Dialysis star ratings in Texas: what the stars mean and how Texas centers score
Medicare’s dialysis star ratings score each center from 1 to 5 stars, and 3 stars is the national average. In Texas, the ratings lean low. In the latest CMS file, only 37 of 744 Texas facilities (5%) have 5 stars, while 76 have 1 star. The average for the 713 rated Texas centers is 2.8 stars, a little below the national midpoint.
What the star rating measures
CMS calls this the Quality of Patient Care Star Rating. It summarizes how a center scores on a set of clinical quality measures, compared with other dialysis centers. CMS groups those measures into areas like:
- preventing hospital stays and deaths,
- avoiding unnecessary blood transfusions,
- using the most effective kind of access to the bloodstream,
- removing waste from the blood (dialysis adequacy),
- keeping bone mineral levels in balance, and
- getting patients on the kidney transplant waitlist.
CMS explains that a 5-star rating means quality of care that is “much above average,” and that a 1- or 2-star rating means “measured health outcomes for that facility were below average.” A CMS expert panel report from May 2026 says 11 quality measures go into the rating, and that scores are compared against fixed cutoffs to assign stars.
The star rating in our file covers the period January 1, 2022 through December 31, 2025.
How Texas centers score
From the CMS Dialysis Facility file for Texas (downloaded November 13, 2026):
| Stars | Texas facilities |
|---|---|
| 5 stars | 37 |
| 4 stars | 116 |
| 3 stars | 306 |
| 2 stars | 178 |
| 1 star | 76 |
| Not rated | 31 |
A few patterns stand out:
- Bexar County has 10 of the state’s 37 five-star centers, more than any other county. Harris and Fort Bend have 4 each.
- Only 50 of the 124 Texas counties with a dialysis center have even one rated at 4 or 5 stars.
- In 26 counties, every rated center has 1 or 2 stars. Many are rural, but the list also includes Potter (Amarillo), Johnson, and Parker counties.
- Among the three big chains, average ratings are close: DaVita 3.0, U.S. Renal Care 2.9, and Fresenius 2.8. The 25 rated centers that aren’t owned by a chain average 1.7 stars. That’s a small group, so treat it as a reason to look closer, not a rule.
Some centers aren’t rated. Several are children’s hospital units, where many adult measures don’t apply. The CMS file doesn’t give a reason for the others.
How to use a star rating
CMS says to use the rating “along with other quality information” when choosing a facility. Stars are a summary. They can hide the details that matter most to you. Practical steps:
- Look at the outcome categories, not just the stars. Every facility page on this site shows whether CMS rated the center’s survival, hospital admissions, readmissions, transfusions, infections, fistula use, and transplant waitlisting as better than, as, or worse than expected.
- Check the schedule and home options. A 5-star center doesn’t help if it has no chair at a time you can make. See centers with a late shift, peritoneal dialysis, or home hemodialysis training.
- Ask your kidney doctor. Your nephrologist may round at certain centers and knows how your care would change.
- Visit and ask questions. Ask about openings, how they handle missed treatments, and who to call after hours.
- Check your insurance before you switch.
How to use this directory
Start with your county or your city. Each table shows stars, stations, and whether the center offers a late shift, peritoneal dialysis, or home hemodialysis training. The star ratings page lists every 5-star center in Texas. We don’t change or re-score CMS data, and we don’t rank centers ourselves. To double-check any center, look it up on Medicare’s Care Compare.
This guide is general information, not medical advice. Talk with your kidney care team before changing where you get dialysis.
Sources
- CMS Provider Data Catalog — Dialysis facilities: Quality of patient care rating
- CMS — Dialysis Facility Quality of Patient Care Star Rating Technical Expert Panel Summary (May 2026)
- CMS Dialysis Facility – Listing by Facility (dataset 23ew-n7w9), Texas rows downloaded November 13, 2026
- Medicare Care Compare (dialysis facilities)