21 health deficiencies
Top issue: Administration (9 deficiencies)
5 fire-safety deficiencies
Top issue: Services (2 deficiencies)
Merkel, TX
1-star overall rating with 1-star inspections with $291,592 in total fines with 21 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
1704 N 1st, Merkel, TX
(325) 928-5673
Overall
1 / 5
CMS overall stars
Health inspections
1 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
1 / 5
Resident outcomes and process measures
Quick facts
Beds
65
Certified beds
Average residents
27
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
2005-06-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Changed ownership
No
Within the last 12 months
Family council
No
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
RN hours / resident day
0.44
Registered nurse staffing · state 0.44 · national 0.68
LPN hours / resident day
1.31
Licensed practical nurse staffing · state 0.95 · national 0.87
Aide hours / resident day
2.04
Nurse aide staffing · state 2.01 · national 2.35
Total nurse hours
3.78
All reported nurse hours · state 3.40 · national 3.89
Licensed hours
1.75
RN + LPN hours · state 1.38 · national 1.54
Weekend hours
3.20
Weekend nurse staffing · state 2.99 · national 3.43
Weekend RN hours
0.34
Weekend registered nurse coverage · state 0.34 · national 0.47
Physical therapist
0.00
Reported PT staffing
Adjusted RN hours
0.53
CMS adjusted RN staffing hours
Adjusted total hours
4.55
CMS adjusted total nurse staffing hours
Case-mix index
1.14
Higher values indicate more complex resident acuity
RN turnover
40%
Annual RN turnover · state 52% · national 45%
Total nurse turnover
61%
Annual nurse turnover · state 52% · national 46%
SNF VBP
Program rank
11,718
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
15.60
Composite VBP score used to determine payment impact.
Payment multiplier
0.9815
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
Readmission
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Healthcare-associated infections
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Total nurse turnover
0
Baseline 58.97% · Performance 74.00% · Measure score 0 · Achievement 0 · Improvement 0
Adjusted total nurse staffing
3.12
Baseline 4.18 hours · Performance 3.97 hours · Measure score 3.12 · Achievement 3.12 · Improvement 0
SNF QRP
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | Not Available |
10.72%
|
Not Available · Eligible stays 18 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Discharge to community | Not Available |
50.57%
|
Not Available · Eligible stays 4 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Medicare spending per beneficiary | 1.35 |
1.02
0.3 pts worse
|
|
| Drug regimen review with follow-up | Not Available |
95.27%
|
Numerator Not Available · Denominator 5 · Too few residents or stays to report publicly. |
| Falls with major injury | Not Available |
0.77%
|
Numerator Not Available · Denominator 5 · Too few residents or stays to report publicly. |
| Discharge self-care score | Not Available |
53.69%
|
Numerator Not Available · Denominator 4 · Too few residents or stays to report publicly. |
| Discharge mobility score | Not Available |
50.94%
|
Numerator Not Available · Denominator 4 · Too few residents or stays to report publicly. |
| Pressure ulcers or injuries, new or worsened | Not Available |
2.29%
|
Numerator Not Available · Denominator 5 · Adjusted rate Not Available · Too few residents or stays to report publicly. |
| Healthcare-associated infections requiring hospitalization | Not Available |
7.12%
|
Not Available · Eligible stays 8 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 46 |
| Staff flu vaccination coverage | Not Available |
42%
|
Numerator Not Available · Denominator Not Available · No data were submitted for this measure. |
| Discharge function score | Not Available |
56.45%
|
Numerator Not Available · Denominator 4 · Too few residents or stays to report publicly. |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 1 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator Not Available · Newly certified or not enough cases to report. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 4 · Too few residents or stays to report publicly. |
Quality measures
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 4.9 |
2.1
2.8 pts worse
|
1.9
3 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 4.9 · Observed 3.2 · Expected 1.2 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 2.7 |
2.1
0.6 pts worse
|
1.8
0.9 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.7 · Observed 2.3 · Expected 1.4 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 99.2% |
97.1%
2.1 pts better
|
93.4%
5.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 96.6% · 4Q avg 99.2% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
97.9%
2.1 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 7.4% |
3.3%
4.1 pts worse
|
3.3%
4.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 6.2% · Q2 9.4% · Q3 6.9% · Q4 6.9% · 4Q avg 7.4% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 3.6% |
2.7%
0.9 pts worse
|
11.4%
7.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 3.6% · Q4 11.1% · 4Q avg 3.6% |
| Percentage of long-stay residents who lose too much weight | 10.1% |
3.3%
6.8 pts worse
|
5.4%
4.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 14.8% · Q2 10.7% · Q3 8.7% · Q4 4.8% · 4Q avg 10.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 25.0% |
18.9%
6.1 pts worse
|
19.6%
5.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 30.0% · Q2 28.6% · Q3 29.2% · Q4 9.1% · 4Q avg 25.0% |
| Percentage of long-stay residents who received an antipsychotic medication | 21.3% |
10.8%
10.5 pts worse
|
16.7%
4.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 20.0% · Q2 26.1% · Q3 18.2% · 4Q avg 21.3% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.0%
About the same
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 9.2% |
15.4%
6.2 pts better
|
16.3%
7.1 pts better
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 9.2% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 13.7% |
16.1%
2.4 pts better
|
14.9%
1.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 13.3% · Q2 7.7% · Q3 8.3% · Q4 27.3% · 4Q avg 13.7% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.6% |
0.5%
0.1 pts worse
|
1.0%
0.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.2% · Q3 0.0% · Q4 0.0% · 4Q avg 0.6% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 8.5% |
