SNF

THE GARDENS OF FAIRFAX HEALTH CARE CENTER

CCN: 366106 · CLEVELAND, OH 44106 · Cuyahoga County

⚠ Inspection > 2 years ago

Overview

Address
9014 CEDAR AVE, CLEVELAND, OH 44106
Phone
2167951363
Certified beds
98
Avg daily residents
43 (44% of beds filled)
Ownership
For-profit corporation
Provider type
Medicare and Medicaid
Medicare/Medicaid since
1996-12-10
Setting
Urban
1 /5
★★★★★
CMS Overall Rating

CMS 5-Star Ratings

CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.

Overall Rating
Composite of Health Inspection, Staffing, and Quality Measures.
★★★★★ 1/5
Health Inspection
Based on the three most recent standard surveys, with more weight on recent results.
★★★★★ 1/5
Staffing
Weighted combination of RN and total nurse staffing hours per resident per day, case-mix adjusted.
★★★★★ 1/5
Quality Measures
15 resident-level quality measures split between long-stay and short-stay (post-acute) residents.
★★★★★ 4/5
Quality Measures breakdown
Long-Stay Quality Measures ★★★★★ 4/5
Short-Stay Quality Measures — Data not available.

Staffing & Workforce

Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.

Role Reported Case-mix expected Adjusted Federal floor
Total nurse
All nursing staff combined: RN + LPN + Aide
 3.79 4.29 3.41 ≥ 3.48
Registered Nurse (RN)
Licensed RN hours. Strongest driver of clinical outcomes.
 0.51 0.75 0.46 ≥ 0.55 Below floor
Licensed Practical Nurse (LPN)
LPN/LVN hours. Often handles medication administration.
 1.16 0.95 1.05 —
Nurse aide
CNA hours. Bulk of direct resident care — bathing, feeding, mobility.
 2.12 2.59 1.91 —
Licensed (RN + LPN)
Combined licensed nurse coverage.
 1.68 — — —
Physical therapist
Rehabilitation therapist hours — important for post-acute / rehab admissions.
 0.02 — — —

Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.

Weekend staffing

Total nurse (weekend)
3.28
hrs / resident / day
RN (weekend)
0.23
hrs / resident / day
Total nurse (adjusted, weekend)
2.96
hrs / resident / day

Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.

Resident acuity

Nursing Case-Mix Index
1.52
higher acuity than avg
Case-Mix Index Ratio
1.10
facility / state ratio

Health Inspections

CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.

Cycle Date Total defs. Standard Complaint Deficiency score Revisits Total score
Cycle 1 (most recent) 2023-05-16 21 19 2 164 1 164
Cycle 2/3 (prior) 2019-10-23 21 14 7 199 2 299
Total weighted health score
197.8
lower is better

Deficiencies (43)

Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).

3 A/B/C No actual harm — minor
39 D/E/F Actual harm — potential for minor
1 J/K/L Immediate jeopardy
Tag Description Scope/Severity Survey date Corrected
0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. D 2025-09-24 2025-11-24
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. D 2025-09-24 2025-09-15
0607 Develop and implement policies and procedures to prevent abuse, neglect, and theft. D 2024-03-29 2024-04-23
0610 Respond appropriately to all alleged violations. D 2024-03-29 2024-04-23
0677 Provide care and assistance to perform activities of daily living for any resident who is unable. D 2024-03-29 2024-04-23
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. J 2024-03-29 2024-04-23
0655 Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted D 2023-12-06 2024-01-04
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. D 2023-12-06 2024-01-04
0558 Reasonably accommodate the needs and preferences of each resident. D 2023-05-16 2023-09-14
0607 Develop and implement policies and procedures to prevent abuse, neglect, and theft. F 2023-05-16 2023-09-14
0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. D 2023-05-16 2023-09-14
0610 Respond appropriately to all alleged violations. D 2023-05-16 2023-09-14
0655 Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted D 2023-05-16 2023-09-14
0677 Provide care and assistance to perform activities of daily living for any resident who is unable. E 2023-05-16 2023-09-14
0688 Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. D 2023-05-16 2023-09-14
0690 Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. D 2023-05-16 2023-09-14
0698 Provide safe, appropriate dialysis care/services for a resident who requires such services. D 2023-05-16 2023-09-14
0727 Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. F 2023-05-16 2023-09-14
0756 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. D 2023-05-16 2023-09-14
0758 Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. E 2023-05-16 2023-09-14
0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. F 2023-05-16 2023-09-14
0805 Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. E 2023-05-16 2023-09-14
0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. F 2023-05-16 2023-09-14
0851 Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. C 2023-05-16 2023-09-14
0880 Provide and implement an infection prevention and control program. F 2023-05-16 2023-09-14
0881 Implement a program that monitors antibiotic use. F 2023-05-16 2023-09-14
0944 Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program. C 2023-05-16 2023-06-26
0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. D 2023-04-20 2023-09-14
0561 Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. E 2019-10-23 2020-02-12
0623 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. D 2019-10-23 2020-02-12
0641 Ensure each resident receives an accurate assessment. D 2019-10-23 2020-02-12
0655 Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted D 2019-10-23 2020-03-07
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. D 2019-10-23 2020-03-07
0677 Provide care and assistance to perform activities of daily living for any resident who is unable. E 2019-10-23 2020-03-07
0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. E 2019-10-23 2020-02-12
0693 Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. D 2019-10-23 2020-02-12
0725 Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. F 2019-10-23 2020-02-12
0732 Post nurse staffing information every day. C 2019-10-23 2020-03-06
0758 Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. D 2019-10-23 2020-02-12
0868 Have the Quality Assessment and Assurance group have the required members and meet at least quarterly F 2019-10-23 2020-02-12
0880 Provide and implement an infection prevention and control program. F 2019-10-23 2020-03-07
0921 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. D 2019-10-23 2020-02-12
0576 Ensure residents have reasonable access to and privacy in their use of communication methods. F 2018-09-13 2018-10-12

