THE ORCHARD
The information listed below provides an in-depth look into the type and quality of care offered at The Orchard. It is important to note that when evaluating if a nursing home is right for you or a loved one, ratings should not be taken as the sole deciding factor, but as one of many aspects to be considered.
Address
THE ORCHARD
20 DELFAE DRIVE
WARSAW, VA 22572
(804) 313-2568
20 DELFAE DRIVE
WARSAW, VA 22572
(804) 313-2568
Nursing Home Ratings
| Health Inspections | |
| Quality Measures | |
| Nursing Staff | |
| R.N. Staff Only | |
| Overall Rating | |
Percent of Beds Occupied
93%Number of Residents and Certified Beds
- Residents: 74
- Certified Beds: 80
This Facility Accepts
- Medicare
- Medicaid
Operational Details
- Operated By Non Profit - Corporation
- Offers Only Resident Counseling
- This Facility is Part of a Chain or Franchise
Resident Services
The information below lists services this facility has provided for residents from October through December 2010. During this period, the most common type of service provided was "Very High Rehabilitation". To get a better idea of the types of services that are commonly performed, compare the "Percent of Service Days" column below. These services are based on submitted claims to Medicare and do not provide a complete overview of all the services provided by The Orchard. For more information read our guide on how nursing facilities are reimbursed, types of services, and ADL index scores.
| Resident Services | Resident Conditions | Percent of Service Days |
Ultra-High Rehabilitation
Rehabilitation 720 Minutes Per Week Minimum
- At least one rehabilitation discipline five days/week
- A second rehabilitation discipline three days/week
| ADL Index Range: 11-16 | 4.6% |
| ADL Index Range: 6-10 | 1.0% |
| ADL Index Range: 0-5 | 14.0% |
| Total Percent: | 19.6% |
Very High Rehabilitation
Rehabilitation 500 Minutes Per Week Minimum
- At least one rehabilitation discipline five days/week
| ADL Index Range: 11-16 | 5.8% |
| ADL Index Range: 6-10 | 19.3% |
| ADL Index Range: 0-5 | 15.2% |
| Total Percent: | 40.3% |
High Rehabilitation
Rehabilitation 325 Minutes Per Week Minimum
- At least one rehabilitation discipline five days/week
| ADL Index Range: 11-16 | 4.1% |
| ADL Index Range: 6-10 | 7.5% |
| ADL Index Range: 0-5 | 2.1% |
| Total Percent: | 13.7% |
Medium Rehabilitation
Rehabilitation 150 Minutes Per Week Minimum
- Five days any combination of three rehabilitation disciplines
| ADL Index Range: 11-16 | 3.1% |
| ADL Index Range: 6-10 | 0.8% |
| ADL Index Range: 0-5 | 0.5% |
| Total Percent: | 4.4% |
Extensive Services
- Tracheostomy care
- Ventilator or respirator
- Isolation for active infectious disease while a resident
- Activities of Daily Living (ADL) score of 2 or more
| ADL Index Range: 2-16 - Isolation for active infectious disease | 2.9% |
| Total Percent: | 2.9% |
Special Care High
- Comatose
- Septicemia
- Diabetes with daily injections and a change of order two or more days
- Quadriplegia with ADL score greater or equal to 5
- Chronic Obstructive Pulmonary Disease (COPD) and shortness of breath when lying flat
- Fever with pneumonia, or vomiting, or weight loss, or feeding tube
- Parenteral/IV feedings
- Respiratory therapy for 7 days
- Activities of Daily Living (ADL) score of 2 or more
| ADL Index Range: 11-14 - No Signs of depression | 7.6% |
| ADL Index Range: 6-10 - No Signs of depression | 0.3% |
| Total Percent: | 7.9% |
Special Care Low
- Cerebral palsy, multiple sclerosis, or Parkinson's disease with ADL score greater or equal to 5
- Respiratory failure and oxygen therapy while a resident
- Feeding tube where calories >= 51% or calories are in the range of 26-50% and fluid >= 501 mL)
- Ulcers: 2 or more stage II or 1 or more stage III or IV pressure ulcers
- Ulcers: 2 or more venous or arterial ulcers
- Ulcers: 1 stage II pressure ulcer and 1 venous or arterial ulcer with 2 or more skin care treatments
- Foot infection/diabetic foot ulcer/open lesions of foot with treatment
- Radiation therapy while a resident
- Dialysis while a resident
- Activities of Daily Living (ADL) score of 2 or more
| ADL Index Range: 11-14 - No Signs of depression | 6.5% |
| ADL Index Range: 6-10 - No Signs of depression | 1.4% |
| Total Percent: | 8.0% |
Clinically Complex
- Pneumonia, hemiplegia with ADL score >=5
- Surgical wounds or open lesions with treatment
- Burns
- Chemotherapy while a resident
- Oxygen therapy while a resident
- IV medications or transfusions while a resident
- Extensive Services, Special Care High or Special Care Low qualifier and ADL score of 0 or 1
| ADL Index Range: 2-5 - No Signs of depression | 0.3% |
| ADL Index Range: 0-1 - No Signs of depression | 2.1% |
| Total Percent: | 2.5% |
Reduced Physical Function
- Urinary and/or bowel training program
- Passive and/or active range of motion (ROM)
- Amputation/prosthesis training
- Dressing or grooming training
- Eating or swallowing training
- Transfer training
- Splint or brace assistance
- Bed mobility and/or walking training
- Communication training
| ADL Index Range: 15-16 - Less restorative nursing | 0.8% |
| Total Percent: | 0.8% |
Rating Details For The Orchard
Nursing Staff - 
The nursing staff is the most important part of what determines the quality of care and comfort of a resident in a nursing home. Government regulations set expectations on time spent with each resident based on the services being provided. The breakdown below lists the nursing types (RN, LPN, LVN, CNA) and a comparison of the reported and expected hours per resident per day.
