ORCHARD POST ACUTE
CCN: 056225 · FRESNO, CA 93727 · Fresno County
Overview
- Address
- 4840 E.TULARE AVENUE, FRESNO, CA 93727
- Phone
- 5592517161
- Certified beds
- 99
- Avg daily residents
- 92 (93% of beds filled)
- Ownership
- For-profit LLC
- Provider type
- Medicare and Medicaid
- Medicare/Medicaid since
- 1970-10-07
- Setting
- Urban
CMS 5-Star Ratings
CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.
Staffing & Workforce
Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.
| Role | Reported | Case-mix expected | Adjusted | Federal floor | |
|---|---|---|---|---|---|
| Total nurse All nursing staff combined: RN + LPN + Aide | 4.14 | 3.90 | 4.09 | ≥ 3.48 | |
| Registered Nurse (RN) Licensed RN hours. Strongest driver of clinical outcomes. | 0.20 | 0.68 | 0.20 | ≥ 0.55 | Below floor |
| Licensed Practical Nurse (LPN) LPN/LVN hours. Often handles medication administration. | 1.21 | 0.87 | 1.20 | — | |
| Nurse aide CNA hours. Bulk of direct resident care — bathing, feeding, mobility. | 2.73 | 2.35 | 2.70 | — | |
| Licensed (RN + LPN) Combined licensed nurse coverage. | 1.41 | — | — | — | |
| Physical therapist Rehabilitation therapist hours — important for post-acute / rehab admissions. | 0.06 | — | — | — |
Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.
Weekend staffing
Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.
Staff turnover
Resident acuity
Health Inspections
CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.
| Cycle | Date | Total defs. | Standard | Complaint | Deficiency score | Revisits | Total score |
|---|---|---|---|---|---|---|---|
| Cycle 1 (most recent) | 2025-05-20 | 14 | 13 | 2 | 92 | 1 | 92 |
| Cycle 2/3 (prior) | 2024-07-26 | 21 | 16 | 21 | 152 | 1 | 152 |
Deficiencies (43)
Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).
| Tag | Description | Scope/Severity | Survey date | Corrected |
|---|---|---|---|---|
| 0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2025-11-19 | 2025-12-12 |
| 0559 | Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made. | D | 2025-05-20 | 2025-06-10 |
| 0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2025-05-20 | 2025-06-10 |
| 0641 | Ensure each resident receives an accurate assessment. | D | 2025-05-20 | 2025-06-10 |
| 0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2025-05-20 | 2025-06-10 |
| 0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | 2025-05-20 | 2025-06-10 |
| 0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | 2025-05-20 | 2025-06-10 |
| 0658 | Ensure services provided by the nursing facility meet professional standards of quality. | E | 2025-05-20 | 2025-06-10 |
| 0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | 2025-05-20 | 2025-06-10 |
| 0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | E | 2025-05-20 | 2025-06-10 |
| 0761 | 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. | E | 2025-05-20 | 2025-06-10 |
| 0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2025-05-20 | 2025-06-10 |
| 0880 | Provide and implement an infection prevention and control program. | E | 2025-05-20 | 2025-06-10 |
| 0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2025-05-20 | 2025-06-10 |
| 0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-01-08 | 2025-02-08 |
| 0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-12-11 | 2025-01-03 |
| 0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-11-05 | 2024-11-27 |
| 0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2024-07-26 | 2024-09-24 |
| 0552 | Ensure that residents are fully informed and understand their health status, care and treatments. | D | 2024-07-26 | 2024-09-24 |
| 0557 | Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | D | 2024-07-26 | 2024-09-24 |
| 0584 | 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. | D | 2024-07-26 | 2024-09-24 |
| 0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | D | 2024-07-26 | 2024-09-24 |
| 0641 | Ensure each resident receives an accurate assessment. | E | 2024-07-26 | 2024-09-24 |
| 0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | E | 2024-07-26 | 2024-09-24 |
| 0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | 2024-07-26 | 2024-09-24 |
| 0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | 2024-07-26 | 2024-09-24 |
| 0658 | Ensure services provided by the nursing facility meet professional standards of quality. | F | 2024-07-26 | 2024-09-24 |
| 0761 | 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. | F | 2024-07-26 | 2024-09-24 |
| 0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | 2024-07-26 | 2024-09-24 |
| 0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-07-26 | 2024-09-24 |
| 0814 | Dispose of garbage and refuse properly. | F | 2024-07-26 | 2024-09-24 |
| 0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2024-07-26 | 2024-09-24 |
| 0880 | Provide and implement an infection prevention and control program. | E | 2024-07-26 | 2024-09-24 |
| 0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2023-09-27 | 2023-09-22 |
| 0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | 2023-08-14 | 2023-08-25 |
| 0584 | 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. | E | 2022-01-21 | 2022-02-17 |
| 0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | 2022-01-21 | 2022-02-17 |
| 0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2022-01-21 | 2022-02-17 |
| 0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2022-01-21 | 2022-02-17 |
| 0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | 2022-01-21 | 2022-02-17 |
| 0758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | 2022-01-21 | 2022-02-17 |
| 0803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | E | 2022-01-21 | 2022-02-17 |
| 0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2022-01-21 | 2022-02-17 |
Financial Health (FY 2023)
Payer mix (share of resident days)
Operating performance
Revenue & costs
Balance sheet
Source: CMS SNF Cost Report (FY 2023). Cost report data lags by ~2 years.
