Federal inspection record · CMS data as of October 1, 2026
Premier Health Care Center
460 W Main St, Ranger, TX · (254) 647-3111
- Certified beds
- 50
- Residents per day
- 44
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- December 31, 2003
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Texas.
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Staffing
★★★★★−1 star
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
Premier Health Care Center carries 135.25 inspection points. That is fewer than 23% of Texas's 1,166 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Texas: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–26 pts
- 4★ 26–51 pts
- 3★ 51–85 pts
- 2★ 85–145.75 pts
- 1★ over 145.75 pts
Bars show every rated home in Texas by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
25 health citations on record since 2024. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (1)
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Everything else, by area of care
Resident Assessment and Care Planning10E
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Ensure each resident receives an accurate assessment.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- D
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- E
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- E
Ensure each resident receives an accurate assessment.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Quality of Life and Care5E
- E
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- E
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- B
Provide safe and appropriate respiratory care for a resident when needed.
- E
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Pharmacy Service2E
- E
Ensure medication error rates are not 5 percent or greater.
- D
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Infection Control2E
- E
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
Environmental2E
- E
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
- D
Keep all essential equipment working safely.
Nutrition and Dietary2F
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nursing and Physician Services1E
- E
Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training.
Inspection history
2026-05-21
14 health deficiencies · 2 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (5 deficiencies)
2025-03-05
7 health deficiencies · 5 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
2024-02-22
4 health deficiencies · 3 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
5
Fines and payment denials
$14,069 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2026-01-15 | Fine | $14,069 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.6 pts better | 1.4 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.3 pts worse | 2.3 | 2.0 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine3.6 pts better | 100.0% | 96.4% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine1.7 pts worse | 95.3% | 97.0% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury4.5 pts worse | 7.7% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms0.2 pts worse | 2.5% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight2.4 pts worse | 5.3% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication0.2 pts worse | 18.0% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication5.7 pts better | 4.1% | 9.8% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened10.1 pts worse | 23.0% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased15.2 pts worse | 31.0% | 15.8% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder4 pts worse | 4.3% | 0.3% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection4.2 pts worse | 5.0% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence4.3 pts better | 8.2% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.7 pts worse | 4.4% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine4.5 pts better | 93.2% | 88.7% | 82.3% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.4 pts better | 0.0% | 1.4% | 1.5% |
·
Who owns and runs it
7 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Alexander, Rainey | Direct Ownership Interest · Individual | 0% | 2 facilities |
| Alexander, Rainey | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Alexander, Rainey | Adp Of The SNF · Individual | 0% | 2 facilities |
| Martinez Irizarry, Axel | Operational/Managerial Control · Individual | 0% | 17 facilities |
| Martinez Irizarry, Axel | Adp Of The SNF · Individual | 0% | 17 facilities |
| Stroh Properties LP | Adp Of The SNF · Organization | 0% | 2 facilities |
| Stroh, Clarence | Adp Of The SNF · Individual | 0% | 2 facilities |
·
Fire safety
10 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke4E
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D
Have a fire alarm with audible and visual signals that transmits the alarm automatically to notify emergency forces in event of fire.
Services3C
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Emergency Preparedness1F
- F
Implement emergency and standby power systems.
Gas, Vacuum, and Electrical Systems1F
- F
Have generator or other power source capable of supplying service within 10 seconds.
Miscellaneous1D
- D
Have restrictions on the use of flammable curtains.
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