CMS PUBLIC RECORD · AUGUST 2026 RELEASERECORDS ARE ONE INPUT—NOT A PLACEMENT RECOMMENDATION
NURSING HOMELEDGERINSPECTIONS · OWNERSHIP · PENALTIES
CMS CCN 1058262026-08-01 PROCESSING DATE

NURSING HOME PUBLIC RECORD

Pavilion At Jacksonville, The

1771 Edgewood Ave W · Jacksonville, FL 32218 · Duval County

CMS OVERALL RATING★★★★☆4/5CMS field—not our score or recommendation
Certified beds60CMS provider file
Recent citation rows30current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.

The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.

01 / INSPECTION LEDGER

Survey cycles in this release

CycleHealth dateHealth deficienciesFire dateFire deficiencies
Cycle 12026-03-1242026-03-1214
Cycle 22024-05-0232024-05-025
Cycle 32022-05-1242022-05-120
02 / CITATION DETAIL

30 rows in the current release

0 rows carry G–L scope/severity codes; 0 carry J–L. 4 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.

2026-03-12 · FIREE0025Severity D · isolated; potential for more than minimal harm

Emergency Preparedness Deficiencies

Create arrangements with other facilities to receive patients.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREE0037Severity D · isolated; potential for more than minimal harm

Emergency Preparedness Deficiencies

Establish staff and initial training requirements.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREE0039Severity D · isolated; potential for more than minimal harm

Emergency Preparedness Deficiencies

Conduct testing and exercise requirements.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREE0042Severity D · isolated; potential for more than minimal harm

Emergency Preparedness Deficiencies

Meet the requirements of an integrated health system.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · HEALTHF0803Severity F · widespread; potential for more than minimal harm

Nutrition and Dietary Deficiencies

Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · HEALTHF0812Severity F · widespread; potential for more than minimal harm

Nutrition and Dietary Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · HEALTHF0842Severity D · isolated; potential for more than minimal harm

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.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · HEALTHF0880Severity D · isolated; potential for more than minimal harm

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREK0222Severity D · isolated; potential for more than minimal harm

Egress Deficiencies

Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREK0324Severity D · isolated; potential for more than minimal harm

Smoke Deficiencies

Provide properly protected cooking facilities.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREK0345Severity E · pattern; potential for more than minimal harm

Smoke Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREK0353Severity D · isolated; potential for more than minimal harm

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREK0372Severity D · isolated; potential for more than minimal harm

Smoke Deficiencies

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREK0521Severity F · widespread; potential for more than minimal harm

Services Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREK0741Severity D · isolated; potential for more than minimal harm

Miscellaneous Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREK0914Severity E · pattern; potential for more than minimal harm

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREK0916Severity E · pattern; potential for more than minimal harm

Gas, Vacuum, and Electrical Systems Deficiencies

Have a battery powered remote alarm panel in a location accessible by operating personnel.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2026-03-12 · FIREK0918Severity E · pattern; potential for more than minimal harm

Gas, Vacuum, and Electrical Systems Deficiencies

Have generator or other power source capable of supplying service within 10 seconds.

Correction field: Deficient, Provider has date of correction · 2026-05-07
2024-05-02 · HEALTHF0644Severity D · isolated; potential for more than minimal harm

Resident Assessment and Care Planning Deficiencies

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Correction field: Deficient, Provider has date of correction · 2024-05-31
2024-05-02 · HEALTHF0661Severity D · isolated; potential for more than minimal harm

Resident Assessment and Care Planning Deficiencies

Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.

Correction field: Deficient, Provider has date of correction · 2024-05-31 · complaint
2024-05-02 · HEALTHF0801Severity D · isolated; potential for more than minimal harm

Nutrition and Dietary Deficiencies

Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

Correction field: Deficient, Provider has date of correction · 2024-05-31
2024-05-02 · HEALTHF0804Severity F · widespread; potential for more than minimal harm

Nutrition and Dietary Deficiencies

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Correction field: Deficient, Provider has date of correction · 2024-05-31
2024-05-02 · FIREK0345Severity E · pattern; potential for more than minimal harm

Smoke Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2024-05-31
2024-05-02 · FIREK0521Severity D · isolated; potential for more than minimal harm

Services Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2024-05-31
03 / ENFORCEMENT FILE

Penalties reported by CMS

Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.

