Cedarbrook Health and Rehabilitation Center

Name: Cedarbrook Health and Rehabilitation Center
Address: 1600 MATTHEW DRIVE, Fort Myers, FL, 33907, US
Telephone: 2392756067

1600 Matthew Drive, Fort Myers, FL 33907 · Lee County · 120 certified beds · avg 115 residents/day · certified since Apr 25, 1991

Part of chain: ASTON HEALTH (38 facilities, chain avg rating 2.7★)

2/5

Health inspection rating (on-site)

Serious findings on record

$16,801

Fines, last 3 years

3.74

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 3/5

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.

Most serious findings (actual harm or immediate jeopardy)

▲ Actual harm, one-off · Nov 15, 2024 · F-0697

The facility did not provide safe and appropriate pain management for a resident who needed it.

Why it matters: Untreated pain causes needless suffering and can lead to depression, poor sleep, and declining health.

Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.

Corrected: Dec 14, 2024 (Deficient, Provider has date of correction)

All citations in the current public record (30)

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.

Date	Severity	What the facility was cited for
Nov 15, 2024	▲ G · Actual harm, one-off	The facility did not provide safe and appropriate pain management for a resident who needed it.
Nov 15, 2024	E · Potential for harm, repeated	The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · from a complaint
Nov 15, 2024	E · Potential for harm, repeated	The facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. · from a complaint
Nov 15, 2024	D · Potential for harm, one-off	The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away.
Nov 15, 2024	D · Potential for harm, one-off	The facility did not fully assess residents on time — a complete assessment of health, abilities, and needs is required when a resident is first admitted and at least once every 12 months after that.
Nov 15, 2024	D · Potential for harm, one-off	The facility did not provide activities that meet residents' needs and interests. Nursing homes must offer meaningful activity programs, not just leave residents idle.
Nov 15, 2024	D · Potential for harm, one-off	The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections.
Nov 15, 2024	D · Potential for harm, one-off	The facility did not safely and appropriately administer IV fluids (fluids given through a vein) for residents who needed them.
Nov 15, 2024	D · Potential for harm, one-off	The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it.
Nov 15, 2024	D · Potential for harm, one-off	The facility did not provide each resident with a nourishing, tasty, well-balanced diet that meets their daily nutritional and special dietary needs.
Nov 15, 2024	E · Potential for harm, repeated	The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · from a complaint
Feb 9, 2023	E · Potential for harm, repeated	The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own.
Feb 9, 2023	E · Potential for harm, repeated	The facility did not provide activities that meet residents' needs and interests. Nursing homes must offer meaningful activity programs, not just leave residents idle.
Feb 9, 2023	E · Potential for harm, repeated	The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist.
Feb 9, 2023	D · Potential for harm, one-off	The facility did not honor residents' right to make their own choices about their daily lives, such as when to wake up, what to eat, or how to spend their time.
Feb 9, 2023	D · Potential for harm, one-off	The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs.
Feb 9, 2023	D · Potential for harm, one-off	The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines.
Feb 9, 2023	D · Potential for harm, one-off	The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Feb 9, 2023	D · Potential for harm, one-off	The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline.
Feb 9, 2023	D · Potential for harm, one-off	The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections.
Feb 9, 2023	D · Potential for harm, one-off	The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it.
Feb 9, 2023	D · Potential for harm, one-off	The facility did not provide food that accounts for each resident's allergies, intolerances, and personal preferences, or did not offer appealing alternatives.
Jun 10, 2021	F · Potential for harm, facility-wide	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Jun 10, 2021	F · Potential for harm, facility-wide	The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices.
Jun 10, 2021	F · Potential for harm, facility-wide	The facility did not keep its building and grounds safe, functional, clean, and comfortable for residents, staff, and visitors.
Jun 10, 2021	D · Potential for harm, one-off	The facility did not honor residents' right to make their own choices about their daily lives, such as when to wake up, what to eat, or how to spend their time.
Jun 10, 2021	D · Potential for harm, one-off	The facility did not honor residents' right to form and take part in resident or family groups, such as a resident council.
Jun 10, 2021	D · Potential for harm, one-off	The facility allowed residents to lose the ability to do daily activities — like bathing, dressing, and eating — when there was no medical reason for the decline. Good care helps residents keep the abilities they have.
Jun 10, 2021	D · Potential for harm, one-off	The facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time.
Jun 10, 2021	D · Potential for harm, one-off	The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock.

Inspection trend by year

Citations from standard inspections stayed about the same across the last two inspection cycles (11 → 10).

Year	Citations	Serious (G–L)	Worst severity that year
2021	8	0	F
2023	11	0	E
2024	11	1	G ▲

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

1 fine totaling $16,801.

Date	Type	Amount / length
Nov 15, 2024	Fine	$16,801

Nurse staffing (from payroll records, adjusted for how much care residents need)

Measure	This facility	Florida avg	U.S. avg	Where it stands
Total nurse staffing (hours per resident per day)	3.74	4.03	3.95	bottom 36% in Florida; bottom 48% in the U.S.
Registered Nurse hours	0.77	0.76	0.69	top 38% in Florida; top 30% in the U.S.
Weekend total nurse staffing	3.44	3.68	3.50	bottom 39% in Florida; top 45% in the U.S.
Weekend RN hours (not acuity-adjusted)	0.58	0.53	0.48	top 32% in Florida; top 24% in the U.S.
Total nursing staff turnover (%)	69.5	41.4	45.8	bottom 2% in Florida; bottom 6% in the U.S.
RN turnover (%)	78.1	46.0	42.9	bottom 5% in Florida; bottom 6% in the U.S.

Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.41, RN 0.70, weekend 3.14. Staffing rating: 3/5.

Self-reported quality measures

Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.

Quality measures rating: 5/5 · long-stay residents: 5/5 · short-stay residents: 4/5

Who owns this facility

For profit - Corporation

Owner / manager	Type	Role	Stake	Since
BF Cedarbrook Trust	Organization	5% or Greater Indirect Ownership Interest	50%	05/05/2023
Cedarbrook Rehab Holdings LLC	Organization	5% or Greater Direct Ownership Interest	100%	05/05/2023
LF Cedarbrook Trust	Organization	5% or Greater Indirect Ownership Interest	50%	05/05/2023
Aston Healthcare LLC	Organization	ADP of the SNF	NOT APPLICABLE	05/05/2023
Atkinstall, Alicia	Individual	Operational/Managerial Control	NOT APPLICABLE	09/24/2024
Aviles, Ursula	Individual	Operational/Managerial Control	NOT APPLICABLE	05/05/2023
Friedman, Leopold	Individual	Individual Is an Owner, Partner or Trustee of Any ADP of the SNF	NOT APPLICABLE	10/16/2025
Martinez Irizarry, Alfonso	Individual	Operational/Managerial Control	NOT APPLICABLE	02/01/2025
Martinez Irizarry, Alfonso	Individual	ADP of the SNF	NOT APPLICABLE	10/16/2025
Soltis, Erin	Individual	Operational/Managerial Control	NOT APPLICABLE	06/24/2024
Soltis, Erin	Individual	ADP of the SNF	NOT APPLICABLE	10/16/2025
Wildes, Donna	Individual	Operational/Managerial Control	NOT APPLICABLE	08/28/2025
Wildes, Donna	Individual	ADP of the SNF	NOT APPLICABLE	08/28/2025

Questions to ask on your visit

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

"How do you assess and manage residents' pain, especially for those who have trouble communicating?"
"How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
"What is your nurse and aide staffing ratio on each shift, including nights and weekends?"
"If my family member falls or their condition changes, exactly when and how will I be notified?"
"How soon after admission is a full assessment completed, and how are the findings shared with the family?"
"Can I see this month's activities calendar, and what do you offer residents who can't leave their rooms?"
"How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
"Who on your staff manages IV therapy, and what training and monitoring is in place?"
"What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
"Can I see the results and plan of correction from your most recent state inspection?"

Nearby facilities (within 20 miles)

Facility	Distance	City	Overall	Inspection	Flags
Page Rehabilitation and Healthcare Center	0.6 mi	Fort Myers, FL	★★☆☆☆	1/5
Fort Myers Rehabilitation and Nursing Center	1.5 mi	Fort Myers, FL	★★☆☆☆	2/5
Aspire at Evans	1.7 mi	Fort Myers, FL	★☆☆☆☆	1/5
Lee Memorial Hospital Skilled Nursing Unit	2.6 mi	Fort Myers, FL	★★★★★	5/5
Ambassador Healthcare at College Park	2.8 mi	Fort Myers, FL	★☆☆☆☆	1/5
Rehab & Healthcare Center of Cape Coral	3.8 mi	Cape Coral, FL	★☆☆☆☆	1/5
Gulf Coast Medical Center Skilled Nursing Unit	4.1 mi	Fort Myers, FL	★★★★★	5/5
Winkler Court	4.1 mi	Fort Myers, FL	★★☆☆☆	1/5
Eagleridge Health and Rehabilitation Center	4.3 mi	Fort Myers, FL	★★★☆☆	2/5	abuse
Healthpark Care Center	5.8 mi	Fort Myers, FL	★★★★★	5/5

Compare this facility with the 3 closest →

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Facility data as of CMS processing date 2026-08-01. CCN 105723.

The Care File

Visit checklist — Cedarbrook Health and Rehabilitation Center

1600 Matthew Drive, Fort Myers, FL 33907 · 2392756067

Health inspection rating 2/5 · CMS overall 3/5· Fines (3y): $16,801

Most serious findings on record:

▲ Nov 15, 2024 (F-0697, Actual harm, one-off): The facility did not provide safe and appropriate pain management for a resident who needed it.

Questions for the administrator:

☐ "How do you assess and manage residents' pain, especially for those who have trouble communicating?"
☐ "How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
☐ "What is your nurse and aide staffing ratio on each shift, including nights and weekends?"
☐ "If my family member falls or their condition changes, exactly when and how will I be notified?"
☐ "How soon after admission is a full assessment completed, and how are the findings shared with the family?"
☐ "Can I see this month's activities calendar, and what do you offer residents who can't leave their rooms?"
☐ "How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
☐ "Who on your staff manages IV therapy, and what training and monitoring is in place?"
☐ "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
☐ "Can I see the results and plan of correction from your most recent state inspection?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 105723 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)