Monroe Manor

Nursing Home & Skilled Nursing · Paris, MO

CMS overall rating

200 South St, Paris, MO 65275-1165 View map

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Monroe Manor accepts Medicare, Medicaid, and private pay.

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Monroe Manor accepts Medicare, Medicaid, and private pay.

Overview of Monroe Manor

Monroe Manor is a 119-bed skilled nursing facility at 200 South Street in Paris, Monroe County, Missouri, administered by Shari Embree and operated by Monroe County Nursing Home District. Established in 1973, it serves Medicare, Medicaid, and private-pay residents,
primarily short-term rehabilitation cases averaging 173 days in length.

Registered nurse time averages only 14 minutes per resident per day, 50% below Missouri’s standard of 28 minutes. Weekend RN coverage drops to 7 minutes per day (65% below the 20-minute state average). Licensed Practical Nurse coverage is at 47 minutes per day, 15% above state average, and Certified Nursing Aide hours match state benchmarks at 2 hours 21 minutes daily. Combined weekend nursing totals 2 hours 30 minutes per day, 18% below Missouri’s state average of 3 hours 3 minutes.

Long-stay residents experience 2.70 hospitalizations per 1,000 days (30% worse than the state average of 2.08 per 1,000). Short-stay ED visits occur in 19.3% of admissions, 44% worse than the state average of 13.4%. Falls with major injury among short-stay residents hit 1.6%, double the state average of 0.8%. High-risk residents with pressure ulcers represent 21.2% of the population, a striking 323% above Missouri’s 5.0% benchmark.

Incontinence management also lags, with 21.4% of low-risk residents experiencing bowel or bladder incontinence (18% worse than state). Pneumococcal vaccination rates (100% of long-stay residents) and depressive symptom identification (0.4%, 97% better than state) represent preventive care and emotional wellness support.

Occupancy stands at 59.5%, below the Missouri average of 66.6%, with a current census of 73 residents in a 119-bed facility. The facility reported a $5.8 million annual operating deficit of $379,000 (negative profit margin of 6.8%), though payroll consumes 79% of revenue.

A complaint investigation completed January 14, 2025 documented a critical infection control failure. Prior regulatory activity includes a November 12, 2024 complaint investigation citing care planning and resident rights deficiencies; a March 14, 2024 standard health inspection identifying deficiencies in catheter justification documentation and pharmacist consultation response requirements; and inspections in April 2022 and March 2019 on record. Across five inspections over the past six years, Monroe Manor accumulated 13 total citations (1 serious, 12 moderate, 0 critical), a rate of 2.6 citations per inspection compared to the Missouri average of 5.67. The facility incurred a single federal civil money penalty of $35,000 in March 2024 and faced no payment denial actions.

The facility provides a Skilled Care Cottage, rehabilitation services, active resident council, and on-site nurse aide training. Private bedrooms, full bathrooms, zero-entry showers, a sun porch, and spa room are available.

Medicare, Medicaid, and private-pay coverage are accepted.

CMS ratings stand at 3/5 overall (14.1% above Missouri average), 2/5 for health inspection (37.9% above state average), 3/5 for staffing (7.4% below state average), and 1/5 for quality measures (64.2% below state average).

Families evaluating Monroe Manor should press for details regarding staffing protocols specifically for behavioral residents, infection control procedures, and preventive care management.

Facility Direct Line (660) 327-4125

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Staffing hours breakdown

Hours per resident per day — compared to state averages

Total nursing care / resident

3h 47m per day

vs avg

5 of 6 metrics below state avg

Standout metric LPN / LVN is +20% above state avg

Staff type	Hours / Day / Resident	vs state avg
Registered Nurse (RN) RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.	14m per day	▼ 51% State avg: 28m per day · National avg: 41m per day
LPN / LVN Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.	49m per day	▲ 20% State avg: 41m per day · National avg: 52m per day
Nurse Aide Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.	2h 13m per day	▼ 5% State avg: 2h 19m per day · National avg: 2h 20m per day
Weekend Total Nursing Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.	2h 40m per day	▼ 13% State avg: 3h 3m per day · National avg: 3h 26m per day
Physical Therapist Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.	0m per day	▼ 100% State avg: 2m per day · National avg: 4m per day
Weekend RN Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.	7m per day	▼ 65% State avg: 20m per day · National avg: 28m per day

Capacity and availability

173 days

119-bed community

A larger shared setting that may offer more common spaces and organized community services.

