Boyce Manor Nursing Home
1600 East Highway, Holdenville, OK 74848 · Hughes County · 155 certified beds · avg 46 residents/day · certified since Oct 18, 2013
Part of chain: BGM ESTATE (15 facilities, chain avg rating 1.8★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 1/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Immediate jeopardy, one-off · May 3, 2025 · F-0600 · triggered by a complaint
The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors.
Why it matters: Abuse and neglect cause direct physical and emotional harm and are among the most serious failures a nursing home can have.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: May 4, 2025 (Deficient, Provider has plan of correction)
▲ Immediate jeopardy, one-off · Dec 17, 2024 · F-0600 · triggered by a complaint
The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors.
Why it matters: Abuse and neglect cause direct physical and emotional harm and are among the most serious failures a nursing home can have.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Dec 18, 2024 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, repeated · Dec 5, 2022 · F-0689
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (K): A life-threatening or extremely dangerous situation affected several residents. Among the most serious findings an inspection can produce.
Corrected: Feb 20, 2023 (Deficient, Provider has date of correction)
All citations in the current public record (32)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| May 3, 2025 | ▲ J · Immediate jeopardy, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint |
| May 3, 2025 | D · Potential for harm, one-off | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · from a complaint |
| Feb 11, 2025 | E · Potential for harm, repeated | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. |
| Feb 11, 2025 | E · Potential for harm, repeated | The facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. |
| Feb 11, 2025 | D · Potential for harm, one-off | The facility did not update each resident's care assessment at least once every 3 months. These regular check-ins keep the resident's care plan matched to their current condition. |
| Feb 11, 2025 | D · Potential for harm, one-off | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Feb 11, 2025 | D · Potential for harm, one-off | The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits. |
| Dec 17, 2024 | ▲ J · Immediate jeopardy, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint |
| Dec 17, 2024 | E · Potential for harm, repeated | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint |
| Dec 7, 2023 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Dec 7, 2023 | F · Potential for harm, facility-wide | The facility did not electronically submit complete and accurate staffing information to the government, based on payroll and other verifiable records. · from a complaint |
| Dec 7, 2023 | E · Potential for harm, repeated | The facility did not fully assess residents on time — a complete assessment of health, abilities, and needs is required when a resident is first admitted and at least once every 12 months after that. |
| Dec 7, 2023 | E · Potential for harm, repeated | The facility did not update each resident's care assessment at least once every 3 months. These regular check-ins keep the resident's care plan matched to their current condition. |
| Dec 7, 2023 | E · Potential for harm, repeated | The facility did not enter each resident's assessment information into the required format and send it to the state within 7 days of completing the assessment, as the rules require. |
| Dec 7, 2023 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Dec 7, 2023 | D · Potential for harm, one-off | The facility did not give residents proper notice about what Medicare or Medicaid covers, or about charges the resident might owe for services that aren't covered. |
| Dec 7, 2023 | D · Potential for harm, one-off | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Dec 7, 2023 | D · Potential for harm, one-off | The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. |
| Dec 7, 2023 | D · Potential for harm, one-off | The facility did not have a licensed pharmacist review each resident's complete medication regimen and medical chart every month, or did not follow its own rules for reporting medication problems. |
| Dec 7, 2023 | D · Potential for harm, one-off | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
| Dec 5, 2022 | ▲ K · Immediate jeopardy, repeated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Dec 5, 2022 | F · Potential for harm, facility-wide | The facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. |
| Dec 5, 2022 | E · Potential for harm, repeated | The facility did not fully assess residents on time — a complete assessment of health, abilities, and needs is required when a resident is first admitted and at least once every 12 months after that. |
| Dec 5, 2022 | E · Potential for harm, repeated | The facility did not enter each resident's assessment information into the required format and send it to the state within 7 days of completing the assessment, as the rules require. |
| Dec 5, 2022 | E · Potential for harm, repeated | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Dec 5, 2022 | E · Potential for harm, repeated | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. |
| Dec 5, 2022 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Dec 5, 2022 | D · Potential for harm, one-off | The facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. |
| Dec 5, 2022 | D · Potential for harm, one-off | The facility did not reassess a resident after a significant change in their condition, such as a sudden decline in health. A full new assessment is required when a resident's condition changes in a major way. |
| Dec 5, 2022 | D · Potential for harm, one-off | The facility did not provide timely, quality laboratory tests to meet residents' needs. |
| Dec 5, 2022 | D · Potential for harm, one-off | The facility did not electronically submit complete and accurate staffing information to the government, based on payroll and other verifiable records. |
| Dec 5, 2022 | D · Potential for harm, one-off | The facility did not develop or maintain an effective training program for its direct care staff, including training on how to communicate effectively with residents. |
Inspection trend by year
Citations from standard inspections decreased between the last two inspection cycles (11 → 5).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2022 | 12 | 1 | K ▲ |
| 2023 | 11 | 0 | F |
| 2024 | 2 | 1 | J ▲ |
| 2025 | 7 | 1 | J ▲ |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
2 fines totaling $90,499.