DateTypeFine amountPayment-denial days
No penalty row appeared in the August 2026 penalties file.
04 / OWNERSHIP DISCLOSURES

Who appears in the CMS file

  • PAVILION HOLDINGS LLCOrganization · DIRECT OWNERSHIP INTEREST
    NOT APPLICABLE · since 03/03/2021
  • FTK CAPITAL LLCOrganization · INDIRECT OWNERSHIP INTEREST
    NOT APPLICABLE · since 05/01/2021
  • NPNH1 LLCOrganization · INDIRECT OWNERSHIP INTEREST
    NOT APPLICABLE · since 05/01/2021
  • SHS KEREN LLCOrganization · INDIRECT OWNERSHIP INTEREST
    NOT APPLICABLE · since 05/01/2021
  • BIRNBAUM, EZRAIndividual · INDIRECT OWNERSHIP INTEREST
    NOT APPLICABLE · since 05/01/2021
  • HIRSCH, SHAYEIndividual · INDIRECT OWNERSHIP INTEREST
    NOT APPLICABLE · since 05/01/2021
  • INZELBUCH, AZRIELIndividual · INDIRECT OWNERSHIP INTEREST
    NOT APPLICABLE · since 05/01/2021
  • MOERMAN, RAFAELIndividual · INDIRECT OWNERSHIP INTEREST
    NOT APPLICABLE · since 05/01/2021
  • SINGER, SIMONIndividual · INDIRECT OWNERSHIP INTEREST
    NOT APPLICABLE · since 05/01/2021
  • KRIESER, AKIVAIndividual · OPERATIONAL/MANAGERIAL CONTROL
    NOT APPLICABLE · since 05/01/2021
  • LEWIS, JOSEPHIndividual · OPERATIONAL/MANAGERIAL CONTROL
    NOT APPLICABLE · since 02/26/2024
  • MOERMAN, RAFAELIndividual · OPERATIONAL/MANAGERIAL CONTROL
    NOT APPLICABLE · since 05/01/2021
  • FASTEN HALBERSTAM LLPOrganization · ADP OF THE SNF
    NOT APPLICABLE · since 05/28/2021
  • FTK CAPITAL LLCOrganization · ADP OF THE SNF
    NOT APPLICABLE · since 05/01/2021
  • NPNH1 LLCOrganization · ADP OF THE SNF
    NOT APPLICABLE · since 05/01/2021
  • PAVILION HOLDINGS LLCOrganization · ADP OF THE SNF
    NOT APPLICABLE · since 03/03/2021
  • PAVILION MANAGEMENT GROUP LLCOrganization · ADP OF THE SNF
    NOT APPLICABLE · since 05/28/2021
  • POWERBACK REHABILITATION LLCOrganization · ADP OF THE SNF
    NOT APPLICABLE · since 05/28/2021

Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.

05 / CMS STAFFING FIELDS

Reported hours and turnover

Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.

Total nurse hours3.35per resident day
RN hours0.51per resident day
Weekend nurse hours3.18per resident day
Staff turnover55.4%CMS reported field
06 / LOCAL RECORDS

Other published facilities nearby

Open the Jacksonville ledger →
Aviata At Harts Harbor180 beds · CMS overall 4/552 citation rowsAviata At Jacksonville116 beds · CMS overall 3/527 citation rowsAviata At San Jose120 beds · CMS overall 3/523 citation rowsBartram Crossing100 beds · CMS overall 2/514 citation rowsCedar Hill Nursing And Rehab Center120 beds · CMS overall 2/527 citation rowsCypress Village100 beds · CMS overall 5/516 citation rowsDolphin Pointe Health Care Center146 beds · CMS overall 3/532 citation rowsFirst Coast Health And Rehabilitation Center100 beds · CMS overall 4/533 citation rows
BEFORE A CARE DECISION

Verify the current record and visit in person.

Use this ledger to frame questions—not to choose care on its own. Recheck Medicare Care Compare, contact the state survey agency and long-term care ombudsman, and ask the facility about anything you find.