Texas

Nursing Home Staffing Profile — 2025Q3

1,160 facilities87,467 residents3.40 avg HPRD

vs National Average

-0.49 HPRD

National avg: 3.90 · Texas: 3.40

📋

Texas ranks among the lower-performing states for nursing home staffing, with an average of 3.40 HPRD — 0.49 hours below the national average. Only 29.8% of facilities meet the CMS staffing benchmark of 3.48 HPRD, compared to 65.8% nationally. RN staffing averages 0.44 HPRD, with 6.5% of facilities meeting the 0.75 research recommendation.

3.40

Average Total HPRD

All nursing staff combined

▼ 0.49 vs national

0.44

Average RN HPRD

Recommended: 0.75

▼ 0.24 vs national

29.8%

Meet CMS Benchmark

346 of 1160 facilities

15.9%

Avg Weekend Drop-off

Staffing reduction on Sat/Sun

2.1%

Avg Agency Staff

Contractor/temp worker hours

—

Had Zero-RN Days

Data unavailable

3.28

Median HPRD

50th percentile (less skewed by outliers)

220

F-Rated Facilities

Under 2.5 HPRD — critically understaffed

Grade Distribution

How Texas's 1,160 facilities grade out

HPRD Distribution

Where facilities fall across the staffing spectrum

Staffing by Ownership Type

For-profit facilities consistently staff lower than non-profit and government-run homes

For-Profit

3.32

avg HPRD

697 facilities (60%)

Non-Profit

3.95

avg HPRD

105 facilities (9%)

Government

3.31

avg HPRD

188 facilities (16%)

💡 Non-profit facilities in Texas average 0.63 more HPRD than for-profit ones — about 19% higher staffing.

▲ Best Staffed in Texas

Top 5 by total nurse HPRD

A+

THE METHODIST HOSPITAL SNF

HENDRICK SKILLED NURSING FACILITY

BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL SKIL

LAREDO MEDICAL CENTER

LAREDO

6.45 HPRD

RN: 3.26

WATKINS-LOGAN-GARRISON TEXAS STATE VETERAN'S HOME

TYLER

6.44 HPRD

RN: 0.59

▼ Most Understaffed in Texas

Bottom 5 by total nurse HPRD

BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR

Graham Oaks Care Center

⚖️

Compare Two Facilities Side by Side

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County Breakdown

Staffing metrics by county in Texas — click a county to see individual facilities

Avg HPRD— total nurse hours per resident per day:≥ 3.48 meets federal benchmark,3.0–3.47 below benchmark,< 3.0 critically low

Meet Benchmark— share of facilities in the county at or above the 3.48 HPRD federal minimum:≥ 50%35–49%< 35%

