Orchard Post Acute
Orchard Post Acute
4.1 (71 reviews)
Skilled Nursing Facility • 99 Licensed Beds
4840 E.tulare Avenue, Fresno, CA
CMS Medicare Ratings
Overall
Inspection
Staffing
Quality
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Orchard Post Acute

Skilled Nursing Facility • 99 Licensed Beds
4840 E.tulare Avenue,
Fresno, CA
CMS Medicare Ratings
Overall
Inspection
Staffing
Quality
View details →
About

Orchard Post Acute – Medicare Certified Since 1970

Orchard Post Acute is a Medicare and Medicaid certified skilled nursing facility located in Fresno, California. This facility has been serving the community for 56 years. A Medicare-certified skilled nursing facility provides 24-hour nursing care, rehabilitation services, and assistance with activities of daily living for patients who need skilled nursing or rehabilitation services on a daily basis.

This facility has 99 certified beds with a current occupancy rate of 94% (averaging 93 residents per day), which is high. Skilled nursing facilities provide 24-hour nursing care for patients who need rehabilitation services after a hospital stay or ongoing care for chronic conditions. Services include skilled nursing, physical therapy, occupational therapy, speech therapy, and assistance with daily activities.

Staffing Levels: Based on CMS payroll data, this facility provides approximately 4.21 hours of total nursing care per resident per day (2.7 hours from CNAs, 1.29 hours from LPNs, 0.22 hours from RNs). Physical therapy staffing is 0.06 hours per resident per day. This staffing level meets research-recommended quality thresholds.

Medicare Quality Ratings: According to CMS, Orchard Post Acute has an overall quality rating of 3 out of 5 stars, which is average compared to other nursing homes nationwide. Individual category ratings are: health inspection: 2 stars, staffing: 3 stars, quality measures: 5 stars.

Medicare Coverage: Medicare covers skilled nursing facility care for up to 100 days following a qualifying hospital stay of at least 3 days. Days 1-20 are fully covered by Medicare, days 21-100 require a daily coinsurance payment. Many residents also use Medicaid, private insurance, or pay privately for long-term stays.

Questions to Ask: When visiting a nursing home, ask about: staff-to-resident ratios and RN coverage around the clock, how they handle medical emergencies, activities and therapy programs, how they communicate with families, their approach to falls prevention, and policies for managing resident complaints.

Visit Medicare Care Compare to view detailed ratings, inspection reports, staffing data, and compare this facility with others in the area.

Quality ratings and facility data are updated periodically by CMS. We recommend verifying current information at Medicare Care Compare.

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Local Comparison Snapshot

How Orchard Post Acute compares to 33 facilities in Fresno, CA

Click a measure name to jump to details • Hover over for definitions

Measure
This Facility
Area Avg
Comparison
Overall Rating
Medicare 5-star rating
3
2.9
Quality Measures
Clinical outcomes & safety
5
4
Health Inspections
State survey results
2
2.5
Staffing
Nurse-to-resident ratio
3
3
Staffing Hours (per resident/day)
RN Hours
Registered nurses
0.22 hrs
0.48 hrs
LPN/LVN Hours
Licensed practical nurses
1.29 hrs
0.98 hrs
CNA Hours
Certified nursing assistants
2.70 hrs
2.44 hrs
Total Nursing Hours
CNA + LPN + RN combined
4.20 hrs
3.90 hrs
Agency/Contractor Usage
Lower agency use often indicates more stable, consistent care
RN Agency Use
% of RN hours from contractors
0 %
0.4 %
LPN/LVN Agency Use
% of LPN hours from contractors
5.4 %
1.2 %
CNA Agency Use
% of CNA hours from contractors
4.8 %
1.1 %
Staff Stability & Occupancy
Staff Turnover
Annual nursing staff turnover
53 %
35 %
Occupancy Rate
Percentage of beds filled
94 %
85 %
Financial Estimate
Based on CMS Cost Report data (for reference only)
Est. Daily Rate
Average cost per day
$620
$394
Estimate Only: This figure is calculated from cost reports and is for informational purposes only. Actual rates vary significantly. See details or contact the facility.
Better than Area
Near Average
Below Area Average

Data from CMS Medicare Compare and Payroll-Based Journal. Area averages based on 33 facilities in Fresno, CA.
Ratings and staffing data typically reflect the most recent quarterly reporting period available.

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Medicare Star Ratings

Official CMS ratings based on health inspections, staffing, and quality measures

Data as of December 2025

What do Medicare star ratings measure?
Medicare rates nursing homes on a 1-5 star scale based on three key areas: health inspection results, staffing levels, and quality measures like falls and infections.
How often are ratings updated?
CMS updates nursing home ratings monthly. Ratings can change based on new inspection results, staffing data from payroll records, and clinical quality outcomes.
Overall Rating
3/5
Quality Measures
5/5
Health Inspections
2/5
Staffing
3/5

Star Ratings History

Quarterly performance from 2013-2026

View on Medicare.gov
Overall
Health Inspections
Quality
Staffing
Source: Centers for Medicare & Medicaid Services

How Does This Facility Compare?

