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Complaint Investigation

The Villas At Roseville

April 30, 2026 · Roseville, MN · 1000 Lovell Avenue
Citations 6
CMS Rating 3/5
Beds 63
Provider ID 245326
Healthcare Facility
The Villas At Roseville
Roseville, MN  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

THE VILLAS AT ROSEVILLE in ROSEVILLE, MN — inspection on April 30, 2026.

Found 6 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

Inspection Findings

FF0604
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Potential for More Than Minimal Harm

Federal health inspectors cited THE VILLAS AT ROSEVILLE in ROSEVILLE, MN for a deficiency under regulatory tag F-F0604 during a standard health inspection conducted on 2026-04-30.

Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies

The facility was found deficient in the following area: Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 6 deficiencies cited during this inspection of THE VILLAS AT ROSEVILLE.

Correction Status: Deficient, Provider has no plan of correction.

Federal health inspectors cited THE VILLAS AT ROSEVILLE in ROSEVILLE, MN for a deficiency under regulatory tag F-F0657 during a standard health inspection conducted on 2026-04-30.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 6 deficiencies cited during this inspection of THE VILLAS AT ROSEVILLE.

Correction Status: Deficient, Provider has no plan of correction.

Federal health inspectors cited THE VILLAS AT ROSEVILLE in ROSEVILLE, MN for a deficiency under regulatory tag F-F0685 during a standard health inspection conducted on 2026-04-30.

Category: Quality of Life and Care Deficiencies

The facility was found deficient in the following area: Assist a resident in gaining access to vision and hearing services.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 6 deficiencies cited during this inspection of THE VILLAS AT ROSEVILLE.

Correction Status: Deficient, Provider has no plan of correction.

disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on

services for 1 of 1 residents (R4) who had a referral to obtain psychiatrist services.

Findings include:R4's quarterly Minimum Data Set (MDS) dated [DATE], identified R4 was cognitively intact with diagnoses of borderline personality disorder, post-traumatic stress disorder and major depressive disorder.R4's provider order dated 3/11/26, indicated psychiatry to see R4 next week, social work to get in touch with case manager to expedite transfer to a setting that would support her mental health, also seeking changes to her psychiatric medications due to her increased anxiety, and R4 requested female caregivers. R4's care plan dated 4/21/26, indicated R4 was at risk for altered behavior related to trauma. R4 required a referral for psychiatry services, collaboration with social services and psychiatry improved social connections and minimize symptomology.R4's psychiatry provider notes were requested however were not provided.

When interviewed on 4/27/26 at 2:50 p.m., R4 stated her post-traumatic stress disorder, anxiety and depression made her feel that she wasn't heard and understood by staff. R4 used an IPAD to speak with a grief therapist but was not offered any additional therapy or mental health support.

When interviewed on 4/29/26 at 11:26 a.m., nursing assistant (NA)-C stated if a resident was having behaviors, stress-based outbursts, the care was to use therapeutic communication, acknowledge their concerns, respond calmly, and explain the situation without judgement, meet the resident where they are at.When interviewed on 4/30/26 at 9:46 a.m., registered nurse (RN)-B stated provider orders were to be followed. If referrals made, it was important, so all caregivers were on the same page and were able to provide cohesive care. RN-B stated she was unaware of the referral for psychiatrist for R4.When interviewed on 4/30/26 at 9:63a.m., service director (SS)-A stated the process to obtain an appointment for psychiatric services were offered on admission, as ordered and as needed.

The social services department was responsible for scheduling appointments with the outside psychiatrist team. SS-A stated R4's order was not completed because social services was unaware of the order.

When interviewed on 4/30/26 at 1:46 p.m., director of nursing (DON) The DON staff were expected to place provider orders into the medical record as soon as possible.

The expectation was to have outside psychiatric appointments set up per orders. It was important to provide/arrange psychological counselling services to meet the needs of the resident, what was driving behaviors, provide proper care, it was a collaborative approach to the behaviors. DON further stated they were not sure why R4's order was missed and it was unknown if the R4 accepted or declined the additional services and would look into it. No further information was provided. A policy titled Trauma Care dated 2/24/23 indicated the inter-disciplinary team monitor effects of approaches to ensure they are implemented and care plans updated.

Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.

For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE

Federal health inspectors cited THE VILLAS AT ROSEVILLE in ROSEVILLE, MN for a deficiency under regulatory tag F-F0791 during a standard health inspection conducted on 2026-04-30.

Category: Quality of Life and Care Deficiencies

The facility was found deficient in the following area: Provide or obtain dental services for each resident.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 6 deficiencies cited during this inspection of THE VILLAS AT ROSEVILLE.

Correction Status: Deficient, Provider has no plan of correction.

Federal health inspectors cited THE VILLAS AT ROSEVILLE in ROSEVILLE, MN for a deficiency under regulatory tag F-F0801 during a standard health inspection conducted on 2026-04-30.

Category: Nutrition and Dietary Deficiencies

The facility was found deficient in the following area: Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

Scope/Severity Level F: widespread, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 6 deficiencies cited during this inspection of THE VILLAS AT ROSEVILLE.

Correction Status: Deficient, Provider has no plan of correction.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in ROSEVILLE, MN, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from THE VILLAS AT ROSEVILLE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


More Reports

About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.