Colonial Village

Name: Colonial Village
Address: 12500 W 137TH ST, Overland Park, KS, 66221, US
Telephone: 9137303700

12500 W 137th St, Overland Park, KS 66221 · Johnson County · 40 certified beds · avg 35 residents/day · certified since Dec 12, 2018

Part of chain: PIVOTAL HEALTH CARE (9 facilities, chain avg rating 3.9★)

2/5

Health inspection rating (on-site)

Serious findings on record

Fines, last 3 years

5.34

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 2/5

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.

Most serious findings (actual harm or immediate jeopardy)

▲ Actual harm, one-off · Oct 31, 2024 · F-0692

The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration.

Why it matters: Malnutrition and dehydration can quickly weaken a resident and lead to serious complications.

Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.

Corrected: Nov 21, 2024 (Deficient, Provider has date of correction)

All citations in the current public record (28)

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.

Date	Severity	What the facility was cited for
Oct 31, 2024	▲ G · Actual harm, one-off	The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration.
Oct 31, 2024	F · Potential for harm, facility-wide	The facility did not observe each nurse aide's job performance or provide regular training as required.
Oct 31, 2024	F · Potential for harm, facility-wide	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Oct 31, 2024	E · Potential for harm, repeated	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide.
Oct 31, 2024	D · Potential for harm, one-off	The facility did not give residents (and their representatives and the ombudsman, a state advocate for residents) proper advance notice before a transfer or discharge, including information about their right to appeal.
Oct 31, 2024	D · Potential for harm, one-off	The facility did not give the resident or their representative written notice of how long it would hold the resident's bed during a hospital stay or approved leave.
Oct 31, 2024	D · Potential for harm, one-off	The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.
Oct 31, 2024	D · Potential for harm, one-off	The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections.
Oct 31, 2024	D · Potential for harm, one-off	The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits.
Oct 31, 2024	D · Potential for harm, one-off	The facility did not arrange hospice services for a resident who needed them, or help the resident move to a facility that could arrange hospice. Hospice provides comfort-focused care for people nearing the end of life.
Jun 8, 2023	E · Potential for harm, repeated	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Jun 8, 2023	E · Potential for harm, repeated	The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock.
Jun 8, 2023	E · Potential for harm, repeated	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Jun 8, 2023	E · Potential for harm, repeated	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide.
Jun 8, 2023	D · Potential for harm, one-off	The facility did not allow residents to take their own medications when a clinical review showed they could do so safely. Residents have this right if their care team determines it's appropriate.
Jun 8, 2023	D · Potential for harm, one-off	The facility used physical restraints — devices that limit a resident's movement — when they weren't needed for medical treatment.
Jun 8, 2023	D · Potential for harm, one-off	The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines.
Jun 8, 2023	D · Potential for harm, one-off	The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required.
Jun 8, 2023	D · Potential for harm, one-off	The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own.
Jun 8, 2023	D · Potential for harm, one-off	The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline.
Jun 8, 2023	D · Potential for harm, one-off	The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections.
Jun 8, 2023	D · Potential for harm, one-off	The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it.
Jun 8, 2023	D · Potential for harm, one-off	The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits.
Jun 8, 2023	C · Minimal risk, facility-wide	The facility did not electronically submit complete and accurate staffing information to the government, based on payroll and other verifiable records.
Nov 2, 2021	F · Potential for harm, facility-wide	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide.
Nov 2, 2021	E · Potential for harm, repeated	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Nov 2, 2021	D · Potential for harm, one-off	The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own.
Nov 2, 2021	D · Potential for harm, one-off	The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections.

Inspection trend by year

Citations from standard inspections decreased between the last two inspection cycles (14 → 10).

Year	Citations	Serious (G–L)	Worst severity that year
2021	4	0	F
2023	14	0	E
2024	10	1	G ▲

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

No fines or payment denials in the published 3-year window.

Nurse staffing (from payroll records, adjusted for how much care residents need)

Measure	This facility	Kansas avg	U.S. avg	Where it stands
Total nurse staffing (hours per resident per day)	5.34	4.58	3.95	top 22% in Kansas; top 9% in the U.S.
Registered Nurse hours	1.21	0.81	0.69	top 14% in Kansas; top 9% in the U.S.
Weekend total nurse staffing	4.85	4.05	3.50	top 20% in Kansas; top 8% in the U.S.
Weekend RN hours (not acuity-adjusted)	0.81	0.49	0.48	top 11% in Kansas; top 11% in the U.S.
Total nursing staff turnover (%)	63.0	48.1	45.8	bottom 16% in Kansas; bottom 12% in the U.S.
RN turnover (%)	61.5	42.0	42.9	bottom 21% in Kansas; bottom 20% in the U.S.

Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 4.43, RN 1.00, weekend 4.02. Staffing rating: 4/5.

Self-reported quality measures

Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.

