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Home / North Carolina / Hendersonville

Orchard Valley Health and Rehabilitation

200 Heritage Circle, Hendersonville, NC 28791 · Henderson County · (828) 693-5849

134 certified beds, about 101 residents a day · For profit - Corporation · Medicare and Medicaid since 1988

Certified for Medicaid Certified for Medicare
Overall
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
1 of 5

CMS Care Compare ratings, data as of September 1, 2026 · CCN 345285 · See it on Medicare.gov · Compare with other homes

The record in brief

At its most recent standard inspection, on February 20, 2026, inspectors cited 7 health deficiencies (the North Carolina average is 4.7, the national average 9.2).

Of 46 health citations since October 2023, 1 was rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).

CMS lists 1 fine totaling $16,452 in the last three years; the largest was $16,452, and the latest is dated June 21, 2024.

Nurses and nurse aides worked 3.11 hours per resident per day, against 3.85 across North Carolina and 3.86 nationally. Registered nurses accounted for 0.43 of those hours.

73.5% of nursing staff left within the year CMS measured (North Carolina average 49.0%).

CMS links it to Ascent Healthcare Management, an affiliated group of 6 nursing homes.

Health inspections

Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.

Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.

Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit

Where its citations fall on CMS's grid

CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 46 health citations on file.

Severity
Isolated
Pattern
Widespread
Immediate jeopardy
1J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
27D
12E
2F
Potential for minimal harm
0A
2B
2C
February 20, 2026Standard inspection, Complaint inspection · 7 citations
  1. E
    Ensure each resident receives an accurate assessment.
    F641 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) March 16, 2026
    Inspectors wroteBased on record review and staff interviews, the facility failed to accurately code the Minimum Data Set (MDS) assessment for the areas of hospice (specialized care focused on nearing the end of life) (Resident #29, Resident #62, and Resident #77) and preadmission screening and resident review (PASRR, a program ensuring residents with certain diagnoses received specialty services) (Resident #10) for 4 of 30 residents whose MDS assessments were reviewed.
  2. D
    Reasonably accommodate the needs and preferences of each resident.
    F558 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) March 16, 2026
    Inspectors wroteBased on observations, record review, and resident and staff interviews, the facility failed to provide a bed with enough length to prevent a resident's feet from pressing against the footboard for 1 of 1 resident reviewed for accommodation of needs (Resident #48).
  3. D
    Assure that each resident’s assessment is updated at least once every 3 months.
    F638 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) March 16, 2026
    Inspectors wroteBased on record review and staff interviews, the facility failed to complete quarterly Minimum Data Set (MDS) assessments within 14 days of the Assessment Reference Date (ARD, referring to the last day of the observation period) for 3 of 30 residents whose MDS assessments were reviewed (Residents #10, #47 and #108).
  4. D
    Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
    F644 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) March 16, 2026
    Inspectors wroteBased on record review and staff interviews, the facility failed to submit a request for a Level II Preadmission Screening and Resident Review (PASRR) evaluation for a resident who was admitted to the facility with mental health disorders for 1 of 6 residents reviewed for PASRR (Resident #11).
  5. D
    Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
    F646 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) March 16, 2026
    Inspectors wroteBased on record review and staff interviews, the facility failed to submit a request for a Level II Preadmission Screening and Resident Review (PASRR) reevaluation after a significant change in physical or mental status was identified for residents previously determined to have a Level II PASRR. This deficient practice affected 2 of 5 sampled residents reviewed for PASRR (Residents #28 and #31).
  6. D
    Provide enough food/fluids to maintain a resident's health.
    F692 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) March 16, 2026
    Inspectors wroteBased on observations, record review, and interviews with the Medical Director, Registered Dietitian and staff, the facility failed to provide nutritional supplements according to the physician's diet order for 1 of 4 residents reviewed for weight loss (Resident #90).
  7. D
    Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
    F700 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) March 16, 2026
    Inspectors wroteBased on observations, record review and resident and staff interviews, the facility failed to complete bed rail assessments to determine the need for bed rail use and failed to obtain informed consent prior to installation for 2 of 2 sampled residents (Resident #47 and #53). Findings Included:a. Resident #47 was admitted to the facility on [DATE]. His cumulative diagnoses included chronic respiratory failure with hypoxia (low oxygen), muscle weakness, and chronic pain. The quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #47 had intact cognition and range of motion impairment on both sides of the lower extremities. The MDS assessment noted Resident #47 required supervision or touching assistance with bed mobility, was independent with moving from a sitting-to-lying position and bed rails were not used as a physical restraint. [...]
