Ralls Nursing HomeCMS ratings, inspections and fines
- Address
- 1111 Avenue P, Ralls, TX 79357
- CCN
- 675407
- Ownership type
- For-profit, partnership
- Certified beds
- 46
- Chain
- None in the CMS record
- Residents per day
- 34
- CMS flags
- CMS abuse icon
The watch list stays in this browser. After each CMS update, it shows the values that changed at the homes on the list.
CMS gives Ralls Nursing Home an overall rating of 1 of 5 stars. The last standard survey was on 16 Sep 2025. The latest survey cycle has 10 health citations. The median for nursing homes in Texas is 8. CMS lists 5 fines with a total of $303,179 for this home in its penalties file. CMS also lists 1 payment denial.
Facilities may see a change in their overall rating for a number of reasons. Since the overall rating is based on three individual domains, a change in any one of the domains can affect the overall rating. Any new data for a nursing home could potentially change a star rating domain.
Centers for Medicare & Medicaid Services, Five-Star Quality Rating System: Technical Users' Guide, July 2026. CMS processed this record on .
Since the last CMS update
The site has no recorded change for this home. In each CMS update, the site compares the ratings, the penalties and the citations of each home.
Ratings
CMS gives each home 1 to 5 stars for health inspections, for staffing and for quality measures, and one overall rating.
| Rating (1 to 5 stars) | This home | Crosby County median | Texas median | US average (CMS) |
|---|---|---|---|---|
| Overall rating | 1 | 2.0 | 3.0 | 3.0 |
| Health inspection rating | 1 | 3.0 | 3.0 | 2.8 |
| Staffing rating | 1 | 1.0 | 2.0 | 2.9 |
| Quality measure rating | 4 | 4.0 | 4.0 | 3.6 |
A median is the middle value of the homes in the group: 2 homes in the county, 1,177 homes in the state. What the CMS star ratings measure
Citations by survey cycle
CMS keeps the last three cycles, and cycle 1 is the latest. A cycle has one standard survey. Citations from complaint and infection control inspections go into cycles of 12 months.
| Survey cycle | Standard survey | Citations | Texas median |
|---|---|---|---|
| Cycle 1 (latest) | 16 Sep 2025 | 10 | 8 |
| Cycle 2 | 20 Aug 2024 | 5 | 8 |
| Cycle 3 | No date | 14 | 8 |
Health citations
The record of one deficiency in an inspection. One inspection can give many citations.
Scope and severity. A letter from A to L on each citation. Scope is the number of residents that the deficiency affected. Severity is the level of harm.
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy to resident health or safety | L0 | ||
| Actual harm that is not immediate jeopardy | H0 | I0 | |
| No actual harm, potential for more than minimal harm | |||
| No actual harm, potential for minimal harm | A0 | B0 | C0 |
Survey cycle 1 (latest): 10 citations
Standard survey of this cycle: .
| Survey date | F-tag | Requirement (CMS text) | Scope and severity | Survey type | Corrected |
|---|---|---|---|---|---|
| 14 Jan 2026 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | J | Complaint investigation | Past Non-Compliance |
| 14 Jan 2026 | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | E | Complaint investigation | 15 Jan 2026 |
| 14 Jan 2026 | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | J | Complaint investigation | Past Non-Compliance |
| 14 Jan 2026 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | J | Complaint investigation | Past Non-Compliance |
| 26 Nov 2025 | F0760 | Ensure that residents are free from significant medication errors. | D | Complaint investigation | 27 Nov 2025 |
| 16 Sep 2025 | F0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | Standard survey | 11 Oct 2025 |
| 16 Sep 2025 | F0585 | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | E | Standard survey | 11 Oct 2025 |
| 16 Sep 2025 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Standard survey | 11 Oct 2025 |
| 16 Sep 2025 | F0727 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | E | Standard survey | 11 Oct 2025 |
| 16 Sep 2025 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard survey | 11 Oct 2025 |
Survey cycle 2: 5 citations
Standard survey of this cycle: .
| Survey date | F-tag | Requirement (CMS text) | Scope and severity | Survey type | Corrected |
|---|---|---|---|---|---|
| 18 Jul 2025 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | J | Complaint investigation | Past Non-Compliance |
| 18 Jul 2025 | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | J | Complaint investigation | Past Non-Compliance |
| 18 Jul 2025 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | J | Complaint investigation | Past Non-Compliance |
| 20 Aug 2024 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 21 Aug 2024 |
| 20 Aug 2024 | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | D | Standard survey | 21 Aug 2024 |
Survey cycle 3: 14 citations
The CMS provider file has no standard survey date for this cycle.
| Survey date | F-tag | Requirement (CMS text) | Scope and severity | Survey type | Corrected |
|---|---|---|---|---|---|
| 10 Jun 2024 | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | Complaint investigation | 23 Jul 2024 |
| 10 Jun 2024 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | K | Complaint investigation | 23 Jul 2024 |
| 10 Jun 2024 | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | K | Complaint investigation | 23 Jul 2024 |
| 10 Jun 2024 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | E | Complaint investigation | 23 Jul 2024 |
| 10 Jun 2024 | F0610 | Respond appropriately to all alleged violations. | E | Complaint investigation | 23 Jul 2024 |
| 9 May 2024 | F0585 | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | E | Complaint investigation | 6 Jun 2024 |
| 9 May 2024 | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | E | Complaint investigation | 6 Jun 2024 |
| 9 May 2024 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Complaint investigation | 6 Jun 2024 |
| 9 May 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | Complaint investigation | 6 Jun 2024 |
| 18 Jul 2023 | F0552 | Ensure that residents are fully informed and understand their health status, care and treatments. | E | Standard survey | 19 Jul 2023 |
| 18 Jul 2023 | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | Standard survey | 24 Jul 2023 |
| 18 Jul 2023 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard survey | 27 Jul 2023 |
| 18 Jul 2023 | F0679 | Provide activities to meet all resident's needs. | D | Standard survey | 19 Jul 2023 |
| 18 Jul 2023 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard survey | 2 Aug 2023 |
The requirement text is the CMS summary of the F-tag. It is not the report of the surveyor. How to read an inspection report
Penalties
A fine, or a payment denial: a period in which Medicare or Medicaid does not pay for new admissions. The CMS penalties file holds three years.