1 year in operation

A newer community that may feature more recent facilities and programs.

Walk Score: 46 / 100

Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.

About this community

Occupancy

Occupancy rate

67%

Similar to the Missouri average: 66.6%

Occupied beds

80 / 119

Average occupied beds in Missouri homes 72 beds

Facility TypeSkilled Nursing Facility

StatusActive

IssuanceJuly 8, 2025

ExpirationJuly 7, 2027

CountyMonroe

License Number052845

Certification TypeMedicare / Medicaid

Monroe Manor is legally operated by Monroe County Nursing Home District, and administered by Shari Embree.

Corporate EntityMONROE COUNTY NURSING HOME DISTRICT

Owner NameMonroe County Nursing Home District

Skilled Nursing Facility

119 units

Total beds

119 units

Rehabilitation Services

Dedicated Alzheimer's Unit

Pets not allowed

Private Accommodations

Private Bedroom

Private Full Bathroom

Zero Entry Shower

24 Hour Care

Large Sun Porch

Spa Room

Touring HoursMonday-Friday: 7:30 a.m. to 4:00 p.m., Closed on holidays

Since 2019 · 7 years of data 52 deficiencies 14 inspections

Inspection Scorecard This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Missouri state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Since 2019 vs. Missouri state average

Overall vs. MO average

Latest Inspection January 14, 2025 Complaint Investigation

Deficiencies Deficiencies are formal regulatory issues recorded during state inspections.	This Facility	MO Average	vs. MO Avg
Total deficiencies Formal regulatory issues recorded by inspectors across all inspection types.	52	35	This facility has 49% more total deficiencies than a typical Missouri assisted living residence (52 vs. MO avg 35).↑ 49% worse
Deficiencies per year Average deficiencies per year since 2019.	7.4	5	This facility has 48% more deficiencies per year than a typical Missouri assisted living residence (7.4 vs. MO avg 5).↑ 48% worse
Deficiencies per inspection Average deficiencies per inspection.	3.7	2.9	This facility has 28% more deficiencies per inspection than a typical Missouri assisted living residence (3.7 vs. MO avg 2.9).↑ 28% worse

Inspections State inspections evaluate whether the facility meets health and safety standards.	This Facility	MO Average	vs. MO Avg
Total inspections Combined count of all routine and focused inspections. Excludes complaint investigations.	14	12	This facility has had 17% more total inspections than the Missouri average (14 vs. MO avg 12). More inspections can mean more regulatory scrutiny rather than worse care.↑ 17% more

Show Inspection Reports

Inspections since 2019

Total health inspections 5

State average N/A

Last Health inspection on Jan 2025

Total health citations

State average N/A

Citations per inspection

2.6

State average N/A

Health citations are formal notices following inspections when they fail to comply with safety and care standards.

10 of 13 citations resulted from standard inspections; and 3 of 13 resulted from complaint investigations.

