Ralls Nursing Home in Ralls, Crosby County, Texas

Ralls, Crosby County, Texas 79357

Status Medicare and Medicaid certifiedMedicare CCN 675407

HHSC license rosteras of November 9, 2026CMS nursing home filerelease October 28, 2026; processing date October 1, 2026CMS processing date for this home October 1, 2026

Verify on TULIP View on Medicare.gov

Location and contact

Address: 1111 Avenue P
Ralls, TX 79357
Open map (OpenStreetMap)
Phone: (806) 253-2596
HHSC facility ID: 004332
License number: 149051

Medicare ratings

Star ratings below are copied from the CMS Provider Information file (official release October 28, 2026; processing date October 1, 2026). They are not assigned by NursingCareLookup. See how to read ratings and CMS Five-Star documentation.

Overall: 1 of 5Overall: 1 of 5 stars
Health inspection: 1 of 5Health inspection: 1 of 5 stars
Staffing: 1 of 5Staffing: 1 of 5 stars
Quality measures: 4 of 5Quality measures: 4 of 5 stars
Long-stay quality measures: 4 of 5Long-stay quality measures: 4 of 5 stars
Short-stay quality measures: Not rated in the CMS file on handShort-stay quality measures: not rated in the CMS file on hand
CMS footnote: 2

Flags in the CMS file

This home has an abuse icon in the CMS file. That is a CMS designation, not a finding we added. Read the explainer and the official complaint channels in the footer.

Staffing hours

Hours are the facility’s reported nurse staffing hours per resident per day from the CMS file. The Texas average is computed on this site from Texas rows in that same file that include a numeric value. It is not copied from another website. Method: Methodology.

Staffing hours per resident per day
Measure	This facility	Texas average (this site)
Total nurse staffing	2.53 hours	3.42 hours n=1,152
Registered nurse	0.34 hours	0.44 hours
LPN	0.72 hours	0.95 hours
Nurse aide	1.47 hours	2.03 hours
Weekend nurse staffing	2.33 hours	2.99 hours

0.88 hours below this site’s computed Texas average.

Total nursing staff turnover: 76.7% (Texas average computed on this site: 50.8%, n=1,096)
RN turnover: 60%
Average residents per day: 36.5
Certified beds (CMS): 46

Penalties in the CMS Provider Information file: 5 finestotaling $303,179; 1 payment denial; 6 total penalties. These are the figures CMS published in this release. Confirm current figures on Medicare.gov.

Fines and payment denials

Individual fines and payment denials below come from the CMS Penalties file (official release October 28, 2026; processing date October 1, 2026). Dates and amounts are copied as published. They can lag later actions or successful appeals. Confirm current figures on Medicare.gov.

CMS fines and payment denials
Date	Type	Fine amount	Payment denial
January 14, 2026	Fine · Fine ID 136751	$8,281	—
January 14, 2026	Fine · Fine ID 136750	$12,740	—
July 18, 2025	Fine · Fine ID 134118	$16,543	—
June 10, 2024	Fine · Fine ID 112950	$203,177	—
June 10, 2024	Payment Denial	—	Start July 12, 2024; 11 days
May 9, 2024	Fine · Fine ID 112827	$62,438	—

MDS quality measures

These figures are the four-quarter averages published in the CMS MDS Quality Measures file (official release October 28, 2026; measure period 2025Q3-2026Q2; processing date October 1, 2026). They are not a grade this site assigned. A “used in Five-Star” flag is the published CMS field that says whether that measure feeds the quality-measure star rating. Quarterly scores are collapsed under each measure. Official definitions are on the CMS Five-Star page.