County	Facilities ↓	Avg HPRD	RN HPRD	Meet Benchmark	Grades
▸Harris	95	3.58	0.53	32.6%	Mixed D/C
▸Dallas	80	3.35	0.45	23.8%	Mixed D/C
▸Tarrant	70	3.40	0.49	31.4%	Mixed D/C
▸Bexar	61	3.39	0.39	34.4%	Mixed D/C
▸Travis	28	3.51	0.50	32.1%	Mixed D/C
▸Hidalgo	22	3.34	0.32	27.3%	Mixed D/C
▸Collin	22	3.43	0.49	27.3%	Mostly C
▸El Paso	21	3.38	0.41	33.3%	Mixed C/D
▸Denton	18	3.51	0.55	33.3%	Mixed C/D
▸Mc Lennan	17	3.41	0.35	47.1%	Mostly D
▸Smith	17	3.64	0.47	47.1%	Mixed D/C
▸Bell	16	3.63	0.67	31.3%	Mixed D/F
▸Fort Bend	15	3.48	0.62	46.7%	Mixed C/B
▸Williamson	15	3.42	0.43	26.7%	Mostly D
▸Lubbock	15	3.38	0.29	13.3%	Mostly D
▸Cameron	14	3.37	0.33	21.4%	Mixed D/F
▸Nueces	14	3.29	0.38	35.7%	Mixed D/F
▸Jefferson	14	3.61	0.27	35.7%	Mixed F/D
▸Brazoria	13	3.39	0.47	23.1%	Mixed C/D
▸Gregg	13	3.75	0.44	53.9%	Mostly D
▸Taylor	12	3.81	0.76	33.3%	Mixed C/D
▸Galveston	12	3.71	0.50	66.7%	Mixed D/A
▸Montgomery	11	3.58	0.37	54.5%	Mixed D/B
▸Grayson	11	3.40	0.40	36.4%	Mixed C/D
▸Ellis	10	3.37	0.34	40.0%	Mixed C/D
▸Wichita	9	3.51	0.43	33.3%	Mostly D
▸Johnson	9	3.25	0.30	22.2%	Mixed D/F
▸Potter	9	3.74	0.49	44.4%	Mostly C
▸Parker	9	3.20	0.55	11.1%	Mixed D/F
▸Angelina	8	3.59	0.47	50.0%	Mixed F/D
▸Guadalupe	8	3.24	0.29	25.0%	Mixed F/D
▸Kaufman	8	3.57	0.48	37.5%	Mixed C/B
▸Tom Green	7	3.46	0.47	28.6%	Mixed C/F
▸Bowie	7	3.35	0.45	28.6%	Mixed D/C
▸Brown	7	3.35	0.54	28.6%	Mostly C
▸Brazos	7	3.16	0.33	14.3%	Mixed D/C
▸Kendall	6	3.59	0.54	33.3%	Mixed C/D
▸Ector	6	3.17	0.40	0.0%	Mostly D
▸Van Zandt	6	3.40	0.35	33.3%	Mostly D
▸Webb	6	3.67	0.97	16.7%	Mixed D/C
▸Anderson	6	4.04	0.46	66.7%	Mixed B/D
▸Hays	6	3.09	0.41	0.0%	Mostly D
▸Henderson	6	3.46	0.40	33.3%	Mixed C/D
▸Cherokee	6	3.33	0.34	16.7%	Mixed C/F
▸Comal	6	3.60	0.44	50.0%	Mixed C/B
▸Hunt	5	2.98	0.31	0.0%	Mostly D
▸Limestone	5	3.29	0.28	0.0%	Mostly D
▸Rockwall	5	3.41	0.41	20.0%	Mostly C
▸Caldwell	5	3.02	0.41	0.0%	Mostly D
▸Midland	5	3.04	0.45	0.0%	Mostly D
▸Hardin	5	3.27	0.30	20.0%	Mostly D
▸Wood	5	3.13	0.35	0.0%	Mixed C/F
▸Lavaca	5	3.09	0.29	0.0%	Mostly D
▸Lamar	5	3.24	0.48	0.0%	Mostly C
▸Fannin	5	3.28	0.41	20.0%	Mostly D
▸Navarro	5	3.29	0.31	40.0%	Mostly D
▸Fayette	5	3.31	0.34	40.0%	Mixed D/F
▸Bastrop	5	2.75	0.25	0.0%	Mostly F
▸Wise	4	3.09	0.26	0.0%	Mixed D/F
▸Coryell	4	3.51	0.30	50.0%	Mixed F/C
▸Victoria	4	3.06	0.30	0.0%	Mixed F/C
▸Liberty	4	3.58	0.33	75.0%	Mixed D/C
▸Burnet	4	3.41	0.35	50.0%	Mixed C/D
▸Polk	4	3.60	0.35	50.0%	Mostly D
▸Gillespie	4	3.03	0.48	0.0%	Mixed C/D
▸Kerr	4	3.27	0.19	25.0%	Mostly F
▸Wilson	4	3.29	0.36	25.0%	Mostly D
▸Washington	4	3.15	0.44	50.0%	Mixed D/B
▸Hopkins	4	3.47	0.51	25.0%	Mostly C
▸Wharton	4	3.09	0.39	0.0%	Mostly D
▸Cass	4	4.13	0.49	75.0%	Mixed C/D
▸Cooke	4	2.84	0.34	0.0%	Mixed D/C
▸Hood	4	3.18	0.42	25.0%	Mostly C
