Ellery Care data study
The Texas nursing homes with the most federal fines
When inspectors find a serious or repeated violation, CMS can fine a nursing home. Using the government's own penalty records (2026-08-09), we ranked the 25 Texas homes that have paid the most.
How to read a fine total
A fine is not a parking ticket. CMS issues one only after an inspection documents a serious or repeated failure to meet federal standards, which can include problems with resident safety, infection control, medication, or neglect. A large total usually means either one very serious event or a pattern over time.
A fine can also reflect a problem the home has already fixed. That is why we show the fine total on each report card next to the home's current rating, its most recent inspection findings, and its staffing. Read them together, not in isolation.
How we built this
We used the total fine amount CMS records for each certified nursing home in CMS Care Compare (Nursing Homes), dataset 4pq5-n9py (retrieved 2026-08-09), covering roughly the last three years, and ranked all rated Texas homes from highest to lowest. Full details on our methodology page.
Common questions
What does it mean when a nursing home is fined?
CMS fines a nursing home when an inspection finds a serious or repeated violation of federal health and safety rules. A large fine total usually points to a serious problem, a pattern of problems, or both.
Does a fine mean a nursing home is unsafe today?
Not always. Fines can reflect past problems the home has since corrected. Read the fine total alongside the home's current star rating, its recent inspection findings, and its staffing before drawing a conclusion.
Where does this fine data come from?
It comes from CMS Care Compare, the government's own record of penalties issued to certified nursing homes over roughly the last three years. Across Texas, 792 rated homes carry at least one fine.
Looking into a specific home?
Every Texas nursing home report card shows its fines next to its ratings, staffing, inspection findings, and antipsychotic rate, in plain English.
Source: CMS Care Compare (Nursing Homes), dataset 4pq5-n9py, retrieved 2026-08-09. Ellery Care accepts no payment from any facility and is not affiliated with CMS. Educational information, not advice. Related: the worst-staffed nursing homes in Texas.