1/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
1/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
The Orchards of Cascadia demonstrates a complex operational picture: strong staffing capacity with financial constraints. Located in Caldwell, Idaho (Canyon County), the 100-bed facility is privately owned by Donna Beeson and CMS-certified for Medicare and Medicaid. Walk score 54 reflects a moderately walkable neighborhood.
2023 financial data reveal operational pressure: gross revenue $12.7 million generated an operating loss of $76.9 thousand (negative 0.6% profit margin). Total payroll $6.2 million represents 48.6% of revenue, below the typical 54–58% for well-run Idaho facilities. However, occupancy improved substantially from 70.1% in 2022 to current 76.9% (7.8% above state average). Facility ranks #11 in Idaho by revenue and #12 by total payroll.
Occupancy trends show a mixed payer population: Medicaid 82.3% of current residents (typically 12-month stays), private-pay 11.4% (typical one month), Medicare 6.3% (typical 27 days). The facility serves 79 current residents and averages 145-day length of stay.
Staffing metrics present strength: staff-to-resident ratio 2.77:1 is 53% better than Idaho average. Licensed practical nurses provide 54 minutes per resident per day (17% above state average; a standout metric). Total adjusted nursing hours 3 hours 45 minutes per day rank 11th of 31 Idaho facilities, though 9% below state average. Staffing includes 26 RNs, 40 LPNs, 106 CNAs among 219 total staff (137 employees, 82 contractors).
CMS ratings: overall 3 stars (8.1% below state average); health inspection 3 stars (7.2% above state); staffing 3 stars (10.3% below); quality measures 3 stars (3.1% below). The June 2024 penalty of $9,000 is sole enforcement action in three years; 77% lower than the state average.
Quality outcomes bifurcate sharply. Long-stay residents show functional preservation: functional decline 17% better than state; depressive symptoms 67% better; hospitalizations and ED visits both improved over state. Short-stay falls prevention is excellent (0% falls with major injury, 100% better than state) yet discharge self-care weak (30.4%, 43% worse than state). Long-stay fall prevention presents a critical deficit: falls with major injury 4.7% (68% worse than state); pressure ulcers 6.0% (64% worse).
The Orchards of Cascadia operates with exceptional staffing ratios and strong long-stay function but faces fall prevention challenges and recent financial deterioration despite occupancy gains.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 12th out of 33 homes in Idaho for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 38m per day | ▼ 25% State avg: 50m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 58m per day | ▲ 26% State avg: 46m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 2h 21m per day | ▼ 5% State avg: 2h 28m per day · National avg: 2h 21m per day |
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 3h 14m per day | ▼ 7% State avg: 3h 28m per day · National avg: 3h 26m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 2m per day | ▼ 74% State avg: 6m per day · National avg: 4m per day |
|
Weekend RN
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 21m per day | ▼ 35% State avg: 32m per day · National avg: 29m per day |
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
53% more staff per resident than Idaho average
0% compared with Idaho average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
26 total: 15 full-time employees and 11 contractors.
26
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.7 hoursAssists with medical care and medications.
40 total: 22 full-time employees and 18 contractors.
40
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.8 hoursHelps with daily care and mobility.
106 total: 58 full-time employees and 48 contractors.
106
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.7 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
4,114 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 58 | 48 | 106 | 19,801 | 92 | 100% | 7.7 |
| Licensed Practical Nurse | 22 | 18 | 40 | 8,108 | 92 | 100% | 8.8 |
| Registered Nurse | 15 | 11 | 26 | 3,625 | 92 | 100% | 8.7 |
| Dental Services Staff | 3 | 0 | 3 | 1,347 | 66 | 72% | 7.6 |
| Clinical Nurse Specialist | 3 | 0 | 3 | 1,152 | 72 | 78% | 8.4 |
| Physical Therapy Assistant | 9 | 0 | 9 | 1,041 | 71 | 77% | 6 |
| Speech Language Pathologist | 9 | 0 | 9 | 612 | 69 | 75% | 6.7 |
| Qualified Social Worker | 6 | 0 | 6 | 559 | 65 | 71% | 6.2 |
| Administrator | 1 | 0 | 1 | 512 | 64 | 70% | 8 |
| Nurse Practitioner | 1 | 0 | 1 | 512 | 64 | 70% | 8 |
| Dietitian | 1 | 0 | 1 | 446 | 62 | 67% | 7.2 |
| Occupational Therapy Aide | 1 | 0 | 1 | 256 | 64 | 70% | 4 |
| Respiratory Therapy Technician | 7 | 0 | 7 | 221 | 49 | 53% | 4 |
| Other Dietary Services Staff | 1 | 0 | 1 | 156 | 29 | 32% | 5.4 |
| Medical Director | 0 | 1 | 1 | 112 | 14 | 15% | 8 |
| Other Physician | 0 | 1 | 1 | 56 | 14 | 15% | 4 |
| Feeding Assistant | 0 | 1 | 1 | 56 | 14 | 15% | 4 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 48 | 6 | 7% | 8 |
| Physician Assistant | 0 | 1 | 1 | 46 | 13 | 14% | 3.5 |
Includes penalties issued in 2024
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database (Data as of Jan 2026)
77% lower than Idaho averageIdaho average: $38K
44% fewer fines than Idaho averageIdaho average: 1.8
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
100% fewer payment denials than Idaho averageIdaho average: 0.0
Penalties are imposed by CMS for violations of federal nursing home regulations.
