Fundamental Healthcare Nursing Homes: Group Profile, Ownership, and CMS Record

Who Is Fundamental Healthcare?

Fundamental Healthcare is the name CMS assigns to a group of skilled nursing facilities located in Texas, South Carolina, Maryland, and several other states. CMS groups these facilities together because they share at least one owner, officer, or management entity; ownership is spread across many facility-level companies rather than consolidated under a single parent.^[3]

By number of CMS-affiliated skilled nursing facilities, the group is the twenty-third-largest nursing home chain in the United States.^[3]

What Kind of Chain Is Fundamental Healthcare?

Fundamental is a skilled nursing facility (SNF) group linked by shared ownership and management relationships. Skilled nursing facilities care for patients who need 24-hour nursing care, often after a hospital stay, and are rated on the federal CMS five-star scale.^[1]

Who Owns Fundamental Healthcare?

In the CMS data, the Fundamental-affiliated facilities are grouped under chain ID 231 because they share at least one owner, officer, or management entity; ownership is spread across many facility-level companies.^[3] Within the CMS data, the facilities are operated as for-profit entities.^[1] Because responsibility is spread across facility-level companies, identifying the specific owning, operating, and management entities for any individual facility is an important early step when a resident is harmed.^[1]

How Big Is the Fundamental Healthcare Nursing Home Chain?

Fundamental Healthcare by the Numbers

Federal CMS data describes the operation's scale:

Facility, state, and bed counts are from the CMS Nursing Home Chain Performance Measures dataset (most recent 2026 release).^[3]

• The most recent federal CMS chain-level data affiliates 66 nursing homes across Indiana, Maryland, Nevada, South Carolina, Texas, and Wisconsin with the chain (CMS chain ID 231) — ranking it #23 of the 611 chains CMS tracks by number of facilities.^[3]
• The affiliated homes hold about 7,905 certified beds.^[3]

Fundamental Healthcare CMS Ratings and Staffing Data

The figures below are reported by CMS for the chain in the most recent CMS Nursing Home Chain Performance Measures release. CMS five-star ratings are relative, point-in-time measures calculated against other facilities nationally; they do not guarantee the quality of care any individual resident receives, and serious harm can occur at a facility regardless of its rating.

• The chain-average overall star rating was about 2.5 of 5 (the national chain average is 3.0). The chain-level component averages CMS publishes were 2.5 for health inspections, 2.2 for staffing, and 3.5 on the quality measure rating, which is largely self-reported.^[3]
• CMS data reports 17 of 65 facilities (26.2%) with a one-star ("much below average") overall rating (national rate 20.5%) and 6 facilities (9.1%) carrying a CMS abuse icon (national rate 9.7%).^[3]
• Average total nurse staffing was about 3.4 hours per resident per day (national 3.9), and reported nursing-staff turnover was about 45.9% (national 45.8%).^[3]
• CMS records show 83 fines totaling about $1.86 million and 0 Medicare payment denials across the chain in the most recent three-year window.^[3][2]

These chain-level averages describe the group as a whole and say nothing about any specific facility or any specific resident's experience. Conditions and ratings vary from home to home and change over time.

Fundamental Healthcare Nursing Home Facilities

The table below is the complete roster of the Fundamental Healthcare-affiliated nursing facilities (CMS chain ID 231) in the federal CMS Provider Information dataset (May 2026 release), which listed 69 facilities. It lists each facility's name, city and state, street address, and phone number, along with any current CMS quality flag. The chain-level totals cited above reflect the most recent CMS Nursing Home Chain Performance Measures release; this per-facility roster is the May 2026 provider-level snapshot and will be refreshed when CMS posts the corresponding provider-level file.^[1]

The "CMS Flag" column marks homes that CMS has identified as a Special Focus Facility, a Special Focus Facility Candidate, behind on inspections ("Delayed inspection"), or carrying an abuse icon. Rows shaded gold indicate a current Special Focus designation or candidacy.^[1]

Source: Centers for Medicare & Medicaid Services, Provider Data Catalog, Nursing Home "Provider Information" dataset (NH_ProviderInfo_May2026.csv), filtered to Fundamental Healthcare, chain ID 231. Inclusion on this list reflects CMS chain-affiliation data and does not by itself indicate that any particular facility committed wrongdoing.^[1]