Penalties (35)

Fines issued
34
last 3 years
Total fines
$200,208
Payment denials
1
Date Type Fine amount
2023-03-20 Fine $4,580
2024-01-02 Fine $4,587
2023-11-20 Fine $4,587
2023-11-13 Fine $4,587
2023-11-06 Fine $4,587
2023-10-23 Fine $4,587
2023-10-17 Fine $4,587
2023-10-10 Fine $4,587
2023-10-02 Fine $4,587
2023-09-25 Fine $4,587
2023-09-18 Fine $4,587
2023-09-11 Fine $4,587
2023-10-30 Fine $4,587
2023-09-05 Fine $4,587
2023-08-28 Fine $4,587
2023-08-21 Fine $4,587
2023-08-14 Fine $4,587
2023-08-07 Fine $4,587
2023-06-26 Fine $4,587
2023-06-20 Fine $4,587
2023-06-12 Fine $4,587
2023-06-05 Fine $4,587
2023-05-30 Fine $4,587
2023-05-23 Fine $4,587
2023-05-15 Fine $4,587
2023-05-08 Fine $4,587
2024-02-20 Fine $4,938
2024-02-12 Fine $4,938
2024-01-08 Fine $4,938
2024-03-29 Fine $10,039
2023-12-11 Fine $13,762
2023-07-17 Fine $13,762
2023-04-17 Fine $13,762
2024-01-22 Fine $14,814
2023-04-20 Payment Denial —

Source: CMS Nursing Home Penalties.

Ownership & Corporate Structure

Chain: FOUNDATIONS HEALTH SOLUTIONS

Chain ID
225
Facilities in chain
63
Legal business name
FHS CEDAR INC
Chain-average star ratings (for peer context)
Overall
4.0
Health
3.8
Staffing
2.1
QM
4.4

Owner / manager organizations (3)

Organization Role Association
FOUNDATIONS HEALTH LLC 5% OR GREATER DIRECT OWNERSHIP INTEREST since 09/01/2024
COLLERAN FAM TR DATED 01-01-2018 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 09/01/2024
FOUNDATIONS HEALTH SOLUTIONS, LLC OPERATIONAL/MANAGERIAL CONTROL since 09/01/2024

Owner / manager individuals (5)

Name Role Association
COLLERAN, BRIAN OPERATIONAL/MANAGERIAL CONTROL since 09/01/2024
EDEH, NKECHI OPERATIONAL/MANAGERIAL CONTROL since 09/01/2024
KRYSTOWSKI, JOHN OPERATIONAL/MANAGERIAL CONTROL since 09/01/2024
COLLERAN, BRIAN CORPORATE OFFICER since 09/01/2024
KRYSTOWSKI, JOHN CORPORATE OFFICER since 09/01/2024

Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.

Facility Features

CCRC
No
Hospital-based
No
Resident / family council
Resident
Sprinkler systems
Yes
Abuse citation flag
No
Methodology & sources

Full methodology →

All Data

Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.

