Texas ›Ralls

Ralls Nursing Home

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1111 Avenue P, Ralls, TX 79357 (opens Google Maps) · Crosby County · (806) 253-2596· 46 certified beds · avg 34 residents/day · certified since Sep 16, 1994 · Medicare and Medicaid certified

Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →

Abuse citation flag (CMS)

What the abuse flag means →

The abuse flag means inspectors cited this facility for abuse that caused harm to a resident within the past year, or potential for harm in each of the last two years. Source: CMS.

1/5
Health inspection rating (on-site)
inspected Sep 16, 2025
9
Serious findings on record
most recent Jan 14, 2026
$303,179
Fines, last 3 years
2.58
Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

New to these records? How to read an inspection report →

Health inspection rating: ★☆☆☆☆1/5 · CMS overall rating: 1/5 · how star ratings work →

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and quality measures from resident assessments and claims.

Most serious findings (actual harm or immediate jeopardy)

▲ Immediate jeopardy, isolated · Jan 14, 2026 · F-0600 · triggered by a complaint

The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors.

Why it matters: Abuse and neglect cause direct physical and emotional harm and are among the most serious failures a nursing home can have.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

▲ Immediate jeopardy, isolated · Jan 14, 2026 · F-0607 · triggered by a complaint

The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection.

Why it matters: Without working prevention policies, mistreatment is more likely to happen and less likely to be caught.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

▲ Immediate jeopardy, isolated · Jan 14, 2026 · F-0609 · triggered by a complaint

The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation.

Why it matters: When incidents aren't reported promptly, abusers may continue harming residents and outside authorities can't step in.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

▲ Immediate jeopardy, isolated · Jul 18, 2025 · F-0600 · triggered by a complaint

The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors.

Why it matters: Abuse and neglect cause direct physical and emotional harm and are among the most serious failures a nursing home can have.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

▲ Immediate jeopardy, isolated · Jul 18, 2025 · F-0607 · triggered by a complaint

The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection.

Why it matters: Without working prevention policies, mistreatment is more likely to happen and less likely to be caught.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

▲ Immediate jeopardy, isolated · Jul 18, 2025 · F-0609 · triggered by a complaint

The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation.

Why it matters: When incidents aren't reported promptly, abusers may continue harming residents and outside authorities can't step in.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

▲ Immediate jeopardy, pattern · Jun 10, 2024 · F-0600 · triggered by a complaint

The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors.

Why it matters: Abuse and neglect cause direct physical and emotional harm and are among the most serious failures a nursing home can have.

Severity (K): Immediate jeopardy to resident health or safety was cited. The scope was a pattern: more than a limited occurrence, without being widespread. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Jul 23, 2024 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, pattern · Jun 10, 2024 · F-0607 · triggered by a complaint

The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection.

Why it matters: Without working prevention policies, mistreatment is more likely to happen and less likely to be caught.

Severity (K): Immediate jeopardy to resident health or safety was cited. The scope was a pattern: more than a limited occurrence, without being widespread. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Jul 23, 2024 (Deficient, Provider has date of correction)

▲ Actual harm, isolated · May 9, 2024 · F-0689 · triggered by a complaint

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Jun 6, 2024 (Deficient, Provider has date of correction)

Inspection findings in the public record

Showing the latest 3 of 29 inspection findings. Open the full record below to read every finding.

  1. J · Immediate jeopardy, isolated

    The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint F-0600

  2. J · Immediate jeopardy, isolated

    The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. · from a complaint F-0607

  3. J · Immediate jeopardy, isolated

    The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint F-0609

View all 29 inspection findingsShow only the latest 3 findings

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.

