Public Record
Villa Maria
From CMS
Facility profile
- CMS overall rating
- 5 / 5
- Certified beds
- 64
- Avg. residents per day
- 58.2
*CMS Five-Star
*CMS
*CMS
Inspection record
On record from CMS
- Citations on record
- 51
- Inspections on file
- 6
- Last inspection
- 2025-07-30
*CMS
*CMS
*CMS
Citations
51 citations on record
Each deficiency cited on a CMS health inspection of this facility, sourced from the federal record. Open a report for the raw CMS Scope and Severity grade on each finding.
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
- 0689Generalpotential for harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 0753Generalpotential for harm
Have restrictions on the use of highly flammable decorations.
- 0712Generalpotential for harm
Have simulated fire drills held at unexpected times.
- 0353Generalpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0324Generalpotential for harm
Provide properly protected cooking facilities.
- 0321Generalpotential for harm
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- 0161Generalpotential for harm
Use approved construction type or materials.
- 0918Generalpotential for harm
Have generator or other power source capable of supplying service within 10 seconds.
- 0920Generalpotential for harm
Ensure proper usage of power strips and extension cords.
- 0700Generalpotential for harm
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
- 0550Generalpotential for harm
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- 0582Generalpotential for harm
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- 0657Generalpotential for harm
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- 0686Generalpotential for harm
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- 0692Generalpotential for harm
Provide enough food/fluids to maintain a resident's health.
- 0755Generalpotential for harm
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- 0004Generalpotential for harm
Develop and maintain an Emergency Preparedness Program (EP).
- 0007Generalpotential for harm
Address patient/client population and determine types of services needed.
- 0222Generalpotential for harm
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- 0324Generalpotential for harm
Provide properly protected cooking facilities.
- 0325Generalpotential for harm
Have properly installed hallway dispensers for alcohol-based hand rub.
- 0353Generalpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0712Generalpotential for harm
Have simulated fire drills held at unexpected times.
- 0761Generalpotential for harm
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- 0918Generalpotential for harm
Have generator or other power source capable of supplying service within 10 seconds.
- 0920Generalpotential for harm
Ensure proper usage of power strips and extension cords.
- 0923Generalpotential for harm
Have proper medical gas storage and administration areas.
- 0321Generalpotential for harm
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- 0345Generalpotential for harm
Have approved installation, maintenance and testing program for fire alarm systems.
- 0353Generalpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0372Generalpotential for harm
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- 0374Generalpotential for harm
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- 0511Generalpotential for harm
Have properly installed electrical wiring and gas equipment.
- 0711Generalpotential for harm
Provide a written emergency evacuation plan.
- 0914Generalpotential for harm
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- 0918Generalpotential for harm
Have generator or other power source capable of supplying service within 10 seconds.
- 0923Generalpotential for harm
Have proper medical gas storage and administration areas.
- 0211Generalpotential for harm
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- 0222Generalpotential for harm
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- 0291Generalpotential for harm
Install emergency lighting that can last at least 1 1/2 hours.
- 0812Generalpotential for harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- 0814Generalpotential for harm
Dispose of garbage and refuse properly.
- 0880Generalpotential for harm
Provide and implement an infection prevention and control program.
- 0758Generalpotential for harm
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
- 0757Generalpotential for harm
Ensure each resident’s drug regimen must be free from unnecessary drugs.
- 0756Generalpotential for harm
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
- 0695Generalpotential for harm
Provide safe and appropriate respiratory care for a resident when needed.
- 0690Generalpotential for harm
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- 0689Generalpotential for harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 0661Generalpotential for harm
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
- 0293Generalpotential for harm
Have properly located and lighted "Exit" signs.
FAQ
Questions and answers
- What is Villa Maria?
- Villa Maria is a Medicare- and Medicaid-certified nursing home in Mulvane, KS, tracked by the Centers for Medicare & Medicaid Services (CMS). Its CMS Certification Number (CCN) is 175456.
- What is the CMS rating for Villa Maria?
- Villa Maria has a CMS overall rating of 5 out of 5 stars. CMS rates nursing homes on health inspections, staffing, and quality measures.
- How many beds does Villa Maria have?
- Villa Maria is certified for 64 beds. It serves an average of 58.2 residents per day.
- How many citations does Villa Maria have?
- Villa Maria has 51 citations on record from CMS health inspections, each tied to a federal deficiency tag.
- When was Villa Maria last inspected?
- Villa Maria was last inspected on July 30, 2025. CMS surveys nursing homes about once a year and after complaints.
- What can I do if I have concerns about care at this facility?
- Start by raising the concern with the facility administrator or director of nursing. Every state also runs a free long-term care ombudsman program that advocates for residents and families; the federal Eldercare Locator at eldercare.acl.gov can connect you with yours. Complaints about quality of care can also be filed with your state survey agency.
*Sourced from the Centers for Medicare & Medicaid Services (CMS). See the official record on CMS Care Compare. If you believe any information is inaccurate, report it here.
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