Ownership & Corporate Structure
Chain: PACS GROUP
- Chain ID
690- Facilities in chain
- 264
- Legal business name
- FRESNO VALLEY SNF, LLC
Owner / manager organizations (3)
| Organization | Role | Association |
|---|---|---|
| PROVIDENCE GROUP NH, LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | since 06/30/2023 |
| PACS GROUP, INC. | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | since 06/30/2023 |
| PACS HOLDINGS, LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | since 06/30/2023 |
Owner / manager individuals (9)
| Name | Role | Association |
|---|---|---|
| HANCOCK, MARK | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | since 04/15/2024 |
| MURRAY, JASON | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | since 04/15/2024 |
| MATIACO, JOSHUA | OPERATIONAL/MANAGERIAL CONTROL | since 12/09/2021 |
| APT, FREDERICK | CORPORATE OFFICER | since 01/01/2024 |
| HANCOCK, MARK | CORPORATE OFFICER | since 01/01/2024 |
| JERGENSEN, JOSHUA | CORPORATE OFFICER | since 06/06/2024 |
| MITCHELL, JOHN | CORPORATE OFFICER | since 01/01/2024 |
| GROSSMAN, STEPHEN | CONTRACTED MANAGING EMPLOYEE | since 01/15/2020 |
| MATIACO, JOSHUA | W-2 MANAGING EMPLOYEE | since 12/09/2021 |
Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.
Facility Features
- CCRC
- No
- Hospital-based
- No
- Resident / family council
- Resident
- Sprinkler systems
- Yes
- Abuse citation flag
- No
- Nursing Home Provider Info (
nh-provider-info), vintage 2026, downloaded 2026-04-14 , 14,703 rows. - Nursing Home Health Deficiencies (
nh-deficiencies), vintage 2026, downloaded 2026-04-14 , 418,972 rows. - Nursing Home Ownership (
nh-ownership), vintage 2026, downloaded 2026-04-14 , 160,393 rows. - Skilled Nursing Facility Cost Report (
snf-cost-report), vintage 2023, downloaded 2026-04-14 , 14,120 rows.
All Data
Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.
Show 113 rows
| Source | Metric | Value | Raw key |
|---|---|---|---|
| Cost Report | Cost per Resident Day ($) | $62 | metrics.cost_per_resident_day |
| Cost Report | Current Ratio | 4.86 | metrics.current_ratio |
| Cost Report | fiscal_year | 2,023 | fiscal_year |
| Cost Report | Medicaid Day Share (%) | 14.2% | metrics.medicaid_day_share |
| Cost Report | Medicare Day Share (%) | 18.6% | metrics.medicare_day_share |
| Cost Report | Net Income ($) | $1,973,720 | metrics.net_income |
| Cost Report | Net Patient Revenue ($) | $14,812,354 | metrics.net_patient_revenue |
| Cost Report | Occupancy Rate (%) | 91.7% | metrics.occupancy_rate |
| Cost Report | Operating Margin (%) | 13.3% | metrics.operating_margin |
| Cost Report | Total Assets ($) | $5,014,802 | metrics.total_assets |
| Cost Report | Total Costs ($) | $2,049,503 | metrics.total_costs |
| Cost Report | Total Fund Balances ($) | $3,812,252 | metrics.fund_balance |
| Cost Report | Total Liabilities ($) | $1,202,550 | metrics.total_liabilities |
| Cost Report | Total Margin (%) | 13.3% | metrics.total_margin |
| Provider Information | Abuse Icon | N | Abuse Icon |
| Provider Information | Adjusted LPN Staffing Hours per Resident per Day | 1.19797 | Adjusted LPN Staffing Hours per Resident per Day |
| Provider Information | Adjusted Nurse Aide Staffing Hours per Resident per Day | 2.69885 | Adjusted Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Adjusted RN Staffing Hours per Resident per Day | 0.19700 | Adjusted RN Staffing Hours per Resident per Day |
| Provider Information | Adjusted Total Nurse Staffing Hours per Resident per Day | 4.09382 | Adjusted Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Adjusted Weekend Total Nurse Staffing Hours per Resident per Day | 3.83280 | Adjusted Weekend Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Administrator turnover footnote | — | Administrator turnover footnote |
| Provider Information | Automatic Sprinkler Systems in All Required Areas | Yes | Automatic Sprinkler Systems in All Required Areas |
| Provider Information | Average Number of Residents per Day | 92.2 | Average Number of Residents per Day |
| Provider Information | Average Number of Residents per Day Footnote | — | Average Number of Residents per Day Footnote |