1 penalty in the past 3 years
Jun 6, 2024 · $9K
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jun 6, 2024Last updated: Jan 2026
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
9.1
In line with Idaho averageIdaho average: 9.6
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
16.2
17% better than Idaho averageIdaho average: 19.6
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
12.9%
23% better than Idaho averageIdaho average: 16.7%
Percent of long-stay residents whose ability to move independently worsened
19.5%
In line with Idaho averageIdaho average: 19.6%
Percent of low risk long-stay residents who lose control of their bowels or bladder
16.3%
28% better than Idaho averageIdaho average: 22.5%
Percent of long-stay residents experiencing one or more falls with major injury
4.7%
68% worse than Idaho averageIdaho average: 2.8%
Percent of long-stay high risk residents with pressure ulcers
6.0%
64% worse than Idaho averageIdaho average: 3.6%
Percent of long-stay residents with a urinary tract infection
1.1%
45% better than Idaho averageIdaho average: 2.0%
Percent of long-stay residents who lose too much weight
2.7%
53% better than Idaho averageIdaho average: 5.6%
Percent of long-stay residents who have depressive symptoms
4.2%
67% better than Idaho averageIdaho average: 12.8%
Percent of long-stay residents who received an antipsychotic medication
19.6%
7% worse than Idaho averageIdaho average: 18.3%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
96.4%
In line with Idaho averageIdaho average: 97.0%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
97.2%
In line with Idaho averageIdaho average: 96.2%
Number of hospitalizations per 1,000 long-stay resident days.
0.80
27% better than Idaho averageIdaho average: 1.10
Number of outpatient emergency department visits per 1,000 long-stay resident days.
1.36
14% better than Idaho averageIdaho average: 1.59
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
96.4%
7% better than Idaho averageIdaho average: 89.7%
Percent of short-stay residents who newly received an antipsychotic medication
1.5%
In line with Idaho averageIdaho average: 1.5%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
91.5%
6% better than Idaho averageIdaho average: 86.5%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
11.7%
33% better than Idaho averageIdaho average: 17.5%
Percentage of short-stay residents who had an outpatient emergency department visit.
13.9%
20% worse than Idaho averageIdaho average: 11.6%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Idaho averageIdaho average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
30.4%
43% worse than Idaho averageIdaho average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
54.7%
8% better than Idaho averageIdaho average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
25% of new residents, usually for short-term rehab.
41% of new residents, often for short stays.
34% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
79Residents meet regularly to discuss policies, care quality, and activities
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for The Orchards of Cascadia from 2012–2023, based on CMS SNF Cost Reports.
Based on CMS SNF Cost Report for fiscal year ending in 12/2023.
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs.
Rank #12 / 33Payroll — State benchmarkedThis home is ranked 12th out of 33 homes in Idaho. Shows total annual staff payroll benchmarked to the Idaho average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Rankings are based only on facilities in Idaho that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay.
Rank #21 / 33Payroll % — State benchmarkedThis home is ranked 21st out of 33 homes in Idaho. Shows payroll as a percentage of revenue versus the Idaho average. Well-run Idaho facilities typically land around 54–58% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Rankings are based only on facilities in Idaho that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
New residents most often arrive under private pay (41% of admissions), and a typical private pay stay runs around 1 months.
Coverage residents most often arrive under.
Coverage residents most often leave under.
The Orchards of Cascadia is located in Caldwell, Idaho.
Here are the financial assistance programs available to residents in Idaho.
The Orchards of Cascadia has a walk score of 54. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
The Orchards of Cascadia's occupancy is 76.9%.
The Orchards of Cascadia is registered as a for-profit.
(208) 466-9292 will put you in contact with the team at The Orchards of Cascadia.
Yes — The Orchards of Cascadia is a CMS-certified provider of Medicare and Medicaid.
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