Average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Orchard Rehabilitation & Nursing Center during CMS and state inspections, most recent first.
The facility did not provide enough nursing staff to meet required care hours, resulting in residents experiencing long waits for assistance and staff being unable to complete essential care tasks or administer medications on time. Both residents and staff reported delays and inadequate care, and facility leadership acknowledged that minimum staffing requirements were not met.
Surveyors found that food and beverages were not served at safe or appetizing temperatures, with hot foods and drinks being lukewarm and cold beverages served warm. Multiple residents reported that their meals were not palatable, and test tray measurements confirmed that items were outside required temperature ranges, contrary to facility policy and regulatory standards.
The facility failed to serve food and drink at safe and appetizing temperatures, with multiple residents reporting dissatisfaction. Observations revealed that hot foods were served cold and cold foods were served warm, contrary to the facility's policy. The Food Service Director and Dietary Aide confirmed the temperature discrepancies.
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards. Observations revealed undated, unlabeled, and out-of-date food items in unit refrigerators, cleanliness issues in the main kitchen, and improper hand hygiene by a cook in the main dining room. Staff interviews indicated inconsistent adherence to food safety protocols.
The facility failed to implement its smoking policy and adequately supervise a resident who was a current smoker with multiple diagnoses. Despite being cognitively intact and having a documented history of tobacco use, the resident did not have a comprehensive care plan for smoking, and no smoking assessments were completed. The resident was observed smoking independently outside the facility, contrary to the facility's policy.
A facility failed to ensure that a nurse aide, who had been working for more than four months, was certified and supervised. The aide performed duties independently despite not passing the certification exam, contrary to facility policy and state regulations.
The facility's Binding Arbitration Agreement did not ensure the selection of a neutral arbitrator agreed upon by both parties or a venue convenient to both parties. This was identified during a survey, and interviews with staff confirmed the omission.
Insufficient Nursing Staff Fails to Meet Resident Care Needs
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the needs of all residents, as required by state regulations and the facility's own policies. Documentation showed that on multiple days, the number of licensed nurse and certified nurse aide hours per resident per day fell below the mandated minimums. For example, on several dates, the facility did not meet the required 1.1 hours per resident per day for licensed nurses and 2.2 hours for certified nurse aides, based on the resident census. The facility assessment and staffing policies indicated that staffing should be based on individualized resident needs, but actual staffing levels did not meet these requirements. Interviews with residents revealed that they experienced significant delays in having their call lights answered, sometimes waiting over an hour or up to three hours for assistance, particularly during the second and third shifts and on weekends. Some residents reported having to use the bathroom unassisted to avoid accidents due to these delays. Staff interviews corroborated these concerns, with certified nurse aides and LPNs stating that they were responsible for large numbers of residents, making it difficult to complete basic care tasks such as showers, turning and positioning, and timely medication administration. Staff reported having to rush care and being unable to provide the level of attention required by residents' care plans. Facility leadership, including the Director of Nursing and the Administrator, acknowledged awareness of the state minimum staffing requirements and admitted that the facility was not meeting these standards. The Director of Human Resources/Scheduler confirmed the minimum staffing numbers for each shift, but also noted challenges with call-ins and maintaining adequate coverage. The deficiency was substantiated by both documentation and direct testimony from residents and staff, demonstrating a consistent pattern of insufficient staffing that impacted resident care.
Failure to Serve Food and Beverages at Safe and Appetizing Temperatures
Penalty
Summary
During a complaint investigation, it was found that the facility did not ensure food and beverages were served at safe and appetizing temperatures, as required by facility policy and regulatory guidelines. Observations during lunch service revealed that while hot food items initially measured above 140°F at the start of tray line service, by the time meals were served to residents, temperatures had dropped significantly. Test tray measurements showed hot foods such as a carrot vegetable blend and chicken with biscuit and gravy were served at 118°F and 115°F, respectively, and beverages like cranberry juice and milk were served at 64.2°F and 56.5°F, all of which are outside the recommended safe temperature ranges. Multiple residents reported that their meals were lukewarm or barely warm, and drinks were not cold, with some describing the food as barely edible or suboptimal in quality. Interviews with the Food Service Director and Administrator confirmed that the observed food and beverage temperatures did not meet the facility's standards or regulatory requirements, which specify that hot foods should be served above 140°F and cold beverages below 41°F. The Food Service Director acknowledged that the test tray temperatures were not acceptable and that foods outside these ranges are considered to be in the danger zone, where bacteria can grow. The deficiency was observed to affect several residents, who consistently reported dissatisfaction with the temperature and palatability of their meals during the investigation.
