Merkel Nursing Center
1704 N. 1ST, Merkel, TX, 79536
Federal Quality Data
Official records from CMS Care Compare — reported by the facility and audited by the Centers for Medicare & Medicaid Services. We present them unmodified. Refreshed March 2026.
CMS Star Ratings
Facility & Staffing
- Ownership
- For profit - Limited Liability company
- Certified beds
- 65 · avg 27 residents/day
- Total nursing staff turnover
- 60.5% — higher than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 40% — lower than most Texas nursing homesTexas avg: 50.5% · National avg: 43.6% · per CMS Care Compare
- Administrators who left
- 0 departed — near the Texas averageTexas avg: 0.6 · National avg: 0.5 · per CMS Care Compare
Enforcement & Citations
- Fines (past 3 years)
- 4 fines · $291,592 total
State licensing & capacity
- License number
- 308455
- Service type
- Medicare/medicaid
- Licensed capacity
- 66 beds
- Bed type breakdown
- 1 licensed-only · 11 Medicare-only · 54 Medicaid/Medicare
- Current license effective
- January 1, 2026
- Current license expires
- January 1, 2029
- Initial license date
- September 1, 1971
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- Emi Health Care Center, Llc (Limited Liability Company (LLC))
- Administrator
- Joe Alexander
Texas HHSC licensing registry · as of April 16, 2026
Federal ownership record
Disclosed owners (5 on record)
- Axel Martinez Irizarry
Adp of The Snf · since 2025
- Clarence Stroh
Adp of The Snf · since 2022
- Joe Alexander
Adp of The Snf · since 2022
- Rainey Renee Alexander
Operational/managerial Control · since 2022
- Stroh Properties lp
Adp of The Snf · since 2022
Recent change of ownership
January 2022 (4 years ago) · acquired from Merkel Nursing Center
Transaction type: Change of Ownership
Source: CMS Provider Enrollment data — SNF Enrollments + All Owners + Change of Ownership, as of April 2026.
Federal inspection record
Immediate-jeopardy citations (CMS scope/severity J–L) are the most serious category federal inspectors issue — meaning a deficiency placed residents in immediate risk of serious harm. Ask the facility for the corrective-action plan filed with CMS, and consider contacting your state long-term care ombudsman for context.
Recent health-deficiency citations (most recent 8 of 56)
- E0949·Dec 4, 2025
Administration Deficiencies
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
- E0945·Dec 4, 2025
Infection Control Deficiencies
Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.
- E0944·Dec 4, 2025
Administration Deficiencies
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
- E0943·Dec 4, 2025
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
- E0942·Dec 4, 2025
Resident Rights Deficiencies
Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.
- E0941·Dec 4, 2025
Administration Deficiencies
Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
- E0940·Dec 4, 2025
Administration Deficiencies
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
- E0909·Dec 4, 2025
Environmental Deficiencies
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.
Federal penalties
By year
- 20251 fine · $274K
- 20233 fines · $17K
Most recent events
- Aug 22, 2025Fine · $274K
- Jun 26, 2023Fine · $4,196
- Jun 20, 2023Fine · $3,846
- May 30, 2023Fine · $9,440
Largest single fine on record: $274K.
Fire-safety citations
9 Life-Safety-Code citations on file. Most recent: Dec 4, 2025. Fire-safety inspections cover building-level Life Safety Code compliance, separate from the resident-care health survey.
Source: CMS Provider Data Catalog — Health Deficiencies, Fire Safety Deficiencies, and Penalties datasets, snapshot Mar 1, 2026.
About this community
Merkel Nursing Center is a 66-bed Medicare/Medicaid nursing home in Merkel, Taylor County, licensed to Emi Health Care Center, LLC. CMS rates it 1 star overall, with 1-star health inspection and 1-star quality measure ratings. Four federal fines totaling $291,592 have been assessed — well above Texas's median of $20,699. The facility is operating at roughly 42% of licensed capacity, with about 27 residents currently.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
What the data says
CMS rates staffing here at 4 stars — roughly the top 9% of Texas nursing homes on staffing. Each resident receives about 227 minutes of nursing care per day. The residents here require less hands-on care than at a typical facility, so those staff hours stretch further than the raw minutes alone would suggest.
Four CMS fines totaling $291,592 have been levied against this facility. About 30% of Texas nursing homes have received no fines at all; the state median for facilities that do receive fines is $20,699. This facility's total is roughly 14 times that median.
The facility holds 65 CMS-certified beds but averaged about 27 residents per day at last count — an occupancy rate of roughly 42%. Paired with the facility's fine history and 1-star ratings across health inspections and quality measures, that low census reflects a pattern across multiple dimensions of the record.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
What the fines were for
Four CMS fines totaling $291,592 have been assessed — ask administrators to identify which deficiencies triggered each fine and what corrective steps were taken.
How 1-star quality measures are being addressed
CMS rates both long-stay quality measures and overall quality at 1 star — ask which specific measures are lowest and what the facility's improvement plan looks like.
Why occupancy is at 42%
The facility averaged about 27 residents in 65 certified beds — ask whether low occupancy reflects recent admissions freezes, referral patterns, or other operational factors.
Staffing consistency across shifts
Weekend nursing hours run at 3.2 minutes per resident compared to 3.8 on weekdays — ask how staffing levels and staff assignments differ between weekdays and weekends.
Resident and family input channels
No resident or family council is listed in the CMS record — ask whether either council exists and how residents and families formally raise concerns.
Administrator tenure and leadership stability
Ask how long the current administrator Joe Alexander has been in the role and who the key clinical leads are, since leadership continuity directly affects day-to-day care consistency.
Where this information comes from
- License, capacity, ownership, administrator: Texas HHSC licensing registry, snapshot as of April 16, 2026.
- Star ratings, staffing, fines, deficiencies: CMS Care Compare, processed March 1, 2026.
- Summary, insights, and tour questions: Written from the state licensing and CMS records above, last updated April 19, 2026.
Read our methodology for how this information is collected and verified.