▸Hill	4	3.14	0.36	25.0%	Mostly D
▸De Witt	4	3.56	0.30	50.0%	Mostly D
▸Eastland	4	3.29	0.40	25.0%	Mixed C/D
▸Colorado	4	3.42	0.41	50.0%	Mixed B/C
▸Atascosa	4	2.97	0.42	0.0%	Mostly D
▸Nacogdoches	4	3.57	0.30	50.0%	Mixed F/C
▸Trinity	3	3.64	1.18	33.3%	Mostly D
▸Val Verde	3	2.96	0.37	0.0%	Mostly D
▸Walker	3	3.65	0.46	33.3%	Mixed C/D
▸Shelby	3	3.39	0.33	0.0%	Mostly D
▸Freestone	3	3.33	0.34	33.3%	Mixed C/D
▸Young	3	2.89	0.46	0.0%	Mostly C
▸San Augustine	3	3.56	0.22	33.3%	Mostly F
▸Gray	3	3.21	0.42	0.0%	Mostly D
▸Rusk	3	3.04	0.29	0.0%	Mostly D
▸Hamilton	3	3.98	1.18	100.0%	Mixed A/D
▸Robertson	3	3.27	0.37	33.3%	Mostly D
▸Harrison	3	4.34	0.33	100.0%	Mostly D
▸Orange	3	3.20	0.26	0.0%	Mostly F
▸Houston	3	2.74	0.23	0.0%	Mostly F
▸Howard	3	3.40	0.49	33.3%	Mostly D
▸Jasper	3	3.47	0.29	33.3%	Mixed C/D
▸Jim Wells	3	3.25	0.33	0.0%	Mixed C/D
▸Randall	3	3.14	0.62	0.0%	Mostly C
▸Karnes	3	3.23	0.44	33.3%	Mostly C
▸Bosque	3	3.01	0.31	33.3%	Mostly D
▸Lampasas	3	3.39	0.47	66.7%	Mostly C
▸Panola	3	3.20	0.33	0.0%	Mostly D
▸Comanche	3	3.31	0.51	33.3%	Mostly D
▸Matagorda	3	3.45	0.45	66.7%	Mixed B/D
▸Maverick	3	3.04	0.31	0.0%	Mostly D
▸Medina	3	3.32	0.56	33.3%	Mixed B/C
▸Milam	3	3.09	0.36	0.0%	Mixed C/D
▸Erath	3	3.11	1.06	33.3%	Mixed B/C
▸Titus	3	3.04	0.49	0.0%	Mixed C/D
▸Uvalde	2	3.22	0.31	0.0%	Mixed D/F
▸Starr	2	3.21	0.40	0.0%	Mixed C/D
▸Crosby	2	3.17	0.34	50.0%	Mostly D
▸Grimes	2	3.09	0.40	0.0%	Mostly D
▸Sabine	2	4.25	1.42	100.0%	Mixed A/F
▸Kleberg	2	3.25	0.36	0.0%	Mixed C/D
▸Coke	2	3.49	0.40	50.0%	Mostly D
▸Gonzales	2	2.92	0.22	0.0%	Mostly F
▸Lamb	2	3.30	0.28	50.0%	Mostly D
▸Mills	2	3.02	0.54	0.0%	Mostly C
▸Coleman	2	3.72	0.31	100.0%	Mixed D/F
▸Callahan	2	3.02	0.52	0.0%	Mostly D
▸Lee	2	3.33	0.29	50.0%	Mixed D/F
▸Calhoun	2	3.05	0.34	0.0%	Mostly D
▸Moore	2	3.84	0.95	50.0%	Mixed A/C
▸San Patricio	2	2.91	0.26	0.0%	Mixed D/F
▸Burleson	2	2.51	0.36	0.0%	Mixed C/F
▸Austin	2	2.95	0.33	0.0%	Mostly D
▸Llano	2	2.99	0.36	0.0%	Mixed C/D
▸Parmer	2	3.06	0.46	0.0%	Mixed C/D
▸Palo Pinto	2	3.12	0.39	0.0%	Mixed D/F
▸Upshur	2	2.90	0.28	0.0%	Mostly D
▸Madison	2	3.09	0.48	0.0%	Mixed C/D
▸Nolan	2	3.02	0.29	50.0%	Mixed D/F
▸Hockley	2	3.06	0.33	0.0%	Mostly D
▸Castro	2	3.48	0.41	50.0%	Mixed B/F
▸Aransas	2	3.15	0.26	0.0%	Mixed D/F
▸Falls	2	3.02	0.51	0.0%	Mixed C/D
▸Somervell	2	3.13	0.31	0.0%	Mostly D
▸Hale	2	2.90	0.26	0.0%	Mixed D/F
▸Hutchinson	2	2.95	0.44	0.0%	Mixed C/D
▸Chambers	2	3.34	0.28	0.0%	Mixed D/F
▸Jackson	2	2.91	0.42	0.0%	Mostly D
▸Terry	2	2.86	0.27	0.0%	Mixed D/F
▸Red River	2	2.96	0.52	0.0%	Mixed C/D
▸Runnels	2	3.12	0.43	0.0%	Mostly D
▸Tyler	2	3.22	0.27	0.0%	Mixed D/F
▸Bee	2	3.61	0.50	50.0%	Mixed B/C
▸Bandera	2	2.97	0.46	0.0%	Mixed C/D
▸Zapata	1	3.66	0.73	100.0%	Mostly B