Compared to 33 other nursing homes in Fresno, CA

Why compare to local facilities?
Local comparisons account for regional staffing markets and demographics. A facility performing above local averages often indicates strong management and quality care relative to area standards.
Orchard Post Acute
Fresno, CA Average

Based on CMS Medicare star ratings. Higher ratings indicate better performance.

Staffing Hours per Resident Day

Orchard Post Acute
Fresno, CA Average

Staffing data from CMS Payroll-Based Journal. Higher hours generally indicate more direct care time.

Staff Turnover Rate

Orchard Post Acute
Fresno, CA Average

Lower turnover rates generally indicate a more stable workforce and better continuity of care.

Agency/Contract Staff Usage

Orchard Post Acute
Fresno, CA Average

Lower agency usage often indicates better staff retention. High agency rates (>30%) may suggest staffing challenges.

Agency Staff Trends

Historical agency/contract staff usage by role

What does agency usage indicate?
Agency/contract staff fill temporary staffing gaps. Lower percentages typically indicate a stable, permanent workforce. Facilities with consistently high agency usage (>30%) may face staff retention challenges, though temporary spikes can occur during seasonal illness or transitions.
CNA
LPN
RN

Data from CMS Payroll-Based Journal (PBJ). Agency % = contractor hours / total hours.

Direct Care Staffing

Average minutes of direct nursing care per resident per day

Data as of December 2025

Understanding staffing levels: Higher staffing is associated with better quality outcomes. Research suggests around 4.1 hours of total nursing care per resident per day as a quality benchmark. Compare this facility's staffing to local averages to assess relative care levels.
162
minutes/day
CNAs
Certified Nursing Assistants
77
minutes/day
LVNs
Licensed Vocational Nurses
13
minutes/day
RNs
Registered Nurses
4
minutes/day
PTs
Physical Therapists

Staffing Trends

Direct care minutes per resident per day

CNAs
LVNs
RNs
PTs
Source: Centers for Medicare & Medicaid Services

Occupancy Rate History

Average daily residents as a percentage of certified beds

Understanding occupancy: Higher occupancy can indicate strong community reputation and demand. Very low occupancy may affect financial stability, while extremely high occupancy could mean limited bed availability.
Orchard Post Acute
Fresno, CA Average (85%)

Data from CMS Provider Info files. Occupancy = Average Residents per Day / Certified Beds.

Staff Turnover History

Annual percentage of nursing staff who left the facility

Data as of December 2025

Understanding turnover: Lower turnover rates generally indicate a more stable workforce and better continuity of care. High turnover can affect care quality and resident relationships. The national average for nursing homes is around 50-60%.
All Nursing Staff
Registered Nurses (RN)
Area Average

Data from CMS Payroll-Based Journal. Turnover = staff who left during the year / total staff.

Average Daily Rate

Average daily charge for care at this facility

Based on CMS Cost Report data (inpatient revenue ÷ total patient days)

FY 2023 Daily Rate
$620
per resident per day
Compared to 31 facilities in your area
Above local median ($394)
Daily Rate Trend (2018-2023)
Contact Facility for Actual Rates
This figure is an average calculated from cost reports and is for informational purposes only. Actual rates vary significantly based on level of care needed, room type, payer source (Medicare, Medicaid, private pay), and other factors. Please contact the facility directly for current pricing and availability.
How This Is Calculated
This average daily rate is calculated from CMS Cost Reports by dividing total inpatient revenue by total patient days. It represents an average across all payers and care levels. Higher rates may indicate more intensive care, specialized services, or regional cost factors.

Data Source: Financial data from CMS Skilled Nursing Facility Cost Reports. Data typically lags 1-2 years. This information is for educational purposes only and should not be the sole basis for financial or care decisions. CareListings does not guarantee accuracy.

Financial Health

Comprehensive financial indicators from CMS Cost Reports

Data from fiscal year 2023 (most recent available - cost report data lags ~2 years)

For-Profit Facility

Financial Summary

Metric This Facility Local Median Comparison
Operating Margin
Profitability ratio
13% -2% Above
Net Income
Annual profit or loss
$1,973,720 $795,403.5 Above
Staff Cost per Resident
Daily salary expense per resident
$183/day $184/day Lower
Occupancy Rate
Bed utilization percentage
94% 89% Higher
Est. Daily Rate
Average revenue per patient day
$620/day $394/day Higher
Total Beds
Licensed bed capacity
99 86 Larger

Local comparisons based on 31 skilled nursing facilities in the Fresno, CA metro area

Revenue & Expenses

Net Patient Revenue
After adjustments & allowances
$14,812,354
Operating Expenses
Total operating costs
$12,843,930
Total Salaries
Staff compensation
$6,053,642
Contract Labor
Agency & temp staff
$166,481

Payer Mix

Medicare
19%
Medicaid
14%
Private Pay & Other
67%

Operating Margin Trend (2018-2023)

Understanding Financial Health
Operating Margin: Percentage of revenue remaining after operating costs. Positive = profitable operations.
Staff Investment: Higher spending per resident often correlates with better care quality.
Payer Mix: Shows revenue sources. Higher Medicare % typically means more post-acute/rehab care; higher Medicaid % indicates more long-term care residents.
Nonprofit/Government: May operate with lower margins while still providing quality care due to community mission.

