For profit - Partnership · 46 certified beds · CMS number 675407
Ralls Nursing Home, Ralls, TX
CMS records 29 health deficiencies at Ralls Nursing Home in Ralls, Texas in its last 3 inspection cycles; the Texas median is 25. Its most recent standard inspection was on Sep 16, 2025. The highest severity cited is K (immediate jeopardy to resident health or safety). 8 citations were at the immediate jeopardy level, 6 of them recorded as past non-compliance (fixed before the inspection). CMS lists 5 fines totaling $303,179 and 1 payment denial in the last three years.
- 29deficiencies, 3 cycles (TX median 25)
- 10in the latest cycle (TX median 8)
- Khighest severity · Immediate jeopardy
- $303,179fines, last 3 years
- 1CMS overall rating (of 5)
Inspections and deficiencies
CMS findings for Ralls Nursing Home as of Sep 1, 2026, grouped by inspection cycle (3 cycles); each is a requirement inspectors found not met, and Ralls Nursing Home may since have corrected or disputed it. Severity letters · Inspection cycles · Care Compare
Most recent cycle (10 deficiencies)
Standard inspection Sep 16, 2025. CMS counts 10 health deficiencies and 2 fire safety deficiencies in this cycle.
Jan 14, 2026 · Complaint inspection
4 deficiencies, highest J
F609 · Reporting suspected abuse and crimes
Requirement cited (CMS): Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Past non-compliance (fixed before the inspection)
F607 · Abuse prevention policies
Requirement cited (CMS): Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Past non-compliance (fixed before the inspection)
F602 · Protecting residents' money and belongings
Requirement cited (CMS): Protect each resident from the wrongful use of the resident's belongings or money.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jan 15, 2026
F600 · Freedom from abuse and neglect
Requirement cited (CMS): Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Past non-compliance (fixed before the inspection)
Nov 26, 2025 · Complaint inspection
1 deficiency, highest D
F760 · No significant medication errors
Requirement cited (CMS): Ensure that residents are free from significant medication errors.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Nov 27, 2025
Sep 16, 2025 · Standard inspection
5 deficiencies, highest E
F812 · Food safety and sanitation
Requirement cited (CMS): Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Oct 11, 2025
F727 · RN coverage and director of nursing
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Oct 11, 2025
F609 · Reporting suspected abuse and crimes
Requirement cited (CMS): Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Oct 11, 2025
F585 · Grievances and how they are handled
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Oct 11, 2025
F565 · Resident and family councils
Requirement cited (CMS): Honor the resident's right to organize and participate in resident/family groups in the facility.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Oct 11, 2025
Previous cycle: 5 deficiencies (standard inspection Aug 20, 2024)
Standard inspection Aug 20, 2024. CMS counts 5 health deficiencies and 2 fire safety deficiencies in this cycle.
Jul 18, 2025 · Complaint inspection
3 deficiencies, highest J
F609 · Reporting suspected abuse and crimes
Requirement cited (CMS): Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Past non-compliance (fixed before the inspection)
F607 · Abuse prevention policies
Requirement cited (CMS): Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Past non-compliance (fixed before the inspection)
F600 · Freedom from abuse and neglect
Requirement cited (CMS): Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Past non-compliance (fixed before the inspection)
Aug 20, 2024 · Standard inspection
2 deficiencies, highest D
F921 · Safe, functional, sanitary building
Requirement cited (CMS): Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Aug 21, 2024
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Aug 21, 2024
Earlier cycle: 14 deficiencies (standard inspection Jul 18, 2023)
Standard inspection Jul 18, 2023. CMS counts 14 health deficiencies and 3 fire safety deficiencies in this cycle.