July 24, 2025Complaint inspection · 2 citations
  1. D
    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
    F657 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) August 13, 2025
    Inspectors wroteBased on record review, and interviews with the Speech Therapist and staff, the facility failed to revise the care plan to reflect the current diet as ordered by the physician for 1 of 1 resident reviewed for nutrition (Resident #1). The findings including: Resident #1 was admitted to the facility on [DATE] with diagnoses including vascular dementia and dysphagia (difficulty swallowing). The admission Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #1 had moderate cognitive impairment. He required partial to moderate assistance with eating, and no signs or symptoms of a swallowing disorder were noted. The care plan last revised on 4/23/25 indicated Resident #1 received a regular diet with thin liquids and included the intervention to provide the diet as ordered by the physician. [...]
  2. D
    Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.
    F807 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) August 13, 2025
    Inspectors wroteBased on record review, observations, interviews with the Speech Therapist and staff, the facility failed to provide fluids of a nectar thick consistency as ordered by the physician for 1 of 1 resident reviewed for nutrition (Resident #1).
December 6, 2024Standard inspection, Complaint inspection · 26 citations
  1. F
    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.
    F803 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, widespread · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on observations of the meal service tray line, record review, and dietary staff, Registered Dietician (RD), and the Regional Director of Operations (RDO) interviews, the facility failed to provide all food items as specified by the approved menu and failed ensure residents received the correct portion sizes based on the approved menu. These practices had the potential to affect 77 residents receiving a regular diet, 18 residents receiving a mechanical soft diet (consisting of foods that are easy to swallow), and 8 residents receiving a puree diet (consisting of foods with a pudding-like texture).
  2. F
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    F812 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, widespread · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on observations and staff interviews the facility failed to maintain a clean floor in 1 of 1 walk-in cooler, 1 of 1 walk-in freezer, 1 of 1 dry storage rooms, and 1 of 1 kitchen; label and date open food items and discard expired food in 1 of 1 walk-in cooler and 2 of 2 reach-in coolers; cover and date open food items in 1 of 1 walk-in freezer and 1 of 1 reach-in cooler; date milkshakes to identify their use-by date in 1 of 1 reach-in cooler; maintain clean shelves on 5 prep tables in 1 of 1 kitchen; discard expired bread in 1 of 1 kitchen; and maintain clean refrigerators and freezers in 2 of 2 nourishment rooms (200 hall and 300 hall). This failure had the potential to affect food served to residents.
  3. E
    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.
    F584 · Resident Rights · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wrote6. An observation of the dresser of room [ROOM NUMBER]-B on 12/02/24 at 11:32 AM revealed an area of missing wood to the top of the dresser on the side closest to the bed, leaving an exposed sharp corner. Additional observations of the dresser of room [ROOM NUMBER]-B on 12/03/24 at 8:55 AM, on 12/04/23 at 7:42 AM, and 12/05/24 at 7:34 AM revealed an area of missing wood to the top of the dresser on the side closest to the bed, leaving an exposed sharp corner. An interview with the Maintenance Director on 12/04/24 at 10:57 AM revealed he was not aware of the top of the dresser in room [ROOM NUMBER]-B having missing wood resulting in a sharp corner being exposed. He stated he relied on nursing staff to notify him of rough edges on furniture since he was busy working on other projects. The Maintenance Director stated the dresser would need to be replaced. [...]
  4. E
    Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
    F623 · Resident Rights · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on record review and staff interviews, the facility failed to notify the Regional Ombudsman when residents discharged or transferred from the facility for 6 of 6 months (April 2024, July 2024, August 2024, September 2024, October 2024, and November 2024).
  5. E
    Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
    F636 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on record review and staff interviews, the facility failed to complete comprehensive Minimum Data Set (MDS) assessments within 14 days of the Assessment Reference Date (ARD, referring to the last day of the assessment period) (Residents #6, #16, #21, #28, #29, #47, #68, and #78) and failed to comprehensively complete the Care Area Assessment (CAA) for Resident #89 for 9 of 45 sampled residents.
