Orchard Rehabilitation & Healthcare Center ratings, inspections, staffing, and fines

1

How this home got 4 stars

The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.

Health inspections

starting point

Everything starts from what state inspectors found on site. This is a ranking against other homes in Alabama.
Staffing

no change

Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
Quality measures

−1 star

Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
Overall

4 of 5

Matches the rating CMS publishes on Care Compare.

2

Where it sits among Alabama homes

Orchard Rehabilitation & Healthcare Center carries 1 inspection point. That is fewer than 92% of Alabama's 223 rated homes.

Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Alabama: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.

5★ 0–3 pts
4★ 3–12 pts
3★ 12–23 pts
2★ 23–46 pts
1★ over 46 pts

Bars show every rated home in Alabama by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.

3

What inspectors found

4 health citations on record since 2018. Each one gets a letter: the row says how badly residents were affected, the column how many.

One resident or a fewA patternWidespread

Immediate jeopardyResidents at risk of serious injury or death

J 2 50 pts

K 0 100 pts

L 0 150 pts

Actual harmA resident was hurt

G 0 20 pts

H 0 35 pts

I 0 45 pts

Potential for harmNo one was hurt, but could have been

D 2 4 pts

E 0 8 pts

F 0 16 pts

Minimal harmPaperwork-level problems

A 0 0 pts

B 0 0 pts

C 0 0 pts

Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.

Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.

Harm and immediate-jeopardy citations (2)

J

Honor 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.

March 16, 2018 · Standard inspection · Resident Rights · F578 · Corrected April 9, 2018
J

Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.

March 16, 2018 · Standard inspection · Quality of Life and Care · F678 · Corrected April 9, 2018

Everything else, by area of care

Administration1D

D
Provide timely, quality laboratory services/tests to meet the needs of residents.
January 31, 2019 · Standard · F770 · Corrected March 1, 2019

Freedom from Abuse, Neglect, and Exploitation1D

D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
March 16, 2018 · Standard · F609 · Corrected April 9, 2018

Inspection history

2021-04-11
0 health deficiencies · 0 fire-safety deficiencies
No concentrated health issue counts in this cycle.
2019-01-31
1 health deficiencies · 1 fire-safety deficiencies
Top issue: Administration (1 deficiency)
2018-03-16
3 health deficiencies · 1 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (1 deficiency)

4

Nursing time per resident, per day

Each resident here gets about 3 h 21 min of nursing staff time a day, 43 min of it from a registered nurse.

This home

3 h 21 min

Alabama average

3 h 54 min

U.S. average

3 h 54 min

Registered nurse
Licensed practical nurse
Nurse aide

Turnover: 30% of nursing staff and 46% of registered nurses left in the past year.

Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.

5

Resident outcomes

Quality measures compared with state and national averages. Most come from assessments the home itself reports.

Measure	This home	State	U.S.
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine3.5 pts better	96.3%	92.8%	93.7%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine0.4 pts worse	95.0%	95.4%	95.3%
Percentage of long-stay residents experiencing one or more falls with major injury2.3 pts worse	5.5%	3.2%	3.2%
Percentage of long-stay residents who have depressive symptoms0.4 pts better	1.1%	1.5%	13.5%
Percentage of long-stay residents who lose too much weight3.5 pts worse	8.9%	5.4%	5.1%
Percentage of long-stay residents who received an antianxiety or hypnotic medication11 pts better	13.3%	24.3%	19.5%
Percentage of long-stay residents who received an antipsychotic medication0.7 pts worse	22.0%	21.3%	15.4%
Percentage of long-stay residents who were physically restrained0.5 pts better	0.0%	0.5%	0.1%
Percentage of long-stay residents whose ability to walk independently worsened8 pts worse	19.0%	11.0%	12.7%
Percentage of long-stay residents whose need for help with daily activities has increased14.8 pts worse	26.3%	11.5%	13.5%
Percentage of long-stay residents with a catheter inserted and left in their bladder1 pts worse	1.9%	0.9%	0.7%
Percentage of long-stay residents with a urinary tract infection0.3 pts better	1.9%	2.2%	1.5%
Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.4 pts worse	12.6%	12.2%	18.3%
Percentage of long-stay residents with pressure ulcers3.1 pts worse	8.3%	5.2%	4.5%
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine3.9 pts worse	81.7%	85.6%	82.3%
Percentage of short-stay residents who newly received an antipsychotic medication8.1 pts worse	10.0%	1.9%	1.5%
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine45.1 pts worse	37.1%	82.2%	80.1%

·

Who owns and runs it

12 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.

Show ownership list

Name	Role	Share	Homes
Ball, Clarence	5% Or Greater Direct Ownership Interest · Individual	100%	9 facilities
Ball Healthcare - Lowndes, LLC	Adp Of The SNF · Organization	0%	1 facilities
Ball Healthcare Service, Inc	Adp Of The SNF · Organization	0%	9 facilities
Ball, Clarence	Corporate Director · Individual	0%	9 facilities
Cash, Cassandra	Operational/Managerial Control · Individual	0%	1 facilities
Cash, Cassandra	Adp Of The SNF · Individual	0%	1 facilities
Greene, Jacquelyn	Operational/Managerial Control · Individual	0%	1 facilities
Greene, Jacquelyn	Adp Of The SNF · Individual	0%	1 facilities
Hall, Matthew	Corporate Officer · Individual	0%	21 facilities
Hall, Matthew	Adp Of The SNF · Individual	0%	21 facilities
Holt, Thomas	Operational/Managerial Control · Individual	0%	2 facilities
Holt, Thomas	Adp Of The SNF · Individual	0%	2 facilities

·

Fire safety

2 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.

Smoke2D

D
Provide properly protected cooking facilities.
January 31, 2019 · K324 · Corrected February 14, 2019
D
Install corridor and hallway doors that block smoke.
March 16, 2018 · K363 · Corrected March 22, 2018

·

Other homes nearby

Father Purcell Memorial Exceptional Children's Ctr
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Worst citation, 3 yrs
none

Nursing / resident / day
2 h 52 min

Fines
$0
John Knox Manor Inc I I
Montgomery, AL

Worst citation, 3 yrs
F

Nursing / resident / day
4 h 26 min

Fines
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Capitol Hill Healthcare Center
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Worst citation, 3 yrs
none

Nursing / resident / day
3 h 58 min

Fines
$0

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