DateSeverityWhat the facility was cited for
Jan 14, 2026▲ J · Immediate jeopardy, isolatedThe facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint · F-0600
Jan 14, 2026▲ J · Immediate jeopardy, isolatedThe facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. · from a complaint · F-0607
Jan 14, 2026▲ J · Immediate jeopardy, isolatedThe facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint · F-0609
Jan 14, 2026E · Potential for more than minimal harm, patternThe facility did not protect residents from misuse of their belongings or money — this is called misappropriation, and it includes theft or improper use of a resident's property or funds. · from a complaint · F-0602
Nov 26, 2025D · Potential for more than minimal harm, isolatedThe facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · from a complaint · F-0760
Sep 16, 2025E · Potential for more than minimal harm, patternThe facility did not honor residents' right to form and take part in resident or family groups, such as a resident council. · F-0565
Sep 16, 2025E · Potential for more than minimal harm, patternThe facility did not honor residents' right to voice complaints without discrimination or retaliation, or did not have a working complaint process that resolves issues promptly. · F-0585
Sep 16, 2025E · Potential for more than minimal harm, patternThe facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. · F-0727
Sep 16, 2025E · Potential for more than minimal harm, patternThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812
Sep 16, 2025D · Potential for more than minimal harm, isolatedThe facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · F-0609
Jul 18, 2025▲ J · Immediate jeopardy, isolatedThe facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint · F-0600
Jul 18, 2025▲ J · Immediate jeopardy, isolatedThe facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. · from a complaint · F-0607
Jul 18, 2025▲ J · Immediate jeopardy, isolatedThe facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint · F-0609
Aug 20, 2024D · Potential for more than minimal harm, isolatedThe facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880
Aug 20, 2024D · Potential for more than minimal harm, isolatedThe facility did not keep its building and grounds safe, functional, clean, and comfortable for residents, staff, and visitors. · F-0921
Jun 10, 2024▲ K · Immediate jeopardy, patternThe facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint · F-0600
Jun 10, 2024▲ K · Immediate jeopardy, patternThe facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. · from a complaint · F-0607
Jun 10, 2024E · Potential for more than minimal harm, patternThe facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint · F-0609
Jun 10, 2024E · Potential for more than minimal harm, patternThe facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint · F-0610
Jun 10, 2024D · Potential for more than minimal harm, isolatedThe facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint · F-0580
May 9, 2024▲ G · Actual harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
May 9, 2024E · Potential for more than minimal harm, patternThe facility did not honor residents' right to voice complaints without discrimination or retaliation, or did not have a working complaint process that resolves issues promptly. · from a complaint · F-0585
May 9, 2024E · Potential for more than minimal harm, patternThe facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. · from a complaint · F-0607
May 9, 2024D · Potential for more than minimal harm, isolatedThe facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · from a complaint · F-0657
Jul 18, 2023F · Potential for more than minimal harm, widespreadThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812
Jul 18, 2023E · Potential for more than minimal harm, patternThe facility did not make sure residents were fully informed about their own health, care, and treatments in a way they could understand. · F-0552
Jul 18, 2023D · Potential for more than minimal harm, isolatedThe facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. · F-0558
Jul 18, 2023D · Potential for more than minimal harm, isolatedThe facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · F-0656
Jul 18, 2023D · Potential for more than minimal harm, isolatedThe facility did not provide activities that meet residents' needs and interests. Nursing homes must offer meaningful activity programs, not just leave residents idle. · F-0679

Inspection trend by year

Citations from standard inspections increased between the last two inspection cycles (2 → 5).

Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01
All citationsSerious citations (G–L)
2023
All citations: 5
Serious citations (G–L): 0
2024
All citations: 11
Serious citations (G–L): 3
2025
All citations: 9
Serious citations (G–L): 3
2026
All citations: 4
Serious citations (G–L): 3

All bars start at zero. Exact values and supporting details remain below.

YearCitationsSerious (G–L)Worst severity that year
202350F
2024113K ▲
202593J ▲
202643J ▲

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

How to file a complaint about care →

5 fines totaling $303,179, plus 1 Medicare payment denial period.

Every penalty CMS publishes for this facility in the 3-year window is listed —none excluded. The count and the dollar total come from two different CMS datasets and agree for this facility. Penalties older than the window are dropped by CMS before publication, not by us.

DateTypeAmount / length
Jan 14, 2026Fine$8,281
Jan 14, 2026Fine$12,740
Jul 18, 2025Fine$16,543
Jun 10, 2024Fine$203,177
Jun 10, 2024Payment Denial11 days from Jul 12, 2024
May 9, 2024Fine$62,438

Nurse staffing (from payroll records, adjusted for how much care residents need)

What these staffing numbers mean →

Nurse time, in contextAdjusted hours per resident per day · Source: CMS, 2026-08-01
This facilityTexas averageU.S. average
Total nurse staffing (hours per resident per day)
This facility: 2.58
Texas average: 3.46
U.S. average: 3.95
Registered Nurse hours
This facility: 0.34
Texas average: 0.44
U.S. average: 0.69
Weekend total nurse staffing
This facility: 2.21
Texas average: 3.04
U.S. average: 3.50

All bars start at zero. Exact values and supporting details remain below.

MeasureThis facilityTexas avgU.S. avgWhere it stands
Total nurse staffing (hours per resident per day)2.583.463.95bottom 5% in Texas; bottom 4% in the U.S.
Registered Nurse hours0.340.440.69bottom 39% in Texas; bottom 14% in the U.S.
Weekend total nurse staffing2.213.043.50bottom 4% in Texas; bottom 4% in the U.S.
Weekend RN hours (not acuity-adjusted)0.250.340.48bottom 36% in Texas; bottom 21% in the U.S.
Total nursing staff turnover (%)72.455.345.8bottom 17% in Texas; bottom 4% in the U.S.
RN turnover (%)57.154.642.9bottom 46% in Texas; bottom 26% in the U.S.

Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 2.31, RN 0.31, weekend 1.98.Comparing with Medicare Care Compare? Care Compare shows the raw figure (2.31 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 1/5.

Quality measures: assessments & claims

Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.

Quality measures rating: 4/5 · long-stay residents: 4/5 · short-stay residents: —/5

Costs & payment

Price evidence · separate from quality

No verified facility-specific private-pay price is available in our data for Ralls Nursing Home. CMS inspection and staffing records do not tell us what this home will charge you.

Calculate a stay from a quote you receive

Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.

Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.

Before you compare prices

  • Request the room type, effective date and itemized daily rate in writing.
  • Ask about therapy, medicines, supplies, care-level charges, deposits, refunds and annual increases.
  • Confirm insurance or Medicaid eligibility and bed availability directly; certification alone does not guarantee either.

Understand who pays for care · How we handle price evidence · Report an incorrect price

Who owns this facility

How to read ownership records →

Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →

For profit - Partnership

Owner / managerTypeRoleStakeSince
Britton, CarlIndividualDirect Ownership InterestNOT APPLICABLE12/01/2023
Chebib, PaulIndividualDirect Ownership InterestNOT APPLICABLE12/01/2023
Childress County Hospital DistrictOrganization5% or Greater Indirect Ownership Interest—12/01/2014
Ralls NH Operations, LTDOrganization5% or Greater Direct Ownership Interest—12/01/2014
Spore, ScottIndividual5% or Greater Direct Ownership Interest—12/01/2014
SSS Holdings LPOrganizationDirect Ownership InterestNOT APPLICABLE12/01/2023
Wolcott, RogerIndividualDirect Ownership InterestNOT APPLICABLE12/01/2023
Britton, CarlIndividualLimited Partnership InterestNOT APPLICABLE12/01/2023
Buchok, AndrewIndividualW-2 Managing EmployeeNOT APPLICABLE08/22/2023
Buchok, AndrewIndividualOperational/Managerial ControlNOT APPLICABLE01/13/2025
Buchok, AndrewIndividualADP of the SNFNOT APPLICABLE01/23/2025
Chebib, PaulIndividualW-2 Managing EmployeeNOT APPLICABLE12/01/2023
Chebib, PaulIndividualOperational/Managerial ControlNOT APPLICABLE12/30/2024
Chebib, PaulIndividualADP of the SNFNOT APPLICABLE01/23/2025
Childress County Hospital DistrictOrganizationADP of the SNFNOT APPLICABLE01/23/2025
Holcomb, HollyIndividualW-2 Managing EmployeeNOT APPLICABLE04/15/1996
Holcomb, HollyIndividualCorporate OfficerNOT APPLICABLE05/29/2021
Holcomb, HollyIndividualADP of the SNFNOT APPLICABLE01/23/2025
Ralls NH Operations, LTDOrganizationADP of the SNFNOT APPLICABLE01/23/2025
Spore, ScottIndividualOperational/Managerial ControlNOT APPLICABLE12/13/2024

Showing 20 of 24 parties CMS has on file for this facility; 4 are not displayed. The full list is in the CMS Ownership dataset.

Questions to ask on your visit

Full visit checklist →

Print visit checklist

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

  • "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
  • "What specific steps do you take to prevent abuse and neglect, and how are staff trained on them?"
  • "When abuse or theft is suspected, who do you notify, how fast, and how do you inform the family?"
  • "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
  • "What safeguards do you have to protect residents' money and belongings, and what happens when something goes missing?"
  • "What systems do you use to prevent medication errors, and what happens when one occurs?"
  • "Does your facility have an active resident council, and how does management respond to its concerns?"
  • "Walk me through what happens when a resident or family files a grievance — who responds and how fast?"

Also worth asking anywhere

  • "Your weekend nurse staffing is reported below the Texas midpoint — how does the weekend schedule differ from a weekday?"
  • "Can I see the plan of correction for the findings in your most recent state inspection?"
  • "CMS reports 72% total nursing staff turnover here — who on the care team has been with you longest?"
  • "The ownership record on file lists 24 owning or managing parties — who makes the decisions about staffing levels?"
  • "Can I visit again unannounced, at a mealtime or on a weekend?"

Nearby facilities (within 20 miles)

FacilityDistanceCityOverallInspectionFlags
Crosbyton Nursing and Rehabilitation Center7.6 miCrosbyton, TX★★☆☆☆3/5

Compare this facility with the 1 closest →

All facilities in Ralls →

Facility data as of CMS processing date 2026-08-01. CCN 675407.

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