Skilled nursing facility · CMS certification number 676053
Merkel Nursing Center
Merkel, Texas · Medicare and Medicaid · 65 certified beds in Care Compare
Download Merkel Nursing Center’s record (CSV, each figure with its worksheet, line and column)
CMS lists this facility as a Special Focus Facility candidate (Care Compare Special Focus Status: SFF Candidate)
In Care Compare’s provider information: Penalties: 2 · Fines: 2 · Fines, total amount: $320,538.00 · Payment denials: 0. The most recent penalty on file: February 16, 2026, Fine, $139,586. Every penalty on file ↓
Merkel Nursing Center: its citable report, full history — $295 · an email when it changes — $99/month
What stands out
- Its latest cost report on file is for fiscal year 2024, covering January 1, 2024 to December 31, 2024 (365 days), and CMS processed it on August 29, 2025.
- Net patient revenue fell from $3.2M in fiscal year 2023 to $1.9M in fiscal year 2024.
- Its result from service to patients: −$854K (2022), $116K (2023), −$770K (2024).
- Its cost reports on file run from fiscal year 2005 to fiscal year 2024.
- Since its cost report for fiscal year 2023 was filed on September 29, 2025, 11 changes are listed on this record: 4 owner changes and 7 owner changes.
- Its net patient revenue of $1.9M ranks 650th of the 681 nursing facilities in Texas whose latest cost report on file is fiscal year 2024.
- 3 of the 5 nursing facilities in Texas closest in size to it, whose latest cost report on file is fiscal year 2024, also report a loss on service to patients.
Merkel Nursing Center: Medicare cost reports
Form CMS-2540-10: each report covers January 1 to December 31 of its year; every report is settled.
| Form CMS-2540-10 | 2024 · report 1438408 | 2023 · report 1440323 | 2022 · report 1397493 | 2021 · report 1366355 | 2020 · report 1301055 | 2019 · report 1268048 | 2018 · report 1238295 | 2017 · report 1207538 | 2016 · report 1171217 | 2015 · report 1143080 | 2014 · report 1102752 | 2013 · report 1075141 | 2012 · report 1045284 | 2011 · report 1014733 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Processed by CMS | August 29, 2025 | September 29, 2025 | October 17, 2024 | October 11, 2023 | September 24, 2021 | September 16, 2020 | July 25, 2019 | August 21, 2018 | July 31, 2017 | September 30, 2016 | July 24, 2015 | August 6, 2014 | August 1, 2013 | October 26, 2012 |
| Total patient revenue | $2,002,596 | $3,439,487 | $2,514,648 | $2,802,214 | $2,825,289 | — | — | — | — | — | — | — | — | — |
| Contractual allowances and discounts | $60,560 | $269,664 | $532,339 | $570,010 | $301,463 | — | — | — | — | — | — | — | — | — |
| Net patient revenue | $1,942,036 | $3,169,823 | $1,982,309 | $2,232,204 | $2,523,826 | — | — | — | — | — | — | — | — | — |
| Total operating expenses | $2,711,750 | $3,054,066 | $2,836,274 | $2,822,531 | $2,650,637 | $2,348,075 | $2,013,509 | $1,952,907 | $1,852,345 | $2,538,772 | $1,684,615 | $1,700,103 | $1,732,964 | — |
| Net income from service to patients | −$769,714 | $115,757 | −$853,965 | −$590,327 | −$126,811 | −$2,348,075 | −$2,013,509 | −$1,952,907 | −$1,852,345 | −$2,538,772 | −$1,684,615 | −$1,700,103 | −$1,732,964 | — |
| Total other income | — | $75,000 | $75,000 | — | $233,150 | — | — | — | — | — | — | — | — | — |
| Net income after other income | −$769,714 | $190,757 | −$778,965 | −$590,327 | $106,339 | −$2,348,075 | −$2,013,509 | −$1,952,907 | −$1,852,345 | −$2,538,772 | −$1,684,615 | −$1,700,103 | −$1,732,964 | — |
