A list of the most recent deficiencies for Orchard Post Acute Care. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
| Deficiency | Type of Deficiency | Deficiency Date | Date Corrected | Resulted from a Complaint? |
|---|---|---|---|---|
| Establish roles under a Waiver declared by secretary. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Establish staff and initial training requirements. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk. | Fire Safety | 2023-08-15 | 2023-10-06 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2023-08-11 | 2023-09-07 | N |
| Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | Health | 2023-08-11 | 2023-09-07 | N |
| Provide activities to meet all resident's needs. | Health | 2023-08-11 | 2023-09-07 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-08-11 | 2023-09-07 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2023-08-11 | 2023-09-07 | N |
| Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Health | 2023-08-11 | 2023-09-07 | N |
| Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | Health | 2023-08-11 | 2023-09-07 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-08-11 | 2023-09-07 | N |
| Ensure that residents are fully informed and understand their health status, care and treatments. | Health | 2023-02-17 | 2023-04-21 | N |
| Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | Health | 2023-02-17 | 2023-04-21 | N |
| Give residents a notice of rights, rules, services and charges. | Health | 2023-02-17 | 2023-04-21 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2023-02-17 | 2023-04-21 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-02-17 | 2023-04-21 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2023-02-17 | 2023-04-21 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-02-17 | 2023-04-21 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2023-02-17 | 2023-04-21 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2023-02-17 | 2023-04-21 | N |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2023-02-17 | 2023-04-21 | N |
| Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration. | Health | 2023-02-17 | 2023-04-21 | N |
| Ensure meals and snacks are served at times in accordance with resident?s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | Health | 2023-02-17 | 2023-04-21 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-02-17 | 2023-04-21 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-02-17 | 2023-04-21 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2023-02-17 | 2023-04-21 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| List the names and contact information of those in the facility. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Implement emergency and standby power systems. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Use approved construction type or materials. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Have a complete alarm system manually initiated and initiated by fire sprinkler system connection. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Properly install and monitor supervisory attachments on automatic sprinkler systems. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Meet requirements for operating features, such as evacuation plans, fire drills, smoking regulations, draperies, decorations and the inspection, testing and maintenance of fire doors. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Provide a written emergency evacuation plan. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Have restrictions on the use of portable space heaters. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Meet requirements for the use of electrical equipment. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2023-02-27 | 2023-03-28 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| List the names and contact information of those in the facility. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Implement emergency and standby power systems. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Use approved construction type or materials. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Meet requirements for the use of electrical equipment. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2022-08-31 | 2022-10-03 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2022-08-19 | 2022-09-26 | N |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2022-08-19 | 2022-09-26 | N |
| Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | Health | 2022-08-19 | 2022-09-26 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2022-08-19 | 2022-09-26 | N |
| Honor each resident's preferences, choices, values and beliefs. | Health | 2022-08-19 | 2022-09-26 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2022-08-19 | 2022-09-26 | N |
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2022-08-19 | 2022-09-26 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2022-08-19 | 2022-09-26 | N |
| Ensure 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. | Health | 2022-08-19 | 2022-09-26 | N |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2022-08-19 | 2022-09-26 | N |
| Ensure meals and snacks are served at times in accordance with resident?s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | Health | 2022-08-19 | 2022-09-26 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-08-19 | 2022-09-26 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-08-19 | 2022-09-26 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-08-19 | 2022-09-26 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-08-19 | 2022-09-26 | Y |
| Respond appropriately to all alleged violations. | Health | 2022-08-19 | 2022-09-26 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-08-19 | 2022-09-26 | Y |
| Provide and implement an infection prevention and control program. | Health | 2022-06-21 | 2022-07-13 | N |
| Provide and implement an infection prevention and control program. | Health | 2021-08-27 | 2021-12-03 | Y |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2021-11-04 | 2021-11-22 | Y |
| Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | Health | 2021-08-27 | 2021-10-15 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-08-27 | 2021-10-15 | Y |
| Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. | Health | 2021-08-27 | 2021-10-15 | Y |
| Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | Health | 2021-07-29 | 2021-08-20 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-05-10 | 2021-08-06 | Y |
| Ensure that the resident and his/her doctor meet face-to-face at all required visits. | Health | 2021-05-10 | 2021-08-06 | Y |
| Let each resident or the resident's legal representative access or purchase copies of all the resident's records. | Health | 2021-06-18 | 2021-07-09 | Y |