| Date | Type | Amount / length |
|---|---|---|
| May 3, 2025 | Fine | $12,463 |
| Dec 17, 2024 | Fine | $78,036 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Oklahoma avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 4.16 | 4.58 | 3.95 | bottom 26% in Oklahoma; top 34% in the U.S. |
| Registered Nurse hours | 0.21 | 0.41 | 0.69 | bottom 11% in Oklahoma; bottom 3% in the U.S. |
| Weekend total nurse staffing | 3.93 | 4.16 | 3.50 | bottom 37% in Oklahoma; top 25% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.33 | 0.28 | 0.48 | top 26% in Oklahoma; bottom 38% in the U.S. |
| Total nursing staff turnover (%) | 61.4 | 55.5 | 45.8 | bottom 31% in Oklahoma; bottom 14% in the U.S. |
| RN turnover (%) | 0.0 | 53.6 | 42.9 | — |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 2.91, RN 0.15, weekend 2.74. Staffing rating: 1/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 4/5 · long-stay residents: 4/5 · short-stay residents: —/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Mitchell, Kelly | Individual | 5% or Greater Direct Ownership Interest | 13% | 12/27/2020 |
| Mitchell, Marcinda | Individual | 5% or Greater Direct Ownership Interest | 13% | 12/27/2020 |
| Mitchell, Robert | Individual | 5% or Greater Direct Ownership Interest | 13% | 12/27/2020 |
| Philip Marion Green Exempt Tr Cu Gilbert F Green Tr | Organization | 5% or Greater Direct Ownership Interest | 23% | 12/12/2025 |
| Tabor, Angela | Individual | 5% or Greater Direct Ownership Interest | 13% | 12/27/2020 |
| Tiffany Seay Exempt Tr | Organization | 5% or Greater Direct Ownership Interest | 27% | 12/12/2025 |
| Advanced Wound Therapy | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Agodi, Faith | Individual | Operational/Managerial Control | NOT APPLICABLE | 06/26/2023 |
| Agodi, Faith | Individual | ADP of the SNF | NOT APPLICABLE | 11/25/2025 |
| Belt, Miranda | Individual | Corporate Officer | NOT APPLICABLE | 12/09/2024 |
| Church, Anjelika | Individual | Operational/Managerial Control | NOT APPLICABLE | 06/26/2025 |
| Forvis Mazars LLP | Organization | ADP of the SNF | NOT APPLICABLE | 01/01/2010 |
| Garmon, Cynthia | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/08/2013 |
| Green, Philip | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 01/19/2026 |
| Johnson, Johnny | Individual | Operational/Managerial Control | NOT APPLICABLE | 08/15/2023 |
| Kemp, Randall | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/02/2007 |
| Kemp, Randall | Individual | ADP of the SNF | NOT APPLICABLE | 04/02/2007 |
| Kerr, Madalyn | Individual | Operational/Managerial Control | NOT APPLICABLE | 08/11/2025 |
| Mitchell, Kelly | Individual | ADP of the SNF | NOT APPLICABLE | 12/12/2025 |
| Mitchell, Marcinda | Individual | ADP of the SNF | NOT APPLICABLE | 12/12/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
- "How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
- "How many hours a day is a registered nurse physically in the building, including weekends?"
- "How do you track that every resident's quarterly assessment happens on time?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "What is your approach to psychiatric medications — how do you try non-drug options first and work to reduce doses over time?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Heartway at Heritage Village Health and Rehab | 1.7 mi | Holdenville, OK | ★★★☆☆ | 3/5 | |
| Elmwood Manor Nursing Home | 8.2 mi | Wewoka, OK | ★☆☆☆☆ | 1/5 | abuse |
| Wewoka Healthcare Center | 8.6 mi | Wewoka, OK | —/5 | abuseSFF |
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Facility data as of CMS processing date 2026-08-01. CCN 375557.