| Provider Information | Case-Mix LPN Staffing Hours per Resident per Day | 0.86608 | Case-Mix LPN Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Nurse Aide Staffing Hours per Resident per Day | 2.35380 | Case-Mix Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Case-Mix RN Staffing Hours per Resident per Day | 0.68266 | Case-Mix RN Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Total Nurse Staffing Hours per Resident per Day | 3.90253 | Case-Mix Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day | 3.43967 | Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Chain Average Health Inspection Rating | 2.6 | Chain Average Health Inspection Rating |
| Provider Information | Chain Average Overall 5-star Rating | 2.9 | Chain Average Overall 5-star Rating |
| Provider Information | Chain Average QM Rating | 4.2 | Chain Average QM Rating |
| Provider Information | Chain Average Staffing Rating | 2.4 | Chain Average Staffing Rating |
| Provider Information | Chain ID | 690 | Chain ID |
| Provider Information | Chain Name | PACS GROUP | Chain Name |
| Provider Information | City/Town | FRESNO | City/Town |
| Provider Information | CMS Certification Number (CCN) | 056225 | CMS Certification Number (CCN) |
| Provider Information | Continuing Care Retirement Community | N | Continuing Care Retirement Community |
| Provider Information | County/Parish | Fresno | County/Parish |
| Provider Information | Date First Approved to Provide Medicare and Medicaid Services | 1970-10-07 | Date First Approved to Provide Medicare and Medicaid Services |
| Provider Information | Geocoding Footnote | — | Geocoding Footnote |
| Provider Information | Health Inspection Rating | 2 | Health Inspection Rating |
| Provider Information | Health Inspection Rating Footnote | — | Health Inspection Rating Footnote |
| Provider Information | Latitude | 36.7432 | Latitude |
| Provider Information | Legal Business Name | FRESNO VALLEY SNF, LLC | Legal Business Name |
| Provider Information | Location | 4840 E.TULARE AVENUE,FRESNO,CA,93727 | Location |
| Provider Information | Long-Stay QM Rating | 5 | Long-Stay QM Rating |
| Provider Information | Long-Stay QM Rating Footnote | — | Long-Stay QM Rating Footnote |
| Provider Information | Longitude | -119.73 | Longitude |
| Provider Information | Most Recent Health Inspection More Than 2 Years Ago | N | Most Recent Health Inspection More Than 2 Years Ago |
| Provider Information | Number of administrators who have left the nursing home | 0 | Number of administrators who have left the nursing home |
| Provider Information | Number of Certified Beds | 99 | Number of Certified Beds |
| Provider Information | Number of Citations from Infection Control Inspections | — | Number of Citations from Infection Control Inspections |
| Provider Information | Number of Facilities in Chain | 264 | Number of Facilities in Chain |
| Provider Information | Number of Fines | 0 | Number of Fines |
| Provider Information | Number of Payment Denials | 0 | Number of Payment Denials |
| Provider Information | Nursing Case-Mix Index | 1.38249 | Nursing Case-Mix Index |
| Provider Information | Nursing Case-Mix Index Ratio | 1.00352 | Nursing Case-Mix Index Ratio |
| Provider Information | Overall Rating | 3 | Overall Rating |
| Provider Information | Overall Rating Footnote | — | Overall Rating Footnote |
| Provider Information | Ownership Type | For profit - Limited Liability company | Ownership Type |
| Provider Information | Physical Therapist Staffing Footnote | — | Physical Therapist Staffing Footnote |
| Provider Information | Processing Date | 2026-03-01 | Processing Date |
| Provider Information | Provider Address | 4840 E.TULARE AVENUE | Provider Address |
| Provider Information | Provider Changed Ownership in Last 12 Months | N | Provider Changed Ownership in Last 12 Months |
| Provider Information | Provider Name | ORCHARD POST ACUTE | Provider Name |
| Provider Information | Provider Resides in Hospital | N | Provider Resides in Hospital |
| Provider Information | Provider SSA County Code | 090 | Provider SSA County Code |
| Provider Information | Provider Type | Medicare and Medicaid | Provider Type |
| Provider Information | QM Rating | 5 | QM Rating |
| Provider Information | QM Rating Footnote | — | QM Rating Footnote |
| Provider Information | Rating Cycle 1 Health Deficiency Score | 92 | Rating Cycle 1 Health Deficiency Score |
| Provider Information | Rating Cycle 1 Health Revisit Score | 0 | Rating Cycle 1 Health Revisit Score |
| Provider Information | Rating Cycle 1 Number of Complaint Health Deficiencies | 2 | Rating Cycle 1 Number of Complaint Health Deficiencies |