| Net income | −$769,714 | $190,757 | −$778,965 | −$590,327 | $106,339 | −$2,348,075 | −$2,013,509 | −$1,952,907 | −$1,852,345 | −$2,538,772 | −$1,684,615 | −$1,700,103 | −$1,732,964 | — |
| Total facility beds, all components | 80 | 80 | 80 | 80 | 80 | 66 | 66 | 66 | 66 | 65 | 65 | 65 | 65 | 65 |
| Bed days available, all components | 29,280 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Medicare (Title XVIII) patient days | 481 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Medicaid (Title XIX) patient days | 7,521 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Other-payer patient days | 4,191 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Total patient days, all components | 12,193 | 1,541 | 2,430 | 10,425 | 13,694 | 15,595 | 16,661 | 15,741 | 13,864 | 915 | 14,914 | 15,754 | 17,505 | 16,151 |
| Medicare discharges | 5 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Medicaid discharges | 11 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Other-payer discharges | 9 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Total discharges, all components | 25 | 62 | 43 | 69 | 63 | 66 | 73 | 64 | 75 | 32 | 63 | 55 | 34 | 40 |
| Average length of stay, Medicare, in days | 96.2 | 54.11 | 92.58 | 58.38 | 45.75 | 56.3 | 39.09 | 33.16 | 46.89 | 50.83 | 46.88 | 50.94 | 41.91 | 32.81 |
| Average length of stay, Medicaid, in days | 683.73 | 1 | 1.75 | 249.38 | 362.42 | 593.11 | 390.83 | 407.5 | 536 | — | — | — | — | — |
| Average length of stay, all patients, in days | 487.72 | 24.85 | 56.51 | 151.09 | 217.37 | 236.29 | 228.23 | 245.95 | 184.85 | 28.59 | 236.73 | 286.44 | 514.85 | 403.78 |
Net income, fiscal years 2024, 2023, 2022, 2021, 2020, 2019, 2018, 2017, 2016, 2015, 2014, 2013, 2012. Checked against the form’s own arithmetic: what that check shows.
Form CMS-2540-96: every report is settled.
| Form CMS-2540-96 | 2010 · report 417986 | 2009 · report 375818 | 2008 · report 354373 | 2007 · report 322695 | 2006 · report 298622 | 2005 · report 265702 |
|---|---|---|---|---|---|---|
| Period began | January 1, 2010 | January 1, 2009 | January 1, 2008 | January 1, 2007 | January 1, 2006 | June 1, 2005 |
| Period ended | December 31, 2010 | December 31, 2009 | December 31, 2008 | December 31, 2007 | December 31, 2006 | December 31, 2005 |
| Days, where not a full year | — | — | — | — | — | 213 |
| Processed by CMS | September 19, 2011 | June 17, 2010 | August 11, 2009 | August 4, 2008 | December 14, 2007 | November 3, 2006 |
| Net patient revenue | $1,844,384 | $1,807,811 | $2,039,865 | $1,925,120 | $2,018,851 | $998,637 |
| Total operating expenses | $1,941,952 | $1,887,902 | $1,931,272 | $1,968,383 | $1,769,416 | $1,031,064 |
| Net income from service to patients | −$97,568 | −$80,091 | $108,593 | −$43,263 | $249,435 | −$32,427 |
| Total other income | $374 | $362 | $308 | $1 | $1 | $596 |
| Total other expenses | — | $1 | — | — | — | — |
| Net income | −$97,194 | −$79,730 | $108,901 | −$43,262 | $249,436 | −$31,831 |
| Total facility beds, all components | 65 | 65 | 65 | 65 | 65 | 66 |
| Total patient days, all components | 17,379 | 18,425 | 17,619 | 19,674 | 19,701 | 11,778 |
| Total discharges, all components | 67 | 65 | 51 | 99 | 84 | 39 |
| Average length of stay, Medicare, in days | 43.74 | 49.54 | 48.58 | 41.65 | 38.86 | 42.5 |
| Average length of stay, Medicaid, in days | 468.88 | 462.48 | 1,000.43 | 296.92 | 354.89 | 431.17 |
| Average length of stay, all patients, in days | 259.39 | 283.46 | 345.47 | 198.73 | 234.54 | 302 |
Net income, fiscal years 2010, 2009, 2008, 2007, 2006, 2005. Checked against the form’s own arithmetic: what that check shows.