Data Source: All financial data on this page comes from CMS Skilled Nursing Facility Cost Reports submitted by the facility to the Centers for Medicare & Medicaid Services. This information is provided for educational purposes only and should not be the sole basis for any financial or care decisions. Cost report data typically lags 1-2 years. CareListings does not guarantee the accuracy of this data.

Who Stays Here

Breakdown of residents by payment type

Based on fiscal year 2023 cost report data

Total Days
33,118
Medicare
Short-term skilled nursing
19%
Medicaid
Long-term care residents
14%
Private Pay / Other
Self-pay, insurance, VA
67%
Higher Medicare %
Indicates more short-term rehabilitation residents. Medicare typically covers up to 100 days of skilled nursing care after a hospital stay.
Higher Medicaid %
Indicates more long-term care residents. Medicaid covers nursing home care for those who qualify financially.

Average Length of Stay

How long residents typically stay at this facility

Based on fiscal year 2023 cost report data

Overall Average
79.42
days
Medicare Stays
38.07
days
Medicaid Stays
943.20
days
Total Admissions
422
Total Discharges
417
Medicare (Short-Term)
Medicare covers skilled nursing for rehabilitation after a hospital stay. Typical stays are 20-30 days for recovery from surgery, stroke, or illness.
Medicaid (Long-Term)
Medicaid covers long-term nursing home care for those who qualify. Many residents stay months or years, receiving ongoing daily care and support.

Services

Comprehensive skilled nursing services, rehabilitation programs, and medical care in FRESNO

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Reviews

4.1 (71 reviews)
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John Mello's profile photo
John Mello 7 months ago

I recently spent 26 days at Orchard Post Acute recovering from a serious surgery. The staff of nurses, nursing assistants and therapists were terrific. The facility was functional with the therapy gym outstanding. The food was surprisingly good. The atmosphere was friendly and caring. The one negative comment I have is in regard to the communication from the staff on matters of patient discharge. I was given two days to vacate by Medicare which was inadequate time to get needed medical equipment to my home. It was necessary to spend many hours following up with staff to make sure that equipment I needed was ordered. I was allowed to borrow some equipment from Orchard until the equipment I required was delivered to my home. I am grateful for that consideration.

E V's profile photo
E V 7 months ago

Their website says they promote healing but how can anyone heal when patient are either room with another person or 3 other people in small tiny rooms? My parent was here for months and staff keeps losing clothing and blankets, even when labeled. Staff doesn't bathe my parent on schedule on a consistent basis and sometime we visit and notice odor and then tell staff to wash my parent before they do it. They've also lied they have given my parent a shower when they hadn't. Another staff outed them out to us. Also, my parent had to sit in his own feces in diapers for hours before they change it. I asked a staff and she said it was dinner time, they didn't have enough staff so they can't do much about it. It seems most of these patients don't have family that advocates for them, so they just take it. We visit often and sees too much unacceptable practices. Without family to advocate, patients are treated like a number. The only positive experience I had was with the skilled therapy department.

Nancy Davila's profile photo
Nancy Davila 4 months ago

My experience as a student training here has been great! Staff are all super helpful and willing to teach students. The facility is well-kept and organized. It’s been a great environment so far!

Gus Elorza's profile photo
Gus Elorza a year ago

My father had the pleasure of experiencing care at Orchard Post Acute, and I am thoroughly impressed with the quality of service provided. From the moment he walked in, my father and myself was struck by the impeccable cleanliness of the entire facility. Every area, from the patient rooms to the common spaces, is maintained with the highest standards of hygiene. Everyone, from the medical professionals to the support staff, is incredibly friendly and attentive. They go out of their way to make sure patients feel comfortable and well-cared for, always offering a warm smile and a kind word. It’s clear that they genuinely care about the well-being of their patients. My family and myself highly recommend Orchard Post Acute to anyone in need of post-acute care. The combination of a pristine environment and a compassionate team makes this facility exceptional.

Valerie Rivera's profile photo
Valerie Rivera a year ago

My experience being at Orchard Post Acute for me was different I worked as a CNA so being the patient was hard but this place made me feel so welcome and the staff there were so good to me the social worker all the nursing staff CNA’s all the nurses and just all the people that worked there were super good to me even the kitchen staff,house keeper to everyone became my new friends and most of all the physical therapy was so good to me I had physical therapy everyday and I showed so much progress being there I was there from may 16 ,2024 to July 24 ,2024 Thank u so much for making a difference in my recovery

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