MERKEL NURSING CENTER

The nursing staff is the most important part of what determines the quality of care and comfort of a resident in a nursing home. Government regulations set expectations on time spent with each resident based on the services being provided. The breakdown below lists the nursing types (RN, LPN, LVN, CNA) and a comparison of the reported and expected hours per resident per day.

Medicare determines quality of care ratings for nursing facilities by surveying several "quality measures", which are broken down into long-term and short-term stay residents, as well as if the action is preventive or if there is a deficiency in the quality of care. State averages for Texas are also provided for comparison purposes. Note: Figures below are averaged over the past nine months.

Long-Term Stay Preventive Actions

Long-Term Stay Deficiencies

Short-Term Stay Preventive Actions

Short-Term Stay Deficiencies

All Medicare and/or Medicaid certified nursing home must undergo health inspections on average once a year, but may be more frequent if the facility is peforming poorly. These inspections cover most aspects of life in a nursing home, and are broken down into deficiencies types, which including: Pharmacy Service, Administration, Resident Rights, Nutrition and Dietary, Resident Assessment, Environmental, and Mistreatment. Below are the list of deficiencies found by inspectors in the past few years along with the degree of harm and how many residents may have been affected. Note: The most recent health survey was on 02/10/2011.

Administration

Hire a Qualified Activities Director. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Have a Detailed, Written Plan for Disasters and Emergencies. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Train All Employees on What to Do in an Emergency. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
1) Review the Work of Each Nurse Aide Every Year; or 2) Give Regular Training for the Nurse Aides. Inspection Date: 02/10/2011 Correction Date: 03/10/2011

Environmental

Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Keep All Essential Equipment Working Safely. Inspection Date: 02/10/2011 Correction Date: 02/25/2011

Mistreatment

1) Hire Only People Who Have No Legal History of Abusing, Neglecting or Mistreating Residents; or 2) Report and Investigate Any Acts or Reports of Abuse, Neglect or Mistreatment of Residents. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Write and Use Policies That Forbid Mistreatment, Neglect and Abuse of Residents and Theft of Residents' Property. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Keep Each Resident Free from Physical Restraints, Unless Needed for Medical Treatment. Inspection Date: 02/10/2011 Correction Date: 03/04/2011
1) Hire Only People Who Have No Legal History of Abusing, Neglecting or Mistreating Residents; or 2) Report and Investigate Any Acts or Reports of Abuse, Neglect or Mistreatment of Residents. Inspection Date: 02/10/2011 Correction Date: 03/04/2011

Nutrition and Dietary

1) Provide 3 Meals Daily at Regular Times; or 2) Serve Breakfast Within 14 Hours After Dinner; or 3) Offer a Snack at Bedtime Each Day. Inspection Date: 09/25/2008 Correction Date: 10/24/2008
Prepare Food That is Nutritional, Appetizing, Tasty, Attractive, Well-Cooked, and at the Right Temperature. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Provide Food in a Way That Meets a Resident's Needs. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Store, Cook, and Give out Food in a Safe and Clean Way. Inspection Date: 02/10/2011 Correction Date: 02/25/2011

Pharmacy Service

Properly Mark Drugs and Other Similar Products. Inspection Date: 09/25/2008 Correction Date: 10/24/2008
Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%. Inspection Date: 02/10/2011 Correction Date: 02/25/2011

Quality Care

Make Sure That Each Resident Who Enters the Nursing Home Without a Catheter is Not Given a Catheter, Unless It is Necessary. Inspection Date: 09/25/2008 Correction Date: 10/24/2008
Provide Activities to Meet the Needs of Each Resident. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Provide Social Services for Related Medical Problems to Help Each Resident Achieve the Highest Possible Quality of Life. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Give Professional Services That Follow Each Resident's Written Care Plan. Inspection Date: 12/18/2009 Correction Date: 01/13/2010

Resident Assessment

Do a New Assessment After Any Major Change in a Resident's Physical or Mental Health. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Develop a Complete Care Plan That Meets All of a Resident's Needs, with Timetables and Actions That Can Be Measured. Inspection Date: 12/18/2009 Correction Date: 01/13/2010

