewide staffing reports an average of 0.43 registered-nurse hours per resident day across Texas facilities (CMS payroll-based nurse staffing file). Nursing staff turnover statewide averages 55.3% on the same CMS measure. Staffing levels and turnover feed the inspection and quality-measure scores that CMS uses in the overall star rating; the Texas figures above should be read against the federal CMS 2024 minimum-staffing rule, which phases in HPRD floors over several years and will reshape this distribution for facilities currently operating below the thresholds.
For families evaluating nursing home options in Texas, the statewide averages above set the backdrop, but placement decisions ultimately turn on facility-level records: the specific deficiencies cited at the most recent inspection, the staffing hours actually logged (as opposed to budgeted), the enforcement history of fines and payment denials, and direct observation through in-person visits. Every facility listed below links to its full CMS record on this site. Data is sourced from CMS Nursing Home Compare and Provider Data; figures reflect the most recent refresh and should be verified with each facility and the Texas state survey agency before any placement decision is finalized.
Top-rated nursing homes in Texas
The 100 highest-rated of Texas's 1,177 certified facilities, ordered by CMS overall star rating. Search all 1,177 Texas facilities →
What the CMS records show in Texas
Texas averages 2.6 of 5 CMS stars - below the 3.0-star national mean. That aggregate describes this CMS registry; it is not a placement or suitability score.
- Each facility record lists CMS overall, inspection, staffing, and quality fields separately. Browse facility records
- Texas's largest published federal fine is $755K; that enforcement field is distinct from the CMS star ratings. View the published record
- The rankings page compares the same state-normalized CMS fields across eligible state cohorts. View state rankings
CMS refreshes this registry quarterly. PlainNursing describes published records; it does not establish suitability, availability, admissions, or individual outcomes.
Read our methodology - how this data is sourced, computed, and verified.
How the CMS fields are recorded
The CMS Five-Star Quality Rating program publishes separate facility fields for health inspections, total nurse staffing hours per resident day, and quality measures drawn from MDS (Minimum Data Set) clinical assessments. CMS normalizes each star field against same-state peers before combining them into the overall rating shown in this registry.
PlainNursing aggregates the current CMS facility records for Texas and displays the source fields and state-relative ranks above. Those records describe the reported dataset only; they do not establish suitability, availability, admissions, or any individual’s outcome.
Source files publish quarterly at data.cms.gov. The official CMS record remains authoritative for facility fields and vintage.
Source: Centers for Medicare & Medicaid Services (CMS) Nursing Home Compare 5-Star Quality Rating, Texas · 2026 Star ratings combine health inspections, staffing, and quality measures. Updated quarterly by CMS.
This registry is informational, not medical or care-placement advice. It describes published CMS fields and links to Medicare.gov Care Compare, the official source for those records.