0.8%
7.7 pts worse
|
1.7%
6.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 9.4% · Q3 7.1% · Q4 17.9% · 4Q avg 8.5% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 7.1% |
15.0%
7.9 pts better
|
19.8%
12.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 12.4% · Q3 9.4% · Q4 6.0% · 4Q avg 7.1% |
| Percentage of long-stay residents with pressure ulcers | 11.5% |
4.2%
7.3 pts worse
|
5.1%
6.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 6.6% · Q2 6.3% · Q3 13.7% · Q4 20.2% · 4Q avg 11.5% · Used in QM five-star |
Survey summary
Top issue: Administration (9 deficiencies)
5 fire-safety deficiencies
Top issue: Services (2 deficiencies)
Top issue: Resident Assessment and Care Planning (5 deficiencies)
3 fire-safety deficiencies
Top issue: Emergency Preparedness (1 deficiency)
Top issue: Nursing and Physician Services (2 deficiencies)
1 fire-safety deficiencies
Top issue: Services (1 deficiency)
Fire safety
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2026-01-31
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2026-01-31
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2026-01-31
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2026-01-31
Fire Safety
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Corrected 2026-01-12
Fire Safety
Conduct testing and exercise requirements.
Corrected 2024-09-30
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2024-10-01
Fire Safety
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Corrected 2024-10-01
Fire Safety
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Corrected 2023-07-09
Inspection history
Health
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Corrected 2026-01-07
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2026-01-07
Health
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.
Corrected 2026-01-07
Health
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.
Corrected 2026-01-07
Health
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Corrected 2026-01-07
Health
Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
Corrected 2026-01-07
Health
Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.
Corrected 2026-01-07
Health
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Corrected 2026-01-07
Health
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Corrected 2026-01-07
Health
Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.
Corrected 2026-01-07
Health
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Corrected 2026-01-07
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2026-01-07
Health
Provide and implement an infection prevention and control program.
Corrected 2026-01-07
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2025-09-01
Health
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.
Corrected 2025-09-25
Health
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Corrected 2025-09-15
Health
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.
Corrected 2025-09-16
Health
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected 2025-09-17
Health
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2025-09-17
Health
Respond appropriately to all alleged violations.
Corrected 2025-09-17
Health
Follow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel.
Corrected 2025-09-18
Health
Provide and implement an infection prevention and control program.
Corrected 2025-01-01
Health
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected 2024-11-08
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2024-11-08
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2024-11-08
Health
Have policies on smoking.
Corrected 2024-11-08
Health
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected 2024-11-08
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2024-11-08
Health
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Corrected 2024-09-15
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2024-09-01
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2024-09-01
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-09-05
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2024-09-05
Health
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.
Corrected 2024-09-15
Health
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.
Corrected 2024-09-02
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2024-09-02
Health
Provide and implement an infection prevention and control program.
Corrected 2024-09-02
Health
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.
Corrected 2024-08-20
Health
Reasonably accommodate the needs and preferences of each resident.
Corrected 2024-09-01
Health
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected 2024-09-15
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2024-09-01
Health
Ensure residents have reasonable access to and privacy in their use of communication methods.
Corrected 2024-08-31
Health
Ensure the activities program is directed by a qualified professional.
Corrected 2024-08-19
Health
Post nurse staffing information every day.
Corrected 2024-09-05
Health
Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
Corrected 2024-09-05
Health
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Corrected 2024-09-05
Health
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Corrected 2024-09-05
Health
Keep all essential equipment working safely.
Corrected 2023-12-20
Health
Reasonably accommodate the needs and preferences of each resident.
Corrected 2023-07-07
Health
Honor the resident's right to manage his or her financial affairs.
Corrected 2023-07-07
Health
Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
Corrected 2023-07-07
Health
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.
Corrected 2023-07-07
Health
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.
Corrected 2023-07-07
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2023-07-07
Health
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Corrected 2023-07-07
Health
Provide and implement an infection prevention and control program.
Corrected 2023-07-07
Penalties and ownership
Fine · fine $274,110
Fine
Fine · fine $4,196
Fine
Fine · fine $3,846
Fine
Fine · fine $9,440
Fine
Operational/Managerial Control · Individual
Nearby options
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Abilene, TX
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