Merkel Nursing Center: nurse staffing hours by quarter →
Who owns Merkel Nursing Center, as filed with CMS
Care Compare
- ADP OF THE SNF: ALEXANDER, JOE (individual), since 01/01/2022; MARTINEZ IRIZARRY, AXEL (individual), since 01/01/2025; STROH PROPERTIES LP (organization), since 01/01/2022; STROH, CLARENCE (individual), since 01/01/2022
- DIRECT OWNERSHIP INTEREST: ALEXANDER, RAINEY (individual), since 01/01/2022
- OPERATIONAL/MANAGERIAL CONTROL: ALEXANDER, RAINEY (individual), since 01/01/2022
Ownership percentage for each: NOT APPLICABLE.
Medicare enrollment
As filed in the CMS file dated October 1, 2026 (Medicare enrollment ownership), under the enrollment of EMI HEALTHCARE LLC (enrollment ID O20211217001022).
- ADP OF THE SNF: AXEL MARTINEZ IRIZARRY (individual), since 01/01/2025; CLARENCE STROH (individual), since 01/01/2022; JOE ALEXANDER (individual), since 01/01/2022; STROH PROPERTIES LP (organization), since 01/01/2022
- DIRECT OWNERSHIP INTEREST: RAINEY RENEE ALEXANDER (individual), 100.00%, since 01/01/2022
- OPERATIONAL/MANAGERIAL CONTROL: RAINEY RENEE ALEXANDER (individual), since 01/01/2022
Paused by CMS: Form CMS-855A, December 11, 2025.
Private equity company, real estate investment trust and holding company: Paused by CMS: AXEL MARTINEZ IRIZARRY; CLARENCE STROH; JOE ALEXANDER; RAINEY RENEE ALEXANDER; RAINEY RENEE ALEXANDER.
Private equity company, real estate investment trust and holding company: No: STROH PROPERTIES LP.
Changes in ownership
- December 1, 2025, enrollment ownership file; no longer listed: RAINEY RENEE ALEXANDER (ADP OF THE SNF); first listed: RAINEY RENEE ALEXANDER (DIRECT OWNERSHIP INTEREST), associated since January 1, 2022; CLARENCE STROH (ADP OF THE SNF), associated since January 1, 2022; AXEL MARTINEZ IRIZARRY (ADP OF THE SNF), associated since January 1, 2025; STROH PROPERTIES LP (ADP OF THE SNF), associated since January 1, 2022; JOE ALEXANDER (ADP OF THE SNF), associated since January 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- October 1, 2025, enrollment ownership file; no longer listed: RAINEY RENEE ALEXANDER (CORPORATE OFFICER); RAINEY RENEE ALEXANDER (5% OR GREATER DIRECT OWNERSHIP INTEREST); STORMIE JONES (W-2 MANAGING EMPLOYEE); first listed: RAINEY RENEE ALEXANDER (ADP OF THE SNF), associated since January 1, 2022; RAINEY RENEE ALEXANDER (OPERATIONAL/MANAGERIAL CONTROL), associated since January 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
Inspections of Merkel Nursing Center
- Cycle 1: health December 4, 2025 (21 deficiencies), fire safety December 4, 2025 (5)
- Cycle 2: health July 31, 2024 (34 deficiencies), fire safety July 31, 2024 (3)
- Cycle 3: health June 8, 2023 (9 deficiencies), fire safety June 8, 2023 (1)
Deficiencies cited at Merkel Nursing Center
64 deficiencies on file, by tag, newest citation first
every one from a health inspection; every one marked “Deficient, Provider has date of correction”; 43 cited from a complaint, marked below. Letter after a date: scope and severity grade.