Quality measures rating: 4/5 · long-stay residents: 4/5 · short-stay residents: 4/5

Who owns this facility

For profit - Corporation

Owner / manager	Type	Role	Stake	Since
3RK, LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	01/01/2021
5 R Cattle, LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	12/01/2018
Anderson, Jordan	Individual	Indirect Ownership Interest	NOT APPLICABLE	10/01/2021
Anderson, Marlene	Individual	Indirect Ownership Interest	NOT APPLICABLE	12/01/2018
Anderson, Wayne	Individual	Indirect Ownership Interest	NOT APPLICABLE	12/01/2018
Cadet Investment LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	12/01/2018
Gulledge, Scott	Individual	Indirect Ownership Interest	NOT APPLICABLE	12/01/2018
Gulledge, Travis	Individual	Indirect Ownership Interest	NOT APPLICABLE	10/01/2021
Howard, Steven	Individual	Indirect Ownership Interest	NOT APPLICABLE	12/01/2018
Lmray, LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	12/01/2018
Poky - 5r LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	07/31/2022
Poky Feeders INC	Organization	Indirect Ownership Interest	NOT APPLICABLE	12/01/2018
Scenic Development LLC	Organization	Direct Ownership Interest	NOT APPLICABLE	12/01/2018
Scenic Holdings LLC	Organization	Direct Ownership Interest	NOT APPLICABLE	07/31/2022
Wood, Gilbert	Individual	Indirect Ownership Interest	NOT APPLICABLE	12/01/2018
WSG LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	12/01/2018
Abby, Amber	Individual	Operational/Managerial Control	NOT APPLICABLE	05/02/2026
Abby, Amber	Individual	ADP of the SNF	NOT APPLICABLE	05/02/2026
Anderson, Jordan	Individual	Operational/Managerial Control	NOT APPLICABLE	01/01/2025
Curana Health of Missouri-Kansas LLC	Organization	ADP of the SNF	NOT APPLICABLE	03/01/2023

Questions to ask on your visit

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

"How do you monitor residents' weight and eating, and what happens when someone starts losing weight?"
"How often do you evaluate your nurse aides and what ongoing training do they receive?"
"What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
"Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
"If you ever planned to discharge or transfer my family member, how much written notice would we receive and how could we appeal?"
"If my family member goes to the hospital, how long will you hold their bed, and will we get that in writing?"
"How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
"How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
"What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
"Can I see the results and plan of correction from your most recent state inspection?"

Nearby facilities (within 20 miles)

Facility	Distance	City	Overall	Inspection	Flags
Nottingham Health and Rehabilitation	0.8 mi	Olathe, KS	★★★★★	5/5
Stratford Commons Rehab & Health Care Center	1.6 mi	Overland Park, KS	★★★☆☆	3/5
Villa St Francis Catholic Care Center INC	2.7 mi	Olathe, KS	★★★★★	3/5
The Plaza Health Services at Santa Marta	2.7 mi	Olathe, KS	★★★★★	4/5
Delmar Gardens of Overland Park	3.5 mi	Overland Park, KS	★★★☆☆	3/5
Tallgrass Creek, INC	3.5 mi	Overland Park, KS	★★★★★	5/5
Aberdeen Village	3.7 mi	Olathe, KS	★★★★★	4/5
Brookdale Overland Park	4.5 mi	Overland Park, KS	★★★★☆	4/5
The Healthcare Resort of Leawood - Iron Horse HLTH	4.7 mi	Leawood, KS	★★☆☆☆	2/5
Azria Health Olathe	4.7 mi	Olathe, KS	★☆☆☆☆	1/5	abuse
Ignite Medical Resort Overland Park LLC	4.8 mi	Overland Park, KS	★★☆☆☆	2/5
Delmar Gardens of Lenexa	4.8 mi	Lenexa, KS	★★★★☆	4/5

Compare this facility with the 3 closest →

All facilities in Overland Park →

Facility data as of CMS processing date 2026-08-01. CCN 175560.

The Care File

Visit checklist — Colonial Village

12500 W 137th St, Overland Park, KS 66221 · 9137303700

Health inspection rating 2/5 · CMS overall 2/5· Fines (3y): $0

Most serious findings on record:

▲ Oct 31, 2024 (F-0692, Actual harm, one-off): The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration.

Questions for the administrator:

☐ "How do you monitor residents' weight and eating, and what happens when someone starts losing weight?"
☐ "How often do you evaluate your nurse aides and what ongoing training do they receive?"
☐ "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
☐ "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
☐ "If you ever planned to discharge or transfer my family member, how much written notice would we receive and how could we appeal?"
☐ "If my family member goes to the hospital, how long will you hold their bed, and will we get that in writing?"
☐ "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
☐ "How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
☐ "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
☐ "Can I see the results and plan of correction from your most recent state inspection?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 175560 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)