| Nursing Hours Per Resident Per Day | Reported | Expected |
| Registered Nurse (RN) Hours | 19 Minutes | 1 Hour and 4 Minutes |
| Licensed Practical/Vocational Nurse (LPN/LVN) Hours | 59 Minutes | 40 Minutes |
| Certified Nursing Assistant (CNA) Hours | 2 Hours and 15 Minutes | 2 Hours and 36 Minutes |
| Total Licensed Nurse Hours | 1 Hour and 17 Minutes | 1 Hour and 43 Minutes |
| Total Nurse Hours | 3 Hours and 32 Minutes | 4 Hours and 19 Minutes |
Quality of Care - 
Medicare determines quality of care ratings for nursing facilities by surveying several "quality measures", which are broken down into long-term and short-term stay residents, as well as if the action is preventive or if there is a deficiency in the quality of care. State averages for Virginia are also provided for comparison purposes. Note: Figures below are averaged over the past nine months.
| This Facility | Virginia Average |
Long-Term Stay Preventive Actions
| Percent of Long-Stay Residents Given Influenza Vaccination During the Flu Season | 90-100% | 92% |
| Percent of Long-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination | 90-100% | 90% |
Long-Term Stay Deficiencies
| Percent of High-Risk Long-Stay Residents Who Have Pressure Sores | 8% | 11% |
| Percent of Long-Stay Residents Whose Need for Help with Daily Activities Has Increased | 11% | 17% |
| Percent of Low-Risk Long-Stay Residents Who Lose Control of Their Bowels or Bladder | 72% | 59% |
| Percent of Long-Stay Residents Whose Ability to Move About in and Around Their Room Got Worse | 5% | 13% |
| Percent of Long-Stay Residents Who Are More Depressed or Anxious | 30% | 15% |
| Percent of Long-Stay Residents Who Have Moderate to Severe Pain | 3% | 3% |
| Percent of Long-Stay Residents Who Spend Most of Their Time in Bed or in a Chair | 2% | 6% |
| Percent of Long-Stay Residents Who Had a Urinary Tract Infection | 13% | 10% |
| Percent of Long-Stay Residents Who Were Physically Restrained | 1% | 2% |
| Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder | 5% | 4% |
| Percent of Long-Stay Residents Who Lose Too Much Weight | 4% | 9% |
Short-Term Stay Preventive Actions
| Percent of Short-Stay Residents Given Influenza Vaccination During the Flu Season | 86% | 83% |
| Percent of Short-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination | 80% | 82% |
Short-Term Stay Deficiencies
| Percent of Short-Stay Residents Who Had Moderate to Severe Pain | 29% | 16% |
| Percent of Short-Stay Residents Who Have Pressure Sores | 6% | 12% |
| Percent of Short-Stay Residents Who Have Delirium | 1% | 2% |
Health Inspection Details - 
All Medicare and/or Medicaid certified nursing home must undergo health inspections on average once a year, but may be more frequent if the facility is peforming poorly. These inspections cover most aspects of life in a nursing home, and are broken down into deficiencies types, which including: Pharmacy Service, Administration, Resident Rights, Nutrition and Dietary, Resident Assessment, Environmental, and Mistreatment. Below are the list of deficiencies found by inspectors in the past few years along with the degree of harm and how many residents may have been affected. Note: The most recent health survey was on 03/24/2011.