- F 0600, freedom from abuse, neglect, and exploitation: February 16, 2026 (K, from a complaint, corrected March 4, 2026).
- F 0689, quality of life and care: February 16, 2026 (K, from a complaint, corrected March 4, 2026); August 22, 2025 (K, from a complaint, corrected September 1, 2025); July 31, 2024 (E, from a complaint, corrected September 5, 2024).
- F 0725, nursing and physician services: February 16, 2026 (K, from a complaint, corrected March 4, 2026).
- F 0726, nursing and physician services: February 16, 2026 (K, from a complaint, corrected March 4, 2026).
- F 0727, nursing and physician services: February 16, 2026 (F, from a complaint, corrected March 4, 2026); June 8, 2023 (E, corrected July 7, 2023).
- F 0728, nursing and physician services: February 16, 2026 (F, from a complaint, corrected March 4, 2026); July 31, 2024 (E, from a complaint, corrected September 15, 2024).
- F 0881, infection control: February 16, 2026 (F, from a complaint, corrected March 4, 2026).
- F 0882, infection control: February 16, 2026 (F, from a complaint, corrected March 4, 2026).
- F 0695, quality of life and care: December 4, 2025 (E, corrected January 7, 2026); July 31, 2024 (E, from a complaint, corrected September 5, 2024).
- F 0842, resident assessment and care planning: December 4, 2025 (D, corrected January 7, 2026); October 17, 2024 (E, from a complaint, corrected November 8, 2024).
- F 0849, administration: December 4, 2025 (E, corrected January 7, 2026).
- F 0867, administration: December 4, 2025 (F, corrected January 7, 2026).
- F 0880, infection control: December 4, 2025 (D, corrected January 7, 2026); December 12, 2024 (D, from a complaint, corrected January 1, 2025); July 31, 2024 (E, from a complaint, corrected September 2, 2024); June 8, 2023 (E, corrected July 7, 2023).
- F 0909, environmental: December 4, 2025 (E, corrected January 7, 2026); July 31, 2024 (E, from a complaint, corrected August 20, 2024).
- F 0940, administration: December 4, 2025 (E, corrected January 7, 2026).
- F 0941, administration: December 4, 2025 (E, corrected January 7, 2026); July 31, 2024 (B, from a complaint, corrected September 5, 2024).
- F 0942, resident rights: December 4, 2025 (E, corrected January 7, 2026).
- F 0943, freedom from abuse, neglect, and exploitation: December 4, 2025 (E, corrected January 7, 2026).
- F 0944, administration: December 4, 2025 (E, corrected January 7, 2026); July 31, 2024 (B, from a complaint, corrected September 5, 2024).
- F 0945, infection control: December 4, 2025 (E, corrected January 7, 2026).
- F 0949, administration: December 4, 2025 (E, corrected January 7, 2026); July 31, 2024 (B, from a complaint, corrected September 5, 2024).
- F 0607, freedom from abuse, neglect, and exploitation: August 22, 2025 (E, from a complaint, corrected September 17, 2025); July 31, 2024 (D, from a complaint, corrected September 15, 2024).
- F 0609, freedom from abuse, neglect, and exploitation: August 22, 2025 (E, from a complaint, corrected September 17, 2025).
- F 0610, freedom from abuse, neglect, and exploitation: August 22, 2025 (E, from a complaint, corrected September 17, 2025).
- F 0801, nutrition and dietary: August 22, 2025 (F, from a complaint, corrected September 25, 2025).