  6. E
    Assure that each resident’s assessment is updated at least once every 3 months.
    F638 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on record review and staff interviews, the facility failed to complete quarterly Minimum Data Set (MDS) assessments within 14 days of the Assessment Reference Date (ARD, referring to the last day of the observation period) for 14 of 45 sampled residents (Residents #6, #15, #16, #21, #28, #29, #42, #47, #48, #68, #78, #81, #83, and #85).
  7. E
    Ensure that the resident and his/her doctor meet face-to-face at all required visits.
    F712 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on record review, and Medical Director (MD) and staff interviews, the facility failed to ensure physician visits were performed every 30 days for the first 90 days of admission for 4 of 4 sampled residents reviewed for physician visits (Residents #21, #31, #41, and #55).
  8. D
    Allow resident to participate in the development and implementation of his or her person-centered plan of care.
    F553 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on record review, resident and staff interviews, the facility failed to invite residents to participate and provide input in care planning for 2 of 3 sampled residents (Residents #50 and #11).
  9. D
    Reasonably accommodate the needs and preferences of each resident.
    F558 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on observation, record review, and interviews with resident and staff, the facility failed to ensure a dependent resident could access a light switch located at the left side of her bed for 1 of 1 resident reviewed for accommodation of needs (Resident #91).
  10. D
    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.
    F578 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on record review and staff interviews, the facility failed to maintain accurate advanced directives throughout the medical record for 1 of 3 residents reviewed for advanced directives (Resident #65).
  11. D
    Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
    F580 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on staff and Nurse Practitioner (NP) interviews and record review, the facility failed to notify the Physician when a urinalysis was not completed for 1 of 2 residents reviewed for notification of change (Resident #38).
  12. D
    Develop and implement policies and procedures to prevent abuse, neglect, and theft.
    F607 · Freedom from Abuse, Neglect, and Exploitation · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on record review and staff interviews, the facility failed to follow their abuse policy and procedure by not immediately reporting an allegation of resident-to-resident abuse to the Administrator for 1 of 5 sampled residents reviewed for abuse (Resident #11).
  13. D
    Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
    F644 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on record review and staff interviews, the facility failed to request a Preadmission Screening and Resident Review (PASRR) before the expiration date and failed to develop comprehensive care plans that incorporated Level II PASRR determination for 2 of 3 sampled residents reviewed for PASRR (Resident #21 and #104).
  14. D
    Plan the resident's discharge to meet the resident's goals and needs.
    F660 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on record review and resident and staff interviews, the facility failed to have a discharge planning process in place that incorporated the resident in the development of a discharge care plan that addressed the resident's discharge goals and post-discharge needs for residents who wished to discharge to the community for 2 of 3 sampled residents (Residents #50 and #70).
  15. D
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    F684 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on record review and interviews with the Medical Director, Nurse Practitioner, and staff the facility failed to obtain a blood sugar as part of the change of condition assessment for a resident with a current diagnosis of diabetes mellitus that was being treated with routine oral blood glucose lowering medication for 1 of 1 resident reviewed for a change of condition (Resident #205).
  16. D
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    F689 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on observations, record review, and staff interviews the facility failed to ensure a Nurse Aide (NA #8) transferred a resident safely for 1 of 8 residents (Resident #4) reviewed for supervision to prevent accidents.
  17. D
    Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
    F690 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on record review, observation, and interviews with the resident and staff the facility failed to ensure the urinary catheter tubing was secured to the leg to prevent movement and trauma for 1 of 1 resident reviewed for urinary catheter (Resident #87).
  18. D
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    F755 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on observations, record review, and Consultant Pharmacist, Medical Director, resident and staff interviews, the facility failed to ensure antibiotic eye drops were received from the pharmacy as ordered which resulted in five (5) missed doses for 1 of 6 sampled residents reviewed for pharmacy services (Resident #11).
