Facility WatchInspection records for every certified US nursing home
Merkel Nursing Center
1704 N 1st Merkel, TX 79536 (325) 928-5673
Special Focus Facility — SFF CandidateAbuse icon
CCN
676053
Certified beds
65
Ownership
For profit - Limited Liability company
Nurse staffing
3.69
Total nurse staffing hours per resident per day, case-mix adjusted
Registered nurses: 0.55 hours per resident per day
Nursing staff turnover: 65% a year
Derived by CMS from the Payroll-Based Journal and refreshed quarterly.
Inspection history
Inspected February 16, 2026
8 citations · from a complaint investigation · Health
F
F0727No actual harm with potential for more than minimal harm · Widespread
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.
Deficient, Provider has date of correction · corrected March 4, 2026
F
F0728No actual harm with potential for more than minimal harm · Widespread
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.
Deficient, Provider has date of correction · corrected March 4, 2026
F
F0881No actual harm with potential for more than minimal harm · Widespread
Implement a program that monitors antibiotic use.
Deficient, Provider has date of correction · corrected March 4, 2026
F
F0882No actual harm with potential for more than minimal harm · Widespread
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Deficient, Provider has date of correction · corrected March 4, 2026
K
F0600Immediate jeopardy to resident health or safety · Pattern
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Deficient, Provider has date of correction · corrected March 4, 2026
K
F0689Immediate jeopardy to resident health or safety · Pattern
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Deficient, Provider has date of correction · corrected March 4, 2026
K
F0725Immediate jeopardy to resident health or safety · Pattern
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Deficient, Provider has date of correction · corrected March 4, 2026
K
F0726Immediate jeopardy to resident health or safety · Pattern
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.
Deficient, Provider has date of correction · corrected March 4, 2026
Inspected December 4, 2025
13 citations · Health
D
F0842No actual harm with potential for more than minimal harm · Isolated
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Deficient, Provider has date of correction · corrected January 7, 2026
D
F0880No actual harm with potential for more than minimal harm · Isolated
Provide and implement an infection prevention and control program.
Deficient, Provider has date of correction · corrected January 7, 2026
E
F0695No actual harm with potential for more than minimal harm · Pattern
Provide safe and appropriate respiratory care for a resident when needed.
Deficient, Provider has date of correction · corrected January 7, 2026
E
F0849No actual harm with potential for more than minimal harm · Pattern
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.
Deficient, Provider has date of correction · corrected January 7, 2026
E
F0909No actual harm with potential for more than minimal harm · Pattern
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.
Deficient, Provider has date of correction · corrected January 7, 2026
E
F0940No actual harm with potential for more than minimal harm · Pattern
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Deficient, Provider has date of correction · corrected January 7, 2026
E
F0941No actual harm with potential for more than minimal harm · Pattern
Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
Deficient, Provider has date of correction · corrected January 7, 2026
E
F0942No actual harm with potential for more than minimal harm · Pattern
Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.
Deficient, Provider has date of correction · corrected January 7, 2026
E
F0943No actual harm with potential for more than minimal harm · Pattern
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Deficient, Provider has date of correction · corrected January 7, 2026
E
F0944No actual harm with potential for more than minimal harm · Pattern
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Deficient, Provider has date of correction · corrected January 7, 2026
E
F0945No actual harm with potential for more than minimal harm · Pattern
Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.
Deficient, Provider has date of correction · corrected January 7, 2026
E
F0949No actual harm with potential for more than minimal harm · Pattern
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Deficient, Provider has date of correction · corrected January 7, 2026
F
F0867No actual harm with potential for more than minimal harm · Widespread
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Deficient, Provider has date of correction · corrected January 7, 2026
Inspected August 22, 2025
8 citations · from a complaint investigation · Health
C
F0844No actual harm with potential for minimal harm · Widespread
Follow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel.
Deficient, Provider has date of correction · corrected September 18, 2025
E
F0607No actual harm with potential for more than minimal harm · Pattern
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Deficient, Provider has date of correction · corrected September 17, 2025
E
F0609No actual harm with potential for more than minimal harm · Pattern
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Deficient, Provider has date of correction · corrected September 17, 2025
E
F0610No actual harm with potential for more than minimal harm · Pattern
Respond appropriately to all alleged violations.
Deficient, Provider has date of correction · corrected September 17, 2025
F
F0801No actual harm with potential for more than minimal harm · Widespread
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.
Deficient, Provider has date of correction · corrected September 25, 2025
F
F0835No actual harm with potential for more than minimal harm · Widespread
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Deficient, Provider has date of correction · corrected September 15, 2025
F
F0838No actual harm with potential for more than minimal harm · Widespread
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.
Deficient, Provider has date of correction · corrected September 16, 2025
K
F0689Immediate jeopardy to resident health or safety · Pattern
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Deficient, Provider has date of correction · corrected September 1, 2025
Inspected December 12, 2024
1 citation · from a complaint investigation · Health
D
F0880No actual harm with potential for more than minimal harm · Isolated
Provide and implement an infection prevention and control program.
Deficient, Provider has date of correction · corrected January 1, 2025
Inspected October 17, 2024
6 citations · from a complaint investigation · Health
D
F0655No actual harm with potential for more than minimal harm · Isolated
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Deficient, Provider has date of correction · corrected November 8, 2024
D
F0657No actual harm with potential for more than minimal harm · Isolated
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Deficient, Provider has date of correction · corrected November 8, 2024
E
F0580No actual harm with potential for more than minimal harm · Pattern
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Deficient, Provider has date of correction · corrected November 8, 2024
E
F0656No actual harm with potential for more than minimal harm · Pattern
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Deficient, Provider has date of correction · corrected November 8, 2024
E
F0842No actual harm with potential for more than minimal harm · Pattern
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Deficient, Provider has date of correction · corrected November 8, 2024
E
F0926No actual harm with potential for more than minimal harm · Pattern
Have policies on smoking.
Deficient, Provider has date of correction · corrected November 8, 2024
Inspected July 31, 2024
19 citations · from a complaint investigation · Health
B
F0732No actual harm with potential for minimal harm · Pattern
Post nurse staffing information every day.
Deficient, Provider has date of correction · corrected September 5, 2024
B
F0941No actual harm with potential for minimal harm · Pattern
Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
Deficient, Provider has date of correction · corrected September 5, 2024
B
F0944No actual harm with potential for minimal harm · Pattern
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Deficient, Provider has date of correction · corrected September 5, 2024
B
F0949No actual harm with potential for minimal harm · Pattern
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Deficient, Provider has date of correction · corrected September 5, 2024
C
F0576No actual harm with potential for minimal harm · Widespread
Ensure residents have reasonable access to and privacy in their use of communication methods.
Deficient, Provider has date of correction · corrected August 31, 2024
C
F0680No actual harm with potential for minimal harm · Widespread
Ensure the activities program is directed by a qualified professional.
Deficient, Provider has date of correction · corrected August 19, 2024
D
F0558No actual harm with potential for more than minimal harm · Isolated
Reasonably accommodate the needs and preferences of each resident.
Deficient, Provider has date of correction · corrected September 1, 2024
D
F0607No actual harm with potential for more than minimal harm · Isolated
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Deficient, Provider has date of correction · corrected September 15, 2024
D
F0686No actual harm with potential for more than minimal harm · Isolated
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Deficient, Provider has date of correction · corrected September 1, 2024
E
F0550No actual harm with potential for more than minimal harm · Pattern
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Deficient, Provider has date of correction · corrected September 1, 2024
E
F0656No actual harm with potential for more than minimal harm · Pattern
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Deficient, Provider has date of correction · corrected September 1, 2024
E
F0689No actual harm with potential for more than minimal harm · Pattern
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Deficient, Provider has date of correction · corrected September 5, 2024
E
F0695No actual harm with potential for more than minimal harm · Pattern
Provide safe and appropriate respiratory care for a resident when needed.
Deficient, Provider has date of correction · corrected September 5, 2024
E
F0728No actual harm with potential for more than minimal harm · Pattern
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.
Deficient, Provider has date of correction · corrected September 15, 2024
E
F0803No actual harm with potential for more than minimal harm · Pattern
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.
Deficient, Provider has date of correction · corrected September 2, 2024
E
F0812No actual harm with potential for more than minimal harm · Pattern
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Deficient, Provider has date of correction · corrected September 2, 2024
E
F0880No actual harm with potential for more than minimal harm · Pattern
Provide and implement an infection prevention and control program.
Deficient, Provider has date of correction · corrected September 2, 2024
E
F0909No actual harm with potential for more than minimal harm · Pattern
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.
Deficient, Provider has date of correction · corrected August 20, 2024
F
F0868No actual harm with potential for more than minimal harm · Widespread
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Deficient, Provider has date of correction · corrected September 15, 2024
Inspected December 15, 2023
1 citation · from a complaint investigation · Health
E
F0908No actual harm with potential for more than minimal harm · Pattern
Keep all essential equipment working safely.
Deficient, Provider has date of correction · corrected December 20, 2023
Inspected June 8, 2023
8 citations · from a complaint investigation · Health
E
F0558No actual harm with potential for more than minimal harm · Pattern
Reasonably accommodate the needs and preferences of each resident.
Deficient, Provider has date of correction · corrected July 7, 2023
E
F0567No actual harm with potential for more than minimal harm · Pattern
Honor the resident's right to manage his or her financial affairs.
Deficient, Provider has date of correction · corrected July 7, 2023
E
F0711No actual harm with potential for more than minimal harm · Pattern
Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
Deficient, Provider has date of correction · corrected July 7, 2023
E
F0727No actual harm with potential for more than minimal harm · Pattern
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.
Deficient, Provider has date of correction · corrected July 7, 2023
E
F0761No actual harm with potential for more than minimal harm · Pattern
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.
Deficient, Provider has date of correction · corrected July 7, 2023
E
F0812No actual harm with potential for more than minimal harm · Pattern
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Deficient, Provider has date of correction · corrected July 7, 2023
E
F0868No actual harm with potential for more than minimal harm · Pattern
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Deficient, Provider has date of correction · corrected July 7, 2023
E
F0880No actual harm with potential for more than minimal harm · Pattern
Provide and implement an infection prevention and control program.
Deficient, Provider has date of correction · corrected July 7, 2023
Penalties
Date
Type
Amount
February 16, 2026
Fine
$210,935
August 22, 2025
Fine
$178,172
June 26, 2023
Fine
$4,196
June 20, 2023
Fine
$3,846
Ownership transfers
Effective
Seller
Buyer
01/01/2022
Distinguished Health Care Inc.
EMI Healthcare LLC
From the CMS Skilled Nursing Facility Change of Ownership dataset. A sale does not by itself say anything about care quality.