Merkel Nursing Center

Penalties

• Feb 16, 2026 — Fine ($137,108)
• Aug 22, 2025 — Fine ($180,952)

Inspection findings

1. Feb 16, 2026 Health · 8 findings
   • Serious Scope/severity K Complaint

     F0600 Freedom from Abuse, Neglect, and Exploitation Deficiencies

     Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

     Corrected Mar 4, 2026 · CMS health inspection

   • Serious Scope/severity K Complaint

     F0689 Quality of Life and Care Deficiencies

     Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

     Corrected Mar 4, 2026 · CMS health inspection

   • Serious Scope/severity K Complaint

     F0725 Nursing and Physician Services Deficiencies

     Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

     Corrected Mar 4, 2026 · CMS health inspection

   • Serious Scope/severity K Complaint

     F0726 Nursing and Physician Services Deficiencies

     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 Mar 4, 2026 · CMS health inspection

   • Not serious Scope/severity F Complaint

     F0727 Nursing and Physician Services Deficiencies

     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 Mar 4, 2026 · CMS health inspection

   • Not serious Scope/severity F Complaint

     F0728 Nursing and Physician Services Deficiencies

     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 Mar 4, 2026 · CMS health inspection

   • Not serious Scope/severity F Complaint

     F0881 Infection Control Deficiencies

     Implement a program that monitors antibiotic use.

     Corrected Mar 4, 2026 · CMS health inspection

   • Not serious Scope/severity F Complaint

     F0882 Infection Control Deficiencies

     Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.

     Corrected Mar 4, 2026 · CMS health inspection

2. Dec 4, 2025 Health · 18 findings
   • Not serious Scope/severity E

     F0695 Quality of Life and Care Deficiencies

     Provide safe and appropriate respiratory care for a resident when needed.

     Corrected Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity D

     F0842 Resident Assessment and Care Planning Deficiencies

     Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

     Corrected Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity E

     F0849 Administration Deficiencies

     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 Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity F

     F0867 Administration Deficiencies

     Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.

     Corrected Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity D

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity E

     F0909 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.

     Corrected Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity E

     F0940 Administration Deficiencies

     Develop, implement, and/or maintain an effective training program for all new and existing staff members.

     Corrected Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity E

     F0941 Administration Deficiencies

     Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.

     Corrected Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity E

     F0942 Resident Rights Deficiencies

     Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.

     Corrected Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity E

     F0943 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.

     Corrected Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity E

     F0944 Administration Deficiencies

     Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.

     Corrected Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity E

     F0945 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.

     Corrected Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity E

     F0949 Administration Deficiencies

     Provide behavior health training consistent with the requirements and as determined by a facility assessment.

     Corrected Jan 7, 2026 · CMS health inspection

   • Not serious Scope/severity E

     K0211 Egress Deficiencies

     Keep aisles, corridors, and exits free of obstruction in case of emergency.

     Corrected Jan 31, 2026 · CMS fire safety

   • Not serious Scope/severity E

     K0321 Smoke Deficiencies

     Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

     Corrected Jan 31, 2026 · CMS fire safety

   • Not serious Scope/severity E

     K0511 Services Deficiencies

     Have properly installed electrical wiring and gas equipment.

     Corrected Jan 31, 2026 · CMS fire safety

   • Not serious Scope/severity C

     K0521 Services Deficiencies

     Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

     Corrected Jan 12, 2026 · CMS fire safety

   • Not serious Scope/severity E

     K0923 Gas, Vacuum, and Electrical Systems Deficiencies

     Have proper medical gas storage and administration areas.

     Corrected Jan 31, 2026 · CMS fire safety

3. Aug 22, 2025 Health · 8 findings
   • Not serious Scope/severity E Complaint

     F0607 Freedom from Abuse, Neglect, and Exploitation Deficiencies

     Develop and implement policies and procedures to prevent abuse, neglect, and theft.

     Corrected Sep 17, 2025 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0609 Freedom from Abuse, Neglect, and Exploitation Deficiencies

     Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

     Corrected Sep 17, 2025 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0610 Freedom from Abuse, Neglect, and Exploitation Deficiencies

     Respond appropriately to all alleged violations.

     Corrected Sep 17, 2025 · CMS health inspection

   • Serious Scope/severity K Complaint

     F0689 Quality of Life and Care Deficiencies

     Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

     Corrected Sep 1, 2025 · CMS health inspection

   • Not serious Scope/severity F Complaint

     F0801 Nutrition and Dietary Deficiencies

     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 Sep 25, 2025 · CMS health inspection

   • Not serious Scope/severity F Complaint

     F0835 Administration Deficiencies

     Administer the facility in a manner that enables it to use its resources effectively and efficiently.

     Corrected Sep 15, 2025 · CMS health inspection

   • Not serious Scope/severity F Complaint

     F0838 Administration Deficiencies

     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 Sep 16, 2025 · CMS health inspection

   • Not serious Scope/severity C Complaint

     F0844 Administration Deficiencies

     Follow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel.

     Corrected Sep 18, 2025 · CMS health inspection

4. Dec 12, 2024 Health · 1 finding
   • Not serious Scope/severity D Complaint

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Jan 1, 2025 · CMS health inspection

5. Oct 17, 2024 Health · 6 findings
   • Not serious Scope/severity E Complaint

     F0580 Resident Rights Deficiencies

     Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

     Corrected Nov 8, 2024 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0655 Resident Assessment and Care Planning Deficiencies

     Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

     Corrected Nov 8, 2024 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0656 Resident Assessment and Care Planning Deficiencies

     Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

     Corrected Nov 8, 2024 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0657 Resident Assessment and Care Planning Deficiencies

     Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

     Corrected Nov 8, 2024 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0842 Resident Assessment and Care Planning Deficiencies

     Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

     Corrected Nov 8, 2024 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0926 Environmental Deficiencies

     Have policies on smoking.