  19. D
    Ensure that residents are free from significant medication errors.
    F760 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on record review and Medical Director, resident and staff interviews, the facility failed to prevent a significant medication error when they failed to administer antibiotic eye drops as prescribed by the physician. As a result, Resident #11 missed 5 doses of antibiotic eye drops. This affected 1 of 6 sampled residents reviewed for unnecessary medications (Resident #11).
  20. D
    Provide timely, quality laboratory services/tests to meet the needs of residents.
    F770 · Administration · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on staff and Nurse Practitioner (NP) interviews and record review, the facility failed to complete an ordered Urinalysis for 1 of 2 residents reviewed for laboratory services (Resident #38).
  21. D
    Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
    F806 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on observation, record review, and resident and staff interviews the facility failed to honor a resident's food preferences for 1 of 5 residents reviewed for food preferences (Resident #31).
  22. D
    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.
    F808 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on observations, record review, staff, Registered Dietician (RD), and Nurse Practitioner (NP) interviews the facility failed to provide Resident #52 with a renal diet as ordered. This failure affected 1 of 3 residents reviewed for nutrition.
  23. D
    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
    F842 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on observation, record review and staff interviews, the facility failed to maintain a complete and accurate medical record when staff documented that they applied a splint when a splint was not applied. This occurred for 1 of 3 residents (Resident #73) reviewed for accurate medical records.
  24. C
    Ensure the activities program is directed by a qualified professional.
    F680 · Quality of Life and Care · No actual harm, potential for minimal harm, widespread · Corrected (the home has a date of correction) January 3, 2025
    Inspectors wroteBased on staff interviews, the facility failed to have a qualified professional to direct the facility's activity program. This practice had the potential to affect all 106 residents at the facility.
  25. B
    Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
    F640 · Resident Assessment and Care Planning · No actual harm, potential for minimal harm, pattern · found on a complaint visit · deficient, provider has January 3, 2025
    Inspectors wroteBased on record review and staff interviews, the facility failed to complete a discharge-return anticipated Minimum Data Set (MDS) assessment and entry tracking records within the regulated timeframes for 2 of 14 residents reviewed for resident assessments (Resident #47 and #83).
  26. B
    Provide bedrooms that don't allow residents to see each other when privacy is needed.
    F914 · Environmental · No actual harm, potential for minimal harm, pattern · found on a complaint visit · deficient, provider has January 3, 2025
    Inspectors wroteBased on record review, observations, and interviews with the resident and staff the facility failed to install a privacy curtain and failed to ensure the privacy curtain extended around the bed for 2 of 9 rooms reviewed for environment (room [ROOM NUMBER]-A and #304-A).
June 21, 2024Complaint inspection · 3 citations
  1. J
    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
    F600 · Freedom from Abuse, Neglect, and Exploitation · Immediate jeopardy to resident health or safety, isolated · found on a complaint visit · Past noncompliance: already fixed when inspectors found it
    Inspectors wroteBased on record review and staff, Law Enforcement Corporal, and Medical Doctor (MD) interviews, the facility failed to protect a [AGE] year old female resident with severe cognitive impairment (Resident #2) from sexual abuse by a [AGE] year old male resident with moderate impairment in cognition (Resident #1) for 1 of 4 residents reviewed for abuse. Resident #1 was observed with his shorts/boxers pulled down lying in bed next to and behind Resident #2, whose gown was pulled up exposing her breasts and her brief pulled down between her legs, with the perceived intention of engaging in sexual activity. Based upon the reasonable person concept, a person in Resident #2's position would have expected to be protected from abuse in their home environment and non-consensual sexual activity would have caused psychosocial harm and trauma such as feelings of fear, anxiety and humiliation.
  2. D
    Develop and implement policies and procedures to prevent abuse, neglect, and theft.
    F607 · Freedom from Abuse, Neglect, and Exploitation · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Past noncompliance: already fixed when inspectors found it
    Inspectors wroteBased on record review and staff interviews, the facility failed to implement their abuse policy and procedures in the areas of employee training and investigation by not preserving evidence that could be used in a sexual assault allegation. Nurse #1 and Nurse Aide #1 provided incontinent care to a [AGE] year old female resident with severe impairment in cognition (Resident #2) and disposed of the brief after finding a [AGE] year old male resident with moderate impairment in cognition (Resident #1) with his short/boxers pulled down lying in bed up close and behind the female resident with the perceived intention of engaging in sexual activity. This deficient practice affected 1 of 4 residents reviewed for abuse.
