Honor X Enterprises, LLC has emerged as the dominant player in Texas’s skilled nursing facility sector, controlling 117 facilities across the state according to the latest CMS data. The company’s portfolio consists exclusively of skilled nursing facilities, with all 117 properties located in Texas. This geographic concentration allows for operational efficiencies and specialized knowledge of local regulations and reimbursement structures.
Honor X Enterprises maintains complete ownership (100%) of 114 of its 117 facilities, with ownership details for the remaining three facilities not specified in the available data. This high rate of full ownership indicates a preference for direct rather than partial ownership or joint venture arrangements.
Market Context and Financial Landscape
The Texas Health and Human Services Commission has implemented direct care staff spending requirements to improve care quality. On the reimbursement front, Texas approved a $900 million increase in Medicaid rates for nursing homes in 2023, addressing historically low reimbursement rates. Additionally, the state is transitioning to the Patient Driven Payment Model (PDPM) for Long-Term Care reimbursement methodology in September 2025, moving away from the Resource Utilization Group system.
The Quality Incentive Payment Program (QIPP) offers additional funding for facilities meeting specific quality metrics, potentially benefiting operators like Honor X Enterprises that can leverage their scale to implement quality improvement initiatives across multiple facilities.
As the largest skilled nursing facility operator in Texas, Honor X Enterprises is well-positioned to navigate these regulatory and reimbursement changes while potentially pursuing further growth opportunities in the state’s M&A environment.
