Contact Information

COUNTRY CLUB RETIREMENT CTR IV
COUNTRY CLUB RETIREMENT CENTER IV, INC
55801 CONNO-MARA DRIVE
BELLAIRE, OH 43906
(740) 676-2300
For profit - Corporation
Medicare certification date2: June 23, 1987
The is the date the nursing home was certified to participate in the Medicare program.

1 Nursing homes can be run by private for-profit corporations, non-profit corporations, religious affiliated organizations or government entities.

2 Agencies that are Medicare Certified are able to participate in Medicare related programs.


Nursing Home Information

  58 residents

  62 certified beds

  Participates in Medicare and Medicaid

  Continuing Care Retirement Community

  In hospital

  Resident Council only

  Automatic sprinklers in all required areas

Quality rating
Health inspection rating
Staffing rating
Substantiated complaints 4
Facility reported incidents None
Number of fines 2
Number of penalties 2
Number of payment denials None

Staffing

Staffing for 58 residents Ohio Average National Average
Hours by Registered Nurse (RN) per resident per day 41 minutes 38 minutes 41 minutes
Hours by Licensed Practial Nurse (LPN & LVN) per resident per day 37 minutes 58 minutes 53 minutes
Hours by Certified Nursing Assistant (CNA) per resident per day 2 hours, 9 minutes 2 hours, 8 minutes 2 hours, 20 minutes
Physical therapy (PT) staff hours per resident per day 7 minutes 5 minutes 7 minutes

Staffing hours per resident is the total number of hours worked by the staff divided by the total number of residents. It doesn't necessarily show the number of nursing staff present at any given time or the amount of care given to any one resident.

Ownership

5% OR GREATER DIRECT OWNERSHIP INTEREST

  • HOLLAND GROUP II, LTD
  • HOLLAND, JOHN
  • HOLLAND-GRESCOCK, TERESA

5% OR GREATER INDIRECT OWNERSHIP INTEREST

  • GRESOCK, JOSHUA
  • HOLLAND, BENJAMIN
  • HOLLAND, NICHOLAS
  • HOLLAND, NOAH
  • HOLLAND-GRESOCK, ADAM
  • HOLLAND-GRESOCK, PATRICIA
  • MUIRDEN-HOLLAND, JOHN

MANAGING EMPLOYEE

  • HARRIS, JANET

OFFICER

  • HARRIS, JANET

Nursing Home Report

In 2016, COUNTRY CLUB RETIREMENT CTR IV charged a total of $1,753,436 for 66 Medicare Beneficiaries. The average age of residents at this skilled nursing facility is about 77.

The report covers only calendar year 2016.

Chronic Condition of Residents
Atrial Fibrillation 32% Alzheimer's 52%
Asthma 36% Cancer 12%
Congestive Heart Failure 53% Kidney Disease 59%
COPD 42% Depression 44%
Diabetes 55% Hyperlipidemia n/a
Hypertension n/a Ischemic Heart Disease n/a
Osteoporosis 14% RA / OA 58%
Schizophrenia 23% Stroke 14%
Demographics
Medicare Beneficiaries 66 Average Age 77
Male 24 Female 42
White 64
Black n/a
Asian 0
Hispanic 0
American Indian 0
Other n/a

Health & Fire Inspection

Most recent health inspection: Aug 18, 2017; fire safety inspection: Aug 15, 2017

Health Deficiencies as of 08/18/2017
Freedom from Abuse, Neglect, and Exploitation None
Quality of Life and Care 6
Resident Assessment and Care Planning 2
Nursing and Physician Services 1
Resident Rights 4
Nutrition and Dietary Deficiencies None
Pharmacy Service 4
Environmental Deficiencies 3
Administration Deficiencies 4
Fire Deficiencies as of 08/15/2017
Emergency Preparedness None
Automatic Sprinkler Systems None
Construction Deficiencies 1
Services Deficiencies 1
Corridor Walls and Doors None
Egress Deficiencies None
Electrical Deficiencies None
Emergency Plans and Fire Drills None
Fire Alarm Systems None
Smoke Deficiencies None
Interior Deficiencies None
Gas, Vacuum, and Electrical Systems None
Hazardous Area None
Illumination and Emergency Power None
Laboratories Deficiencies None
Medical Gases and Anesthetizing Areas None
Smoking Regulations None
Miscellaneous Regulations 2

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See also