Failure to Serve Food at Safe and Appetizing Temperatures
Penalty
Summary
The facility failed to provide food and drink at safe and appetizing temperatures for residents in the Main Dining Room, Unit 1, Unit 2, and Unit 3. Observations and interviews revealed that meals were served at suboptimal temperatures, with hot foods being served cold and cold foods being served warm. Residents #85, #74, #51, #4, and #1 reported dissatisfaction with the temperature and quality of their meals, and the interim Ombudsman confirmed receiving similar complaints from other residents. During a lunch meal tray observation, the Food Service Director measured the temperatures of various food items and found them to be outside the safe temperature range. For example, chicken and biscuits measured 122.9 degrees Fahrenheit, mixed vegetables measured 116.8 degrees Fahrenheit, apple juice measured 57.5 degrees Fahrenheit, and milk measured 55.2 degrees Fahrenheit. Similar observations were made for meal trays served on Unit 3, Unit 1, and Unit 2, where food items consistently failed to meet the required temperature standards. Interviews with the Food Service Director and Dietary Aide #1 confirmed that the facility's policy required hot foods to be served above 140 degrees Fahrenheit and cold foods below 40 degrees Fahrenheit. However, the actual temperatures recorded during the survey were significantly below these standards. The Director of Nursing also acknowledged the importance of serving food at safe temperatures to ensure resident satisfaction and prevent food-borne illnesses.
Food Storage and Hygiene Deficiencies
Penalty
Summary
The facility did not store, prepare, distribute, and serve food in accordance with professional standards for food service safety. Observations revealed that the nourishment room refrigerators in Units 1, 2, and 3 contained undated, unlabeled, and out-of-date food and drink items. The main kitchen was found to have a greasy oven door, a heavily soiled splatter guard behind the stove, a commercial coffee maker and carafes that were heavily stained, and a rusty and dusty desk fan under the tray line. Additionally, the cook in the main dining room was observed not following proper hand hygiene while serving a meal. In Unit 2, the refrigerator contained undated soup, an unopened container of hummus not labeled with a name, an individual poured cup of juice undated, and an opened container of hot chicken dip not labeled with a name. In Unit 1, the refrigerator had undated cups of pudding, an unopened container of milk, two opened containers of prune juice not labeled with the date opened, and pitchers of juice not labeled with the date poured. In Unit 3, the refrigerator contained an unopened container of Greek yogurt not labeled with a name, an undated cup of macaroni salad, and pitchers of juice not labeled with the date poured. Staff interviews revealed that the night shift nurses were supposed to check the refrigerators, but this was not consistently done. The main kitchen was observed to have cleanliness issues, including a greasy oven door, a heavily soiled splatter guard, and a dusty and rusty desk fan. The cook in the main dining room was observed using improper hand hygiene, including wiping their glove on their pants and not changing gloves after touching multiple surfaces. The Food Service Director confirmed that the kitchen equipment should be cleaned daily and that food should be served with utensils, not hands. The Infection Preventionist also confirmed that the cook's actions were an infection control issue.
