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Nursing HomeMedicaid Investigative

Rocky River Gardens Rehab and Nursing Ctr

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

4102 Rocky River Dr, Kamm's Corners · Cleveland, OH 44135120 bedsLicensed & Active
2/5
Medicare
Inspection
Quality
Staffing
Google rating
3.1/5

based on 47 Google reviews

5
4
3
2
1
Rocky River Gardens Rehab and Nursing Ctr Nursing Home in Cleveland, OH — Street View
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6/ 10
high Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Low overall rating (2/5 stars)
  • Low staffing rating (1/5 stars)
  • Above-median deficiencies (16 vs median 8.0)
  • High staff turnover (52%)
  • High RN turnover (79%)

Bottom 25% in OH · Critically understaffed (RN) · Worst in GARDEN HEALTHCARE GROUP chain · $104,742 in fines

Source: Medicare data

What this means for your family

While the facility's physical therapy department is frequently praised for helping patients regain mobility, the recurring, credible reports of bed bug infestations and poor hygiene are critical red flags. We strongly advise families to conduct an unannounced visit and specifically inspect the cleanliness of resident rooms and common areas before considering admission.

Google Reviews

Google Reviews

47 reviews on Google
Rocky River Gardens Rehab and Nursing Center receives highly polarized feedback, with many reviewers praising the physical therapy department while others report severe, recurring issues with facility hygiene and pest control. Families consistently express alarm regarding reports of bed bug infestations and poor communication, though some rehab patients report positive experiences with nursing staff and recovery outcomes.

Quality Themes

Tap a score for details
Food2.0Staff5.0Clean1.0ActivitiesN/AMeds2.0MemoryN/AComms2.0Value1.0

Strengths

  • Highly effective physical and occupational therapy
  • Attentive and pleasant nursing staff for rehab patients
  • Strong recovery outcomes for short-term rehab

Concerns

  • Bed bug and pest infestation (mentioned by 8 reviewers)
  • Poor facility cleanliness and maintenance (mentioned by 5 reviewers)
  • Inadequate communication and administrative disorganization (mentioned by 3 reviewers)
  • Understaffing and lack of patient care oversight (mentioned by 3 reviewers)

Rating Trends

Tap a year to see what changed

234'17(3)'19(9)'21(3)'23(6)'25(3)'26(9)

Distribution · 51 analyzed

5
23
4
5
3
0
2
0
1
23

How They Respond to Reviews

0%response rate

Questions for Your Tour

  • 1We've heard wonderful things about the effectiveness of your physical and occupational therapy programs; could you tell us more about how the rehab team supports a resident's recovery journey?
  • 2What specific steps are being taken to ensure the facility is kept clean, well-maintained, and comfortable for all residents?
  • 3How does the nursing team manage medication schedules and ensure there is consistent oversight for patient care?
  • 4Can you describe the dining experience, including how much input residents have regarding meal quality and variety?
  • 5How does the administration ensure that families are kept informed and communicated with regarding any changes in a resident's care?
  • 6In the event of a medical emergency after hours, what is the protocol for contacting doctors and ensuring immediate care?

Personalized based on this facility's data


Key Review Excerpts

The therapists (all the therapists, occupational & physical) are amazing. Sweet as pie and just so helpful.

Rehab patient · 2021★★★★★

It’s a terrible place they take a vantage of many old people they’re liars they take their money it’s a filthy place they do not care

Long-term resident's family · 2022☆☆☆☆

They have bed bugs bad and are aware and nothing is being done. They scheduled agency on the second floor cause none of their staff wants to work on that floor and you can’t even work at the nursing station due to the infestation.

Visitor/Observer · 2023☆☆☆☆
Source: 47 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.33hrs
44%
Registered nurses for medical care
Total Nursing
3.27hrs
80%
All nurses + aides combined
Staff Turnover
57%
Lower is better (< 30% = good)
RN Turnover
77%
Lower is better (< 30% = good)

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating
5/ 5
Better Than Avg

7

measures

Worse Than Avg

6

measures

Mixed Results

4

measures

Long-Stay Residents
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility69.9%
Worse than Avg
Here
69.9%
US
93.4%
OH
92.6%
Cuyahoga
88.3%
😔

Residents with depression symptoms

↓ Lower is better
This Facility29.5%
Mixed vs Avgs
Here
29.5%
US
12.1%
OH
28.2%
Cuyahoga
29.8%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

🛏️

Residents needing more daily help over time

↓ Lower is better
This Facility0.6%
Better than Avg
Here
0.6%
US
14.4%
OH
5.8%
Cuyahoga
5.1%
🚶

Residents whose walking got worse

↓ Lower is better
This Facility3.3%
Better than Avg
Here
3.3%
US
15.3%
OH
6.9%
Cuyahoga
5.6%
⚖️

Residents who lost too much weight

↓ Lower is better
This Facility16.1%
Worse than Avg
Here
16.1%
US
5.3%
OH
6.3%
Cuyahoga
5.9%
💊

Residents on antipsychotic medication

↓ Lower is better
This Facility15.1%
Mixed vs Avgs
Here
15.1%
US
15.5%
OH
9.4%
Cuyahoga
8.3%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility52.7%
Worse than Avg
Here
52.7%
US
79.8%
OH
75.6%
Cuyahoga
65.1%
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility55.6%
Worse than Avg
Here
55.6%
US
81.8%
OH
78.4%
Cuyahoga
69.4%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility0.0%
Better than Avg
Here
0.0%
US
1.6%
OH
1.2%
Cuyahoga
1.3%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

16deficiencies
4penalties
Well above state avg (10.1)
14 complaint-triggered
$104,742 in fines

Families have repeatedly filed complaints about this facility, with concerning patterns of deficiencies in resident protection from abuse and neglect, accident prevention, and medication management. Recent 2024 complaints included serious allegations of abuse/neglect that occurred multiple times, alongside persistent issues with facility safety and proper medication handling. While the facility has correction dates for most violations, the recurring nature of abuse-related complaints and safety deficiencies across multiple years suggests ongoing care quality concerns that families should carefully investigate.

