Merkel Nursing Center
Nursing Home · Merkel, TX
CMS certification number676053
CMS lists this nursing home as a Special Focus Facility candidate – one of the lowest-performing nursing homes in its state based on inspection history.
This facility was cited for abuse, neglect or exploitation in a recent inspection (CMS abuse icon).
Contact & location
1704 N. 1stMerkel, TX 79536
Taylor County
- Phone
- (325) 928-5673
- ZIP code
- 79536 – all care providers
Facility details
- Certified beds
- 65
- Residents per day
- 18.7 (29% occupied)
- Ownership
- For profit - Limited Liability company
- Legal name
- Emi Healthcare LLC
- Medicare certified since
- June 1, 2005
- Participates in
- Medicare and Medicaid
CMS star ratings
Staffing
Hours of nursing care per resident per day, from payroll data. More hours generally mean more time for each resident.
- Total nurse staffing
- 3.35 (state 3.39 · U.S. 3.86)
- Registered nurses (RN)
- 0.68 (state 0.43 · U.S. 0.69)
- Licensed practical nurses
- 1.58 (state 0.95 · U.S. 0.86)
- Nurse aides
- 1.09 (state 2.00 · U.S. 2.32)
- Weekend total
- 2.52 (state 2.98 · U.S. 3.42)
- Nursing staff turnover
- 71.1 (state 55.3 · U.S. 45.8)%
- RN turnover
- —
- Administrators who left
- 0 in the last year
Inspections
- Last standard inspection
- December 4, 2025
- Health deficiencies (last cycle)
- 29.0 (state 9.3 · U.S. 9.3)
- From complaints
- 16
- Citations on record (3 years)
- 64 health · 9 fire safety · includes immediate jeopardy
| Date | Citation | Severity | Status |
|---|---|---|---|
| 2026-02-16 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. F0600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies · complaint inspection |
K Immediate jeopardy to resident health or safety |
Corrected 2026-03-04 |
| 2026-02-16 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. F0689 · Quality of Life and Care Deficiencies · complaint inspection |
K Immediate jeopardy to resident health or safety |
Corrected 2026-03-04 |
| 2026-02-16 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. F0725 · Nursing and Physician Services Deficiencies · complaint inspection |
K Immediate jeopardy to resident health or safety |
Corrected 2026-03-04 |
| 2026-02-16 | 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. F0726 · Nursing and Physician Services Deficiencies · complaint inspection |
K Immediate jeopardy to resident health or safety |
Corrected 2026-03-04 |
| 2026-02-16 | 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. F0727 · Nursing and Physician Services Deficiencies · complaint inspection |
F No actual harm, potential for more than minimal harm |
Corrected 2026-03-04 |
| 2026-02-16 | 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. F0728 · Nursing and Physician Services Deficiencies · complaint inspection |
F No actual harm, potential for more than minimal harm |
Corrected 2026-03-04 |
| 2026-02-16 | Implement a program that monitors antibiotic use. F0881 · Infection Control Deficiencies · complaint inspection |
F No actual harm, potential for more than minimal harm |
Corrected 2026-03-04 |
| 2026-02-16 | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. F0882 · Infection Control Deficiencies · complaint inspection |
F No actual harm, potential for more than minimal harm |
Corrected 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. F0867 · Administration Deficiencies |
F No actual harm, potential for more than minimal harm |
Corrected 2026-01-07 |
| 2025-12-04 | Provide safe and appropriate respiratory care for a resident when needed. F0695 · Quality of Life and Care Deficiencies |
E No actual harm, potential for more than minimal harm |
Corrected 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. F0849 · Administration Deficiencies |
E No actual harm, potential for more than minimal harm |
Corrected 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. F0909 · Environmental Deficiencies |
E No actual harm, potential for more than minimal harm |
Corrected 2026-01-07 |
| 2025-12-04 | Develop, implement, and/or maintain an effective training program for all new and existing staff members. F0940 · Administration Deficiencies |
E No actual harm, potential for more than minimal harm |
Corrected 2026-01-07 |
| 2025-12-04 | Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members. F0941 · Administration Deficiencies |
E No actual harm, potential for more than minimal harm |
Corrected 2026-01-07 |
| 2025-12-04 | Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents. F0942 · Resident Rights Deficiencies |
E No actual harm, potential for more than minimal harm |
Corrected 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. F0943 · Freedom from Abuse, Neglect, and Exploitation Deficiencies |
E No actual harm, potential for more than minimal harm |
Corrected 2026-01-07 |
| 2025-12-04 | Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program. F0944 · Administration Deficiencies |
E No actual harm, potential for more than minimal harm |
Corrected 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. F0945 · Infection Control Deficiencies |
E No actual harm, potential for more than minimal harm |
Corrected 2026-01-07 |
| 2025-12-04 | Provide behavior health training consistent with the requirements and as determined by a facility assessment. F0949 · Administration Deficiencies |
E No actual harm, potential for more than minimal harm |
Corrected 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. F0842 · Resident Assessment and Care Planning Deficiencies |
D No actual harm, potential for more than minimal harm |
Corrected 2026-01-07 |
| 2025-12-04 | Provide and implement an infection prevention and control program. F0880 · Infection Control Deficiencies |
D No actual harm, potential for more than minimal harm |
Corrected 2026-01-07 |
| 2025-08-22 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. F0689 · Quality of Life and Care Deficiencies · complaint inspection |
K Immediate jeopardy to resident health or safety |
Corrected 2025-09-01 |
| 2025-08-22 | 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. F0801 · Nutrition and Dietary Deficiencies · complaint inspection |
F No actual harm, potential for more than minimal harm |
Corrected 2025-09-25 |
| 2025-08-22 | Administer the facility in a manner that enables it to use its resources effectively and efficiently. F0835 · Administration Deficiencies · complaint inspection |
F No actual harm, potential for more than minimal harm |
Corrected 2025-09-15 |