CMS MDS quality measures, four-quarter averages
Measure	Stay	Four-quarter average	Used in Five-Star QM rating
Percentage of long-stay residents whose need for help with daily activities has increased Quarterly scores Q1 12.0% · Q2 4.5% · Q3 22.7% · Q4 16.7% · Period 2025Q3-2026Q2 · Measure code 401	Long Stay	14.0%	Yes, as published by CMS
Percentage of long-stay residents with a catheter inserted and left in their bladder Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 406	Long Stay	0.0%	Yes, as published by CMS
Percentage of long-stay residents with a urinary tract infection Quarterly scores Q1 6.1% · Q2 6.3% · Q3 0.0% · Q4 10.0% · Period 2025Q3-2026Q2 · Measure code 407	Long Stay	5.6%	Yes, as published by CMS
Percentage of long-stay residents experiencing one or more falls with major injury Quarterly scores Q1 2.9% · Q2 2.9% · Q3 9.7% · Q4 12.5% · Period 2025Q3-2026Q2 · Measure code 410	Long Stay	6.9%	Yes, as published by CMS
Percentage of long-stay residents whose ability to walk independently worsened Quarterly scores Q1 — (CMS footnote 9) · Q2 — (CMS footnote 9) · Q3 — (CMS footnote 9) · Q4 — (CMS footnote 9) · Period 2025Q3-2026Q2 · Measure code 451	Long Stay	13.2%	Yes, as published by CMS
Percentage of long-stay residents with pressure ulcers Quarterly scores Q1 0.0% · Q2 2.2% · Q3 2.5% · Q4 4.5% · Period 2025Q3-2026Q2 · Measure code 479	Long Stay	2.3%	Yes, as published by CMS
Percentage of long-stay residents who received an antipsychotic medication Quarterly scores Q1 — (CMS footnote 9) · Q2 — (CMS footnote 9) · Q3 — (CMS footnote 9) · Q4 — (CMS footnote 9) · Period 2025Q3-2026Q2 · Measure code 481	Long Stay	13.5%	Yes, as published by CMS
Percentage of long-stay residents who lose too much weight Quarterly scores Q1 22.7% · Q2 9.1% · Q3 9.1% · Q4 4.2% · Period 2025Q3-2026Q2 · Measure code 404	Long Stay	11.1%	No, as published by CMS
Percentage of long-stay residents who have depressive symptoms Quarterly scores Q1 0.0% · Q2 0.0% · Q3 — (CMS footnote 9) · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 408	Long Stay	0.0%	No, as published by CMS
Percentage of long-stay residents who were physically restrained Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 409	Long Stay	0.0%	No, as published by CMS
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine Quarterly scores Q1 79.4% · Q2 79.4% · Q3 80.6% · Q4 71.9% · Period 2025Q3-2026Q2 · Measure code 415	Long Stay	77.9%	No, as published by CMS
Percentage of long-stay residents who received an antianxiety or hypnotic medication Quarterly scores Q1 44.4% · Q2 53.8% · Q3 68.0% · Q4 66.7% · Period 2025Q3-2026Q2 · Measure code 452	Long Stay	58.1%	No, as published by CMS
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine Quarterly scores Q1 — (CMS footnote 28) · Q2 — (CMS footnote 28) · Q3 — (CMS footnote 28) · Q4 — (CMS footnote 28) · Period 2025Q3-2026Q2 · Measure code 454	Long Stay	91.4%	No, as published by CMS
Percentage of long-stay residents with new or worsened bowel or bladder incontinence Quarterly scores Q1 12.5% · Q2 25.8% · Q3 25.6% · Q4 32.6% · Period 2025Q3-2026Q2 · Measure code 480	Long Stay	23.9%	No, as published by CMS
Percentage of short-stay residents who newly received an antipsychotic medication Quarterly scores Q1 — (CMS footnote 9) · Q2 — (CMS footnote 9) · Q3 — (CMS footnote 9) · Q4 — (CMS footnote 9) · Period 2025Q3-2026Q2 · Measure code 434	Short Stay	— (CMS footnote 9)	Yes, as published by CMS
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine Quarterly scores Q1 — (CMS footnote 9) · Q2 — (CMS footnote 9) · Q3 — (CMS footnote 9) · Q4 — (CMS footnote 9) · Period 2025Q3-2026Q2 · Measure code 430	Short Stay	18.0%	No, as published by CMS
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine Quarterly scores Q1 — (CMS footnote 28) · Q2 — (CMS footnote 28) · Q3 — (CMS footnote 28) · Q4 — (CMS footnote 28) · Period 2025Q3-2026Q2 · Measure code 472	Short Stay	— (CMS footnote 9)	No, as published by CMS

Inspection citations

30 health citations in the CMS file (18 from complaint surveys). Highest scope/severity letter in the file: J — Isolated, immediate jeopardy.