| Provider Information | Rating Cycle 1 Number of Health Revisits | 1 | Rating Cycle 1 Number of Health Revisits |
| Provider Information | Rating Cycle 1 Number of Standard Health Deficiencies | 13 | Rating Cycle 1 Number of Standard Health Deficiencies |
| Provider Information | Rating Cycle 1 Standard Survey Health Date | 2025-05-20 | Rating Cycle 1 Standard Survey Health Date |
| Provider Information | Rating Cycle 1 Total Health Score | 92 | Rating Cycle 1 Total Health Score |
| Provider Information | Rating Cycle 1 Total Number of Health Deficiencies | 14 | Rating Cycle 1 Total Number of Health Deficiencies |
| Provider Information | Rating Cycle 2 Number of Standard Health Deficiencies | 16 | Rating Cycle 2 Number of Standard Health Deficiencies |
| Provider Information | Rating Cycle 2 Standard Health Survey Date | 2024-07-26 | Rating Cycle 2 Standard Health Survey Date |
| Provider Information | Rating Cycle 2/3 Health Deficiency Score | 152 | Rating Cycle 2/3 Health Deficiency Score |
| Provider Information | Rating Cycle 2/3 Health Revisit Score | 0 | Rating Cycle 2/3 Health Revisit Score |
| Provider Information | Rating Cycle 2/3 Number of Complaint Health Deficiencies | 21 | Rating Cycle 2/3 Number of Complaint Health Deficiencies |
| Provider Information | Rating Cycle 2/3 Number of Health Revisits | 1 | Rating Cycle 2/3 Number of Health Revisits |
| Provider Information | Rating Cycle 2/3 Total Health Score | 152 | Rating Cycle 2/3 Total Health Score |
| Provider Information | Rating Cycle 2/3 Total Number of Health Deficiencies | 21 | Rating Cycle 2/3 Total Number of Health Deficiencies |
| Provider Information | Registered Nurse hours per resident per day on the weekend | 0.14657 | Registered Nurse hours per resident per day on the weekend |
| Provider Information | Registered Nurse turnover | 50.0 | Registered Nurse turnover |
| Provider Information | Registered Nurse turnover footnote | — | Registered Nurse turnover footnote |
| Provider Information | Reported Licensed Staffing Hours per Resident per Day | 1.41000 | Reported Licensed Staffing Hours per Resident per Day |
| Provider Information | Reported LPN Staffing Hours per Resident per Day | 1.21088 | Reported LPN Staffing Hours per Resident per Day |
| Provider Information | Reported Nurse Aide Staffing Hours per Resident per Day | 2.72793 | Reported Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Reported Physical Therapist Staffing Hours per Resident Per Day | 0.06408 | Reported Physical Therapist Staffing Hours per Resident Per Day |
| Provider Information | Reported RN Staffing Hours per Resident per Day | 0.19912 | Reported RN Staffing Hours per Resident per Day |
| Provider Information | Reported Staffing Footnote | — | Reported Staffing Footnote |
| Provider Information | Reported Total Nurse Staffing Hours per Resident per Day | 4.13793 | Reported Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Short-Stay QM Rating | 4 | Short-Stay QM Rating |
| Provider Information | Short-Stay QM Rating Footnote | — | Short-Stay QM Rating Footnote |
| Provider Information | Special Focus Status | — | Special Focus Status |
| Provider Information | Staffing Rating | 2 | Staffing Rating |
| Provider Information | Staffing Rating Footnote | — | Staffing Rating Footnote |
| Provider Information | State | CA | State |
| Provider Information | Telephone Number | 5592517161 | Telephone Number |
| Provider Information | Total Amount of Fines in Dollars | 0.00 | Total Amount of Fines in Dollars |
| Provider Information | Total number of nurse staff hours per resident per day on the weekend | 3.87411 | Total number of nurse staff hours per resident per day on the weekend |
| Provider Information | Total Number of Penalties | 0 | Total Number of Penalties |
| Provider Information | Total nursing staff turnover | 52.1 | Total nursing staff turnover |
| Provider Information | Total nursing staff turnover footnote | — | Total nursing staff turnover footnote |
| Provider Information | Total Weighted Health Survey Score | 107.000 | Total Weighted Health Survey Score |
| Provider Information | Urban | Y | Urban |
| Provider Information | With a Resident and Family Council | Resident | With a Resident and Family Council |
| Provider Information | ZIP Code | 93727 | ZIP Code |