| 2025-08-22 | 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. F0838 · Administration Deficiencies · complaint inspection |
F No actual harm, potential for more than minimal harm |
Corrected 2025-09-16 |
| 2025-08-22 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. F0607 · Freedom from Abuse, Neglect, and Exploitation Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2025-09-17 |
| 2025-08-22 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. F0609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2025-09-17 |
| 2025-08-22 | Respond appropriately to all alleged violations. F0610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2025-09-17 |
| 2025-08-22 | Follow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel. F0844 · Administration Deficiencies · complaint inspection |
C No actual harm, potential for minimal harm |
Corrected 2025-09-18 |
| 2024-12-12 | Provide and implement an infection prevention and control program. F0880 · Infection Control Deficiencies · complaint inspection |
D No actual harm, potential for more than minimal harm |
Corrected 2025-01-01 |
| 2024-10-17 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. F0580 · Resident Rights Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-11-08 |
| 2024-10-17 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. F0656 · Resident Assessment and Care Planning Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-11-08 |
| 2024-10-17 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. F0842 · Resident Assessment and Care Planning Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-11-08 |
| 2024-10-17 | Have policies on smoking. F0926 · Environmental Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-11-08 |
| 2024-10-17 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted F0655 · Resident Assessment and Care Planning Deficiencies · complaint inspection |
D No actual harm, potential for more than minimal harm |
Corrected 2024-11-08 |
| 2024-10-17 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. F0657 · Resident Assessment and Care Planning Deficiencies · complaint inspection |
D No actual harm, potential for more than minimal harm |
Corrected 2024-11-08 |
| 2024-07-31 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly F0868 · Administration Deficiencies · complaint inspection |
F No actual harm, potential for more than minimal harm |
Corrected 2024-09-15 |
| 2024-07-31 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. F0550 · Resident Rights Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-09-01 |
| 2024-07-31 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. F0656 · Resident Assessment and Care Planning Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-09-01 |
| 2024-07-31 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. F0689 · Quality of Life and Care Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-09-05 |
| 2024-07-31 | Provide safe and appropriate respiratory care for a resident when needed. F0695 · Quality of Life and Care Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-09-05 |
| 2024-07-31 | 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. F0728 · Nursing and Physician Services Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-09-15 |
| 2024-07-31 | 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. F0803 · Nutrition and Dietary Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-09-02 |
| 2024-07-31 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. F0812 · Nutrition and Dietary Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-09-02 |
| 2024-07-31 | Provide and implement an infection prevention and control program. F0880 · Infection Control Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-09-02 |
| 2024-07-31 | 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. F0909 · Environmental Deficiencies · complaint inspection |
E No actual harm, potential for more than minimal harm |
Corrected 2024-08-20 |
| 2024-07-31 | Reasonably accommodate the needs and preferences of each resident. F0558 · Resident Rights Deficiencies · complaint inspection |
D No actual harm, potential for more than minimal harm |
Corrected 2024-09-01 |
| 2024-07-31 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. F0607 · Freedom from Abuse, Neglect, and Exploitation Deficiencies · complaint inspection |
D No actual harm, potential for more than minimal harm |
Corrected 2024-09-15 |
| 2024-07-31 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. F0686 · Quality of Life and Care Deficiencies · complaint inspection |
D No actual harm, potential for more than minimal harm |
Corrected 2024-09-01 |
| 2024-07-31 | Ensure residents have reasonable access to and privacy in their use of communication methods. F0576 · Resident Rights Deficiencies · complaint inspection |
C No actual harm, potential for minimal harm |
Corrected 2024-08-31 |
Severity letters A–L combine how widespread a problem was (isolated, pattern, widespread) with how serious (from potential for minimal harm to immediate jeopardy). How to read inspection results
Fines & penalties
2 penalties in the last three years, including $318,060 in fines.
| Date | Type | Amount |
|---|---|---|
| 2026-02-16 | Fine | $137,108 |
| 2025-08-22 | Fine | $180,952 |
Ownership & management
| Name | Role | Since |
|---|---|---|
| Alexander, Joe (individual) | Administrator · NOT APPLICABLE | |
| Martinez Irizarry, Axel (individual) | Administrator · NOT APPLICABLE | |
| Stroh Properties LP (organization) | Administrator · NOT APPLICABLE | |
| Stroh, Clarence (individual) | Administrator · NOT APPLICABLE | |
| Alexander, Rainey (individual) | Direct Ownership Interest · NOT APPLICABLE | |
| Alexander, Rainey (individual) | Operational/managerial Control · NOT APPLICABLE |
Frequently asked questions
What is the rating of Merkel Nursing Center?
Merkel Nursing Center has a 1-star overall rating from the Centers for Medicare & Medicaid Services on a scale of 1 to 5, compared with a 2.6-star average in Texas.
How many beds does Merkel Nursing Center have?
It has 65 certified beds and cares for about 19 residents per day.
Has Merkel Nursing Center been fined?
Yes. CMS lists 2 penalties totaling $318,060 in the last three years.
What is the phone number of Merkel Nursing Center?
(325) 928-5673. The facility is located at 1704 N. 1st, Merkel, TX 79536.
Source: CMS Care Compare, August 2026. Information is provided as published by CMS; verify details directly with the facility.