- F 0835, administration: August 22, 2025 (F, from a complaint, corrected September 15, 2025).
- F 0838, administration: August 22, 2025 (F, from a complaint, corrected September 16, 2025).
- F 0844, administration: August 22, 2025 (C, from a complaint, corrected September 18, 2025).
- F 0580, resident rights: October 17, 2024 (E, from a complaint, corrected November 8, 2024).
- F 0655, resident assessment and care planning: October 17, 2024 (D, from a complaint, corrected November 8, 2024).
- F 0656, resident assessment and care planning: October 17, 2024 (E, from a complaint, corrected November 8, 2024); July 31, 2024 (E, from a complaint, corrected September 1, 2024).
- F 0657, resident assessment and care planning: October 17, 2024 (D, from a complaint, corrected November 8, 2024).
- F 0926, environmental: October 17, 2024 (E, from a complaint, corrected November 8, 2024).
- F 0550, resident rights: July 31, 2024 (E, from a complaint, corrected September 1, 2024).
- F 0558, resident rights: July 31, 2024 (D, from a complaint, corrected September 1, 2024); June 8, 2023 (E, corrected July 7, 2023).
- F 0576, resident rights: July 31, 2024 (C, from a complaint, corrected August 31, 2024).
- F 0680, quality of life and care: July 31, 2024 (C, from a complaint, corrected August 19, 2024).
- F 0686, quality of life and care: July 31, 2024 (D, from a complaint, corrected September 1, 2024).
- F 0732, nursing and physician services: July 31, 2024 (B, from a complaint, corrected September 5, 2024).
- F 0803, nutrition and dietary: July 31, 2024 (E, from a complaint, corrected September 2, 2024).
- F 0812, nutrition and dietary: July 31, 2024 (E, from a complaint, corrected September 2, 2024); June 8, 2023 (E, corrected July 7, 2023).
- F 0868, administration: July 31, 2024 (F, from a complaint, corrected September 15, 2024); June 8, 2023 (E, corrected July 7, 2023).
- F 0908, environmental: December 15, 2023 (E, from a complaint, corrected December 20, 2023).
- F 0567, resident rights: June 8, 2023 (E, corrected July 7, 2023).
- F 0711, nursing and physician services: June 8, 2023 (E, corrected July 7, 2023).
- F 0761, pharmacy service: June 8, 2023 (E, corrected July 7, 2023).
Penalties
| Penalty date | Type | Fine amount | Payment denial began | Payment denial, days | Fine ID |
|---|---|---|---|---|---|
| February 16, 2026 | Fine | $139,586 | 137431 | ||
| August 22, 2025 | Fine | $180,952 | 135284 |
From the Care Compare penalties file NH_Penalties_Oct2026.csv, processed on October 1, 2026.
Merkel Nursing Center in Care Compare
- Ownership Type: For profit - Limited Liability company
- Legal Business Name: EMI HEALTHCARE LLC
- Date First Approved to Provide Medicare and Medicaid Services: 2005-06-01
- Provider Resides in Hospital: N
- Continuing Care Retirement Community: N
- Urban: Y
- County/Parish: Taylor
- Telephone Number: 3259285673
- Special Focus Status: SFF Candidate
- Provider Changed Ownership in Last 12 Months: N
- With a Resident and Family Council: None
- Automatic Sprinkler Systems in All Required Areas: Yes
- Average Number of Residents per Day: 3.8
- Overall Rating: 1
- Health Inspection Rating: 1
- QM Rating: 1
- Long-Stay QM Rating: 1
Care Compare, October 1, 2026: provider information NH_ProviderInfo_Oct2026.csv · inspections NH_SurveySummary_Oct2026.csv · citations NH_HealthCitations_Oct2026.csv · penalties NH_Penalties_Oct2026.csv · ownership NH_Ownership_Oct2026.csv.
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Report a figure on Merkel Nursing Center’s record that differs from its CMS file, quoting 676053.