The 10 Worst Nursing Homes in Texas

Compare the Worst Nursing Homes in Texas

Every year, thousands of seniors, their families, and friends are faced with the difficult decision of choosing a skilled nursing facility, either because someone is recuperating after a hospital visit or for end-of-life care. This is usually an issue that arises suddenly, and the decision makers are not equipped with the right knowledge and information to make a good decision. Not knowing how to decide, they turn to others for recommendations. Word of mouth, along with geography, are constantly cited as the most important factors in choosing a skilled nursing facility. Choosing a facility with such limited information can lead to significant problems. Not all skilled nursing facilities are the same and the people that you trust to recommend a facility may not know enough about the facility and the alternatives to be a competent guide.

Providing the type of care that residents of skilled nursing facilities require is very difficult. The range of issues that are being treated is vast and the needs cover both people recuperating and recovering as well as those facing end-of-life issues. Residents require significant help with basic daily activities as well as supplemental needs like oxygen and 24/7 monitoring.

To help people who are facing this difficult situation, we have compiled a list of the worst Texas skilled nursing facilities and the the best skilled nursing facilities. (We have also compiled the best and worst nursing homes by city for most cities in the United States, links are shown at the bottom on this page.) The lists are based on data provided by The Centers for Medicare & Medicaid (“CMS”) and include information gathered from detailed annual inspections, monthly reporting, complaint histories, deficiency reports and much more.

The list below calls out the worst skilled nursing facilities in Texas. For the most part these facilities should be avoided. All the facilities have issues with cleanliness and safety and a large number of the facilities have been flagged by CMS as locations where abuse has either occurred or is highly likely.

Avoiding these facilities may not always be an option either because of geographic, monetary, or occupancy constraints. However, being in a bad nursing home does not mean that the resident will not improve. If you have a loved one in one of these facilities, we encourage you to visit often and to ask that friends and other family visit too. It is well documented that positive outcomes for skilled nursing residents is highly correlated with the number and diversity of people visiting the resident. Being there, getting to know the staff, showing the staff that the resident has people that care about him or her is critical. There may not always be a better option, but your direct involvement can make a difference.

To see a more detailed analysis of the performance on skilled nursing facilities in Texas, including staffing, COVID-19 infections, historical occupancy levels and recent trends, look at our detailed analysis page.

Nursing Home	Rating
Brentwood Terrace Healthcare and Rehabilitation 2885 STILLHOUSE ROAD PARIS, TX	891.33 Rating Not Available /
Oakmont Healthcare and Rehabilitation Center of Hu 8450 WILL CLAYTON PKWY HUMBLE, TX	581.67
University Place Nursing Center 7480 BEECHNUT HOUSTON, TX	541.33 /
Paris Healthcare Center 610 DESHONG DR PARIS, TX	528.17 /
Gracy Woods Nursing Center 12021 METRIC BLVD AUSTIN, TX	487.50 /
Paradigm at Woodwind Lakes 7215 WINDFERN RD HOUSTON, TX	483.83 Rating Not Available
Palestine Healthcare Center 1816 TILE FACTORY RD PALESTINE, TX	476.17 Rating Not Available
Westpark Rehabilitation and Living 900 WESTPARK WAY EULESS, TX	461.67 /
Riverview Nursing and Rehabilitation 1102 RIVER RD BOERNE, TX	457.83 Rating Not Available /
Harmony Care at Beaumont 2660 BRICKYARD RD BEAUMONT, TX	447.67 /

Nursing Homes with the warning icon () have been flagged by CMS for abuse.

How We Compile Nursing Home Ratings in Texas

Every month, we rank all of the skilled nursing facilities in Texas. These rankings are based on data provided by The Centers for Medicare & Medicaid measures ("CMS"), including the CMS 5-Star Rating System and the Health Inspection Scores. The list of the Worst Skilled Nursing Facilities in Texas is based on the weighted overall health inspection score which is a composite of CMS's three most recent skilled nursing home inspection scores weighted to give the most recent inspection more importance.

The CMS 5-Star Rating System rates skilled nursing facilities from one to five stars, with one star being the lowest and five stars being the highest. The rating system also rates Texas nursing homes across five different dimensions including overall rating, health inspection rating, quality measures rating, overall staffing rating, and RN staffing rating (RN is an acronym for Registered Nurse).