The list below is drawn from the CMS Health Deficiencies file. We show the tag, a plain-language reading of the scope and severity letter, whether the survey was a standard or complaint survey, the survey date, and whether CMS recorded a correction. We do not reprint the official deficiency narrative here. Read that text on TULIP or Medicare.gov. A facility may appeal a finding; a successful appeal can alter or remove a citation.

Scope and severity letters (A–L)

CMS assigns one letter from a grid of scope (how widely a problem was found) and severity (how serious the harm was or could be). The short labels below are our wording of that grid, not a different rating system.

Scope and severity letters used in CMS health citations
Severity	Isolated	Pattern	Widespread
Potential for minimal harm	A	B	C
No actual harm, potential for more than minimal harm	D	E	F
Actual harm	G	H	I
Immediate jeopardy	J	K	L

2026 — 5 citations

Tag 0726D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: August 13, 2026

CMS records a correction date (August 26, 2026)

More detail

Nursing and Physician Services Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0609J

J — Isolated, immediate jeopardy

Complaint survey

Survey date: January 14, 2026

Past non-compliance, as recorded by CMS

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0607J

J — Isolated, immediate jeopardy

Complaint survey

Survey date: January 14, 2026

Past non-compliance, as recorded by CMS

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0602E

E — Pattern, potential for more than minimal harm

Complaint survey

Survey date: January 14, 2026

CMS records a correction date (January 15, 2026)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0600J

J — Isolated, immediate jeopardy

Complaint survey

Survey date: January 14, 2026

Past non-compliance, as recorded by CMS

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

2025 — 9 citations

Tag 0760D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: November 26, 2025

CMS records a correction date (November 27, 2025)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0812E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: September 16, 2025

CMS records a correction date (October 11, 2025)

More detail

Nutrition and Dietary Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0727E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: September 16, 2025

CMS records a correction date (October 11, 2025)

More detail

Nursing and Physician Services Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0609D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: September 16, 2025

CMS records a correction date (October 11, 2025)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0585E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: September 16, 2025

CMS records a correction date (October 11, 2025)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0565E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: September 16, 2025

CMS records a correction date (October 11, 2025)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0609J

J — Isolated, immediate jeopardy

Complaint survey

Survey date: July 18, 2025

Past non-compliance, as recorded by CMS

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0607J

J — Isolated, immediate jeopardy

Complaint survey

Survey date: July 18, 2025

Past non-compliance, as recorded by CMS

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0600J

J — Isolated, immediate jeopardy

Complaint survey

Survey date: July 18, 2025

Past non-compliance, as recorded by CMS

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

2024 — 11 citations

Tag 0921D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: August 20, 2024

CMS records a correction date (August 21, 2024)

More detail

Environmental Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0880D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: August 20, 2024

CMS records a correction date (August 21, 2024)

More detail

Infection Control Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0610E

E — Pattern, potential for more than minimal harm

Complaint survey

Survey date: June 10, 2024

CMS records a correction date (July 23, 2024)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0609E

E — Pattern, potential for more than minimal harm

Complaint survey

Survey date: June 10, 2024

CMS records a correction date (July 23, 2024)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0607K

K — Pattern, immediate jeopardy

Complaint survey

Survey date: June 10, 2024

CMS records a correction date (July 23, 2024)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0600K

K — Pattern, immediate jeopardy

Complaint survey

Survey date: June 10, 2024

CMS records a correction date (July 23, 2024)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0580D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: June 10, 2024

CMS records a correction date (July 23, 2024)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0689G

G — Isolated, actual harm

Complaint survey

Survey date: May 9, 2024

CMS records a correction date (June 6, 2024)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0657D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: May 9, 2024

CMS records a correction date (June 6, 2024)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0607E

E — Pattern, potential for more than minimal harm

Complaint survey

Survey date: May 9, 2024

CMS records a correction date (June 6, 2024)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0585E

E — Pattern, potential for more than minimal harm

Complaint survey

Survey date: May 9, 2024

CMS records a correction date (June 6, 2024)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