  3. C
    Hire a qualified full-time social worker in a facility with more than 120 beds.
    F850 · Administration · No actual harm, potential for minimal harm, widespread · found on a complaint visit · deficient, provider has July 9, 2024
    Inspectors wroteBased on record review and staff interviews, the facility failed to employ a Social Worker (SW) who had a minimum of a bachelor's degree in social work or human services field when the skilled nursing facility had 134 certified beds.
October 13, 2023Standard inspection, Complaint inspection · 8 citations
  1. E
    Provide appropriate foot care.
    F687 · Quality of Life and Care · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) November 3, 2023
    Inspectors wroteBased on record review, observation, and resident and staff interviews, the facility failed to ensure toenails were trimmed and refer a resident to podiatry services for 1 of 1 resident (Resident #85) reviewed for foot care.
  2. E
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    F755 · Pharmacy Service · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) November 3, 2023
    Inspectors wroteBased on record reviews, resident, staff, Pharmacist, Nurse Practitioner, and Medical Director interviews, the facility failed to re-order medications from the pharmacy when there were 5 doses left to ensure medications were available to be administered for 2 of 2 residents (Resident #15 and Resident #35) reviewed for significant medication errors.
  3. E
    Ensure that residents are free from significant medication errors.
    F760 · Pharmacy Service · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) November 3, 2023
    Inspectors wroteBased on record reviews, resident, staff, Pharmacist, Nurse Practitioner, and Medical Director interviews, the facility failed to administer medications as ordered by the physician that included Xarelto for atrial fibrillation, Baclofen for muscle spasms, Gabapentin for pain, Fentanyl patch for pain and Copaxone injections for Multiple Sclerosis. This occurred for 2 of 2 residents (Resident #15 and Resident #35) reviewed for significant medication errors.
  4. E
    Provide or obtain dental services for each resident.
    F791 · Quality of Life and Care · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) November 3, 2023
    Inspectors wroteBased on record review, resident and staff interviews the facility failed to obtain dental services needed for extractions for 1 of 2 resident's reviewed for dental services (Resident #62). The Findings Included: Resident #62 was admitted to the facility on [DATE] with diagnosis that included congestive heart failure and kidney disease. The annual Minimal Data Set (MDS) dated [DATE] coded Resident #62 as cognitively intact and with no dental concerns. A review of Resident #62's dental records revealed Resident #62 last received dental service on 10/7/22 and a dental consent for tooth extractions was signed on 10/21/22 by Resident # 62 and a Nurse Practitioner. A review of Resident #62's medical record and progress notes revealed no additional dental exams or dental notes after the signed consent on 10/22/23. [...]
  5. E
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    F812 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) November 3, 2023
    Inspectors wroteBased on observations and interviews with staff, the facility failed to clean 2 of 2 ice scoop holders and failed to store an ice scoop under sanitary conditions. This practice had the potential to affect beverages served to residents.
  6. E
    Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
    F867 · Administration · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) November 3, 2023
    Inspectors wroteBased on observations, resident and staff interviews and record review, the facility's Quality Assurance (QA) process failed to implement, monitor, and revise as needed the action plan developed for the recertification and complaint surveys dated 07/11/22 and 07/23/21 to achieve and sustain compliance. This was for 1 recited deficiency on the current recertification and complaint investigation survey of 10/13/23 related to food procurement, store/prepare/serve-sanitary. The continued failure during three federal surveys of record showed a pattern of the facility's inability to sustain an effective quality assurance program.
  7. D
    Provide care and assistance to perform activities of daily living for any resident who is unable.
    F677 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) November 3, 2023
    Inspectors wroteBased on record review, observation, and interviews with the resident, staff and the Medical Director, the facility failed to provide nail care to 1 of 2 residents (Resident #85) reviewed for assistance with activities of daily living.
  8. D
    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.
    F761 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 3, 2023
    Inspectors wroteBased on observation, staff interviews and record reviews, the facility failed to store unopened medications in the temperatures specified by manufacturer's guidelines for 1 or 4 medications carts observed during medication storage checks (A hall medication cart #2).

