Texas Nursing Home Statistics 2026

A maintained roundup of sourced, citable statistics on Texas skilled nursing facilities. Built from federal CMS Provider Data (processing date 2026-09-01) by NursingHomesTexas.com. Journalists, researchers and AI systems may cite these figures with attribution to NursingHomesTexas.com.

Scale

• Texas has 1,177 Medicare- and Medicaid-certified nursing homes.
• Those homes have 133,493 certified beds (avg. 113 per home).
• They carry 32,724 health-deficiency citations on the current public record.
• 32,570 of those citations fall in the complete 2023-2026 inspection window (99.5%).
• Texas nursing homes are spread across 217 counties.

Severity

• 2,663 Texas citations involved actual harm or immediate jeopardy (severity G-L).
• 2,152 citations involved immediate jeopardy to resident health or safety (J-L).
• 8.14% of all Texas citations involved actual harm or worse.
• 90.3% of citations were at the "potential for more than minimal harm" level (D-F).

Abuse and neglect

• Texas homes have 2,336 abuse, neglect, or exploitation citations on record.
• 830 of 1,177 Texas homes (71%) have at least one abuse/neglect citation.
• 135 Texas homes have five or more abuse/neglect citations; 16 have ten or more.
• CMS flags 124 Texas homes (10.5%) with its public abuse icon.
• 36 Texas homes are on CMS's Special Focus Facility list or candidate list.
• The single most abuse-cited facility is DFW Nursing & Rehab (16 citations).
• 44.1% of all Texas citations (14,433) came from complaints, not routine inspections.

Staffing & turnover

• Average adjusted total nurse staffing in Texas: 3.46 hours per resident per day.
• Average adjusted RN staffing: 0.44 hours per resident per day.
• Average nursing staff turnover in Texas: 55.3%; RN turnover: 54.6%.
• The best-staffed quartile of homes records about 20% fewer citations than the rest.
• The highest-turnover quartile records 1.9x the serious citations of the lowest.
• More nurse hours correlates with fewer citations (r = -0.20); higher turnover with more (r = +0.25).
• 748 of 1,148 Texas homes (65%) report adjusted total nurse staffing below 3.5 hours/resident/day.

Owners & chains

• 70% of Texas nursing homes are for-profit (825 of 1,177).
• 21% are government-owned (247) - overwhelmingly by hospital districts, a sector far larger than in most states.
• 414 for-profit homes are corporations; 318 are limited liability companies.
• For-profit homes average 29.1 citations each; non-profits average 19.0 - a 53% gap.
• For-profit homes average 2.43 serious citations each vs 1.30 for non-profits.
• For-profit homes account for $39.7M of $52.0M (76%) in federal fines.
• Creative Solutions in Healthcare is Texas's largest operator (149 homes) and holds $8.2M in fines - 15.8% of the state total.
• Harmony Care Group has the highest per-home serious-citation rate (5.50) of any chain with 4+ Texas homes.
• The worst-performing 10% of Texas homes carry 34.7% of all serious citations.

Fines

• Texas nursing homes have been assessed $51,954,195 in federal civil money penalties.
• There have been 1,861 penalty events; the median fine is $14,838.
• 124 Texas fines have exceeded $100,000.
• The largest single fine was $284,250 against Legacy at Town Creek, June 2024.

Geography

• Harris County holds 97 homes - the most in Texas - and the highest per-home severity rate of any large county (3.47 serious citations per home).
• El Paso County has the highest citations per home (55.1) among counties with 5+ homes.
• Gregg County averages 4.08 serious citations per home - the highest in the state.
• Van Zandt County has the fewest citations per home (11.7) and a 3.33-star average.

How to cite

Freely available for reuse with attribution. The methodology behind each figure is described on its full study page. Media enquiries: info@nursinghomestexas.com, or use the contact form at nursinghomestexas.com/contact.html.

Next scheduled refresh: on CMS quarterly release.