Texas and Illinois Nursing Home Data Shows a Warning Families Should Not Ignore

The newest federal nursing home data tells a stark story about two of the country's largest care markets: Texas and Illinois are carrying a much heavier share of high-risk nursing home records than the national average.

Senior Care Report Card processed the May 2026 CMS nursing home update across 14,696 facilities nationwide. The update refreshed provider information, ownership data, health deficiencies, fire safety records, MDS quality measures, and claims-based quality measures.

For families searching phrases like "Texas nursing home ratings," "Illinois nursing home violations," "worst nursing homes near me," or "best nursing homes in Texas," the most important takeaway is this: state averages hide major differences between individual facilities, cities, and ownership groups.

Nationally, 27.2% of nursing homes now fall into the two highest-risk bands: Concerning or Poor.

In Texas and Illinois, the share is far higher.

That means nearly one in two nursing homes in both Texas and Illinois currently sits in a risk band where families should slow down and ask more specific questions before choosing care.

This does not mean every facility in Texas or Illinois is unsafe. Both states also have strong homes. But the overall pattern is too large to dismiss as noise.

Why this matters for families

Most families do not choose nursing homes in calm conditions. They choose after a hospitalization, a fall, a dementia crisis, or a discharge deadline. They often have days to make a decision.

That pressure creates a dangerous shortcut: families rely on proximity, brochures, star ratings, and whoever has an available bed.

The May 2026 CMS data shows why that is risky.

In Texas, 209 facilities are currently in the Poor band and 365 are in the Concerning band. In Illinois, 176 facilities are Poor and 137 are Concerning.

Those bands are not labels based on reputation. They come from CMS-derived signals: inspection history, penalties, staffing indicators, complaints, and quality outcomes.

Texas: a large market with concentrated risk

Texas has 1,176 nursing homes in the current dataset. The average Senior Care Report Card score is 55.4, putting the statewide average near the lower edge of the "Fair" range.

The risk is not evenly distributed.

Several Texas cities show high concentrations of facilities in the Concerning or Poor bands:

This is where the data becomes practical. A family searching for a nursing home in Austin, Fort Worth, Waco, or El Paso should not treat all nearby options as similar. The gap between facilities can be wide.

Two Texas facilities had serious score drops in the May update:

A drop like that should prompt questions. What changed in the latest inspection, complaint, penalty, or quality data? Was there a new citation? Did staffing or complaint signals worsen? Is the facility aware of the change, and can leadership explain what they are doing about it?

Illinois: fewer facilities, similar risk pressure

Illinois has fewer facilities than Texas, but the risk pattern is almost as pronounced.

Out of 667 Illinois nursing homes, 313 are currently in the Concerning or Poor bands. That is 46.9% of the state's nursing homes.

Chicago has the largest raw count of high-risk facilities in the state:

Illinois also had more serious score drops than Texas in this update: 7 serious score movements versus 5 in Texas.

Notable Illinois drops included:

Again, the point is not panic. The point is targeted attention.

The deeper signal: movement in both directions

The May data is not one-sided. Some facilities moved down, but others moved up.

In Texas, the largest band transition groups included:

In Illinois, the largest transition groups included:

This matters because nursing home quality is not static. A facility can improve after leadership changes, enforcement, or operational correction. A facility can also decline after staffing instability, ownership changes, repeated citations, or unresolved care issues.

Monthly updates help families avoid relying on stale reputations.

What families should do with this data

If you are comparing nursing homes in Texas or Illinois, use the data as a triage tool.

Start with these questions:

1. Is the facility currently rated Excellent, Good, Fair, Concerning, or Poor?
2. Did the facility's score move sharply in the latest update?
3. Is the facility in a city where many nearby homes are also high risk?
4. Are the concerns driven by inspections, penalties, staffing, complaints, or quality outcomes?
5. Can the facility explain recent inspection findings in plain language?

Families should be especially cautious when a facility is both in a high-risk band and recently declined.

What to ask on a tour

Do not ask, "Are you a good nursing home?"

Ask specific questions:

• Your recent safety score changed. What changed in your latest CMS data?
• Were there new inspection citations or complaint findings?
• Did your staffing levels change?
• Have penalties or enforcement actions changed?
• What corrective actions have been completed since the latest survey?
• How do you notify families when a serious incident occurs?

The quality of the answer matters. A strong facility should be able to explain its record without defensiveness or vague reassurance.

The human reality behind the numbers

For families, this data is not academic. It often arrives at the worst moment: a parent cannot go home safely, a spouse needs memory care, or a hospital discharge planner is asking for choices by tomorrow.

That is why state-level patterns matter.

When nearly half of facilities in a state fall into higher-risk bands, families need more than a list of available beds. They need a way to quickly eliminate options that deserve caution, identify homes that look comparatively stronger, and ask better questions before signing placement paperwork.

The May 2026 CMS update does not tell families which facility to choose. But it does tell them where to look harder.

For Texas and Illinois, the message is clear: compare carefully, check recent changes, and do not assume the closest available bed is the safest one.

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Frequently Asked Questions

Are Texas nursing homes worse than the national average? In the May 2026 Senior Care Report Card analysis, Texas had 48.8% of nursing homes in the Concerning or Poor bands, compared with 27.2% nationally. That does not mean every Texas facility is unsafe, but it does mean families should compare facilities carefully.

Are Illinois nursing homes high risk? Illinois had 46.9% of facilities in the Concerning or Poor bands in the May 2026 update. Chicago, Decatur, Joliet, Belleville, and Rockford showed notable concentrations of higher-risk facilities.

What does a serious score drop mean? A serious score drop means newly refreshed CMS-derived data materially changed a facility's risk profile. It may reflect inspection findings, penalties, complaints, staffing indicators, or quality outcomes.

Should I avoid every facility in the Poor band? Not automatically, but a Poor-band facility deserves careful review. Ask about recent inspections, repeated citations, staffing, enforcement actions, and corrective plans before choosing care.

Where can I compare Texas and Illinois nursing homes? Use Senior Care Report Card to search by facility, city, state, or ZIP and compare CMS inspection, staffing, enforcement, complaint, quality, and ownership signals.

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