that the Cleveland Clinic Foundation was one of at least 230 instances in which validated serious incidents—dubbed "immediate jeopardy" complaints—led CMS to threaten loss of ability to serve Medicare patients unless the problems were fixed immediately. Due to numerous serious ongoing safety violations, the Cleveland Clinic Foundation was on payment termination track for 19 months, placing at stake $1B in annual Medicare/Medicaid reimbursement. The citations were reported and analyzed in detail by Modern Healthcare, which posted some of the safety documents. In its 2020 Overall Hospital Quality Star Ratings, CMS gave a five-star rating to the Cleveland Clinic, as well as several community hospitals in the Cleveland Clinic system, including Fairview Hospital, Hillcrest Hospital, and Lutheran Hospital. In these ratings, Cleveland Clinic Martin North Hospital received a one-star rating. During the early phase of the COVID-19 pandemic, administration at the Cleveland Clinic initially instructed employees that they were not allowed to wear face masks outside of patient care areas. The Cleveland Clinic stated they made this decision as they felt the current body of evidence at the time did not support their use. Other hospitals however require such masks. Later, with growing evidence of mask efficacy, this policy were revised and all staff members were required to wear cloth or protective masks. Masks were obtained from a variety of sources, including Amish and sports apparel manufacturers, among other suppliers. In 2021, amid the COVID-19 pandemic, the Cleveland Clinic permitted its staff to be unvaccinated against COVID. Locations Cleveland Clinic operates 19 family health and ambulatory surgery centers in surrounding communities, a 1,000 bed multispecialty hospital and family health center in Weston, Florida, and two Cleveland Clinic Canada locations in Toronto, Canada. The system operates 11 affiliated hospitals in northeast Ohio, numbering 2,588 total beds. Additionally Cleveland Clinic operates five affiliated hospitals in Florida with 289 total beds, Cleveland Clinic Abu Dhabi with 564 total beds, and London, United Kingdom with 185 total beds; for a grand total of 6,026 beds. Ohio locations Cleveland Clinic's main campus consists of 60 buildings on near University Circle, in Fairfax, Cleveland. In 1996, the Cleveland Clinic took over Fairview Health System centered on Fairview Hospital and serving the West Side of Cleveland and the western suburbs. In the same year, the Cleveland Clinic also took over the four-hospital Meridia Health System, absorbing Euclid Hospital in Euclid, Hillcrest Hospital in Mayfield Heights, Huron Hospital in