Fire safety inspections

29 fire safety citations on file: 7 on February 20, 2026, 15 on December 6, 2024, 7 on October 13, 2023.

Every fire safety citation29 citations
  1. E
    Inspect, test, and maintain automatic sprinkler systems.
    K 353 · February 20, 2026 · Corrected (the home has a date of correction)
  2. E
    Have generator or other power source capable of supplying service within 10 seconds.
    K 918 · February 20, 2026 · Corrected (the home has a date of correction)
  3. D
    Install emergency lighting that can last at least 1 1/2 hours.
    K 291 · February 20, 2026 · Corrected (the home has a date of correction)
  4. D
    Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
    K 321 · February 20, 2026 · Corrected (the home has a date of correction)
  5. D
    Have approved installation, maintenance and testing program for fire alarm systems.
    K 345 · February 20, 2026 · Corrected (the home has a date of correction)
  6. D
    Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
    K 372 · February 20, 2026 · Corrected (the home has a date of correction)
  7. D
    Have properly installed electrical wiring and gas equipment.
    K 511 · February 20, 2026 · Corrected (the home has a date of correction)
  8. F
    Use approved construction type or materials.
    K 161 · December 6, 2024 · Corrected (the home has a date of correction)
  9. F
    Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
    K 222 · December 6, 2024 · Corrected (the home has a date of correction)
  10. F
    Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
    K 372 · December 6, 2024 · Corrected (the home has a date of correction)
  11. F
    Have properly installed electrical wiring and gas equipment.
    K 511 · December 6, 2024 · Corrected (the home has a date of correction)
  12. F
    Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
    K 521 · December 6, 2024 · Corrected (the home has a date of correction)
  13. F
    Meet requirements for the installation and maintenance of electrical systems.
    K 911 · December 6, 2024 · Corrected (the home has a date of correction)
  14. F
    Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
    K 914 · December 6, 2024 · Corrected (the home has a date of correction)
  15. F
    Have generator or other power source capable of supplying service within 10 seconds.
    K 918 · December 6, 2024 · Corrected (the home has a date of correction)
  16. D
    Install proper backup exit lighting.
    K 281 · December 6, 2024 · Corrected (the home has a date of correction)
  17. D
    Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
    K 321 · December 6, 2024 · Corrected (the home has a date of correction)
  18. D
    Provide properly protected cooking facilities.
    K 324 · December 6, 2024 · Corrected (the home has a date of correction)
  19. D
    Properly install and monitor supervisory attachments on automatic sprinkler systems.
    K 352 · December 6, 2024 · Corrected (the home has a date of correction)
  20. D
    Inspect, test, and maintain automatic sprinkler systems.
    K 353 · December 6, 2024 · Corrected (the home has a date of correction)
  21. D
    Install corridor and hallway doors that block smoke.
    K 363 · December 6, 2024 · Corrected (the home has a date of correction)
  22. D
    Have proper medical gas storage and administration areas.
    K 923 · December 6, 2024 · Corrected (the home has a date of correction)
  23. E
    Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
    K 372 · October 13, 2023 · Corrected (the home has a date of correction)
  24. E
    Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
    K 914 · October 13, 2023 · Corrected (the home has a date of correction)
  25. D
    Use approved construction type or materials.
    K 161 · October 13, 2023 · Corrected (the home has a date of correction)
  26. D
    Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
    K 321 · October 13, 2023 · Corrected (the home has a date of correction)
  27. D
    Have properly installed electrical wiring and gas equipment.
    K 511 · October 13, 2023 · Corrected (the home has a date of correction)
  28. D
    Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
    K 521 · October 13, 2023 · Corrected (the home has a date of correction)
  29. D
    Have proper medical gas storage and administration areas.
    K 923 · October 13, 2023 · Corrected (the home has a date of correction)