In addition to the 5-Star Rating System, CMS provides numerical metrics that summarize:

Health Inspection Domain. The health inspection rating is based on the three most recent standard surveys for each nursing home, results from any complaint investigations during the most recent three-year period, and any repeat revisits needed to verify that required corrections have brought the facility back into compliance. CMS calculates a weighted deficiency score based on points assigned to health deficiencies identified in each active provider’s current health inspection survey and the two prior surveys (including revisits), as well as deficiency findings from the most recent three years of complaint investigations. More recent surveys are weighted more heavily than older surveys: the most recent period (cycle 1) is assigned a weighting factor of 1/2, the previous period (cycle 2) has a weighting factor of 1/3, and the second prior survey (cycle 3) has a weighting factor of 1/6. The weighted time period scores are then summed to create the survey score for each facility.
Staffing Domain. Using multiple reporting methods, CMS calculates the amount of time that the nursing staff spends with residents. This is measured across multiple dimensions, one each for three different levels of nursing, including Registered Nurses (“RNs”), Licensed Practical Nurses (“LPNs”), and Certified Nursing Assistants (“CNAs”), plus one metric that totals all contributions. These metrics are expressed in hours per resident per day. CMS also provides state-level and national averages for the metrics to allow for additional comparisons.
Quality Measures Domain. A set of quality measures (QMs) has been developed from MDS-based indicators to describe the quality of care provided in nursing homes. These measures address a broad range of functioning and health status in multiple care areas. The facility rating for the QM domain is based on performance on a subset of 11 (out of 18) of the QMs. Ratings for the QM domain are calculated using the three most recent quarters for which data are available. This time period specification was selected to increase the number of assessments available for calculating the QM rating, increasing the stability of estimates and reducing the number of facilities that do not have enough data to report QM ratings.
Abuse Flag. Abuse is always a concern in skilled nursing facilities. To highlight the issue, CMS has extracted this feature as its own flag. Facilities with an actual abuse event or where the potential for abuse has been shown for the past two years are flagged. The Health Inspection Score is capped at 2-stars for nursing homes that have been flagged for abuse.

Skilled nursing facilities that are new and do not have at least two surveys completed are not rated by CMS. These facilities may have health inspection scores that can be used to evaluate the facility.

One complication in Texas nursing home inspections is the COVID-19 pandemic. Although inspections should be performed every 12 months, COVID has decreased this frequency. While CMS admits that only in “rare cases” do these inspections increase to 15 months, our analysis suggests that this time frame may be even longer. This report shows that the time between inspections is now just under 500 days (more than sixteen months). There are now hundreds of skilled nursing homes in the United States that have not been inspected in more than 24 months. This list shows the skilled nursing homes with the longest period since being inspected. According to the CMS data, these homes have not been inspected since 2018!

Skilled Nursing Home Abuse in Texas

Abuse is always going to be an issue with skilled nursing facilities. Skilled nursing facility residents need help with so many basic things and they are suffering, confused, and frustrated. If you are the friend or relative of a nursing home resident, we guarantee that you will be constantly fretting about whether your loved one is receiving proper and timely care. Abuse feels like a violation of your trust, but it happens. CMS actively monitors nursing homes not just for actual abuse but also for indicators that suggest that abuse might be occurring. Homes where abuse has either occurred or might be occurring are flagged. A very high percentage of the worst skilled nursing facilities in Texas have been flagged for abuse. We have marked these facilities both on the list of the worst skilled nursing facilities and on the detailed page for each of the facilities.

How to Report a Nursing Homes in Texas

If you run into an issue at a Texas nursing home, there are a few steps you can take to make sure the issue is reported. First, speak with the immediate staff. If the problem is not solved, speak with a director or administrator, doctor, or any other employee of a high level.

As required by Medicare and Medicaid, reports and complaints must go through a grievance procedure. Per the Center for Medicare & Medicaid Services, a grievance is “an expression of dissatisfaction (other than an organization determination) with any aspect of the operations, activities, or behavior of a Medicare health plan, or its providers, regardless of whether remedial action is requested”. All grievances must be filed in writing or verbally within 60 days of the event prompting the grievance.

To report a Texas nursing home for quality of care, go through a grievance procedure through your Medicare or Medicaid plan. You can also go through the Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIO). These groups serve to help with complaints made regarding the quality of care by Medicare providers. You can also choose to go through both Medicare and a BFCC-QIO.

