50/100
Below average
Ralls Nursing Home
1111 Avenue P, Ralls, TX 79357
- Certified beds
- 46
- Occupancy
- 73%
- Ownership
- For-profit
- Accepts
- Medicare + Medicaid
What to ask about before you visit
These are findings in the public CMS record for this home. They are not our opinion, each one comes straight from a federal inspection or enforcement file.
Abuse icon on record
CMS flags this facility for citations of abuse that caused harm, or potential for harm, to residents.
$303,179 in federal fines
CMS has fined this facility across 5 penalty action(s).
Nursing staff turnover of 72%
High turnover means residents rarely see the same caregiver twice. The national average is about 50%.
Our read on Ralls Nursing Home
Ralls Nursing Home runs on 2.31 nurse hours per resident day, roughly 40% under the national average of 3.86, and weekend coverage drops another 14% below its own weekday levels. That thin staffing sits behind 29 deficiencies on the current record, nine of them at harm or jeopardy level and 13 abuse-related, with five fines totaling $303,179. Annual turnover of 72.4% means most of the aides and nurses working here last year aren't the ones working here now. The last inspection was September 2025, so the record is current, not stale. One bright spot: the quality measure rating is 4 out of 5, but quality scores are largely built from resident assessment data the facility itself reports, and they don't offset a 1-out-of-5 inspection and staffing picture.
Written from the CMS figures for this home shown further down this page. Nothing here is paid for or supplied by the home.
How this grade was calculated
Every point is shown. Nothing is weighted behind the scenes, the full formula is on How we grade.
A full pentagon is full marks. The shape shows what kind of good or bad a home is, two homes can share a score and look nothing alike.
Inspection safety
30/30Citations from state health inspections over the last three surveys, weighted by how much harm CMS says they caused.
- →No citations recorded in the last 3 years
Staffing
8/30Nursing hours per resident per day, adjusted for how sick the residents are, plus RN cover and weekend consistency.
- →2.58 total nurse hours per resident per day (national median 3.77)
- →0.31 RN hours per resident per day
- →Weekend staffing drops 14% against weekdays
Staff stability
0/15How much of the nursing team leaves in a year. High turnover means a resident rarely sees the same face twice.
- →72% of nursing staff left in the last year
- →-2 for 2 administrator departures
Resident outcomes
12/15The CMS quality-measure rating, built from resident outcomes like falls, pressure ulcers, infections and antipsychotic use.
- →4 of 5 stars on the CMS quality-measure rating
Enforcement history
0/10Fines and payment denials CMS has imposed. A denial of payment means CMS stopped paying for new admissions.
- →$303,179 in federal fines across 5 action(s)
- →-0 for 1 denial(s) of Medicare payment for new admissions
Grade ceiling applied
- Capped at 64 (grade C), CMS abuse icon on record
Staffing, against the national average
Full detailHours of nursing care each resident receives per day. The marker on each bar is the national average.
RNs are the licence level most likely to catch a resident deteriorating.
The shift most families visit, and the one thinned first.
The share of nursing staff who left over the last year.
Recent inspection findings
Last standard health inspection: September 16, 2025 (1 year ago). No citations were recorded.
No health-inspection citations on record for this facility in the current CMS release.
What families say
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Common questions about Ralls Nursing Home
What is the ElderGrade for Ralls Nursing Home? +
Ralls Nursing Home holds an ElderGrade of D (50 out of 100), which we describe as "below average". The grade combines its inspection citations, nurse staffing levels, staff turnover, resident outcomes and enforcement history from the federal CMS record.
How many nursing hours does each resident get at Ralls Nursing Home? +
Residents receive an average of 2.31 nursing hours per day across all nursing staff, against a national average of 3.86 hours.
Has Ralls Nursing Home been cited for harming residents? +
No. None of the 0 citations on record were scored at the levels CMS uses to indicate actual harm or immediate jeopardy.
Does Ralls Nursing Home accept Medicaid? +
Yes, Ralls Nursing Home is certified to accept Medicaid, which is the programme that pays for long-term custodial care once a resident meets their state's income and asset limits.
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