Breakdown of citation severity (last 7 years)

Critical health citations

In line with State average

State average: N/A

Serious health citations

In line with State average

State average: N/A

0 critical citations State average: N/A

1 serious citation State average: N/A

12 moderate citations State average: N/A

0 minor citations State average: N/A

Citations history (last 7 years)

Infection Control moderate citation Jan 14, 2025

Corrected

Care Planning moderate citation Nov 12, 2024

Corrected

Resident Rights moderate citation Nov 12, 2024

Corrected

Pharmacy moderate citation Mar 14, 2024

Corrected

Total staff 156

Employees 60

Contractors 96

Staff to resident ratio 2.14 : 1

0% compared with State average

State average ratio: 0 : 0

Avg staff/day 33

Average shift 9.1 hours

0% compared with State average

State average: 0 hours

Total staff hours (quarter) 27,562

Nursing staff breakdown

7.6 hours

10.7 hours

9.6 hours

Contractor staffing

7,055 contractor hours this quarter

Certified Nursing Assistant: 55 Medication Aide/Technician: 20 Licensed Practical Nurse: 12 Registered Nurse: 9

Staff by category


Certified Nursing Assistant	12	55	67	7,681	92	100%	9.6
Medication Aide/Technician	12	20	32	5,246	92	100%	10.4
Licensed Practical Nurse	5	12	17	3,656	92	100%	10.7
Other Dietary Services Staff	12	0	12	3,183	92	100%	6.1
Nurse Aide in Training	6	0	6	2,535	92	100%	10.9
RN Director of Nursing	4	0	4	2,079	73	79%	8.1
Registered Nurse	5	9	14	1,038	92	100%	7.6
Nurse Practitioner	1	0	1	570	64	70%	8.9
Administrator	1	0	1	547	64	70%	8.5
Dietitian	1	0	1	537	66	72%	8.1
Occupational Therapy Aide	1	0	1	492	62	67%	7.9

67 Certified Nursing Assistant

% of Days 100%

32 Medication Aide/Technician

% of Days 100%

17 Licensed Practical Nurse

% of Days 100%

12 Other Dietary Services Staff

% of Days 100%

6 Nurse Aide in Training

% of Days 100%

4 RN Director of Nursing

% of Days 79%

14 Registered Nurse

% of Days 100%

1 Nurse Practitioner

% of Days 70%

1 Administrator

% of Days 70%

1 Dietitian

% of Days 72%

1 Occupational Therapy Aide

% of Days 67%

View All Staffing Data

Total fines amount $35K

52% lower than State average

State average: $73K

Number of fines 1

59% fewer fines than State average

State average: 2.4

Payment Denials 0

100% fewer payment denials than State average

State average: 0.7

Fines amount comparison

This facility $35K

State average $73K

Penalty History

Penalties are imposed by CMS for violations of federal nursing home regulations.

