Nursing homes in Texas

Before the brochure: look at staffing

The single best-evidenced predictor of safe care is not the marketing — it's nurse hours per resident per day (how much hands-on nursing time each resident actually gets). CMS measures it from payroll. Researchers and CMS point to about 4.1 total nurse hours/resident/day as a staffing-adequacy reference.

In Texas, the median nursing home reports 3.27 hours/resident/day — and just 9% (104 of 1,126 that report staffing; 50 report none) meet the 4.1-hour reference. The catch a star rating hides: 273 Texas homes rated 4–5★ overall staff below the 4.1-hour adequacy reference — they sit flagged understaffed for rating in the table below, which opens sorted by staffing, not stars.