Monroe Manor
226 E Monroe Street, Jay, OK 74346 · Delaware County · 98 certified beds · avg 42 residents/day · certified since Sep 15, 2002 · Medicare and Medicaid certified
Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 2/5
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 · Sep 23, 2024 · F-0695 · triggered by a complaint
The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it.
Why it matters: Mistakes in breathing care can quickly become life-threatening for residents who depend on oxygen or equipment.
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: Oct 21, 2024 (Deficient, Provider has date of correction)
▲ Actual harm, one-off · Sep 23, 2024 · F-0684 · triggered by a complaint
The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Why it matters: Care that strays from doctor's orders or ignores the resident's wishes can lead to declining health and avoidable harm.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Oct 21, 2024 (Deficient, Provider has date of correction)
▲ Actual harm, one-off · Jan 23, 2024 · F-0684 · triggered by a complaint
The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Why it matters: Care that strays from doctor's orders or ignores the resident's wishes can lead to declining health and avoidable harm.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Feb 15, 2024 (Deficient, Provider has date of correction)
All citations in the current public record (19)
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 |
|---|---|---|
| Jun 23, 2026 | E · Potential for harm, repeated | The facility gave residents unnecessary mind-altering (psychotropic) medications, or used drugs in a way that restrained residents by dulling their ability to think, move, or function. · from a complaint |
| Sep 23, 2024 | ▲ J · Immediate jeopardy, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. · from a complaint |
| Sep 23, 2024 | ▲ G · Actual harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint |
| Sep 23, 2024 | D · Potential for harm, one-off | The facility used feeding tubes without a valid medical reason or the resident's agreement, or did not provide proper care to residents who have feeding tubes. · from a complaint |
| Aug 14, 2024 | E · Potential for harm, repeated | 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. |
| Aug 14, 2024 | E · Potential for harm, repeated | 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. |
| Aug 14, 2024 | 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. |
| Aug 14, 2024 | 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. |
| Aug 14, 2024 | D · Potential for harm, one-off | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. |
| Jul 23, 2024 | D · Potential for harm, one-off | The facility did not provide safe and appropriate pain management for a resident who needed it. · from a complaint |
| May 28, 2024 | D · Potential for harm, one-off | 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 |
| May 28, 2024 | D · Potential for harm, one-off | The facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint |
| Jan 30, 2024 | D · Potential for harm, one-off | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint |
| Jan 23, 2024 | ▲ G · Actual harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint |
| Jan 23, 2024 | E · Potential for harm, repeated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint |
| Jan 23, 2024 | D · Potential for harm, one-off | The facility did not treat residents with respect and dignity, or did not let them keep and use their own personal belongings. · from a complaint |
| Jul 14, 2023 | E · Potential for harm, repeated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Jul 14, 2023 | D · Potential for harm, one-off | 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. |
| Apr 9, 2021 | E · Potential for harm, repeated | The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline. |
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (2 → 5).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2021 | 1 | 0 | E |
| 2023 | 2 | 0 | E |
| 2024 | 15 | 3 | J ▲ |
| 2026 | 1 | 0 | E |
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 $31,773, plus 1 Medicare payment denial period.
| Date | Type | Amount / length |
|---|---|---|
| Jul 23, 2024 | Fine | $23,755 |
| Jan 23, 2024 | Fine | $8,018 |
| Jan 23, 2024 | Payment Denial | 8 days from Feb 15, 2024 |
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) | 4.74 | 4.58 | 3.95 | top 37% in Oklahoma; top 18% in the U.S. |
| Registered Nurse hours | 0.62 | 0.41 | 0.69 | top 12% in Oklahoma; top 46% in the U.S. |
| Weekend total nurse staffing | 4.38 | 4.16 | 3.50 | top 35% in Oklahoma; top 14% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.31 | 0.28 | 0.48 | top 29% in Oklahoma; bottom 34% in the U.S. |
| Total nursing staff turnover (%) | 60.0 | 55.5 | 45.8 | bottom 35% in Oklahoma; bottom 17% in the U.S. |
| RN turnover (%) | 80.0 | 53.6 | 42.9 | bottom 25% in Oklahoma; bottom 6% in the U.S. |
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 3.60, RN 0.47, weekend 3.33. Staffing rating: 3/5.
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: 3/5 · long-stay residents: 3/5 · short-stay residents: —/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Monroe Manor Nursing, LLC | Organization | 5% or Greater Direct Ownership Interest | 100% | 01/01/2023 |
| Rhine, Zvi | Individual | 5% or Greater Indirect Ownership Interest | 100% | 01/01/2023 |
| Aguirre, Ayo | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/20/2025 |
| Aguirre, Ayo | Individual | ADP of the SNF | NOT APPLICABLE | 05/20/2025 |
| Mease, Darrell | Individual | Operational/Managerial Control | NOT APPLICABLE | 03/01/2022 |
| Mease, Darrell | Individual | ADP of the SNF | NOT APPLICABLE | 03/01/2022 |
| Monroe Manor Nursing, LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 01/01/2023 |
| Rhine, Zvi | Individual | Operational/Managerial Control | NOT APPLICABLE | 03/01/2022 |
| Rhine, Zvi | Individual | ADP of the SNF | NOT APPLICABLE | 03/01/2022 |
| TLC Eretz Management LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 03/01/2022 |
| TLC Eretz Management LLC | Organization | ADP of the SNF | NOT APPLICABLE | 03/01/2022 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "How many residents here use oxygen or breathing equipment, and who checks that equipment each shift?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "What percentage of your residents are on antipsychotic or sedating medications, and how do you work to reduce that?"
- "How do you decide when a feeding tube is truly needed, and how do staff care for residents who have one?"
- "What is your approach to psychiatric medications — how do you try non-drug options first and work to reduce doses over time?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
- "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 |
|---|---|---|---|---|---|
| Grove Nursing Center | 10.5 mi | Grove, OK | ★★★☆☆ | 3/5 | |
| Betty Ann Nursing Center | 10.5 mi | Grove, OK | ★☆☆☆☆ | 1/5 | |
| Grand Lake Villa | 10.6 mi | Grove, OK | ★★☆☆☆ | 1/5 | abuse |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 375415.