2023 — 5 citations

Tag 0812F

F — Widespread, potential for more than minimal harm

Standard survey

Survey date: July 18, 2023

CMS records a correction date (August 2, 2023)

More detail

Nutrition and Dietary Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0679D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: July 18, 2023

CMS records a correction date (July 19, 2023)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0656D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: July 18, 2023

CMS records a correction date (July 27, 2023)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0558D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: July 18, 2023

CMS records a correction date (July 24, 2023)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0552E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: July 18, 2023

CMS records a correction date (July 19, 2023)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

License and identity (HHSC)

License effective: December 1, 2023
License expires: December 1, 2026
Initial license date: September 1, 1971
Facility licensed: Yes
Facility certified (HHSC): Yes
Service type: MEDICARE/MEDICAID
Total licensed capacity: 46 beds
Bed mix (HHSC): Licensed only 0; Medicaid only 0; Medicare only 7; Medicare/Medicaid 39; ICF/IID 0
Alzheimer capacity: 0
Administrator: Casey Hollis
Management company: Ralls Nh Operations LTD

Ownership

Ownership below comes from the CMS file when a row joined on this home’s Medicare number. HHSC also records an owner and entity type; those appear after the CMS data. The HHSC entity type “HOSPITAL DISTRICT/AUTHORITY” is very common in the state roster and may not describe day-to-day control. It is not used as a headline here.

CMS ownership type: For profit - Partnership

CMS ownership records
Name	Role	Type	Share	Associated
RALLS NH OPERATIONS, LTD	5% OR GREATER DIRECT OWNERSHIP INTEREST	Organization	NO PERCENTAGE PROVIDED	since 12/01/2014
SPORE, SCOTT	5% OR GREATER DIRECT OWNERSHIP INTEREST	Individual	NO PERCENTAGE PROVIDED	since 12/01/2014
SSS HOLDINGS LP	DIRECT OWNERSHIP INTEREST	Organization	NOT APPLICABLE	since 12/01/2023
BRITTON, CARL	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 12/01/2023
CHEBIB, PAUL	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 12/01/2023
WOLCOTT, ROGER	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 12/01/2023
CHILDRESS COUNTY HOSPITAL DISTRICT	5% OR GREATER INDIRECT OWNERSHIP INTEREST	Organization	NO PERCENTAGE PROVIDED	since 12/01/2014
HOLCOMB, HOLLY	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 05/29/2021
STRATTON, EMILEE	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 03/18/2018
BUCHOK, ANDREW	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 08/22/2023
CHEBIB, PAUL	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 12/01/2023
SPORE, SCOTT	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 12/13/2024

9 more CMS ownership records

Additional CMS ownership records
Name	Role	Type	Share	Associated
BRITTON, CARL	LIMITED PARTNERSHIP INTEREST	Individual	NOT APPLICABLE	since 12/01/2023
WOLCOTT, ROGER	LIMITED PARTNERSHIP INTEREST	Individual	NOT APPLICABLE	since 12/01/2023
CHILDRESS COUNTY HOSPITAL DISTRICT	ADP OF THE SNF	Organization	NOT APPLICABLE	since 01/23/2025
RALLS NH OPERATIONS, LTD	ADP OF THE SNF	Organization	NOT APPLICABLE	since 01/23/2025
BUCHOK, ANDREW	ADP OF THE SNF	Individual	NOT APPLICABLE	since 08/22/2023
CHEBIB, PAUL	ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/01/2023
HOLCOMB, HOLLY	ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/01/2014
SPORE, SCOTT	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/23/2025
STRATTON, EMILEE	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/23/2025

HHSC owner fields

Owner (HHSC): Childress County Hospital District
Type of entity (HHSC): HOSPITAL DISTRICT/AUTHORITY

Public data compiled by NursingCareLookup, not an endorsement or a recommendation, and not medical or legal advice. This site is not affiliated with HHSC, CMS, or Medicare. Figures can lag events at the facility, including surveys, corrections, and successful appeals (an appeal can alter or remove a citation). Verify current facts on TULIP and Medicare.gov, and visit in person before you decide. HHSC roster as of November 9, 2026 (America/Chicago). CMS file: official release October 28, 2026; processing date October 1, 2026.