The nursing home failed to provide proper pressure ulcer care and failed to prevent new pressure sores from developing. Cited April 2026 — isolated incident, actual harm.
View the original federal record
F-Tag 686 — 42 CFR §483.25(b) — S/S: G
Nursing home report
Villa at Borgess Place
Kalamazoo, MI · Medicare-certified · 101 beds
Needs attention
For-profitChain member
Data as of July 1, 2026
2 of 5 overall
Villa at Borgess Place has an overall 2-star rating, with a 1-star health inspection rating despite 5-star quality measures and 3-star staffing. It reports 4.40 nurse staffing hours per resident per day versus the 4.1 federal benchmark, and it had $45,130 in fines in the last 24 months with a recent federal penalty.
Facility ratings
Health inspections
Staffing
4.3952 hrs/resident/day
Quality measures
Last inspection: April 21, 2026Penalties, last 24 months: $45,130recent federal penalty
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 4.3952.
Staffing detail
- Registered nurses
- 0.58
- Licensed practical nurses
- 1.09
- Nurse aides
- 2.72
- Weekend nursing
- 3.90
Hours per resident per day.
Total staff turnover: 64%
Registered nurse turnover: 62%
Resident outcomes
Each measure compares a year ago with the most recent quarter. Green means the facility moved the right way; red means the wrong way.
Negative outcomes
Lower is better — fewer affected residents. A decrease is good (green); an increase is concerning (red).
Long-stay residents on antipsychotic medication
6.2%6.7%No change
Residents with a fall causing major injury
3.4%3.7%No change
Residents with pressure ulcers (bedsores)
8.9%8.6%No change
Residents with a urinary tract infection
0%0%No change
Residents who lost too much weight
0%5.1%Worsening
Residents who were physically restrained
0%0%No change
Residents needing more help with daily activities
10.3%9.8%Improving
Residents whose ability to walk got worse
—14.1%—
Long-stay residents on antianxiety or sleep medication
12.5%17.1%Worsening
Short-stay residents newly given an antipsychotic
0%0.6%Worsening
Residents with a long-term catheter
1.3%0%Improving
Residents with new or worsening incontinence
31.6%29.9%Improving
Residents with depressive symptoms
7.4%11.1%Worsening
Positive outcomes
Higher is better — e.g. vaccinations. An increase is good (green); a decrease is concerning (red).
Long-stay residents given the seasonal flu vaccine
—100%—
Long-stay residents given the pneumonia vaccine
100%100%No change
Short-stay residents given the seasonal flu vaccine
—94.1%—
Short-stay residents given the pneumonia vaccine
91.3%85.3%Worsening
What the inspectors found
The nursing home failed to keep the area free of hazards and provide enough supervision to prevent accidents. Cited March 2026 — isolated incident, actual harm.
View the original federal record
F-Tag 689 — 42 CFR §483.25(d) — S/S: G
The nursing home failed to develop and carry out a complete care plan that met each resident’s needs with clear steps and timelines. Cited August 2025 — isolated incident, actual harm.
View the original federal record
F-Tag 656 — 42 CFR §483.21(b)(1) — S/S: G
The home failed to make sure food was safely sourced, stored, prepared, and served according to professional standards. Cited August 2025 — widespread issue, potential for harm.
View the original federal record
F-Tag 812 — 42 CFR §483.60(i) — S/S: F
The home failed to ensure meals and menus were planned, updated, and followed to meet residents’ nutritional needs. Cited June 2025 — widespread issue, potential for harm.
View the original federal record
F-Tag 803 — 42 CFR §483.60 — S/S: F
Recent history
- STAFFING
Reported nurse staffing met or exceeded the federal recommendation.
- INSPECTION
Health inspection found 3 health deficiencies.
See what inspectors found
- STAFFING
Reported nurse staffing met or exceeded the federal recommendation.
- INSPECTION
Health inspection found 4 health deficiencies.
See what inspectors found
- INSPECTION
Health inspection found 6 health deficiencies.
See what inspectors found
- PENALTY
A federal fine of $45,130 was recorded.
- PENALTY
A federal payment denial was recorded.
- PENALTY
A federal fine of $69,430 was recorded.
- INSPECTION
Health inspection found 18 health deficiencies.
See what inspectors found
Penalties & enforcement
On record with Medicare: 1 fine · $45,130 in total fines · 1 payment denial.
- 23 days
Medicare/Medicaid payment denial
Aug 13, 2025
- $45,130
Federal fine
Aug 13, 2025
Operator & ownership
Recent ownership change · Sep 3, 2024
Now operated by Villa at Borgess Place, previously Ascension Living Borgess Place.
- Ownership
- For profit - Corporation
- Chain
- Part of VILLA HEALTHCARE · 18 homes · 2.8 stars avg
- Occupancy
- 92.6 residents on an average day (92% of 101 beds)
- Resident voice
- Resident council
- Medicare history
- Certified for 50 years
Things at a nursing home change — inspections, staffing, ownership, news.
Source: Centers for Medicare & Medicaid Services — public records, updated monthly. GoodStanding presents official records with plain-language summaries. Always visit a facility in person.