Nursing Care Index

Merkel Nursing Center

Merkel, Taylor County, Texas · CCN 676053 · For-profit (LLC) · not part of a chain

CMS rates Merkel Nursing Center 1 of 5 overall as of August 2026. 65 certified beds, 19 residents a day on average. 64 citations on record from the current inspection cycles, 5 at immediate jeopardy; 2 fines totalling $318,060.

On record

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★☆☆☆☆ 1 of 5
Health inspections★☆☆☆☆ 1 of 5
Staffing★★★☆☆ 3 of 5
Quality measures★☆☆☆☆ 1 of 5
Quality: long-stay / short-stay1 / — of 5

Staffing

Total nurse staffing3.34902 hours per resident per day
Registered nurses0.68327 hours per resident per day
Weekend total2.51782 hours per resident per day
Nursing staff turnover71.1%
Administrators who left0

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2026-02-16
complaint survey
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0600
K Immediate jeopardy to resident health or safety; pattern Deficient, Provider has date of correction
2026-03-04
2026-02-16
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
K Immediate jeopardy to resident health or safety; pattern Deficient, Provider has date of correction
2026-03-04
2026-02-16
complaint survey
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 · tag F0725
K Immediate jeopardy to resident health or safety; pattern Deficient, Provider has date of correction
2026-03-04
2026-02-16
complaint survey
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 · tag F0726
K Immediate jeopardy to resident health or safety; pattern Deficient, Provider has date of correction
2026-03-04
2026-02-16
complaint survey
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 · tag F0727
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2026-03-04
2026-02-16
complaint survey
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.
Nursing and Physician Services Deficiencies · tag F0728
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2026-03-04
2026-02-16
complaint survey
Implement a program that monitors antibiotic use.
Infection Control Deficiencies · tag F0881
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2026-03-04
2026-02-16
complaint survey
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Infection Control Deficiencies · tag F0882
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2026-03-04
2025-12-04 Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Administration Deficiencies · tag F0867
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2026-01-07
2025-12-04 Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-07
2025-12-04 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.
Administration Deficiencies · tag F0849
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-07
2025-12-04 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.
Environmental Deficiencies · tag F0909
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-07
2025-12-04 Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Administration Deficiencies · tag F0940
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-07
2025-12-04 Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
Administration Deficiencies · tag F0941
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-07
2025-12-04 Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.
Resident Rights Deficiencies · tag F0942
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-07
2025-12-04 Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0943
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-07
2025-12-04 Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Administration Deficiencies · tag F0944
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-07
2025-12-04 Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.
Infection Control Deficiencies · tag F0945
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-07
2025-12-04 Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Administration Deficiencies · tag F0949
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-07
2025-12-04 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-01-07
2025-12-04 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-01-07
2025-08-22
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
K Immediate jeopardy to resident health or safety; pattern Deficient, Provider has date of correction
2025-09-01
2025-08-22
complaint survey
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.
Nutrition and Dietary Deficiencies · tag F0801
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-09-25
2025-08-22
complaint survey
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Administration Deficiencies · tag F0835
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-09-15
2025-08-22
complaint survey
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.
Administration Deficiencies · tag F0838
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-09-16
2025-08-22
complaint survey
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0607
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-09-17
2025-08-22
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-09-17
2025-08-22
complaint survey
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-09-17
2025-08-22
complaint survey
Follow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel.
Administration Deficiencies · tag F0844
C No actual harm, with potential for minimal harm; widespread Deficient, Provider has date of correction
2025-09-18
2024-12-12
complaint survey
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-01-01
2024-10-17
complaint survey
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights Deficiencies · tag F0580
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-08
2024-10-17
complaint survey
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 · tag F0656
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-08
2024-10-17
complaint survey
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-08
2024-10-17
complaint survey
Have policies on smoking.
Environmental Deficiencies · tag F0926
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-08
2024-10-17
complaint survey
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 · tag F0655
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-11-08
2024-10-17
complaint survey
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies · tag F0657
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-11-08
2024-07-31
complaint survey
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Administration Deficiencies · tag F0868
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-09-15
2024-07-31
complaint survey
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-01
2024-07-31
complaint survey
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 · tag F0656
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-01
2024-07-31
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-05
2024-07-31
complaint survey
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-05
2024-07-31
complaint survey
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.
Nursing and Physician Services Deficiencies · tag F0728
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-15
2024-07-31
complaint survey
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 · tag F0803
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-02
2024-07-31
complaint survey
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-02
2024-07-31
complaint survey
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-02
2024-07-31
complaint survey
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.
Environmental Deficiencies · tag F0909
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-08-20
2024-07-31
complaint survey
Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies · tag F0558
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-01
2024-07-31
complaint survey
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0607
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-15
2024-07-31
complaint survey
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-01
2024-07-31
complaint survey
Ensure residents have reasonable access to and privacy in their use of communication methods.
Resident Rights Deficiencies · tag F0576
C No actual harm, with potential for minimal harm; widespread Deficient, Provider has date of correction
2024-08-31
2024-07-31
complaint survey
Ensure the activities program is directed by a qualified professional.
Quality of Life and Care Deficiencies · tag F0680
C No actual harm, with potential for minimal harm; widespread Deficient, Provider has date of correction
2024-08-19
2024-07-31
complaint survey
Post nurse staffing information every day.
Nursing and Physician Services Deficiencies · tag F0732
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2024-09-05
2024-07-31
complaint survey
Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
Administration Deficiencies · tag F0941
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2024-09-05
2024-07-31
complaint survey
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Administration Deficiencies · tag F0944
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2024-09-05
2024-07-31
complaint survey
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Administration Deficiencies · tag F0949
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2024-09-05
2023-12-15
complaint survey
Keep all essential equipment working safely.
Environmental Deficiencies · tag F0908
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-12-20
2023-06-08 Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies · tag F0558
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-07
2023-06-08 Honor the resident's right to manage his or her financial affairs.
Resident Rights Deficiencies · tag F0567
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-07
2023-06-08 Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
Nursing and Physician Services Deficiencies · tag F0711
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-07
2023-06-08 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 · tag F0727
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-07
2023-06-08 Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Pharmacy Service Deficiencies · tag F0761
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-07
2023-06-08 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-07
2023-06-08 Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Administration Deficiencies · tag F0868
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-07
2023-06-08 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-07

Fines and payment denials

DatePenaltyAmount
2026-02-16Fine$137,108
2025-08-22Fine$180,952

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

NameRoleShareSince
Stroh Properties Lp
Organization
adp of the snf2022-01-01
Alexander, Joe
Individual
adp of the snf2022-01-01
Martinez Irizarry, Axel
Individual
adp of the snf2025-01-01
Stroh, Clarence
Individual
adp of the snf2022-01-01
Alexander, Rainey
Individual
direct ownership interest2022-01-01
Alexander, Rainey
Individual
operational/managerial control2022-01-01

What changed

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Taylor County.