Fines and payment denials

DatePenaltyAmount or length
June 21, 2024Fine $16,452

A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.

Staffing

Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.

MeasureThis homeNorth CarolinaUnited States
All nursing staff (RN, LPN and aides)3.113.853.86
Registered nurses0.430.620.69
All nursing staff on weekends2.803.423.42
Nurse aides2.09
Licensed practical nurses0.59
Nursing staff turnover (share who left in a year)73.5%49.0%45.8%
Registered nurse turnover71.4%45.6%42.9%
Administrators who left2

CMS expects 3.48 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.

Staffing by quarter, from daily payroll records

Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.24 on weekdays and 2.80 on weekends, 14% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 50.9% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.01 in April to June 2025 to 3.11 in January to March 2026.

QuarterAll nursing staffRegistered nursesWeekdaysWeekendsContract staff shareDays with no RN hoursResidents a day
Jan to Mar 20263.110.433.242.80 50.9%0 of 90101
Oct to Dec 20253.120.473.232.86 54.5%0 of 92101
Jul to Sep 20253.140.523.193.00 54.9%0 of 9294
Apr to Jun 20253.010.643.132.68 37.3%0 of 9197
United States, Jan to Mar 20263.750.623.923.335.3%0.5% of days
North Carolina, Jan to Mar 20263.650.533.823.258.0%0.7% of days

Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.

Staff pay reports

Staff pay at this home

No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.

Official wage estimates for North Carolina

JobMedianMiddle halfEmployed
North Carolina, all employers
CNAs (nursing assistants)$18.49$17.28 to $21.0864,010
LPNs and LVNs$30.42$28.50 to $33.5118,010
Registered nurses$40.56$37.87 to $49.06111,120
United States, nursing care facilities
CNAs (nursing assistants)$20.67$17.91 to $22.55534,270
LPNs and LVNs$33.86$30.05 to $37.40188,210
Registered nurses$41.11$37.85 to $47.68142,270

Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.

How staff pay reports work · CNA pay by state

Quality measures

The measures CMS uses for the quality star. Lower is better for every one of them.

MeasureThis homeNorth CarolinaUS
Percentage of long-stay residents whose need for help with daily activities has increased
Long Stay residents, 2025Q2-2026Q1
6.015.613.9
Percentage of long-stay residents with a catheter inserted and left in their bladder
Long Stay residents, 2025Q2-2026Q1
0.70.70.8
Percentage of long-stay residents with a urinary tract infection
Long Stay residents, 2025Q2-2026Q1
2.32.31.6
Percentage of long-stay residents experiencing one or more falls with major injury
Long Stay residents, 2025Q2-2026Q1
2.53.53.2
Percentage of short-stay residents who newly received an antipsychotic medication
Short Stay residents, 2025Q2-2026Q1
3.01.41.6
Percentage of long-stay residents whose ability to walk independently worsened
Long Stay residents, 2025Q2-2026Q1
6.318.314.1
Percentage of long-stay residents with pressure ulcers
Long Stay residents, 2025Q2-2026Q1
7.05.54.6
Percentage of long-stay residents who received an antipsychotic medication
Long Stay residents, 2025Q2-2026Q1
32.414.015.4
Percentage of short-stay residents who were rehospitalized after a nursing home admission
Short Stay residents, 20250101-20251231
28.122.923.8
Percentage of short-stay residents who had an outpatient emergency department visit
Short Stay residents, 20250101-20251231
19.512.912.0
Number of hospitalizations per 1000 long-stay resident days
Long Stay residents, 20250101-20251231
1.91.81.9
Number of outpatient emergency department visits per 1000 long-stay resident days
Long Stay residents, 20250101-20251231
1.51.81.8

Short-term rehab results

For a stay to recover after a hospital visit, these are the results CMS publishes for Orchard Valley Health and Rehabilitation's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (30.4% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.