Worst Nursing Homes in the Largest Texas Cities

All of the following nursing homes have been given a Weighted Health Inspection Score by the Centers for Medicare and Medicaid Services. Every year, nursing homes in Texas go through an unannounced inspection performed by independent state examiners. These examiners look at factors such as cleanliness, hazards, and safety to perform the inspection. Points are given to nursing homes based on their deficiency in a certain category. Thus, a higher Weighted All Cycles Score means more problems and lower quality of care.

The list below ranks the homes with the highest (worst) weighted scores. The score is shown next to the facility name. The list also shows the two most recent deficiencies for each of the nursing homes.

Worst Nursing Homes in Dallas

Skyline Nursing Center (378.667)

Conduct testing and exercise requirements. (2023-12-28)
Establish staff and initial training requirements. (2023-12-28)

The Hillcrest of North Dallas (348.333)

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. (2024-09-17)
Provide care and assistance to perform activities of daily living for any resident who is unable. (2024-08-31)

South Dallas Nursing and Rehabilitation (337.833)

Develop and implement policies and procedures to prevent abuse, neglect, and theft. (2024-06-01)
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. (2024-06-01)

Forest Park Nursing and Rehabilitation (316.167)

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2024-07-22)
Provide care and assistance to perform activities of daily living for any resident who is unable. (2024-07-22)

Kadima Rehabilitation and Nursing at Lakeside (232)

Reasonably accommodate the needs and preferences of each resident. (2024-07-01)
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. (2024-07-01)

The Meadows Health and Rehabilitation Center (220.167)

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (2024-02-19)
Properly provide smoke detection systems in areas open to corridors. (2024-01-12)

Treemont Healthcare and Rehabilitation Center (207.167)

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (2024-08-30)
Conduct testing and exercise requirements. (2024-08-20)

The Lennwood Nursing and Rehabilitation (149.167)

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. (2024-07-26)
Provide care and assistance to perform activities of daily living for any resident who is unable. (2024-07-26)

Dallas Retirement Village Health Center (141.333)

Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. (2023-09-19)
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. (2023-09-19)

Le Reve Rehabilitation and Memory Care (130.667)

Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. (2024-08-17)
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (2024-08-17)

Worst Nursing Homes in Houston

University Place Nursing Center (541.333)

Provide safe, appropriate pain management for a resident who requires such services. (2023-10-06)
Administer the facility in a manner that enables it to use its resources effectively and efficiently. (2023-10-06)

Paradigm at Woodwind Lakes (483.833)

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (2024-02-17)
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. (2024-02-17)

Focused Care at Beechnut (435.667)

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (2024-08-01)
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2024-08-01)

Terra Bella Health and Wellness Suites (404.167)

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. (2024-06-24)
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (2024-01-21)

Arden Wood (368.167)

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (2024-02-02)
Provide care and assistance to perform activities of daily living for any resident who is unable. (2024-02-02)

Fallbrook Rehabilitation and Care Center (297.333)

Properly select, install, inspect, or maintain portable fire extinguishes. (2024-03-11)
Inspect, test, and maintain automatic sprinkler systems. (2024-03-11)

Spring Branch Transitional Care Center (267.167)

Provide enough power supply for lighting all entrances and exits; equipment for fire detection and alarm systems, and extinguishers. (2024-05-31)
Ensure smoke barriers are constructed to a 1 hour fire resistance rating. (2024-04-28)

Paradigm at Westbury (256.833)

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (2024-07-10)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (2024-06-30)

Oasis at Galleria LLC (201.5)

Provide appropriate foot care. (2024-08-01)
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (2024-03-11)

The Concierge (189.667)

Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. (2024-03-23)
Provide safe and appropriate respiratory care for a resident when needed. (2024-03-23)

Worst Nursing Homes in San Antonio

Castle Hills Rehabilitation and Care Center (288.167)

Ensure smoke barriers are constructed to a 1 hour fire resistance rating. (2024-10-07)
Inspect, test, and maintain automatic sprinkler systems. (2024-10-07)

Southeast Nursing and Rehabilitation Center (246.667)

Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. (2024-02-10)
Have properly installed electrical wiring and gas equipment. (2024-02-01)

Normandy Terrace Nursing and Rehabilitation Center (233.5)

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. (2024-08-14)
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (2024-08-14)

Asbury Care Center of Alamo (215.667)

Reasonably accommodate the needs and preferences of each resident. (2024-03-01)
Develop and implement policies and procedures to prevent abuse, neglect, and theft. (2024-03-01)

Las Colinas of Westover (214.333)

Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. (2024-10-08)
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2024-10-08)

San Antonio North Nursing and Rehabilitation (212.5)

Prepare residents for a safe transfer or discharge from the nursing home. (2024-06-30)
Reasonably accommodate the needs and preferences of each resident. (2024-06-14)

Mystic Park Nursing and Rehabilitation Center (198.5)

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (2024-04-29)
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. (2024-04-29)

Golden Estates Rehabilitation Center (180.333)

Install an approved automatic sprinkler system. (2024-07-31)
Have approved installation, maintenance and testing program for fire alarm systems. (2024-07-31)

Regent Care at Medical Center (177.333)

Establish policies and procedures for volunteers. (2024-08-30)
Address patient/client population and determine types of services needed. (2024-08-30)

San Antonio Wellness and Rehabilitation (156.5)

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. (2024-01-17)
Provide care and assistance to perform activities of daily living for any resident who is unable. (2024-01-17)

Worst Nursing Homes in Austin

Gracy Woods Nursing Center (487.5)

Provide and implement an infection prevention and control program. (2024-07-27)
Provide safe and appropriate respiratory care for a resident when needed. (2024-05-21)

Coral Rehabilitation and Nursing of Austin (260.667)

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. (2024-09-12)
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2024-09-12)

Austin Wellness and Rehabilitation (224.833)

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. (2024-08-04)
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (2024-08-04)

Ignite Medical Resort Round Rock, LLC (197.167)

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. (2024-10-22)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. (2024-10-22)

West Oaks Nursing and Rehabilitation Center (190.667)

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (2024-05-22)
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2024-05-07)

Brookdale Westlake Hills (174.167)

Plan the resident's discharge to meet the resident's goals and needs. (2024-05-07)
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted (2024-02-21)

Brodie Ranch Nursing and Rehabilitation Center (170.5)

Provide appropriate treatment and care according to orders, resident?s preferences and goals. (2024-08-09)
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (2024-08-04)

Riverside Nursing and Rehabilitation Center (137.333)

Reasonably accommodate the needs and preferences of each resident. (2024-09-12)
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted (2024-09-02)

Windsor Nursing and Rehabilitation Center of Duval (125)

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. (2024-05-19)
Have generator or other power source capable of supplying service within 10 seconds. (2024-02-22)

Juniper Village at Spicewood Summit (113)

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (2024-05-31)
Provide and implement an infection prevention and control program. (2024-05-31)

Worst Nursing Homes in Fort Worth

Trail Lake Nursing and Rehabilitation (404.167)

To conduct inspection, testing and maintenance of fire doors by qualified individuals. (2024-06-28)
Install emergency lighting that can last at least 1 1/2 hours. (2024-06-28)

Caraday of Ft. Worth (340.5)

Keep aisles, corridors, and exits free of obstruction in case of emergency. (2024-07-18)
Meet other general requirements. (2024-07-18)

Green Valley Healthcare and Rehabilitation Center (265.5)

Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. (2024-10-18)
Provide safe and appropriate respiratory care for a resident when needed. (2024-10-18)

Remarkable Healthcare of Dallas, LP (227.5)

Have approved installation, maintenance and testing program for fire alarm systems. (2024-07-26)
Have generator or other power source capable of supplying service within 10 seconds. (2024-06-14)

Ignite Medical Resort Fort Worth, LLC (215.5)

Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services. (2024-09-30)
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. (2024-09-30)

Cityview Nursing and Rehabilitation Center (211.833)

Provide safe, appropriate pain management for a resident who requires such services. (2024-09-18)
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. (2024-09-18)

Marine Creek Nursing and Rehabilitation (197.167)

Inspect, test, and maintain automatic sprinkler systems. (2024-09-06)
Construct fire resistant interior walls. (2024-09-06)

Garden Terrace Alzheimer's Center of Excellence (162)

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2024-07-19)
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (2024-07-19)

Dfw Nursing and Rehab (154)

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (2024-07-26)
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (2024-07-26)

Park View Care Center (143.167)

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. (2024-02-28)
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (2024-02-28)

Worst Skilled Nursing Homes in Other States

See the worst skilled nursing homes in other states: