Merkel Nursing Center
1704 N 1st · Merkel, TX · 79536 · 3259285673
65 certified beds For profit - Limited Liability company
Why this verdict
- Carries CMS’s abuse warning icon.
- Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (5 citations).
- Inspection record is far worse than the national median (deficiency count and severity).
- Federal penalties on record: $389,107 in fines in the last 24 months.
Red flags
Special Focus Facility candidate
CMS lists this facility as a candidate for its Special Focus program for persistently poor inspection performance.
CMS abuse warning
CMS flags this facility with its abuse icon: cited for abuse that caused harm in the past year, or potential harm in the past two years.
5 immediate-jeopardy citations in the most recent inspection cycle
Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.
1 abuse-related citation at the actual-harm level
Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.
$389,107 in federal fines in the last 24 months
2 fines — CMS fines are reserved for verified, serious non-compliance.
65% of nursing staff left within a year
High turnover disrupts continuity of care; the national median is 45%.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 1 of 5 Inspections: 1 of 5 Staffing: 2 of 5 Quality measures: 1 of 5
| Total nurse hours / resident-day | 3.18 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.48 | 0.55–0.75 |
| Weekend hours / resident-day | 2.50 | ≈ weekday level |
| Nursing turnover / year | 65% | median 45% |
| Fines (3-yr window) | 4 · $397,149 |
Inspection citations (64 in the current record)
-
Immediate jeopardy · K February 16, 2026 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected March 4, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Immediate jeopardy · K February 16, 2026 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected March 4, 2026 · Quality of Life and Care
-
Immediate jeopardy · K February 16, 2026 · found via complaint
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected March 4, 2026 · Nursing and Physician Services
-
Immediate jeopardy · K February 16, 2026 · found via complaint
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.
Corrected March 4, 2026 · Nursing and Physician Services
-
Potential for harm · F February 16, 2026 · found via complaint
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 March 4, 2026 · Nursing and Physician Services
-
Potential for harm · F February 16, 2026 · found via complaint
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 March 4, 2026 · Nursing and Physician Services
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Potential for harm · F February 16, 2026 · found via complaint
Implement a program that monitors antibiotic use.
Corrected March 4, 2026 · Infection Control
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Potential for harm · F February 16, 2026 · found via complaint
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Corrected March 4, 2026 · Infection Control
-
Potential for harm · E December 4, 2025
Provide safe and appropriate respiratory care for a resident when needed.
Corrected January 7, 2026 · Quality of Life and Care
-
Potential for harm · D December 4, 2025
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected January 7, 2026 · Resident Assessment and Care Planning
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Potential for harm · E December 4, 2025
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 January 7, 2026 · Administration
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Potential for harm · F December 4, 2025
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Corrected January 7, 2026 · Administration
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Potential for harm · D December 4, 2025
Provide and implement an infection prevention and control program.
Corrected January 7, 2026 · Infection Control
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Potential for harm · E December 4, 2025
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 January 7, 2026 · Environmental
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Potential for harm · E December 4, 2025
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Corrected January 7, 2026 · Administration
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Potential for harm · E December 4, 2025
Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
Corrected January 7, 2026 · Administration
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Potential for harm · E December 4, 2025
Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.
Corrected January 7, 2026 · Resident Rights
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Potential for harm · E December 4, 2025
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Corrected January 7, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E December 4, 2025
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Corrected January 7, 2026 · Administration
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Potential for harm · E December 4, 2025
Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.
Corrected January 7, 2026 · Infection Control
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Potential for harm · E December 4, 2025
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Corrected January 7, 2026 · Administration
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Immediate jeopardy · K August 22, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected September 1, 2025 · Quality of Life and Care
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Potential for harm · E August 22, 2025 · found via complaint
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected September 17, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E August 22, 2025 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected September 17, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E August 22, 2025 · found via complaint
Respond appropriately to all alleged violations.
Corrected September 17, 2025 · Freedom from Abuse, Neglect, and Exploitation
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| February 16, 2026 | Fine | $210,935 |
| August 22, 2025 | Fine | $178,172 |
| June 26, 2023 | Fine | $4,196 |
| June 20, 2023 | Fine | $3,846 |
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 676053 · certified since June 1, 2005. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.