Map showing the location of THE GARDENS OF FAIRFAX HEALTH CARE CENTER in CLEVELAND, Ohio
9014 CEDAR AVE, CLEVELAND, OH, 44106

Overall Score

CMS Five-Star Quality Rating
1/5Much below averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • OhioLowest tier among peers911 rated homes · average 3.2★
  • Cuyahoga CountyLowest tier among peers92 rated homes · average 3.0★
  • United StatesLowest tier among peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point1★−1.8 vs OH avg
  • StaffingCan add or remove a star1★−1.4 vs OH avg
  • Quality measuresCan add or remove a star4★−0.4 vs OH avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

  • Standard inspection overdueThe most recent standard health inspection is older than CMS expects, so the health inspection rating may not reflect current conditions.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among peersOH avg2.8★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover1★Lowest tier among peersOH avg2.4★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments4★Above only 12% of peersOH avg4.4★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff3.79hrsAbove 65% of peersOH avg3.73Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.51hrsAbove only 35% of peersOH avg0.63Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is betterNo dataOH avg50%RN turnover
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$218,526Above only 2% of peersOH avg$23,502Fines · denials36 · 1
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
43citations
7inspection dates
0actual harm (G–I)
1immediate jeopardy (J–L)
Sep 24, 2025most recent

Citations by monthSep 2018 – Sep 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Sep 24, 20252 citationsCycle 1worst D · no actual harm
  1. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Nov 24, 2025
  2. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Sep 15, 2025
Mar 29, 20244 citationsCycle 2worst J · immediate jeopardy$10,039
  1. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareJ · isolatedCorrected Apr 23, 2024
  2. F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Apr 23, 2024
  3. F610Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Apr 23, 2024
  4. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareD · isolatedCorrected Apr 23, 2024
Dec 6, 20232 citationsCycle 3worst D · no actual harm$13,762
  1. F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care PlanningD · isolatedCorrected Jan 4, 2024
  2. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningD · isolatedCorrected Jan 4, 2024
May 16, 202319 citationsCycle 1worst F · no actual harm$4,587, $4,587, $4,587, $4,587
  1. F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Quality of Life and CareD · isolatedCorrected Sep 14, 2023
  2. F698Provide safe, appropriate dialysis care/services for a resident who requires such services.Quality of Life and CareD · isolatedCorrected Sep 14, 2023
  3. F727Have 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.Nursing and Physician ServicesF · widespreadCorrected Sep 14, 2023
  4. F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy ServiceD · isolatedCorrected Sep 14, 2023
  5. F758Implement 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.Pharmacy ServiceE · patternCorrected Sep 14, 2023
  6. F804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.Nutrition and DietaryF · widespreadCorrected Sep 14, 2023
  7. F805Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.Nutrition and DietaryE · patternCorrected Sep 14, 2023
  8. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Sep 14, 2023
  9. F851Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.AdministrationC · widespreadCorrected Sep 14, 2023
  10. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected Sep 14, 2023
  11. F881Implement a program that monitors antibiotic use.Infection ControlF · widespreadCorrected Sep 14, 2023
  12. F688Provide 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.Quality of Life and CareD · isolatedCorrected Sep 14, 2023
  13. F558Reasonably accommodate the needs and preferences of each resident.Resident RightsD · isolatedCorrected Sep 14, 2023
  14. F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.Freedom from Abuse, Neglect, and ExploitationF · widespreadCorrected Sep 14, 2023
  15. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Sep 14, 2023
  16. F610Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Sep 14, 2023
  17. F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care PlanningD · isolatedCorrected Sep 14, 2023
  18. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareE · patternCorrected Sep 14, 2023
  19. Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.AdministrationC · widespreadCorrected Jun 26, 2023
Apr 20, 20231 citationCycle 3worst D · no actual harmpayment denial, $13,762
  1. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Sep 14, 2023
Oct 23, 201914 citationsCycle 2worst F · no actual harm
  1. F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningD · isolatedCorrected Feb 12, 2020
  2. F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care PlanningD · isolatedCorrected Mar 7, 2020
  3. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningD · isolatedCorrected Mar 7, 2020
  4. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareE · patternCorrected Mar 7, 2020
  5. F693Ensure 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.Quality of Life and CareD · isolatedCorrected Feb 12, 2020
  6. F725Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.Nursing and Physician ServicesF · widespreadCorrected Feb 12, 2020
  7. F732Post nurse staffing information every day.Nursing and Physician ServicesC · widespreadCorrected Mar 6, 2020
  8. F758Implement 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.Pharmacy ServiceD · isolatedCorrected Feb 12, 2020
  9. F868Have the Quality Assessment and Assurance group have the required members and meet at least quarterlyAdministrationF · widespreadCorrected Feb 12, 2020
  10. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected Mar 7, 2020
  11. F921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.EnvironmentalD · isolatedCorrected Feb 12, 2020
  12. F561Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.Resident RightsE · patternCorrected Feb 12, 2020
  13. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareE · patternCorrected Feb 12, 2020
  14. F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident RightsD · isolatedCorrected Feb 12, 2020
Sep 13, 20181 citationCycle 3worst F · no actual harm
  1. F576Ensure residents have reasonable access to and privacy in their use of communication methods.Resident RightsF · widespreadCorrected Oct 12, 2018

