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The 25 worst-staffed nursing homes in Texas

Nurse staffing is the strongest predictor of nursing home safety. Using CMS's payroll-based staffing data (2026-08-09), we ranked every rated Texas nursing home by total nurse hours per resident per day. These 25 report the fewest — all well below the Texas median of 3.27 hours and the federal target of 3.48.

#FacilityCityNurse hrs/dayvs medianOverall
1Houston County Nursing HomeCrockett1.98-39%★★★★
2Premier Health Care CenterRanger2.21-33%
3South Dallas Nursing & RehabilitationDallas2.23-32%
4San Saba Nursing & RehabilitationSan Saba2.26-31%★★★★★
5Apex Secure Care BrownfieldBrownfield2.27-30%
6Ralls Nursing Home⚠ abuseRalls2.31-29%
7Brentwood Place OneDallas2.31-29%★★★★
8Clarendon Nursing HomeClarendon2.36-28%★★★
9Focused Care At Hogan ParkMidland2.37-28%
10Avir At BanderaBandera2.40-27%
11Glenview Wellness & RehabilitationNorth Richland Hills2.40-27%
12Windsor Nursing And Rehabilitation Center Of WeslaWeslaco2.41-26%★★
13Paradigm At The Prairies⚠ abuseEl Campo2.42-26%
14Cypress Pointe Health & WellnessHouston2.43-26%★★★
15Navasota Nursing & RehabilitationNavasota2.49-24%
16Brentwood Place TwoDallas2.51-23%★★
17Huebner Creek Health & Rehabilitation CenterSan Antonio2.52-23%
18Buena Vida Nursing And Rehab OdessaOdessa2.52-23%★★★
19Post Nursing & Rehab CenterPost2.54-22%★★★
20Sweetwater Healthcare CenterSweetwater2.55-22%★★★
21Pecan Tree Rehab And Healthcare CenterGainesville2.57-21%
22Brentwood Place ThreeDallas2.58-21%
23Avante Rehabilitation CenterIrving2.58-21%★★
24Yoakum Nursing And Rehabilitation CenterYoakum2.59-21%★★
25Towers Nursing HomeSmithville2.59-21%★★★★

How we built this

We used the total reported nurse staffing hours per resident per day from CMS Care Compare (Nursing Homes), dataset 4pq5-n9py (retrieved 2026-08-09), a payroll-based measure CMS collects from every certified nursing home. We ranked all 1,135 rated Texas facilities from lowest to highest.

To keep the ranking credible we excluded reporting artifacts: continuing-care retirement communities (whose per-resident math is distorted by large independent-living populations), facilities with fewer than 25 average residents, and any facility reporting below 1.5 hours per resident per day — a level no real skilled-nursing facility operates at, indicating an incomplete payroll submission rather than genuine staffing. Full details on our methodology page.

Lantern accepts no payment from any care facility and is not affiliated with CMS. This is educational information, not advice. If a family member lives in one of these facilities, staffing is one factor among many — review the full facility report card and speak with the facility directly. Related: 133 Texas nursing homes flagged for abuse →