Resident Rights

Allow Residents to Easily See the Results of the Nursing Home's Most Recent Survey. Inspection Date: 09/25/2008 Correction Date: 10/24/2008
Immediately Tell the Resident, Doctor, and a Family Member If: the Resident is Injured, There is a Major Change in Resident's Physical/Mental Health, There is a Need to Alter Treatment Significantly, or the Resident Must Be Transferred or Discharged. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Let Residents Complain Without Being Treated Differently or Badly. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Try to Resolve Each Resident's Complaints Quickly. Inspection Date: 12/18/2009 Correction Date: 01/13/2010
Listen to the Resident or Family Groups or Act on Their Complaints or Suggestions. Inspection Date: 12/18/2009 Correction Date: 01/13/2010

Below is a list of any civil penalities or denials of payment for new admissions (DPNA) that this facility received in the previous three years. Note: Monetary figures are not available for DPNAs.

The table below lists incident reports by the nursing staff or administration for Merkel Nursing Center, as well as complaints by residents or their family in the previous three years.

Administration

Hire Nurse Aides Who Have Completed Required Training and Shown That They Are Skilled. Complaint Filed: 12/21/2010 Correction Date: 01/05/2011
Hire Nurse Aides Who Have Shown That They Are Skilled and Care for Residents Safely On-The-Job. Complaint Filed: 12/21/2010 Correction Date: 01/13/2011

Quality Care

Use a Registered Nurse at Least 8 Hours a Day, 7 Days a Week. Complaint Filed: 10/26/2010 Correction Date: 10/27/2010
Give Each Resident Enough Fluids to Keep Them Healthy and Prevent Dehydration. Complaint Filed: 12/21/2010 Correction Date: 01/07/2011
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Complaint Filed: 03/10/2011 Correction Date: 03/11/2011
Give Residents Proper Treatment to Prevent New Bed (Pressure) Sores or Heal Existing Bed Sores. Complaint Filed: 03/10/2011 Correction Date: 03/16/2011

Resident Rights

Let the Resident or the Resident's Representative Look at All Records. Complaint Filed: 12/18/2009 Correction Date: 01/13/2010

Nursing homes certified by Medicare and/or Medicaid are required to have fire safety inspections to meet Life Safety Code (LSC) standards. Below is a list of deficiencies that Merkel Nursing Center had in recent fire safety inspections. This information can be used to see if all standards were met, the degree of harm, the number of residents affected, and the date when deficiencies were corrected. Note: The most recent fire safety survey was on 02/09/2011.

Automatic Sprinkler Systems

Automatic Sprinkler Systems That Have Been Maintained in Working Order. Inspection Date: 09/24/2008 Correction Date: 10/24/2008

Electrical

Properly Installed Electrical Wiring and Equipment. Inspection Date: 09/24/2008 Correction Date: 10/24/2008
Properly Installed Electrical Wiring and Equipment. Inspection Date: 02/09/2011 Correction Date: 03/10/2011

Emergency Plans and Fire Drills

Did Not Have a Written Emergency Evacuation Plan. Inspection Date: 12/17/2009 Correction Date: 01/11/2010
Record of Quarterly Fire Drills for Each Shift Under Varying Conditions. Inspection Date: 02/09/2011 Correction Date: 02/25/2011

Exits and Egress

Exits That Are Accessible at All Times. Inspection Date: 02/09/2011 Correction Date: 03/01/2011

Fire Alarm Systems

A Fire Alarm System That Can Be Heard Throughout the Facility. Inspection Date: 02/09/2011 Correction Date: 03/01/2011

Laboratories

Proper Facilities for the Use and Storage of Combustible Liquids. Inspection Date: 02/09/2011 Correction Date: 02/25/2011

Medical Gases and Anesthetizing Areas

Proper Medical Gas Storage and Administration Areas. Inspection Date: 02/09/2011 Correction Date: 03/10/2011

Smoke Compartmentation and Control

Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour. Inspection Date: 12/17/2009 Correction Date: 12/18/2009
Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour. Inspection Date: 02/09/2011 Correction Date: 02/28/2011
Proper Construction of Ducts Through Walls Designed to Prevent Smoke Passage. Inspection Date: 02/09/2011 Correction Date: 03/01/2011

Smoking Regulations

Posted "No-Smoking" Signs in Areas Where Smoking is Not Permitted or Did Not Provide Ashtrays Where Smoking Was Allowed. Inspection Date: 02/09/2011 Correction Date: 03/10/2011