Texas PBJ Nursing Home StaffingTexas PBJ Staffing
Texas's statewide staffing ratio is 3.33 HPRD in Q1 2026. Texas's statewide staffing ratio is up slightly (+0.02) since Q1 2025. This level is below the national ratio of 3.75 HPRD and ranks #50 out of 51 states.
- Q2 2025: 3.34
- Q3 2025: 3.35
- Q4 2025: 3.34
- Q1 2026: 3.33
Staffing hours per resident day for Texas, calculated by PBJ320 from CMS’s quarterly PBJ nurse staffing files.
Texas
Direct staff excludes Admin/DON. Direct staff excludes Admin/DON.
Texas
Texas
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Explore Texas
PBJ320 High-risk facilities in Texas
370 facilities flagged for staffing or quality concerns.
| Facility | City | CMS ratings | Risk flags | Total HPRD |
|---|---|---|---|---|
| Accel at Willow BendPlano | Plano | 1★1★S | 3.62 HPRD | |
| Advanced Health & Rehab Center of GarlandGarland | Garland | 1★ | 2.97 HPRD | |
| Afton Oaks Nursing and Rehabilitation CenterHouston | Houston | SFF cand.c.⚠1★ | 3.59 HPRD | |
| Alfredo Gonzalez Texas State Veterans HomeMcallen | Mcallen | ⚠ | 3.58 HPRD | |
| Apex Secure Care BrownfieldBrownfield | Brownfield | 1★1★S | 2.27 HPRD |
Staffing snapshot
Latest state staffing metrics for Texas.
| Metric | Texas | CMS Region 6CMS Region 6 includes Arkansas, Louisiana, New Mexico, Oklahoma, and Texas.Regional figures are calculated from facility-level data using the same methodology as the state figures. | U.S. | State rankRanks compare the 50 states and D.C. by the displayed metric value. A higher or lower rank is not inherently positive or negative for every metric, including contract staffing share and rural-facility share. |
|---|---|---|---|---|
| Total Nurse Staffing HPRD | 3.33 | 3.52+0.19 vs TX | 3.75+0.41 vs TX | #50 of 51 |
| Direct Care Nurse HPRD | 3.06 | 3.23+0.18 vs TX | 3.48+0.42 vs TX | #51 of 51 |
| RN HPRD | 0.40 | 0.38-0.03 vs TX | 0.62+0.22 vs TX | #47 of 51 |
| RN Direct Care HPRD | 0.28 | 0.24-0.03 vs TX | 0.44+0.16 vs TX | #47 of 51 |
| Nurse Aide HPRD | 2.00 | 2.18+0.19 vs TX | 2.26+0.27 vs TX | #49 of 51 |
| Contract Staff Percentage | 2.2% | 2.9%+0.7 pts vs TX | 5.3%+3.1 pts vs TX | #48 of 51 |
| Median Case-Mix HPRD (Acuity) | — | 3.58 | 3.74 | #21 of 51 |
| Rural Facilities (Share) | 27% | 33%+6.9 pts vs TX | 27%Same as TX | #32 of 51 |
State rank reflects the displayed value, not necessarily stronger or weaker performance.
Ownership groups in Texas
Most facilities linked in CMS owner data (Texas).
| Organization | Homes |
|---|---|
| Gary R Blake | 139 |
| Malisa a Blake | 139 |
| Linda F Huggins | 138 |
| Welltower Nnn Group, LLC | 115 |
| Welltower Op, LLC | 114 |
| Aaron Travitsky | 112 |
| Nochum Freund | 104 |
| Welltower Inc | 95 |
Ownership changes in Texas
700 ownership changes at 700 Texas facilities · 01/01/2016 – 02/01/2026.
Showing 10 of 40
Showing the most recent 40 of 700 indexed changes. Browse full TX ownership & CHOW search.
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How these figures are calculatedMethods, definitions, and data sources
Staffing from CMS Payroll-Based Journal (PBJ) public nurse files (2017–2026), plus Provider Information (September 2026 processing snapshot) and chain data where shown. State staffing context via March 2022 compendium. Methodology · PBJ guide.
Metrics
- Hours Per Resident Day (HPRD): Total staff hours ÷ average residents. Example: 350 hours for 100 residents = 3.5 HPRD.
- Direct Care (excl. Admin, DON): Hours per resident day for direct care staff only (RN, LPN, CNA, NAtrn, MedAide), excluding administrative and supervisory roles.
- Contract Staff %: Share of hours provided by contract staff.
- Census: Average number of residents during the period.
Note: Some states set minimums (e.g., NJ, CA, NY at 3.5 HPRD); a federal 3.48 minimum was recently overturned (2025). A 2001 federal study linked 4.1 HPRD to better outcomes in that study. Staffing needs vary by resident acuity (case-mix), day, and shift. Estimates on PBJ Takeaway assume roughly 60% of staff are CNAs.
Data transparency
The PBJ Dashboard pulls directly from CMS data and is carefully vetted for accuracy. Still, sometimes a bug sneaks into the jelly. That could mean: a systemic CMS data reporting issue (e.g., Q2 2017 contract staffing, missing data in 2020 due to COVID) or there could be a coding error on our part. If you spot something that looks off, please let me know via the contact form so I can set things right.
Trend charts omit quarters with implausible submitted HPRD (total/direct below 0.25; RN, LPN, and aide use role floors and neighbor-quarter rules). Full criteria.
Rankings, within-state percentiles, CMS flags (including abuse icon): How metrics are calculated.