| Date | Type | Fine | Days without payment |
|---|---|---|---|
| 14 Jan 2026 | Fine | $12,740 | |
| 14 Jan 2026 | Fine | $8,281 | |
| 18 Jul 2025 | Fine | $16,543 | |
| 10 Jun 2024 | Fine | $203,177 | |
| 10 Jun 2024 | Payment denial | 11 | |
| 9 May 2024 | Fine | $62,438 |
Staffing
Hours per resident per day. The nurse hours for one resident on an average day. CMS calculates the figure from the hours that the home reports for a quarter.
| Staff | This home | Texas median | Texas average (CMS) |
|---|---|---|---|
| All nurse staff | 2.31 | 3.30 | 3.39 |
| Registered nurses (RN) | 0.31 | 0.40 | 0.43 |
| Licensed practical nurses (LPN) | 0.71 | 0.95 | |
| Nurse aides | 1.29 | 2.00 | |
| All nurse staff, weekends | 1.98 | 2.90 | 2.98 |
- Nurse staff turnover in a year
- 72.4%
- Nurse staff turnover, Texas median
- 52.1%
- RN turnover in a year
- 57.1%
- Administrators who left in a year
- 2
Homes report the hours to CMS in the Payroll-Based Journal.
Quality measures
A figure that CMS calculates from the assessments of residents. One example is the percentage of long-stay residents with a fall and a major injury.
| Measure (CMS text) | Residents | This home | Texas median | US median |
|---|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 11.0% | 14.9% | 12.6% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 0.0% | 0.0% | 0.3% |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 4.7% | 0.3% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 4.5% | 3.0% | 2.8% |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 12.8% | 12.4% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 1.2% | 3.4% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 12.2% | 8.3% | 13.4% |
For each measure in this table, CMS gives more points in the quality measure rating for a lower percentage. The site calculates the medians from the CMS file. What the CMS star ratings measure
Ownership
An organisation in the CMS ownership file. CMS records its role, for example an ownership interest, operational or managerial control, or a mortgage interest.
- Ownership type
- For-profit, partnership
- Legal business name
- Childress County Hospital District
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Ralls NH Operations, Ltd | 5% or greater direct ownership interest | 1 Dec 2014 | |
| SSS Holdings LP | Direct ownership interest | 1 Dec 2023 | |
| Childress County Hospital District | 5% or greater indirect ownership interest | 1 Dec 2014 | |
| Childress County Hospital District | Adp of the snf | 23 Jan 2025 | |
| Ralls NH Operations, Ltd | Adp of the snf | 23 Jan 2025 |
The site shows organisations only. It does not show the names of persons.
Other homes in Crosby County
| Nursing home | City | Overall rating | Citations, latest cycle | Fines | Last standard survey | |
|---|---|---|---|---|---|---|
| Crosbyton Nursing and Rehabilitation Center | Crosbyton | 2 of 5 | 13 | $0 | 2 Dec 2025 |
Official channels
- Care Compare record of this nursing homeMedicare.gov. The official CMS record of this home.
- Texas Health and Human Services: complaint and incident intakeThe complaint page of the State Survey Agency for Texas, from the CMS list of agencies.
- Contact information for State Survey AgenciesCMS. The web address and the telephone number of the State Survey Agency of each state. These agencies investigate complaints about nursing homes.
- Filing a complaintMedicare.gov. The page names the State Survey Agency as the place for a complaint about nursing home care or facility conditions.
- Eldercare LocatorAdministration for Community Living. A public service that connects older adults and their families to local services. Telephone: 1-800-677-1116.
Cite this page
Centers for Medicare & Medicaid Services, Care Compare. Record of Ralls Nursing Home (CCN 675407). Data processed 1 Aug 2026. Elder Care Record, https://eldercarerecord.com/facility/ralls-nursing-home-ralls-tx-675407/
Provenance
- Licence
- US government work, public domain
- CMS processed the data on
A program makes this page from the CMS files, and the same files always give the same text. How the site makes the figures. Report an error.
Questions
- When was Ralls Nursing Home last inspected?
- The latest inspection with a citation in the CMS record was on 14 Jan 2026. It was a complaint investigation. It gave 4 citations. The standard survey before the last one was on 20 Aug 2024.
- Who operates Ralls Nursing Home?
- The CMS record gives the ownership type as for-profit, partnership. CMS lists no chain for the home. The CMS ownership file names no organisation for operational or managerial control. This site does not show the names of persons.
- Is Ralls Nursing Home a Special Focus Facility?
- No. The CMS provider file lists no Special Focus status for this home. CMS lists 6 homes in Texas as Special Focus Facilities and 30 as candidates.
- Where does the data on this page come from?
- The data comes from the CMS Care Compare files for nursing homes. CMS processed the files on 1 Aug 2026. The Care Compare record on Medicare.gov is the official record of the home.