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Show 99 rows
Source Metric Value Raw key
Provider Information Abuse Icon N Abuse Icon
Provider Information Adjusted LPN Staffing Hours per Resident per Day 1.04846 Adjusted LPN Staffing Hours per Resident per Day
Provider Information Adjusted Nurse Aide Staffing Hours per Resident per Day 1.90507 Adjusted Nurse Aide Staffing Hours per Resident per Day
Provider Information Adjusted RN Staffing Hours per Resident per Day 0.46021 Adjusted RN Staffing Hours per Resident per Day
Provider Information Adjusted Total Nurse Staffing Hours per Resident per Day 3.41375 Adjusted Total Nurse Staffing Hours per Resident per Day
Provider Information Adjusted Weekend Total Nurse Staffing Hours per Resident per Day 2.95767 Adjusted Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Administrator turnover footnote 26 Administrator turnover footnote
Provider Information Automatic Sprinkler Systems in All Required Areas Yes Automatic Sprinkler Systems in All Required Areas
Provider Information Average Number of Residents per Day 42.8 Average Number of Residents per Day
Provider Information Average Number of Residents per Day Footnote — Average Number of Residents per Day Footnote
Provider Information Case-Mix LPN Staffing Hours per Resident per Day 0.95135 Case-Mix LPN Staffing Hours per Resident per Day
Provider Information Case-Mix Nurse Aide Staffing Hours per Resident per Day 2.58556 Case-Mix Nurse Aide Staffing Hours per Resident per Day
Provider Information Case-Mix RN Staffing Hours per Resident per Day 0.74987 Case-Mix RN Staffing Hours per Resident per Day
Provider Information Case-Mix Total Nurse Staffing Hours per Resident per Day 4.28678 Case-Mix Total Nurse Staffing Hours per Resident per Day
Provider Information Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day 3.77835 Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Chain Average Health Inspection Rating 3.8 Chain Average Health Inspection Rating
Provider Information Chain Average Overall 5-star Rating 4.0 Chain Average Overall 5-star Rating
Provider Information Chain Average QM Rating 4.4 Chain Average QM Rating
Provider Information Chain Average Staffing Rating 2.1 Chain Average Staffing Rating
Provider Information Chain ID 225 Chain ID
Provider Information Chain Name FOUNDATIONS HEALTH SOLUTIONS Chain Name
Provider Information City/Town CLEVELAND City/Town
Provider Information CMS Certification Number (CCN) 366106 CMS Certification Number (CCN)
Provider Information Continuing Care Retirement Community N Continuing Care Retirement Community
Provider Information County/Parish Cuyahoga County/Parish
Provider Information Date First Approved to Provide Medicare and Medicaid Services 1996-12-10 Date First Approved to Provide Medicare and Medicaid Services
Provider Information Geocoding Footnote — Geocoding Footnote
Provider Information Health Inspection Rating 1 Health Inspection Rating
Provider Information Health Inspection Rating Footnote — Health Inspection Rating Footnote
Provider Information Latitude 41.4996 Latitude
Provider Information Legal Business Name FHS CEDAR INC Legal Business Name
Provider Information Location 9014 CEDAR AVE,CLEVELAND,OH,44106 Location
Provider Information Long-Stay QM Rating 4 Long-Stay QM Rating
Provider Information Long-Stay QM Rating Footnote — Long-Stay QM Rating Footnote
Provider Information Longitude -81.623 Longitude
Provider Information Most Recent Health Inspection More Than 2 Years Ago Y Most Recent Health Inspection More Than 2 Years Ago
Provider Information Number of administrators who have left the nursing home — Number of administrators who have left the nursing home
Provider Information Number of Certified Beds 98 Number of Certified Beds
Provider Information Number of Citations from Infection Control Inspections — Number of Citations from Infection Control Inspections
Provider Information Number of Facilities in Chain 63 Number of Facilities in Chain
Provider Information Number of Fines 34 Number of Fines
Provider Information Number of Payment Denials 1 Number of Payment Denials
Provider Information Nursing Case-Mix Index 1.51862 Nursing Case-Mix Index
Provider Information Nursing Case-Mix Index Ratio 1.10232 Nursing Case-Mix Index Ratio
Provider Information Overall Rating 1 Overall Rating
Provider Information Overall Rating Footnote — Overall Rating Footnote
Provider Information Ownership Type For profit - Corporation Ownership Type
Provider Information Physical Therapist Staffing Footnote — Physical Therapist Staffing Footnote
Provider Information Processing Date 2026-03-01 Processing Date
Provider Information Provider Address 9014 CEDAR AVE Provider Address