Jun 10, 2024 · Complaint inspection
5 deficiencies, highest K
F610 · Investigating and responding to allegations
Requirement cited (CMS): Respond appropriately to all alleged violations.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 23, 2024
F609 · Reporting suspected abuse and crimes
Requirement cited (CMS): Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 23, 2024
F607 · Abuse prevention policies
Requirement cited (CMS): Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- Severity
- K Immediate jeopardy to resident health or safety, pattern
- Status
- Correction date Jul 23, 2024
F600 · Freedom from abuse and neglect
Requirement cited (CMS): Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- Severity
- K Immediate jeopardy to resident health or safety, pattern
- Status
- Correction date Jul 23, 2024
F580 · Telling residents and families about changes
Requirement cited (CMS): Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 23, 2024
May 9, 2024 · Complaint inspection
4 deficiencies, highest G
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- G Actual harm (not immediate jeopardy), isolated
- Status
- Correction date Jun 6, 2024
F657 · Care plan timing and team review
Requirement cited (CMS): Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 6, 2024
F607 · Abuse prevention policies
Requirement cited (CMS): Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jun 6, 2024
F585 · Grievances and how they are handled
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jun 6, 2024
Jul 18, 2023 · Standard inspection
5 deficiencies, highest F
F812 · Food safety and sanitation
Requirement cited (CMS): Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Severity
- F No actual harm, potential for more than minimal harm, widespread
- Status
- Correction date Aug 2, 2023
F679 · Activities program
Requirement cited (CMS): Provide activities to meet all resident's needs.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 19, 2023
F656 · Comprehensive person-centered care plan
Requirement cited (CMS): Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 27, 2023
F558 · Accommodating individual needs and preferences
Requirement cited (CMS): Reasonably accommodate the needs and preferences of each resident.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 24, 2023
F552 · Being informed about health and treatment
Requirement cited (CMS): Ensure that residents are fully informed and understand their health status, care and treatments.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 19, 2023
Tags cited in more than one inspection
5 tags cited on more than one inspection date at Ralls Nursing Home; each date counts once and does not mean the same incident. PNC = past non-compliance.
| Tag | Inspections | Dates |
|---|---|---|
| F607 Abuse prevention policies | 4 | Jan 14, 2026 (PNC); Jul 18, 2025 (PNC); Jun 10, 2024; May 9, 2024 |
| F609 Reporting suspected abuse and crimes | 4 | Jan 14, 2026 (PNC); Sep 16, 2025; Jul 18, 2025 (PNC); Jun 10, 2024 |
| F600 Freedom from abuse and neglect | 3 | Jan 14, 2026 (PNC); Jul 18, 2025 (PNC); Jun 10, 2024 |
| F585 Grievances and how they are handled | 2 | Sep 16, 2025; May 9, 2024 |
| F812 Food safety and sanitation | 2 | Sep 16, 2025; Jul 18, 2023 |
Fines and payment denials
| Date | Type | Amount / length |
|---|---|---|
| Jan 14, 2026 | Fine | $8,281 |
| Jan 14, 2026 | Fine | $12,740 |
| Jul 18, 2025 | Fine | $16,543 |
| Jun 10, 2024 | Fine | $203,177 |
| Jun 10, 2024 | Payment Denial | 11 days from Jul 12, 2024 |
| May 9, 2024 | Fine | $62,438 |
Staffing and CMS ratings
- Total nurse staff hours per resident per day
- 2.31 h (below the Texas median of 3.27 h)
- RN hours per resident per day
- 0.31 h (below the Texas median of 0.38 h)
- Weekend nurse staff hours per resident per day
- 1.98 h
- Nursing staff turnover
- 72.4% (Texas median 52.1%)
- Administrators who left
- 2
- CMS overall rating
- 1 of 5
- Health inspection rating
- 1 of 5
- Staffing rating
- 1 of 5
- Quality measure rating
- 4 of 5
CMS figures for Ralls Nursing Home, copied as published; Texas medians are ours.
Facility details
- Address
- 1111 Avenue P, Ralls, TX 79357
- Phone
- (806) 253-2596
- County
- Crosby
- Accepts
- Medicare and Medicaid
- Ownership
- For profit - Partnership
- Chain (CMS)
- Not part of a chain in CMS data
- Certified beds
- 46
- Average residents per day
- 33.7
- In Medicare/Medicaid since
- Sep 16, 1994
- Inside a hospital
- No
- Continuing care retirement community
- No
- Resident and family council
- Resident
- Sprinklers in all required areas
- Yes
Questions to ask on a visit
Based on the tags cited most often here.
- Can families get a summary of the home's abuse prevention and reporting policy? (F607, cited 4 times)
- Who at the home is responsible for reporting incidents to the state? (F609, cited 4 times)
- How does the home screen, train, and supervise staff to protect residents? (F600, cited 3 times)
- Who is the grievance official, and how are complaints tracked and answered? (F585, cited 2 times)
Source
CMS Provider Data Catalog: Provider Information, Health Deficiencies, Penalties, Survey Summary. Processed by CMS Sep 1, 2026; next update Oct 28, 2026.