Country Club Retirement Ctr Iv
Country Club Retirement Ctr Iv Information
| Facility Name | Country Club Retirement Ctr Iv |
| Location | 55801 Conno-mara Drive, Bellaire, OH 43906 |
| County (SSA Code) | Belmont (60) |
| Phone Number | 740-676-2300 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 62 |
| Average Number of Residents | 52.3 |
| CCRC Facility? | Yes |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Short Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | No |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Resident |
| Provider Business Name | COUNTRY CLUB RETIREMENT CENTER IV, INC |
| Ownership Type | For profit - Partnership |
| Date First Approved | 1987-06-23 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 1.92969 |
| Reported LPN Staffing Hours per Resident per Day | 0.63038 |
| Reported RN Staffing - Hours per Resident per Day | 0.96802 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 1.5984 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.52809 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.07484 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.21605 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.8551 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.47342 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.54458 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.17336 |
| Total Weighted Health Survey Score for three cycles | 112.167 |
| Rating cycle 1 Standard Survey Health Date | 2019-12-18 |
| Rating cycle 1 - Health Deficiency Score | 10 |
| Rating cycle 1 - Total Health Inspection Score | 72 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-10-19 |
| Rating cycle 2 - Health Deficiency Score | 72 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-08-18 |
| Rating cycle 3 - Health Deficiency Score | 160 |
| Rating cycle 3 - Total Health Inspection Score | 160 |
| Number of Facility-Reported Incidents | 0 |
| Number of Substantiated Complaints | 4 |
| Number of Substantiated Complaints | 4 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |