ANALYSIS

The 10 Worst Nursing Homes in Texas

A list of the ten worst skilled nursing homes in Texas. Based on the Weighted Health Inspection Score developed by the Centers for Medicare and Medicaid Services.

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
Paradigm at Woodwind Lakes
7215 WINDFERN RD
HOUSTON, TX
698.33
/
Oakmont Healthcare and Rehabilitation Center of Hu
8450 WILL CLAYTON PKWY
HUMBLE, TX
620.50
Oasis at Austin
3509 ROGGE LN
AUSTIN, TX
617.33
Rating Not Available /
Brentwood Terrace Healthcare and Rehabilitation
2885 STILLHOUSE ROAD
PARIS, TX
611.83
/
Paris Healthcare Center
610 DESHONG DR
PARIS, TX
598.67
/
Riverview Nursing and Rehabilitation
1102 RIVER RD
BOERNE, TX
574.67
Rating Not Available /
Remarkable Healthcare of Fort Worth
6649 N RIVERSIDE DR
FORT WORTH, TX
564.83
Rating Not Available /
University Place Nursing Center
7480 BEECHNUT
HOUSTON, TX
541.33
/
Skyline Nursing Center
3326 BURGOYNE
DALLAS, TX
516.17
/
Palestine Healthcare Center
1816 TILE FACTORY RD
PALESTINE, TX
511.67
Rating Not Available /

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 (516.167)
    • Conduct testing and exercise requirements. (2023-12-28)
    • Establish staff and initial training requirements. (2023-12-28)
  • Forest Park Nursing and Rehabilitation (263.167)
    • Provide appropriate foot care. (2024-01-19)
    • Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. (2024-01-19)
  • Treemont Healthcare and Rehabilitation Center (250.5)
    • Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (2024-02-01)
    • 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. (2024-02-01)
  • Kadima Rehabilitation and Nursing at Lakeside (234)
    • Use approved construction type or materials. (2024-01-26)
    • Establish an Emergency Preparedness Program (EP). (2024-01-26)
  • The Meadows Health and Rehabilitation Center (220.833)
    • 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. (2024-02-19)
    • Properly provide smoke detection systems in areas open to corridors. (2024-01-12)
  • Dallas Retirement Village Health Center (150.667)
    • 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)
    • 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)
  • Fair Park Health and Rehabilitation Center (150.333)
    • 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. (2023-10-06)
    • Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. (2023-06-30)
  • South Dallas Nursing and Rehabilitation (120.333)
    • Respond appropriately to all alleged violations. (2023-11-24)
    • 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. (2023-09-18)
  • Brentwood Place One (118.5)
    • Provide safe and appropriate respiratory care for a resident when needed. (2023-12-01)
    • Provide enough food/fluids to maintain a resident's health. (2023-12-01)
  • Brentwood Place Two (109.833)
    • 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. (2023-11-09)
    • Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (2023-11-09)

Worst Nursing Homes in Houston

  • Paradigm at Woodwind Lakes (698.333)
    • 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)
    • 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)
  • 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)
  • Fallbrook Rehabilitation and Care Center (378.333)
    • 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 (347.833)
    • Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (2023-11-17)
    • Encode each resident?s assessment data and transmit these data to the State within 7 days of assessment. (2023-11-17)
  • Terra Bella Health and Wellness Suites (337)
    • Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (2023-11-24)
    • Ensure that residents are free from significant medication errors. (2023-11-24)
  • Arden Wood (336)
    • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. (2024-01-12)
    • Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. (2024-01-12)
  • Afton Oaks Nursing Center (228.833)
    • Have simulated fire drills held at unexpected times. (2024-02-23)
    • Ensure smoke barriers are constructed to a 1 hour fire resistance rating. (2024-02-23)
  • Paradigm at Westbury (228.167)
    • Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (2024-02-07)
    • Have policies on smoking. (2024-02-07)
  • Park Manor of Westchase (217)
    • Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. (2024-01-31)
    • Provide care and assistance to perform activities of daily living for any resident who is unable. (2024-01-31)
  • Park Manor of Cypress Station (211)
    • Reasonably accommodate the needs and preferences of each resident. (2023-09-27)
    • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. (2023-09-27)

Worst Nursing Homes in San Antonio

  • Southeast Nursing and Rehabilitation Center (359)
    • 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)
  • Asbury Care Center of Alamo (210.333)
    • Provide properly protected cooking facilities. (2023-12-30)
    • Have generator or other power source capable of supplying service within 10 seconds. (2023-12-28)
  • San Antonio North Nursing and Rehabilitation (186)
    • Provide and implement an infection prevention and control program. (2024-02-02)
    • Provide and implement an infection prevention and control program. (2023-10-16)
  • Mystic Park Nursing and Rehabilitation Center (166.333)
    • PASARR screening for Mental disorders or Intellectual Disabilities (2023-12-13)
    • Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (2023-12-13)
  • San Antonio Wellness and Rehabilitation (162.5)
    • 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)
  • Las Colinas of Westover (157.167)
    • Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. (2023-12-24)
    • Provide appropriate treatment and care according to orders, resident?s preferences and goals. (2023-12-24)
  • Hunters Pond Rehabilitation and Healthcare (149)
    • Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder. (2024-02-10)
    • Honor the resident's right to manage his or her financial affairs. (2024-01-20)
  • Oak Park Nursing and Rehabilitation Center (132.333)
    • 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. (2024-01-01)
    • Reasonably accommodate the needs and preferences of each resident. (2024-01-01)
  • San Antonio Residence and Rehabilitation Center (130.5)
    • Ensure each resident receives an accurate assessment. (2024-02-19)
    • Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. (2023-11-13)
  • Memorial Medical Nursing Center (128.167)
    • Provide care and assistance to perform activities of daily living for any resident who is unable. (2024-03-09)
    • Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (2024-03-09)

Worst Nursing Homes in Austin

  • Oasis at Austin (617.333)
    • Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2024-02-12)
    • Provide and implement an infection prevention and control program. (2024-02-12)
  • Gracy Woods Nursing Center (387.333)
    • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. (2024-03-21)
    • Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2024-01-27)
  • Retirement and Nursing Center Austin (199)
    • Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency. (2024-04-12)
    • Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. (2024-04-12)
  • Brookdale Westlake Hills (179.333)
    • Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services. (2024-02-21)
    • Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted (2024-02-21)
  • Riverside Nursing and Rehabilitation Center (152)
    • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. (2023-09-25)
    • Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted (2023-06-30)
  • Juniper Village at Spicewood Summit (146.5)
    • 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. (2023-10-27)
    • Ensure that residents are free from significant medication errors. (2023-10-27)
  • West Oaks Nursing and Rehabilitation Center (141.833)
    • Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. (2023-12-26)
    • Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. (2023-10-10)
  • Brodie Ranch Nursing and Rehabilitation Center (141.167)
    • Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (2024-03-08)
    • Honor the resident's right to manage his or her financial affairs. (2024-02-09)
  • Windsor Nursing and Rehabilitation Center of Duval (125)
    • Have generator or other power source capable of supplying service within 10 seconds. (2024-02-22)
    • Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. (2024-01-31)
  • Ignite Medical Resort Round Rock, LLC (108.167)
    • Plan the resident's discharge to meet the resident's goals and needs. (2023-12-08)
    • Provide safe and appropriate respiratory care for a resident when needed. (2023-09-28)

Worst Nursing Homes in Fort Worth

  • Remarkable Healthcare of Fort Worth (564.833)
    • Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. (2023-12-01)
    • Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. (2023-12-01)
  • Trail Lake Nursing and Rehabilitation (468.667)
    • Reasonably accommodate the needs and preferences of each resident. (2024-01-31)
    • Provide appropriate pressure ulcer care and prevent new ulcers from developing. (2024-01-31)
  • Caraday of Ft. Worth (285.333)
    • Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (2024-01-31)
    • Provide or get specialized rehabilitative services as required for a resident. (2024-01-31)
  • Remarkable Healthcare of Dallas, LP (210.333)
    • Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (2024-02-09)
    • Provide care and assistance to perform activities of daily living for any resident who is unable. (2024-02-09)
  • Mira Vista Court (172.5)
    • Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. (2024-03-20)
    • Ensure each resident receives an accurate assessment. (2023-10-14)
  • Garden Terrace Alzheimer's Center of Excellence (155.333)
    • Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. (2024-01-05)
    • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. (2024-01-05)
  • Dfw Nursing and Rehab (150.5)
    • 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. (2024-02-01)
    • Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (2024-02-01)
  • Green Valley Healthcare and Rehabilitation Center (148.167)
    • To conduct inspection, testing and maintenance of fire doors by qualified individuals. (2024-03-25)
    • Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. (2024-03-25)
  • Ignite Medical Resort Fort Worth, LLC (145.667)
    • Provide and implement an infection prevention and control program. (2023-12-01)
    • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. (2023-11-20)
  • Park View Care Center (140.5)
    • 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)
    • Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. (2024-02-28)

Worst Skilled Nursing Homes in Other States

See the worst skilled nursing homes in other states:

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