Independent · Federal inspection records, searchable
Not a law firm · Not a government agency
Nursing Home Violations Public inspection data, searchable
Facility profile · CCN 055329

Villa Serena Healthcare Center

43 federal citations on record , including 2 at the Immediate Jeopardy level, and 1 federal enforcement actions totaling $26,685.

2 Immediate Jeopardy

Record summary

Federal record · Q1 2026
43
Total citations
37
Last 3 years
2
Actual harm+
1
Federal penalties
$26,685
Total fines
4
Overall ★ rating

Most common violation categories here

Quality of Care10 Environment & Safety7 Care Planning5 Nutrition & Dietary5 Resident Rights4

Most common F-tags at this facility

F6843 F9113 F9123 F6982 F8122

Citation history

43 on record
SurveyF-TagViolationSeveritySource
Nov 25, 2025F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.DComplaint
Mar 28, 2025F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.DComplaint
Jan 18, 2025F836Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.EComplaint
Jan 18, 2025F912Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.FStandard
Jan 18, 2025F911Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents.EStandard
Jan 18, 2025F887Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.FStandard
Jan 18, 2025F881Implement a program that monitors antibiotic use.EStandard
Jan 18, 2025F880Provide and implement an infection prevention and control program.FStandard
Jan 18, 2025F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.EStandard
Jan 18, 2025F805Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.DStandard
Jan 18, 2025F803Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.EStandard
Jan 18, 2025F800Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.DStandard
Jan 18, 2025F773Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.DStandard
Jan 18, 2025F761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.EStandard
Jan 18, 2025F759Ensure medication error rates are not 5 percent or greater.EStandard
Jan 18, 2025F758Implement 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.EStandard
Jan 18, 2025F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.DStandard
Jan 18, 2025F698Provide safe, appropriate dialysis care/services for a resident who requires such services.EStandard
Jan 18, 2025F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.EStandard
Jan 18, 2025F678Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.JStandard
Jan 18, 2025F644Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.DStandard
Jan 18, 2025F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.JStandard
Jan 18, 2025F578Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.DStandard
Jan 18, 2025F554Allow residents to self-administer drugs if determined clinically appropriate.DStandard
May 31, 2024F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.DComplaint
May 31, 2024F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DComplaint
May 6, 2024F880Provide and implement an infection prevention and control program.FComplaint
Jan 21, 2024F912Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.BStandard
Jan 21, 2024F911Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents.BStandard
Jan 21, 2024F908Keep all essential equipment working safely.FStandard
Jan 21, 2024F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.FStandard
Jan 21, 2024F770Provide timely, quality laboratory services/tests to meet the needs of residents.DStandard
Jan 21, 2024F692Provide enough food/fluids to maintain a resident's health.DStandard
Jan 21, 2024F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.DStandard
Jan 21, 2024F645PASARR screening for Mental disorders or Intellectual DisabilitiesDStandard
Jan 21, 2024F558Reasonably accommodate the needs and preferences of each resident.DStandard
Jan 21, 2024F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.EStandard
Nov 17, 2021F912Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.BStandard
Nov 17, 2021F911Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents.BStandard
Nov 17, 2021F698Provide safe, appropriate dialysis care/services for a resident who requires such services.DStandard
Nov 17, 2021F695Provide safe and appropriate respiratory care for a resident when needed.DStandard
Nov 17, 2021F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DStandard
Nov 17, 2021F641Ensure each resident receives an accurate assessment.DStandard

Federal enforcement history

Federal regulators have imposed 1 enforcement actions against this facility, including 1 civil money penalties totaling $26,685 .

DateTypeFinePayment denial
Jan 18, 2025Fine$26,685—
About this record A citation is a finding by a state survey team working under federal contract. It is not a court judgment. The description above is drawn verbatim from federal public datasets. Facilities have the right to appeal findings through an Informal Dispute Resolution (IDR/IIDR) process.

Concerned about care at Villa Serena Healthcare Center?

An attorney who focuses on nursing-home abuse and neglect can review the facility's record with you — citation patterns, scope/severity levels, complaint-driven findings — and tell you whether the law recognizes what happened.

  • Consultation is free and confidential
  • You pay nothing unless there is a recovery
  • Your note is shared only with vetted plaintiff attorneys
Free · Confidential · Nationwide network
Free Consultation Request
Tell us about your family's situation
A plaintiff attorney will review your note and respond within one business day.