Provider Information Provider Changed Ownership in Last 12 Months N Provider Changed Ownership in Last 12 Months
Provider Information Provider Name THE GARDENS OF FAIRFAX HEALTH CARE CENTER Provider Name
Provider Information Provider Resides in Hospital N Provider Resides in Hospital
Provider Information Provider SSA County Code 170 Provider SSA County Code
Provider Information Provider Type Medicare and Medicaid Provider Type
Provider Information QM Rating 4 QM Rating
Provider Information QM Rating Footnote — QM Rating Footnote
Provider Information Rating Cycle 1 Health Deficiency Score 164 Rating Cycle 1 Health Deficiency Score
Provider Information Rating Cycle 1 Health Revisit Score 0 Rating Cycle 1 Health Revisit Score
Provider Information Rating Cycle 1 Number of Complaint Health Deficiencies 2 Rating Cycle 1 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 1 Number of Health Revisits 1 Rating Cycle 1 Number of Health Revisits
Provider Information Rating Cycle 1 Number of Standard Health Deficiencies 19 Rating Cycle 1 Number of Standard Health Deficiencies
Provider Information Rating Cycle 1 Standard Survey Health Date 2023-05-16 Rating Cycle 1 Standard Survey Health Date
Provider Information Rating Cycle 1 Total Health Score 164 Rating Cycle 1 Total Health Score
Provider Information Rating Cycle 1 Total Number of Health Deficiencies 21 Rating Cycle 1 Total Number of Health Deficiencies
Provider Information Rating Cycle 2 Number of Standard Health Deficiencies 14 Rating Cycle 2 Number of Standard Health Deficiencies
Provider Information Rating Cycle 2 Standard Health Survey Date 2019-10-23 Rating Cycle 2 Standard Health Survey Date
Provider Information Rating Cycle 2/3 Health Deficiency Score 199 Rating Cycle 2/3 Health Deficiency Score
Provider Information Rating Cycle 2/3 Health Revisit Score 100 Rating Cycle 2/3 Health Revisit Score
Provider Information Rating Cycle 2/3 Number of Complaint Health Deficiencies 7 Rating Cycle 2/3 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 2/3 Number of Health Revisits 2 Rating Cycle 2/3 Number of Health Revisits
Provider Information Rating Cycle 2/3 Total Health Score 299 Rating Cycle 2/3 Total Health Score
Provider Information Rating Cycle 2/3 Total Number of Health Deficiencies 21 Rating Cycle 2/3 Total Number of Health Deficiencies
Provider Information Registered Nurse hours per resident per day on the weekend 0.23127 Registered Nurse hours per resident per day on the weekend
Provider Information Registered Nurse turnover — Registered Nurse turnover
Provider Information Registered Nurse turnover footnote 26 Registered Nurse turnover footnote
Provider Information Reported Licensed Staffing Hours per Resident per Day 1.67508 Reported Licensed Staffing Hours per Resident per Day
Provider Information Reported LPN Staffing Hours per Resident per Day 1.16411 Reported LPN Staffing Hours per Resident per Day
Provider Information Reported Nurse Aide Staffing Hours per Resident per Day 2.11520 Reported Nurse Aide Staffing Hours per Resident per Day
Provider Information Reported Physical Therapist Staffing Hours per Resident Per Day 0.01691 Reported Physical Therapist Staffing Hours per Resident Per Day
Provider Information Reported RN Staffing Hours per Resident per Day 0.51097 Reported RN Staffing Hours per Resident per Day
Provider Information Reported Staffing Footnote — Reported Staffing Footnote
Provider Information Reported Total Nurse Staffing Hours per Resident per Day 3.79028 Reported Total Nurse Staffing Hours per Resident per Day
Provider Information Short-Stay QM Rating — Short-Stay QM Rating
Provider Information Short-Stay QM Rating Footnote 2 Short-Stay QM Rating Footnote
Provider Information Special Focus Status — Special Focus Status
Provider Information Staffing Rating 1 Staffing Rating
Provider Information Staffing Rating Footnote — Staffing Rating Footnote
Provider Information State OH State
Provider Information Telephone Number 2167951363 Telephone Number
Provider Information Total Amount of Fines in Dollars 200208.00 Total Amount of Fines in Dollars
Provider Information Total number of nurse staff hours per resident per day on the weekend 3.28390 Total number of nurse staff hours per resident per day on the weekend
Provider Information Total Number of Penalties 35 Total Number of Penalties
Provider Information Total nursing staff turnover — Total nursing staff turnover
Provider Information Total nursing staff turnover footnote 26 Total nursing staff turnover footnote
Provider Information Total Weighted Health Survey Score 197.750 Total Weighted Health Survey Score
Provider Information Urban Y Urban
Provider Information With a Resident and Family Council Resident With a Resident and Family Council
Provider Information ZIP Code 44106 ZIP Code