Failure to Implement Smoking Policy and Supervise Resident
Penalty
Summary
The facility did not ensure that the residents' environment remained as free from accident hazards as possible, and each resident received adequate supervision. Specifically, the facility failed to implement their smoking policy for Resident #116, who was a current smoker with diagnoses including diabetes mellitus, glaucoma, and chronic obstructive pulmonary disease. Despite being cognitively intact and having a documented history of tobacco use, Resident #116 did not have a comprehensive care plan for smoking, and no smoking assessments were completed from 9/20/2022 through 4/10/2024. The resident was observed smoking independently outside the facility, contrary to the facility's policy that required smoking materials to be surrendered and locked up by staff. Interviews with various staff members, including an LPN, Activity Aide, Director of Activities, and the Director of Nursing, revealed that they were aware of Resident #116's smoking habits but did not ensure the resident was assessed or care planned for smoking. The Administrator and Director of Nursing acknowledged that Resident #116 should have been assessed and care planned for smoking back in August 2023 when the resident was caught smoking outside on the property. The facility's failure to follow its smoking policy and adequately supervise Resident #116 led to the deficiency noted in the survey.
Failure to Ensure Nurse Aide Certification and Supervision
Penalty
Summary
The facility did not ensure that a nurse aide, who had been working for more than four months, was competent and certified to provide nursing and nursing-related services. Specifically, Resident Assistant #1 had been functioning in the role of a nurse aide for over four months without receiving nurse aide certification. Despite completing a 48-hour temporary Nurse Aide to Certified Nurse Aide training program, Resident Assistant #1 was not found in the New York State Nurse Aide Registry and had failed the certification exam multiple times. The facility's policy required that nurse aide trainees work under direct supervision of certified and licensed staff, but Resident Assistant #1 was performing duties independently without such supervision. Interviews with various staff members, including Licensed Practical Nurses and the Director of Nursing, confirmed that Resident Assistant #1 was performing certified nursing assistant duties independently, contrary to the facility's policy and state regulations. The Director of Nursing and the Administrator acknowledged that they were aware of the expired COVID-19 waivers and the requirement for certification but had not ensured compliance. The Director of Human Resources also confirmed that Resident Assistant #1 had not successfully completed the academic portion of the certification exam and was supposed to be supervised by a certified nursing assistant until passing the exam. The facility could not provide documented evidence of the dates when Resident Assistant #1 took the certification exams, further indicating a lack of proper oversight and documentation. This deficiency highlights the facility's failure to ensure that nurse aides are properly trained, certified, and supervised, potentially compromising the quality of care provided to residents.
Deficiency in Binding Arbitration Agreement
Penalty
Summary
The facility did not ensure that their Binding Arbitration Agreement provided for the selection of a neutral arbitrator agreed upon by both parties and a venue that is convenient to both parties. This deficiency was identified during a Standard survey completed on 4/16/24, which included interviews and record reviews for three residents. The facility's policy and procedure for entering into Binding Arbitration Agreements, dated 10/24/22, did not address the use of a neutral arbitrator agreed upon by both parties or the selection of a convenient venue. The Arbitration Agreement specified that disputes would be resolved by binding arbitration administered by the American Arbitrators Association or another arbitration association chosen solely by the facility, without addressing the convenience of the venue for both parties. Review of the Arbitration Agreements for three residents revealed no documented evidence that the agreements addressed the selection of a neutral arbitrator or a convenient venue. Interviews with the Admission Coordinator and the Administrator confirmed that the facility's Arbitration Agreement did not include language for choosing a neutral arbitrator or an agreed-upon location. The Admission Coordinator was unaware of these requirements, and the Administrator acknowledged that the agreements should follow regulations for resident protection. There had been no disputes settled through the arbitration process at the time of the survey.
What surveyors are citing around you — mapped
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Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 52 citations issued within 25 miles in the last 12 months — including the 2 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Medina
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Medina Memorial Hospital Snf | 1.5 mi | ★★★★★ | 0 | 0 |
| The Villages Of Orleans Health And Rehab Center | 3.6 mi | ★★★★★ | 1 | 0 |
| Absolut Center For Nursing And Rehabilitation At G | 10.3 mi | ★★★★★ | 1 | 1 |
| Elderwood At Lockport | 15.2 mi | ★★★★★ | 1 | 0 |
| Lockport Rehab & Health Care Center | 15.8 mi | ★★★★★ | 13 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.