▸Andrews	1	5.30	0.68	100.0%	Mostly B
▸Armstrong	1	2.96	0.71	0.0%	Mostly D
▸Bailey	1	3.98	1.04	100.0%	Mostly B
▸Baylor	1	3.17	0.38	0.0%	Mostly D
▸Blanco	1	3.22	0.80	0.0%	Mostly C
▸Brooks	1	3.37	0.42	0.0%	Mostly C
▸Camp	1	3.26	0.30	0.0%	Mostly D
▸Childress	1	2.80	0.30	0.0%	Mostly D
▸Clay	1	3.38	0.46	0.0%	Mostly C
▸Collingsworth	1	3.08	0.37	0.0%	Mostly D
▸Concho	1	2.98	0.33	0.0%	Mostly D
▸Crane	1	3.21	0.28	0.0%	Mostly D
▸Crockett	1	4.90	0.76	100.0%	Mostly A
▸Dawson	1	2.75	0.33	0.0%	Mostly D
▸Deaf Smith	1	3.56	0.37	100.0%	Mostly D
▸Delta	1	3.03	0.33	0.0%	Mostly D
▸Dimmit	1	3.46	0.36	0.0%	Mostly D
▸Donley	1	2.51	0.25	0.0%	Mostly F
▸Duval	1	3.18	0.39	0.0%	Mostly D
▸Foard	1	3.03	0.65	0.0%	Mostly C
▸Franklin	1	3.68	0.71	100.0%	Mostly B
▸Frio	1	3.11	0.40	0.0%	Mostly C
▸Gaines	1	4.36	0.57	100.0%	Mostly B
▸Garza	1	3.46	0.52	0.0%	Mostly C
▸Goliad	1	3.38	0.48	0.0%	Mostly C
▸Hall	1	2.30	0.51	0.0%	Mostly F
▸Hansford	1	5.43	0.64	100.0%	Mostly B
▸Haskell	1	3.31	0.31	0.0%	Mostly D
▸Hemphill	1	5.15	0.52	100.0%	Mostly C
▸Jack	1	3.67	0.16	100.0%	Mostly F
▸Jim Hogg	1	3.72	0.48	100.0%	Mostly C
▸Jones	1	3.48	0.65	0.0%	Mostly C
▸Kent	1	3.64	0.34	100.0%	Mostly D
▸Knox	1	3.21	0.28	0.0%	Mostly D
▸La Salle	1	3.14	0.27	0.0%	Mostly D
▸Leon	1	4.51	0.29	100.0%	Mostly D
▸Lipscomb	1	1.59	0.14	0.0%	Mostly F
▸Live Oak	1	3.17	0.43	0.0%	Mostly C
▸Mc Culloch	1	4.28	0.54	100.0%	Mostly C
▸Marion	1	3.53	0.43	100.0%	Mostly C
▸Menard	1	3.67	0.75	100.0%	Mostly B
▸Mitchell	1	2.32	0.21	0.0%	Mostly F
▸Montague	1	2.77	0.19	0.0%	Mostly F
▸Morris	1	4.79	0.27	100.0%	Mostly D
▸Motley	1	4.42	0.40	100.0%	Mostly D
▸Newton	1	3.62	0.30	100.0%	Mostly D
▸Ochiltree	1	5.01	0.67	100.0%	Mostly B
▸Pecos	1	2.81	0.20	0.0%	Mostly F
▸Rains	1	3.11	0.34	0.0%	Mostly D
▸Reagan	1	4.74	0.46	100.0%	Mostly C
▸Real	1	3.84	0.20	100.0%	Mostly F
▸Reeves	1	3.16	0.45	0.0%	Mostly C
▸Refugio	1	2.93	0.67	0.0%	Mostly D
▸San Jacinto	1	3.36	0.22	0.0%	Mostly F
▸San Saba	1	2.28	0.44	0.0%	Mostly F
▸Schleicher	1	4.88	0.65	100.0%	Mostly B
▸Scurry	1	2.86	0.41	0.0%	Mostly D
▸Sherman	1	2.38	1.41	0.0%	Mostly F
▸Stephens	1	3.92	0.47	100.0%	Mostly C
▸Sterling	1	5.27	0.60	100.0%	Mostly B
▸Stonewall	1	3.89	0.22	100.0%	Mostly F
▸Waller	1	3.12	0.43	0.0%	Mostly C
▸Ward	1	3.48	0.33	100.0%	Mostly D
▸Wheeler	1	3.08	0.44	0.0%	Mostly C
▸Wilbarger	1	3.07	0.61	0.0%	Mostly C
▸Willacy	1	3.12	0.41	0.0%	Mostly C
▸Yoakum	1	4.49	0.52	100.0%	Mostly C

HPRD Range in Texas

The spread between best and worst staffed facilities

3.06

25th pctile

3.28

Median

3.56

75th pctile

Source: CMS Staffing & Quality Data — 2025Q3 · data.cms.gov

Staffing grades are based on CMS-published thresholds and research recommendations. CMS is not affiliated with and does not endorse this website.