Special Focus Facilities and SFF Candidates in Fundamental Healthcare

The Special Focus Facility (SFF) program is run by CMS to identify nursing homes with a history of serious quality problems; CMS describes these facilities as among the poorest-performing nursing homes in the country. A "Special Focus Facility Candidate" is a home with a history of serious quality issues that has not yet been formally placed in the program.^[4]

According to the most recent CMS Nursing Home Chain Performance Measures release, Fundamental Healthcare had 1 Special Focus Facility and 2 Special Focus Facility Candidates at the chain level.^[3] The CMS Provider Information dataset (May 2026 release) flagged 2 facilities with a Special Focus designation or candidacy and 7 facilities carrying an abuse icon at that point in time; these designations are reassessed by CMS monthly and can change.^[1]

Fundamental Healthcare Special Focus Facility Candidates (May 2026)

• Magnolia Manor - Inman — Inman, SC
• Terra Bella Health and Wellness Suites — Houston, TX

Fundamental Healthcare Facilities With a CMS Abuse Icon (May 2026)

• Spanish Trails Rehabilitation Suites — Albuquerque, NM
• Springdale Healthcare Center — Camden, SC
• Lake Emory Post Acute Care — Inman, SC
• Physical Rehabilitation and Wellness Center of Spa — Spartanburg, SC
• Mira Vista Court — Fort Worth, TX
• Terra Bella Health and Wellness Suites — Houston, TX
• San Gabriel Rehabilitation and Care Center — Round Rock, TX

Fundamental Healthcare Facilities With a Delayed CMS Inspection (May 2026)

• Oakland Nursing & Rehabilitation Center — Oakland, MD

Fundamental Healthcare Fines, Lawsuits, and Regulatory Record

The items below are drawn from federal CMS enforcement data and from the U.S. Department of Justice.

Federal Civil Money Penalties and Payment Denials

CMS enforcement records show that, across the chain, CMS imposed 83 fines totaling about $1.86 million in the most recent three-year window reflected in the data.^[2][3]

2016 False Claims Act Settlement (Rehabilitation Therapy)

In January 2016, as part of a larger multi-party settlement led by the therapy provider RehabCare, Fundamental Administrative Services and two of its nursing facilities agreed to pay about $2.2 million to resolve allegations that they submitted inflated Medicare claims for rehabilitation therapy that was not reasonable, necessary, or skilled. According to the Department of Justice, these were allegations; the settlement was not an admission of wrongdoing.^[6]

Other Litigation

As with any large group of nursing facilities, individual Fundamental-affiliated facilities have also been named in civil lawsuits alleging resident injury or neglect. The resolution of any individual case depends on its own facts, and the existence of a lawsuit is not a finding of liability. The sources reviewed for this page do not reflect any additional major federal fraud settlement against the current chain beyond the 2016 matter described above; this statement is limited to the sources cited here.^[1]

How Michael Hill Trial Law Investigates Claims Against Fundamental Healthcare

Michael Hill Trial Law focuses exclusively on nursing home abuse and neglect. The firm has handled more than 1,000 cases against nursing home operators and has recovered hundreds of millions of dollars for clients, including a $26 million verdict in Ohio.^[5]

Thin staffing and high staff turnover are among the conditions that can contribute to preventable harm in a nursing home, because residents depend on consistent, adequate staffing for basic care. A facility's overall CMS rating does not determine whether a particular resident was harmed, and serious injuries can occur at facilities with average or above-average ratings. When we investigate a claim against a Fundamental Healthcare facility, we identify the specific entities that owned, operated, and managed the home, compare the home's CMS staffing and inspection history against what happened to the resident, and obtain the facility's care records and any available documentation. The kinds of injuries and claims our firm investigates include:

• Bedsores and pressure injuries
• Falls and fractures
• Malnutrition and dehydration
• Infections and sepsis
• Medication errors
• Elopement (wandering away from a facility)
• Understaffing and neglect
• Physical or sexual assault
• Wrongful death

We are investigating claims against facilities operated under the Fundamental Healthcare name. If your loved one was injured or died in a Fundamental Healthcare nursing home, the public record on this page may be relevant to your situation. Our firm serves families nationwide.

