Merkel Nursing Center
On Medicare Special Focus status, a serious quality warning. Visit in person and ask tough questions before deciding.
based on 7 Google reviews

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Quality Concerns Identified
Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.
- Low overall rating (1/5 stars)
- Above-median deficiencies (21 vs median 8.0)
- High staff turnover (60%)
Bottom 25% in Texas · Below recommended RN staffing · Above average staffing · $291,592 in fines
What this means for your family
There is currently insufficient information in these reviews to provide a recommendation. Because the reviews lack descriptive details about care, staffing, or facilities, families should schedule an in-person tour and speak directly with current residents' families before making a decision.
Google Reviews
Google Reviews
7 reviews analyzed“It is difficult to assess the quality of care at Merkel Nursing Center because most reviewers provided star ratings without any descriptive text. While there are several high ratings, there is a lack of specific information regarding nursing, cleanliness, or dining to help a family make an informed decision.”
Rating Trends
Tap a year to see what changed
Distribution
How They Respond to Reviews
Questions for Your Tour
- 1I noticed your staffing rating is quite high; how does that strong team presence help ensure residents feel supported and safe throughout the day?
- 2With the recent updates to your care processes, what specific steps has the facility taken to improve health inspection outcomes and resident safety?
- 3How does the nursing team manage medical emergencies or sudden changes in a resident's condition during the night shifts?
- 4What kind of daily activities or social outings do you have planned to keep the residents engaged and connected with one another?
- 5Since you are a smaller, 66-resident community, how do you ensure that each person's unique care plan is closely monitored and updated?
- 6We saw that you are very responsive to feedback from families; how does the administration involve families in the care decision-making process?
Personalized based on this facility's data
Staffing
Staffing Hours
per resident/day · Medicare 2026Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.
Quality Measures
Quality Measures
Resident outcomes compared with national, state, and local averages · 14 measures
4
measures
7
measures
3
measures
Residents on antipsychotic medication
Residents with pressure sores (bedsores)
Residents whose bladder or bowel control got worse
Residents who got a urinary tract infection
Residents with depression symptoms
Residents vaccinated for pneumonia
US average from Medicare published data
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
Merkel Nursing Center has a concerning pattern with 65 deficiencies across 7 surveys, with two-thirds triggered by family complaints. Recurring issues include administration problems, infection control failures, and resident safety hazards. Critical concerns involve abuse prevention policies, safety supervision, and staff training deficiencies that have persisted across multiple surveys, suggesting ongoing operational challenges despite reported corrections.
Feb 16, 2026Complaint8
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Nursing and Physician Services Deficiencies
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.
Nursing and Physician Services Deficiencies
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.
Infection Control Deficiencies
Implement a program that monitors antibiotic use.
Infection Control Deficiencies
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Dec 4, 2025Routine18
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Administration Deficiencies
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Environmental Deficiencies
Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.
Administration Deficiencies
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Administration Deficiencies
Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
Resident Rights Deficiencies
Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Administration Deficiencies
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Infection Control Deficiencies
Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.
Administration Deficiencies
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Aug 22, 2025Complaint8
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Nutrition and Dietary Deficiencies
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Administration Deficiencies
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Administration Deficiencies
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Administration Deficiencies
Follow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel.
Dec 12, 2024Complaint1
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Oct 17, 2024Complaint6
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Environmental Deficiencies
Have policies on smoking.
Resident Assessment and Care Planning Deficiencies
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Jul 31, 2024Complaint19
Administration Deficiencies
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Assessment and Care Planning Deficiencies
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 Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Nursing and Physician Services Deficiencies
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.
Nutrition and Dietary Deficiencies
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Environmental Deficiencies
Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Resident Rights Deficiencies
Ensure residents have reasonable access to and privacy in their use of communication methods.
Quality of Life and Care Deficiencies
Ensure the activities program is directed by a qualified professional.
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Administration Deficiencies
Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
Administration Deficiencies
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Administration Deficiencies
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Federal Penalties
Fine
Feb 16, 2026
$210,935
Fine
Aug 22, 2025
$178,172
Fine
Jun 26, 2023
$4,196
Fine
Jun 20, 2023
$3,846
Fine
May 30, 2023
$9,440
Ownership & Operations
Who Operates This Facility
Emi Health Care Center, LLC
for profit
JOE ALEXANDER
Ownership & Management
Owners
Alexander, Rainey
Owner
Key personnel
Contact
Get in Touch
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References & Resources
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
Google Maps
Photos, directions & neighborhood info
Google Reviews
7 reviews from families & visitors
Official Website
Visit distinguishedhealthcareinc.com
Medicare data downloads
Original nursing home datasets
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