     Corrected Nov 8, 2024 · CMS health inspection

6. Jul 31, 2024 Fire Safety · 22 findings
   • Not serious Scope/severity F

     E0039 Emergency Preparedness Deficiencies

     Conduct testing and exercise requirements.

     Corrected Sep 30, 2024 · CMS fire safety

   • Not serious Scope/severity E Complaint

     F0550 Resident Rights Deficiencies

     Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

     Corrected Sep 1, 2024 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0558 Resident Rights Deficiencies

     Reasonably accommodate the needs and preferences of each resident.

     Corrected Sep 1, 2024 · CMS health inspection

   • Not serious Scope/severity C Complaint

     F0576 Resident Rights Deficiencies

     Ensure residents have reasonable access to and privacy in their use of communication methods.

     Corrected Aug 31, 2024 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0607 Freedom from Abuse, Neglect, and Exploitation Deficiencies

     Develop and implement policies and procedures to prevent abuse, neglect, and theft.

     Corrected Sep 15, 2024 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0656 Resident Assessment and Care Planning Deficiencies

     Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

     Corrected Sep 1, 2024 · CMS health inspection

   • Not serious Scope/severity C Complaint

     F0680 Quality of Life and Care Deficiencies

     Ensure the activities program is directed by a qualified professional.

     Corrected Aug 19, 2024 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0686 Quality of Life and Care Deficiencies

     Provide appropriate pressure ulcer care and prevent new ulcers from developing.

     Corrected Sep 1, 2024 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0689 Quality of Life and Care Deficiencies

     Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

     Corrected Sep 5, 2024 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0695 Quality of Life and Care Deficiencies

     Provide safe and appropriate respiratory care for a resident when needed.

     Corrected Sep 5, 2024 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0728 Nursing and Physician Services Deficiencies

     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 Sep 15, 2024 · CMS health inspection

   • Not serious Scope/severity B Complaint

     F0732 Nursing and Physician Services Deficiencies

     Post nurse staffing information every day.

     Corrected Sep 5, 2024 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0803 Nutrition and Dietary Deficiencies

     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 Sep 2, 2024 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0812 Nutrition and Dietary Deficiencies

     Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

     Corrected Sep 2, 2024 · CMS health inspection

   • Not serious Scope/severity F Complaint

     F0868 Administration Deficiencies

     Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

     Corrected Sep 15, 2024 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Sep 2, 2024 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0909 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.

     Corrected Aug 20, 2024 · CMS health inspection

   • Not serious Scope/severity B Complaint

     F0941 Administration Deficiencies

     Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.

     Corrected Sep 5, 2024 · CMS health inspection

   • Not serious Scope/severity B Complaint

     F0944 Administration Deficiencies

     Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.

     Corrected Sep 5, 2024 · CMS health inspection

   • Not serious Scope/severity B Complaint

     F0949 Administration Deficiencies

     Provide behavior health training consistent with the requirements and as determined by a facility assessment.

     Corrected Sep 5, 2024 · CMS health inspection

   • Not serious Scope/severity E

     K0353 Smoke Deficiencies

     Inspect, test, and maintain automatic sprinkler systems.

     Corrected Oct 1, 2024 · CMS fire safety

   • Not serious Scope/severity C

     K0521 Services Deficiencies

     Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

     Corrected Oct 1, 2024 · CMS fire safety

7. Dec 15, 2023 Health · 1 finding
   • Not serious Scope/severity E Complaint

     F0908 Environmental Deficiencies

     Keep all essential equipment working safely.

     Corrected Dec 20, 2023 · CMS health inspection

8. Jun 8, 2023 Health · 9 findings
   • Not serious Scope/severity E

     F0558 Resident Rights Deficiencies

     Reasonably accommodate the needs and preferences of each resident.

     Corrected Jul 7, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0567 Resident Rights Deficiencies

     Honor the resident's right to manage his or her financial affairs.

     Corrected Jul 7, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0711 Nursing and Physician Services Deficiencies

     Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.

     Corrected Jul 7, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0727 Nursing and Physician Services Deficiencies

     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 Jul 7, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0761 Pharmacy Service Deficiencies

     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 Jul 7, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0812 Nutrition and Dietary Deficiencies

     Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

     Corrected Jul 7, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0868 Administration Deficiencies

     Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

     Corrected Jul 7, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Jul 7, 2023 · CMS health inspection

   • Not serious Scope/severity C

     K0521 Services Deficiencies

     Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

     Corrected Jul 9, 2023 · CMS fire safety

Owners and managers (as published by CMS)

• ALEXANDER, JOE — adp of the snf, NOT APPLICABLE, since 01/01/2022
• ALEXANDER, RAINEY — direct ownership interest, NOT APPLICABLE, since 01/01/2022
• ALEXANDER, RAINEY — operational/managerial control, NOT APPLICABLE, since 01/01/2022
• MARTINEZ IRIZARRY, AXEL — adp of the snf, NOT APPLICABLE, since 01/01/2025
• STROH, CLARENCE — adp of the snf, NOT APPLICABLE, since 01/01/2022
• STROH PROPERTIES LP — adp of the snf, NOT APPLICABLE, since 01/01/2022