Degree of Harm
- Potential for Minimal Harm
- Minimal Harm or Potential for Harm
- Resident Harmed
- Immediate Jeopardy to Resident Health
Residents Affected
- Isolated
- Some Residents
- Many Residents
| Deficiencies Found By Inspectors | Degree of Harm | Residents Affected |
Administration
Get Proof That a Nurse Aide Has the Training and Skills That the State Requires.
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Follow All Laws and Professional Standards.
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Give or Get Lab Tests to Meet the Needs of Residents.
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Keep Accurate and Appropriate Medical Records.
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Environmental
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents.
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Keep Safe, Clean and Homelike Surroundings.
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Have a Program to Keep Infection from Spreading.
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Provide at Least One Room to Use As a Dining Room and for Activities, That is a Good Size, with Good Lighting, Airflow and Furniture.
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Mistreatment
Write and Use Policies That Forbid Mistreatment, Neglect and Abuse of Residents and Theft of Residents' Property.
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Nutrition and Dietary
Store, Cook, and Give out Food in a Safe and Clean Way.
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Pharmacy Service
Have Drugs and Other Similar Products Available, Which Are Needed Every Day and in Emergencies, and Give Them out Properly.
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Have Drugs and Other Similar Products Available, Which Are Needed Every Day and in Emergencies, and Give Them out Properly.
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Quality Care
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene.
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Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible.
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Develop/Implement Required Procedures for the Administration of Immunizations.
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Give Professional Services That Meet a Professional Standard of Quality.
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Use a Registered Nurse at Least 8 Hours a Day, 7 Days a Week.
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Resident Assessment
Make Sure All Assessments Are Accurate, Coordinated by an Rn, Done by the Right Professional, and Are Signed by the Person Completing Them.
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Make Sure All Assessments Are Accurate, Coordinated by an Rn, Done by the Right Professional, and Are Signed by the Person Completing Them.
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Develop a Complete Care Plan That Meets All of a Resident's Needs, with Timetables and Actions That Can Be Measured.
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Make Sure All Assessments Are Accurate, Coordinated by an Rn, Done by the Right Professional, and Are Signed by the Person Completing Them.
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Resident Rights
Immediately Tell the Resident, Doctor, and a Family Member If: the Resident is Injured, There is a Major Change in Resident's Physical/Mental Health, There is a Need to Alter Treatment Significantly, or the Resident Must Be Transferred or Discharged.
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Deficiencies from Complaints and Incidents
The table below lists incident reports by the nursing staff or administration for The Orchard, as well as complaints by residents or their family in the previous three years.
Degree of Harm
- - Potential for Minimal Harm
- - Minimal Harm or Potential for Harm
- - Resident Harmed
- - Immediate Jeopardy to Resident Health
Residents Affected
- - Isolated
- - Some Residents
- - Many Residents
| Formal Complaints | Degree of Harm | Residents Affected |
Environmental
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents.
|  | |
Fire Safety
Nursing homes certified by Medicare and/or Medicaid are required to have fire safety inspections to meet Life Safety Code (LSC) standards. Below is a list of deficiencies that The Orchard had in recent fire safety inspections. This information can be used to see if all standards were met, the degree of harm, the number of residents affected, and the date when deficiencies were corrected. Note: The most recent fire safety survey was on 04/11/2011.
Degree of Harm
- - Potential for Minimal Harm
- - Minimal Harm or Potential for Harm
- - Resident Harmed
- - Immediate Jeopardy to Resident Health
Residents Affected
- - Isolated
- - Some Residents
- - Many Residents
| Deficiencies Found By Inspectors | Degree of Harm | Residents Affected |
Automatic Sprinkler Systems
Automatic Sprinkler Systems That Have Been Maintained in Working Order.
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Automatic Sprinkler Systems That Have Been Maintained in Working Order.
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Automatic Sprinkler Systems That Have Been Maintained in Working Order.
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Portable Fire Extinguishers.
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Electrical
Weekly Inspections and Monthly Testing of Generators.
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Properly Installed Electrical Wiring and Equipment.
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Exits and Egress
Exits That Are Accessible at All Times.
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Exits That Are Accessible at All Times.
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Hazardous Area
Construction That Can Resist Fire for One Hour or an Approved Fire Extinguishing System.
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Medical Gases and Anesthetizing Areas
No-Smoking Signs Where Oxygen is Used.
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Smoke Compartmentation and Control
Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour.
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Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour.
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Source: Medicare Nursing Home Compare; Department of Health of Virginia - Center for Quality Health Care Services and Consumer Protection - Retrieved 2011