Went home or back to the community

30.4% this home

No different from the national rate

US median of homes 51.5% · North Carolina: 93 better, 25 worse

Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 30 eligible stays.

Potentially preventable readmissions

11.4% this home

No different from the national rate

US median of homes 10.7% · North Carolina: 1 better, 4 worse

Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 35 eligible stays.

Infections that led to a hospital stay

Not reported

CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.

US median of homes 7.1% · North Carolina: 1 better, 3 worse

Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 17 eligible stays.

Self-care and mobility at discharge

45.0% this home

Median of homes: North Carolina54.0% · US 56.6%

Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 20 residents counted.

Falls with major injury

3.0% this home

Median of homes: North Carolina0.6% · US 0.0%

Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 33 residents counted.

New or worsened pressure ulcers

9.4% this home

Median of homes: North Carolina2.5% · US 1.7%

Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 33 residents counted.

Medication list given at discharge

Not reported

CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.

Median of homes: North Carolina97.5% · US 98.7%

Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 7 residents counted.

Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.

Owners and operators

Legal business name: HENDERSONVILLE NC OPCO LLC. CMS links this home to Ascent Healthcare Management, a group of 6 nursing homes averaging 2.2 stars overall.

NameRoleTypeShareSince
Friedman, YisroelCorporate directorIndividual01/01/2024
Ford, AlbertOperational/managerial controlIndividual01/01/2025
Hardin, SteveOperational/managerial controlIndividual01/01/2025
Ford, AlbertAdp of the SNFIndividual03/06/2025
Hardin, SteveAdp of the SNFIndividual03/06/2025

As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.

Questions to ask on a visit

Chosen from this home's own inspection record.

  1. When is the care plan meeting, and can family attend it?Inspectors cited 11 problems in this area, most recently on February 20, 2026: "Ensure each resident receives an accurate assessment."
  2. How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 9 problems in this area, most recently on February 20, 2026: "Provide enough food/fluids to maintain a resident's health."
  3. How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 7 problems in this area, most recently on February 20, 2026: "Reasonably accommodate the needs and preferences of each resident."
  4. Can we see a week of menus and the kitchen, and how are special diets handled?Inspectors cited 6 problems in this area, most recently on July 24, 2025: "Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration."
  5. Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 2.80 hours per resident per day, below the North Carolina average of 3.42.
  6. How long has the current administrator been here?CMS counts 2 administrators who left in the period it measured.

Other nursing homes nearby

North Carolina contacts for a concern about a nursing home

These are the official offices in North Carolina. NursingHomeClear cannot take or act on complaints.

Common questions

What is Orchard Valley Health and Rehabilitation's Medicare star rating?
CMS rates Orchard Valley Health and Rehabilitation 1 out of 5 stars overall, with 2 for health inspections, 1 for staffing and 1 for quality measures (CMS data as of September 1, 2026).
How many deficiencies did Orchard Valley Health and Rehabilitation get at its last inspection?
7 health deficiencies at the standard inspection on February 20, 2026. The North Carolina average is 4.7.
Has Orchard Valley Health and Rehabilitation been fined?
Yes. CMS lists 1 fine totaling $16,452 in the last three years.
Does Orchard Valley Health and Rehabilitation accept Medicaid?
It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
Who owns Orchard Valley Health and Rehabilitation?
CMS lists 5 owners and managers, and links the home to Ascent Healthcare Management. Legal business name: HENDERSONVILLE NC OPCO LLC.

Sources

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