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Nursing HomeMedicaid Investigative

Merkel Nursing Center

On Medicare Special Focus status, a serious quality warning. Visit in person and ask tough questions before deciding.

1704 N. 1st, Merkel, TX 7953666 bedsLicensed & Active
1/5
Medicare
Inspection
Quality
Staffing
Google rating
3.9/5

based on 7 Google reviews

5
4
3
2
1
Merkel Nursing Center Nursing Home in Merkel, TX — Street View
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4/ 10
moderate Risk

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

Source: Medicare data

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

2343.02019(2)5.02020(1)5.02021(2)4.02022(1)1.02023(1)4.02026(1)

Distribution

5
3
4
2
3
1
2
0
1
1

How They Respond to Reviews

0%response rate

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

Source: 7 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.48hrs
64%
Registered nurses for medical care
Total Nursing
3.18hrs
78%
All nurses + aides combined
Staff Turnover
65%
Lower is better (< 30% = good)
RN Turnover
60%
Lower is better (< 30% = good)

Both 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

Medicare Rating
1/ 5
Better Than Avg

4

measures

Worse Than Avg

7

measures

Mixed Results

3

measures

Long-Stay Residents
💊

Residents on antipsychotic medication

↓ Lower is better
This Facility22.1%
Worse than Avg
Here
22.1%
US
15.4%
TX
9.4%
Taylor
13.3%
🩹

Residents with pressure sores (bedsores)

↓ Lower is better
This Facility14.8%
Worse than Avg
Here
14.8%
US
4.9%
TX
4.0%
Taylor
4.6%
🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility9.4%
Better than Avg
Here
9.4%
US
19.4%
TX
14.2%
Taylor
19.0%
🦠

Residents who got a urinary tract infection

↓ Lower is better
This Facility10.5%
Worse than Avg
Here
10.5%
US
1.6%
TX
0.8%
Taylor
1.3%
😔

Residents with depression symptoms

↓ Lower is better
This Facility6.9%
Mixed vs Avgs
Here
6.9%
US
12.1%
TX
2.5%
Taylor
5.7%
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility98.3%
Better than Avg
Here
98.3%
US
93.4%
TX
96.9%
Taylor
97.7%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

29deficiencies
5penalties
Well above state avg (9.1)
51 complaint-triggered
$291,592 in fines

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, 2026Complaint
8
0600SevereCorrected

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.

0689SevereCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0725SevereCorrected

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.

0726SevereCorrected

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.

0727ModerateCorrected

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.

0728ModerateCorrected

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.

0881ModerateCorrected

Infection Control Deficiencies

Implement a program that monitors antibiotic use.

0882ModerateCorrected

Infection Control Deficiencies

Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.

Dec 4, 2025Routine
18
0867ModerateCorrected

Administration Deficiencies

Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.

0695ModerateCorrected

Quality of Life and Care Deficiencies

Provide safe and appropriate respiratory care for a resident when needed.

0849ModerateCorrected

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.

0909ModerateCorrected

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.

0940ModerateCorrected

Administration Deficiencies

Develop, implement, and/or maintain an effective training program for all new and existing staff members.

0941ModerateCorrected

Administration Deficiencies

Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.

0942ModerateCorrected

Resident Rights Deficiencies

Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.

0943ModerateCorrected

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.

0944ModerateCorrected

Administration Deficiencies

Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.

0945ModerateCorrected

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.

0949ModerateCorrected

Administration Deficiencies

Provide behavior health training consistent with the requirements and as determined by a facility assessment.

0211ModerateCorrected

Egress Deficiencies

Keep aisles, corridors, and exits free of obstruction in case of emergency.

0321ModerateCorrected

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

0511ModerateCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

0923ModerateCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have proper medical gas storage and administration areas.

0842MinorCorrected

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.

0880MinorCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0521MinorCorrected

Services Deficiencies

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Aug 22, 2025Complaint
8
0689SevereCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0801ModerateCorrected

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.

0835ModerateCorrected

Administration Deficiencies

Administer the facility in a manner that enables it to use its resources effectively and efficiently.

0838ModerateCorrected

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.

0607ModerateCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

0609ModerateCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

0610ModerateCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

0844MinorCorrected

Administration Deficiencies

Follow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel.

Dec 12, 2024Complaint
1
0880MinorCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

Oct 17, 2024Complaint
6
0580ModerateCorrected

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.

0656ModerateCorrected

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.

0842ModerateCorrected

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.

0926ModerateCorrected

Environmental Deficiencies

Have policies on smoking.

0655MinorCorrected

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

0657MinorCorrected

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, 2024Complaint
19
0868ModerateCorrected

Administration Deficiencies

Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

0550ModerateCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

0656ModerateCorrected

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.

0689ModerateCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0695ModerateCorrected

Quality of Life and Care Deficiencies

Provide safe and appropriate respiratory care for a resident when needed.

0728ModerateCorrected

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.

0803ModerateCorrected

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.

0812ModerateCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0880ModerateCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0909ModerateCorrected

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.

0558MinorCorrected

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

0607MinorCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

0686MinorCorrected

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

0576MinorCorrected

Resident Rights Deficiencies

Ensure residents have reasonable access to and privacy in their use of communication methods.

0680MinorCorrected

Quality of Life and Care Deficiencies

Ensure the activities program is directed by a qualified professional.

0732MinorCorrected

Nursing and Physician Services Deficiencies

Post nurse staffing information every day.

0941MinorCorrected

Administration Deficiencies

Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.

0944MinorCorrected

Administration Deficiencies

Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.

0949MinorCorrected

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

Owner / Operator

Emi Health Care Center, LLC

Organization Type

for profit

Administrator

JOE ALEXANDER

Ownership & Management

Owners

Alexander, Rainey

Owner

Key personnel

Alexander, RaineyManagerStroh Properties LpAdp of the SnfAlexander, JoeAdp of the SnfMartinez Irizarry, AxelAdp of the SnfStroh, ClarenceAdp of the Snf
Source: Medicare provider data

Contact

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References & Resources

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