Who Owns Texas's Nursing Homes, Home Health Agencies and Hospices
Every Medicare-certified facility in Texas, matched to the corporate family that actually controls it — not just the LLC on the licence. Rebuilt from CMS ownership filings each month.
Largest Operators in Texas
Ranked by facilities controlled across every legal entity in the corporate family. CMS lists these as separate companies; the family column shows how many.
| Corporate family | Facilities | SNF | Home health | Hospice | Legal entities |
|---|---|---|---|---|---|
| Regency Integrated Health Services LLC | 57 | 57 | — | — | 16 |
| AHM Texas LP, Inc | 49 | — | 38 | 11 | 3 |
| Honor X Enterprises, LLC | 47 | 47 | — | — | 5 |
| HHCS Managers LLC | 38 | — | 1 | 37 | 2 |
| Focused Post Acute Care Partners Management, LLC | 25 | 25 | — | — | 4 |
| Heart To Heart Hospice Holdings LLC | 22 | — | — | 22 | 5 |
| Guardian Home Care Holdings Inc | 20 | — | 14 | 6 | 5 |
| Choice Rehab Holdings, Inc. PE | 19 | — | 13 | 6 | 23 |
| Integracare Intermediate Holdings Inc | 19 | — | 19 | — | 4 |
| TVG NP Homecare Acquisition, Inc. PE | 19 | — | 13 | 6 | 33 |
| Advanced HCS LLC | 18 | 18 | — | — | 1 |
| Cornerstone Healthcare Inc | 16 | — | 6 | 10 | 6 |
| Stonegate Senior Living, LP | 13 | 13 | — | — | 13 |
| LHCG Partner II LLC | 13 | — | 10 | 3 | 3 |
| Odyssey Healthcare Inc. | 11 | — | — | 11 | 7 |
All 3,159 Owner Organisations in Texas
| facility | ccn | care_setting | owner_org | relationship | ownership_pct | association_date | corporate_family | confidence |
|---|---|---|---|---|---|---|---|---|
| ••••% | ||||||||
| ••••% | ||||||||
| ••••% |
Plus every recorded change of ownership with parties and dates. See a worked example of the file · full field list.
How Concentrated Is Texas Healthcare Ownership?
Of the 3,816 Medicare-certified nursing homes, home health agencies and hospices WhoOwnsCare tracks in Texas, 24% are resolved to multi-facility corporate families, and the five largest families alone are associated with 6% of the state’s facilities. The ranked view is on the largest operators in Texas page; how families are resolved from CMS filings is documented in the methodology.
Recent Nursing Home Ownership Changes
| Buyer | Seller | Effective |
|---|---|---|
| MAVERICK COUNTY HOSPITAL DISTRICT | APOLLO HEALTHCARE AT BAY AREA LP | 2025-11-19 |
| SOUTH LIMESTONE HOSPITAL DISTRICT | CITY OF WEST | 2025-10-01 |
| 821 US HIGHWAY 81 W OPCO LLC | SLP NEW BRAUNFELS LLC | 2025-10-01 |
| MEADOWS OF CORSICANA LLC | COUNTRY MEADOWS HEALTH AND REHABILITATION LLC | 2025-10-01 |
| 214 JONES RD OPCO LLC | LOH ELKHART LLC | 2025-10-01 |
269 nursing home ownership changes have been recorded in Texas since January 2023. CMS's change-of-ownership file lags — recent quarters are incomplete and fill in over time, so treat the most recent months as a floor rather than a count.
Texas Ownership Intelligence
Largest Nursing Home Operators
Ranked by facilities actually controlled, not by legal entities filed.
Nursing Home Ownership
For-profit, nonprofit, private equity and REIT ownership across Texas.
Ownership Changes and CHOW
Recorded Medicare ownership transfers, with buyers and sellers attributed.
Nursing Home Acquisitions
Who is buying, who is selling, and which operators are expanding.
Distressed Facilities
Operational, regulatory, financial and corporate stress scoring.
Home Health Operators
Largest home health companies and their ownership in Texas.
Hospice Operators
Largest hospice companies and their ownership in Texas.
Texas Ownership Intelligence Summary
WhoOwnsCare covers 3,816 Medicare-certified providers in Texas (1680 home health agencies, 1160 skilled nursing facilities, 976 hospices). 53.2% are resolved to an operating family; the five largest families hold 10.6% of resolved providers and the largest single family, Regency Integrated Health Services LLC, operates 57 (2.81%).
State pages for the largest families: Regency Integrated Health Services LLC in Texas; AHM Texas LP, Inc in Texas; Honor X Enterprises, LLC in Texas; HHCS Managers LLC in Texas; Focused Post Acute Care Partners Management, LLC in Texas; Heart To Heart Hospice Holdings LLC in Texas; Guardian Home Care Holdings Inc in Texas; Choice Rehab Holdings, Inc. in Texas; TVG NP Homecare Acquisition, Inc. in Texas; Integracare Intermediate Holdings Inc in Texas.
Concentration
1292 distinct operating families are present. Herfindahl index (HHI) of resolved providers: 39.8 (below 1,500 is unconcentrated on the customary antitrust scale). Interpretation: Texas ownership is fragmented at the family level; limitation: shares are computed over resolved providers only.
Ownership Changes
Fastest-Growing and Contracting Operators
Most facilities acquired in the last 36 months: Honor X Enterprises, LLC (6); Lion Plaza LP (4); Priority Management Group, LLC (3); Elite HC Holdings LLC (3); The Ensign Group Inc (2).
Most facilities divested in the last 36 months: Memorial Medical Center (6); Uptown FS LLC (1).
Basis: recorded CMS SNF changes of ownership only; home health and hospice transfers are not covered by a public CHOW dataset.
Distress and Financial Reporting
Distress 2.0 bands across scored facilities: Low 274 Watch 536 High 259 Severe 84 Insufficient data 2663.
HCRIS financial metrics are available for 75% of eligible Texas facilities (2,848); among reporting facilities 65% reported a positive net result and the median facility result is positive.
Staffing and quality values are a single CMS snapshot (coverage: staffing 30%, star ratings 30%); trends require archived releases and are not derived.
Related Texas Research and Reports
- Largest operators in Texas
- Texas ownership changes
- Texas distressed facilities
- Texas acquisition intelligence
- Texas home health operators
- Texas hospice operators
- Get the state ownership intelligence report: Texas Ownership Dataset ($249)
Largest Corporate Families in Texas
- Regency Integrated Health Services LLC — 57 facilities
- AHM Texas LP, Inc — 49 facilities
- Honor X Enterprises, LLC — 47 facilities
- HHCS Managers LLC — 38 facilities
- Focused Post Acute Care Partners Management, LLC — 25 facilities
- Heart To Heart Hospice Holdings LLC — 22 facilities in Texas
- Guardian Home Care Holdings Inc — 20 facilities
- Choice Rehab Holdings, Inc. — 19 facilities in Texas
- Integracare Intermediate Holdings Inc — 19 facilities
- TVG NP Homecare Acquisition, Inc. — 19 facilities in Texas
- Advanced HCS LLC — 18 facilities
- Cornerstone Healthcare Inc — 16 facilities in Texas