Ralls Nursing Home
1111 Avenue P · Ralls, TX · 79357 · 8062532596
46 certified beds For profit - Partnership
Why this verdict
- Carries CMS’s abuse warning icon.
- Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (6 citations).
- Inspection record is far worse than the national median (deficiency count and severity).
- Federal penalties on record: $42,023 in fines in the last 24 months.
- Inspection results have improved across recent cycles.
Red flags
CMS abuse warning
CMS flags this facility with its abuse icon: cited for abuse that caused harm in the past year, or potential harm in the past two years.
6 immediate-jeopardy citations in the most recent inspection cycle
Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.
8 abuse-related citations at the actual-harm level
Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.
Medicare/Medicaid payments were denied
CMS refused payment for new admissions for a period — one of its strongest enforcement tools.
Total nurse staffing below 3.0 hours per resident-day
2.75 reported hours vs the 3.48 minimum CMS's own staffing study recommends.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 1 of 5 Inspections: 1 of 5 Staffing: 1 of 5 Quality measures: 4 of 5
| Total nurse hours / resident-day | 2.75 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.39 | 0.55–0.75 |
| Weekend hours / resident-day | 2.39 | ≈ weekday level |
| Nursing turnover / year | 52% | median 45% |
| Fines (3-yr window) | 5 · $307,638 |
Inspection citations (29 in the current record)
-
Immediate jeopardy · J January 14, 2026 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Past Non-Compliance · Freedom from Abuse, Neglect, and Exploitation
-
Immediate jeopardy · J January 14, 2026 · found via complaint
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Past Non-Compliance · Freedom from Abuse, Neglect, and Exploitation
-
Immediate jeopardy · J January 14, 2026 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Past Non-Compliance · Freedom from Abuse, Neglect, and Exploitation
-
Potential for harm · E January 14, 2026 · found via complaint
Protect each resident from the wrongful use of the resident's belongings or money.
Corrected January 15, 2026 · Freedom from Abuse, Neglect, and Exploitation
-
Potential for harm · D November 26, 2025 · found via complaint
Ensure that residents are free from significant medication errors.
Corrected November 27, 2025 · Pharmacy Service
-
Potential for harm · E September 16, 2025
Honor the resident's right to organize and participate in resident/family groups in the facility.
Corrected October 11, 2025 · Resident Rights
-
Potential for harm · E September 16, 2025
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.
Corrected October 11, 2025 · Resident Rights
-
Potential for harm · D September 16, 2025
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected October 11, 2025 · Freedom from Abuse, Neglect, and Exploitation
-
Potential for harm · E September 16, 2025
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.
Corrected October 11, 2025 · Nursing and Physician Services
-
Potential for harm · E September 16, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected October 11, 2025 · Nutrition and Dietary
-
Immediate jeopardy · J July 18, 2025 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Past Non-Compliance · Freedom from Abuse, Neglect, and Exploitation
-
Immediate jeopardy · J July 18, 2025 · found via complaint
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Past Non-Compliance · Freedom from Abuse, Neglect, and Exploitation
-
Immediate jeopardy · J July 18, 2025 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Past Non-Compliance · Freedom from Abuse, Neglect, and Exploitation
-
Potential for harm · D August 20, 2024
Provide and implement an infection prevention and control program.
Corrected August 21, 2024 · Infection Control
-
Potential for harm · D August 20, 2024
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Corrected August 21, 2024 · Environmental
-
Immediate jeopardy · K June 10, 2024 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected July 23, 2024 · Freedom from Abuse, Neglect, and Exploitation
-
Immediate jeopardy · K June 10, 2024 · found via complaint
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected July 23, 2024 · Freedom from Abuse, Neglect, and Exploitation
-
Potential for harm · D June 10, 2024 · found via complaint
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected July 23, 2024 · Resident Rights
-
Potential for harm · E June 10, 2024 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected July 23, 2024 · Freedom from Abuse, Neglect, and Exploitation
-
Potential for harm · E June 10, 2024 · found via complaint
Respond appropriately to all alleged violations.
Corrected July 23, 2024 · Freedom from Abuse, Neglect, and Exploitation
-
Actual harm · G May 9, 2024 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected June 6, 2024 · Quality of Life and Care
-
Potential for harm · E May 9, 2024 · found via complaint
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.
Corrected June 6, 2024 · Resident Rights
-
Potential for harm · E May 9, 2024 · found via complaint
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected June 6, 2024 · Freedom from Abuse, Neglect, and Exploitation
-
Potential for harm · D May 9, 2024 · found via complaint
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected June 6, 2024 · Resident Assessment and Care Planning
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Potential for harm · E July 18, 2023
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected July 19, 2023 · Resident Rights
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| January 14, 2026 | Fine | $12,740 |
| January 14, 2026 | Fine | $12,740 |
| July 18, 2025 | Fine | $16,543 |
| June 10, 2024 | Fine | $203,177 |
| June 10, 2024 | Payment Denial | 11 days |
| May 9, 2024 | Fine | $62,438 |
Better-scoring options nearby
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 675407 · certified since September 16, 1994. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.