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.79hrsAbove 65% of peers+0.06 vs OH avg
  • Registered nursesRN hours only0.51hrsAbove only 35% of peers−0.12 vs OH avg
  • Licensed practical nursesLPN hours1.16hrs
  • Nurse aidesCNA hours2.12hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.28hrs
  • Ohio average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is betterOH avg 50%
  • RN turnoverRegistered nurses onlyNot ranked by CMS
  • Administrators who leftIn the past year
  • Occupancy98 certified beds · ~43 residents a day44%Above only 1% of peersOH avg 83%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $218,526In fines
  • 36Fines
  • 1Payment denial
  • $23,502OH avg in fines
Above only 2% of peersFewer fines than 2% of rated homes in Ohio

Actions on record

  1. Mar 29, 2024Civil money penalty$10,039
  2. Feb 20, 2024Civil money penalty$4,938
  3. Feb 12, 2024Civil money penalty$4,938
  4. Jan 22, 2024Civil money penalty$14,814
  5. Jan 8, 2024Civil money penalty$4,938
  6. Jan 2, 2024Civil money penalty$4,587
  7. Dec 11, 2023Civil money penalty$13,762
  8. Nov 20, 2023Civil money penalty$4,587
  9. Nov 13, 2023Civil money penalty$4,587
  10. Nov 6, 2023Civil money penalty$4,587
  11. Oct 30, 2023Civil money penalty$4,587
  12. Oct 23, 2023Civil money penalty$4,587
  13. Oct 17, 2023Civil money penalty$4,587
  14. Oct 10, 2023Civil money penalty$4,587
  15. Oct 2, 2023Civil money penalty$4,587
  16. Sep 25, 2023Civil money penalty$4,587
  17. Sep 18, 2023Civil money penalty$4,587
  18. Sep 11, 2023Civil money penalty$4,587
  19. Sep 5, 2023Civil money penalty$4,587
  20. Aug 28, 2023Civil money penalty$4,587
  21. Aug 21, 2023Civil money penalty$4,587
  22. Aug 14, 2023Civil money penalty$4,587
  23. Aug 7, 2023Civil money penalty$4,587
  24. Jul 17, 2023Civil money penalty$13,762
  25. Jun 26, 2023Civil money penalty$4,587
  26. Jun 20, 2023Civil money penalty$4,587
  27. Jun 12, 2023Civil money penalty$4,587
  28. Jun 5, 2023Civil money penalty$4,587
  29. May 30, 2023Civil money penalty$4,587
  30. May 23, 2023Civil money penalty$4,587
  31. May 15, 2023Civil money penalty$4,587
  32. May 8, 2023Civil money penalty$4,587
  33. Apr 20, 2023Denial of payment for new admissionsfrom Jul 20, 2023
  34. Apr 17, 2023Civil money penalty$13,762
  35. Mar 20, 2023Civil money penalty$4,580
  36. Mar 13, 2023Civil money penalty$4,580
  37. Feb 21, 2023Civil money penalty$13,738

Ownership

As filed with CMS

Structure

Ownership type
For profit - Corporation
Chain
Foundations Health Solutions63 facilities in the chain4.0★ chain average
Certification
Medicare and Medicaid
Location type
Urban
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Foundations Health LLC
Indirect owners (5%+)
  • Colleran Fam Tr Dated 01-01-2018
Operational or managerial control
  • Foundations Health Solutions, LLC
  • Brian Colleran
  • Nkechi Edeh
  • John Krystowski
Corporate officers
  • Brian Colleran
  • John Krystowski

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 366106 · 9014 CEDAR AVE, CLEVELAND, OH, 44106.
  • Percentiles compare this facility with every rated nursing home in Ohio and Cuyahoga County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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