Jan 14, 2026Complaint
6
0880Potential for harm · WidespreadCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0677Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

0761Potential for harm · PatternCorrected

Pharmacy Service Deficiencies

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.

0921Potential for harm · PatternCorrected

Environmental Deficiencies

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

0689Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0842Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Dec 4, 2024Complaint
2
0600Immediate jeopardy · IsolatedResolved (past non-compliance)

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

0690Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Oct 23, 2024Complaint
1
0689Immediate jeopardy · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Jul 22, 2024Complaint
2
0600Immediate jeopardy · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

0550Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Apr 12, 2024Routine
31
0161Potential for harm · Widespread

Construction Deficiencies

Use approved construction type or materials.

0761Potential for harm · WidespreadCorrected

Pharmacy Service Deficiencies

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.

0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0211Potential for harm · WidespreadCorrected

Egress Deficiencies

Keep aisles, corridors, and exits free of obstruction in case of emergency.

0291Potential for harm · WidespreadCorrected

Egress Deficiencies

Install emergency lighting that can last at least 1 1/2 hours.

0311Potential for harm · WidespreadCorrected

Smoke Deficiencies

Have an enclosure around a vertical opening shaft.

0324Potential for harm · WidespreadCorrected

Smoke Deficiencies

Provide properly protected cooking facilities.

0341Potential for harm · WidespreadCorrected

Smoke Deficiencies

Install a fire alarm system that can be heard throughout the facility.

0345Potential for harm · WidespreadCorrected

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

0353Potential for harm · WidespreadCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0363Potential for harm · WidespreadCorrected

Smoke Deficiencies

Install corridor and hallway doors that block smoke.

0511Potential for harm · WidespreadCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

0711Potential for harm · WidespreadCorrected

Miscellaneous Deficiencies

Provide a written emergency evacuation plan.

0741Potential for harm · WidespreadCorrected

Miscellaneous Deficiencies

Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

0781Potential for harm · WidespreadCorrected

Miscellaneous Deficiencies

Have restrictions on the use of portable space heaters.

0225Potential for harm · PatternCorrected

Egress Deficiencies

Have stairways and smokeproof enclosures used as exits that meet safety requirements.

0232Potential for harm · PatternCorrected

Egress Deficiencies

Have corridors or aisles that are unobstructed and are at least 8 feet in width.

0321Potential for harm · PatternCorrected

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

0355Potential for harm · PatternCorrected

Smoke Deficiencies

Properly select, install, inspect, or maintain portable fire extinguishes.

0374Potential for harm · PatternCorrected

Smoke Deficiencies

Install smoke barrier doors that can resist smoke for at least 20 minutes.

0521Potential for harm · PatternCorrected

Services Deficiencies

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

0753Potential for harm · PatternCorrected

Miscellaneous Deficiencies

Have restrictions on the use of highly flammable decorations.

0920Potential for harm · PatternCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

0569Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.

0637Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Assess the resident when there is a significant change in condition

0641Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

0686Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

0756Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

0758Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

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.

0759Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure medication error rates are not 5 percent or greater.

0842Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Dec 15, 2023Complaint
1
0921Potential for harm · WidespreadCorrected

Environmental Deficiencies

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

Federal Penalties

Fine

Oct 23, 2024

$17,068

Fine

Oct 23, 2024

$17,414

Payment Denial

Oct 23, 2024

25-day denial

Fine

Jul 22, 2024

$33,586

Ownership & Operations

Who Operates This Facility

Owner / Operator

Rocky River Gardens Rehab and Nursing Ctr

Organization Type

for profit

Chain Affiliation

Chain Name

Garden Healthcare Group

Chain Size

6 facilities nationwide

Chain avg rating: 2.2/5 · Rank 5 of 6 (Worst)

Ownership & Management

Owners

Chickiestrong Rocky River LLC

Owner · Organization

Garden Care El-Dg Holdings, LLC

Owner · Organization

Braunstein Bears 2016 Trust

Owner (parent company) · Organization

Chickiestrong Real Estate LLC

Owner (parent company) · Organization

Eatery Capital LLC

Owner (parent company) · Organization

Eatery Manager LLC

Owner (parent company) · Organization

Eatery Trust

Owner (parent company) · Organization

Garden Ohio Operating Holdings LLC

Owner (parent company) · Organization

Garden Ohio Operating Managing Member LLC

Owner (parent company) · Organization

Feuer, Samuel

Owner (parent company)

Leshkowitz, Eli

Owner (parent company)

Key personnel

Bhimani, JayantilalManaging Control - Governing BodyHolzheimer, BrianManaging Control - Governing BodyLeshkowitz, EliOfficer / DirectorChickiestrong Rocky River LLCManagerBhimani, JayantilalManager
Source: Medicare provider data

Contact

Get in Touch

Contact this facility directly and verify the details that matter most to your family.

References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.

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