Earlier this year, the federal government repealed the Biden-era CMS minimum staffing rule. That regulation would have mandated that nursing homes provide at least 3.48 total nurse hours per resident per day, including a minimum of 0.55 RN hours and 2.45 CNA (Certified Nursing Assistant) hours.

Because it was repealed before most facilities had to comply, the rule never took effect. For families evaluating long-term care facilities in Texas right now, this means there is no federal floor ensuring how much direct nursing care your loved one receives each day.

To understand the local impact, we analyzed and scored all 1,176 licensed Texas nursing homes using official federal CMS data. Here is where Texas stands on Registered Nurse (RN) staffing relative to national benchmarks:

The typical nursing home in Texas provides 38% fewer RN hours per resident than the national average. The repealed federal mandate would have required a 0.55 RN hour minimum—a threshold Texas already misses on average.

Out of the 1,176 facilities tracked in our database, 40% score below 50 out of 100 on the ProximCares quality rating scale, where staffing levels serve as one of the heaviest weighted factors.

RN hours per resident day are not just a bureaucratic metric; it is a direct indicator of clinical oversight. Registered nurses are responsible for early infection detection, identifying medication errors, and managing acute changes in patient condition.

Peer-reviewed healthcare research consistently links low RN staffing levels in skilled nursing facilities to negative outcomes, including:

Without a federal regulatory floor, the quality gap between the best and worst-staffed facilities remains wide.

When evaluating a specific provider, navigate to the Staffing tab on any profile page to compare that facility’s daily RN hours directly against the Texas state average.

This single data point provides more insight into day-to-day care quality than almost any other metric available.

Fort Worth currently features 31 rated nursing homes with an average ProximCares score of 53.8 out of 100, marking it as one of the lower-performing major metropolitan areas in Texas for eldercare quality.

The data reveals a stark disparity in local care: the highest-rated facility in Fort Worth scores 89 out of 100, while the lowest scores just 14. This 75-point variance underscores why data-driven selection is critical for local families.

You can review the complete data, individual staffing metrics, and performance scores for all local facilities at the ProximCares Fort Worth Nursing Homes Directory.

To review performance metrics for other municipalities, search your city at ProximCares.

Until next time,

Theron Harris

Founder, ProximCares