Frequently Asked Questions About Fundamental Healthcare

Who owns Fundamental Healthcare?

Fundamental Healthcare is the name CMS assigns to a group of skilled nursing facilities that share at least one owner, officer, or management entity. Ownership is spread across many facility-level companies rather than consolidated under a single parent, so families should confirm the owning, operating, and management entities for any individual facility.

How many nursing homes are in the Fundamental Healthcare group?

Federal CMS data affiliates about 66 skilled nursing facilities with the group across six states, concentrated in Texas and South Carolina, ranking it the twenty-third-largest nursing home chain in the United States by number of facilities.

How is Fundamental Healthcare rated by Medicare?

According to the most recent CMS chain data, the group's average overall star rating is about 2.5 of 5 (national average 3.0), with staffing rated 2.2 of 5. About 26.2% of its facilities carry a one-star overall rating and 9.1% carry a CMS abuse icon. CMS star ratings are relative, point-in-time measures and do not guarantee the care any individual resident receives.

Has Fundamental Healthcare been sued or fined?

CMS enforcement records show 83 fines totaling about $1.86 million in the most recent three-year window. Separately, in 2016 Fundamental Administrative Services paid about $2.2 million as part of a larger federal rehabilitation-therapy settlement led by RehabCare. The settlement resolved allegations and was not an admission of liability.

What should I do if a loved one was harmed at a Fundamental-affiliated facility?

Michael Hill Trial Law investigates abuse and neglect claims against nursing home operators nationwide, including Fundamental-affiliated facilities. Because responsibility is spread across facility-level companies, identifying the responsible entities is an important early step. You can contact the firm for a confidential review of your situation.

Sources

1. Centers for Medicare & Medicaid Services, Provider Data Catalog, Nursing Home "Provider Information" dataset (NH_ProviderInfo_May2026.csv), filtered to Fundamental Healthcare, chain ID 231 (facility counts, addresses, phone numbers, bed counts, ownership type, star ratings, abuse icons, Special Focus status, delayed inspections). https://data.cms.gov/provider-data/dataset/4pq5-n9py
2. Centers for Medicare & Medicaid Services, Provider Data Catalog, Nursing Home "Penalties" file (May 2026 release) (fine amounts and payment denials). https://data.cms.gov/provider-data/
3. Centers for Medicare & Medicaid Services, Provider Data Catalog / data.gov, "Nursing Home Chain Performance Measures" (Affiliated Entity Performance Measures) dataset, most recent 2026 release, filtered to Fundamental Healthcare (CMS chain ID 231): affiliated-facility count, states, bed count, chain-average star ratings, one-star share, abuse-icon share, Special Focus Facilities and candidates, fines, payment denials, staffing hours, and turnover. https://data.cms.gov/provider-data/ ; dataset listing: https://catalog.data.gov/dataset/nursing-home-chain-performance-measures
4. Centers for Medicare & Medicaid Services, "Special Focus Facility (SFF) Program" overview and monthly candidate/participant lists. https://www.cms.gov/medicare/health-safety-standards/certification-compliance/special-focus-facility
5. Michael Hill Trial Law. https://protectseniors.com/
6. U.S. Department of Justice, District of Massachusetts, "United States Recovers Over $133 Million From Fraudulent Nursing Home Therapy Claims" (Jan. 12, 2016): multi-party settlement led by RehabCare ($125 million) in which Fundamental Administrative Services and two of its nursing facilities paid about $2.2 million to resolve allegations of inflated Medicare therapy claims. https://www.justice.gov/usao-ma/pr/united-states-recovers-over-133-million-fraudulent-nursing-home-therapy-claims

This page is for general informational purposes and is not legal advice. It is attorney advertising. Ratings, fines, and Special Focus data are from federal CMS records and reflect inspection findings and regulatory penalties, not court judgments. The 2016 rehabilitation-therapy settlement resolved allegations only and was not an admission or determination of liability. CMS star ratings are relative, point-in-time measures and do not guarantee the care any individual resident receives. Facility data and corporate ownership change over time; verify current details before relying on them. Last reviewed: October 26, 2026.