1 penalty in the past 3 years

Mar 14, 2024 · $35K

Civil Money Penalty Mar 14, 2024

$35K

Last updated: Jan 2026

High-risk clinical events score 14.7

34% worse than State average

State average: 10.9

Functional decline score 20.5

5% worse than State average

State average: 19.5

Long-stay resident measures

Average

Need for Help with Daily Activities Increased 22.5%

14% worse than State average

State average: 19.8%

Walking Ability Worsened 17.6%

15% better than State average

State average: 20.6%

Low Risk Residents with Bowel/Bladder Incontinence 21.4%

18% worse than State average

State average: 18.1%

Falls with Major Injury 3.9%

In line with State average

State average: 4.0%

High Risk Residents with Pressure Ulcers 21.2%

323% worse than State average

State average: 5.0%

Urinary Tract Infection 0.8%

70% better than State average

State average: 2.7%

Lost Too Much Weight 8.2%

47% worse than State average

State average: 5.6%

Depressive Symptoms 0.4%

97% better than State average

State average: 12.8%

Antipsychotic Use 20.9%

5% better than State average

State average: 22.0%

Pneumococcal Vaccine 100.0%

17% better than State average

State average: 85.2%

Influenza Vaccine 92.8%

In line with State average

State average: 90.9%

Hospitalizations per 1,000 days 2.70

30% worse than State average

State average: 2.08

ED visits per 1,000 days 1.35

43% better than State average

State average: 2.35

Short-stay resident measures

Significantly below average

Pneumococcal Vaccine 97.2%

46% better than State average

State average: 66.6%

Antipsychotic medication increase 1.3%

41% better than State average

State average: 2.2%

Influenza Vaccine 69.6%

10% better than State average

State average: 63.5%

Re-hospitalized after SNF stay 21.7%

14% better than State average

State average: 25.3%

Emergency department visits 19.3%

44% worse than State average

State average: 13.4%

Falls with major injury 1.6%

103% worse than State average

State average: 0.8%

Ability to care for self at discharge 55.6%

In line with State average

State average: 53.7%

Successful return to home or community 52.1%

In line with State average

State average: 50.6%

Breakdown by payment type

Medicare

63% of new residents, usually for short-term rehab.

Typical stay 25 days

Private pay

33% of new residents, often for short stays.

Typical stay 7 - 8 months

Medicaid

4% of new residents, often for long-term daily care.

Typical stay 6 - 7 years

Total residents 73

Medicare

8.2% of residents

Medicaid

43.8% of residents

Private pay or other

47.9% of residents

Programs & Services

Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Nurse Aide Training

State-approved Nurse Aide Training and Competency Evaluation Program on-site

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

Financial Trends

Historical financial and operational data for Monroe Manor from 2011–2023, based on CMS SNF Cost Reports.

Key figures below are for fiscal year ending in 12/2023.

Occupancy Rate 59.5% ↓ 1.3pp vs 2022

Net Patient Income -$650.1K ↑ ~$410.3K vs 2022

Payroll Costs $2.8M ↑ ~$11.4K vs 2022

Operating Margin -10.9% ↑ 7.9pp vs 2022

Metric	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023
Occupancy %	64.6%	65.8%	75.5%	75.0%	74.8%	68.5%	71.7%	66.5%	63.5%	49.7%	62.3%	60.8%	59.5%
Beds	119	119	119	119	119	119	119	119	119	119	119	119	119
Net Income	$109,995	$270,571	$402,199	$198,595	$16,469	$81,687	-$231,858	-$530,592	-$150,538	$390,320	$39,135	-$61,363	-$378,969
Gross Revenue	$4,166,094	$4,769,797	$5,118,633	$5,288,103	$5,419,090	$5,297,735	$5,920,564	$5,572,710	$5,429,441	$5,398,200	$5,008,068	$5,134,923	$5,552,247
Operating Expenses	$4,619,513	$4,878,006	$5,188,606	$5,514,571	$5,892,624	$5,666,775	$6,483,295	$6,467,790	$6,002,715	$6,424,618	$6,239,497	$6,697,304	$6,590,163
Net Patient Income	-$61,593	$93,852	$221,785	$22,184	-$158,487	-$111,211	-$420,754	-$784,945	-$386,025	-$474,397	-$680,663	-$1,060,397	-$650,125
Net Patient Revenue	$4,557,920	$4,971,858	$5,410,391	$5,536,755	$5,734,137	$5,555,564	$6,062,541	$5,682,845	$5,616,690	$5,950,221	$5,558,834	$5,636,907	$5,940,038
Payroll Costs	$2,449,866	$2,465,101	$2,490,547	$2,701,725	$3,029,184	$3,051,820	$3,491,175	$3,687,672	$3,448,224	$3,175,562	$3,100,911	$2,746,703	$2,758,087
Operating Margin %	-1.4%	1.9%	4.1%	0.4%	-2.8%	-2.0%	-6.9%	-13.8%	-6.9%	-8.0%	-12.2%	-18.8%	-10.9%
Medicare %	10.1%	9.0%	5.6%	6.3%	7.4%	6.8%	7.3%	6.6%	7.4%	11.3%	9.2%	10.8%	8.4%
Medicaid %	49.3%	47.0%	49.6%	45.5%	42.7%	47.4%	40.1%	46.2%	53.8%	64.3%	59.2%	50.4%	51.0%
Private %	40.6%	44.0%	44.8%	48.1%	49.9%	45.8%	52.6%	47.1%	38.8%	24.4%	31.6%	38.8%	40.6%
Net Patient Revenue/Day	$162	$173	$165	$170	$176	$186	$195	$197	$204	$275	$206	$214	$230
Cost/Day	$165	$170	$158	$169	$181	$190	$208	$224	$218	$297	$231	$254	$255
Avg Length of Stay	280.7 days	289.5 days	443.2 days	509.2 days	378.0 days	488.7 days	247.3 days	179.4 days	151.5 days	105.1 days	229.2 days	197.0 days	173.4 days

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 12/2023.

Net patient revenue

$5.9M

Net patient income

-$650.1K

Government Operated by federal authorities.

Net patient revenue

$5.9M

Net patient income

-$650.1K

Other income

$271.2K

Payroll costs

$2.8M 46.4% of net patient revenue

Other operating costs

$3.8M

Total costs

$6.6M

TYPE OF STAY

Mostly short-term rehab stays

Most residents typically stay for a few weeks or months before returning home or moving on.

Most new residents arrive under Medicare (63% of admissions), and a typical Medicare stay runs around 25 days.

Coverage residents most often arrive under.

Medicare 63%

Private pay 33%

Medicaid 4%

Coverage residents most often leave under.

Medicare 38%

Private pay 42%

Medicaid 20%

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The information below is reported by the Missouri Department of Health and Senior Services, Division of Regulation and Licensure.


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Nursing Home Explorer

Who is the owner of Monroe Manor?

Monroe Manor is legally operated by Monroe County Nursing Home District, and administered by Shari Embree.

Is Monroe Manor in a walkable area?

Monroe Manor has a walk score of 46. Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.

What is the license number of Monroe Manor?

According to MO state health department records, Monroe Manor's license number is 052845.

When does Monroe Manor's license expire?

According to MO state health department records, Monroe Manor's license expires on July 7, 2027.

What is the occupancy rate at Monroe Manor?

Monroe Manor's occupancy is 67%.

Are pets allowed at Monroe Manor?

No, Monroe Manor has a no-pet policy.

Is Monroe Manor a government-operated facility?

Monroe Manor is a government-operated nursing facility in MO.

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Monroe Manor

Overview of Monroe Manor

Quality ratings

Staffing hours breakdown

Capacity and availability

About this community

Occupancy

License Details

Ownership & Operating Entity

Type Of Units

Therapy & Rehabilitation

Memory & Specialized Care

Additional Policies & Features

Amenities & Lifestyle

Contact Monroe Manor

Inspection History

Inspection Scorecard This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Missouri state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Deficiencies Deficiencies are formal regulatory issues recorded during state inspections.

Inspections State inspections evaluate whether the facility meets health and safety standards.

Health Inspection History

Inspections since 2019

Breakdown of citation severity (last 7 years)

Citations history (last 7 years)

Staffing Data

Nursing staff breakdown

Registered Nurse

Licensed Practical Nurse

Certified Nursing Assistant

Contractor staffing

Staff by category

67 Certified Nursing Assistant

32 Medication Aide/Technician

17 Licensed Practical Nurse

12 Other Dietary Services Staff

6 Nurse Aide in Training

4 RN Director of Nursing

14 Registered Nurse

1 Nurse Practitioner

1 Administrator

1 Dietitian

1 Occupational Therapy Aide

Penalties and fines

Fines amount comparison

Fines amount comparison

Penalty History

Quality of care over time

Long-stay resident measures

Short-stay resident measures

Breakdown by payment type

Medicare

Private pay

Medicaid

Facility Characteristics

Programs & Services

Residents Group

Nurse Aide Training

Active Resident Council

Financial Trends

Financial Performance

Payroll & Labor Costs

Payer Mix (percentage)

Finances and operations

Who this home usually serves

Mostly short-term rehab stays

Admissions

Discharges

Places of interest near Monroe Manor

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