COUNTRY CLUB RETIREMENT CTR IV

Continuing care retirement community · For profit - Limited Liability company · COUNTRY CLUB REHABILITATION CAMPUS chain · 62 certified beds · CCN 365699 · COUNTRY CLUB RETIREMENT CENTER IV, INC · Belmont · OH


COUNTRY CLUB RETIREMENT CTR IV is a 62-bed nursing home in BELLAIRE, Ohio. CMS has certified it for Medicare and Medicaid since 1987-06-23. It averages 42.6 residents a day.

What harm was found in the violations cited at COUNTRY CLUB RETIREMENT CTR IV?

CMS lists 45 health-inspection deficiencies for COUNTRY CLUB RETIREMENT CTR IV since 2019-12-18, 32 of them in the three years to 2026-08-01: the highest scope-and-severity letter on record is J; the most recent health inspection was 2026-03-17.

Survey dateTagDeficiencySeverity
2026-03-17F0684, F0697Provide appropriate treatment and care according to orders, resident’s preferences and goals. / Provide safe, appropriate pain management for a resident who requires such services.G
2026-03-17F0880, F0882, F0919Provide and implement an infection prevention and control program. / Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. / Make sure that a working call system is available in each resident's bathroom and bathing area.F
2026-03-17F0686, F0689, F0692, F0842, F0881Provide appropriate pressure ulcer care and prevent new ulcers from developing. / Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. / Provide enough food/fluids to maintain a resident's health. / Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. / Implement a program that monitors antibiotic use.D
2026-01-26F0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.D
2025-11-25F0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.F
2025-11-25F0677, F0725, F0842Provide care and assistance to perform activities of daily living for any resident who is unable. / Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. / Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.E
2025-11-25F0609, F0880Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. / Provide and implement an infection prevention and control program.D
2025-08-27F0692Provide enough food/fluids to maintain a resident's health.G
2025-03-12F0690, F0695Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. / Provide safe and appropriate respiratory care for a resident when needed.D
2024-09-30F0580, F0604, F0644, F0645, F0684, F0688, F0695, F0756, F0757, F0758, F0790, F0881Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. / Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. / Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. / PASARR screening for Mental disorders or Intellectual Disabilities / Provide appropriate treatment and care according to orders, resident’s preferences and goals. / Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. / Provide safe and appropriate respiratory care for a resident when needed. / Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. / Ensure each resident’s drug regimen must be free from unnecessary drugs. / Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. / Provide routine and 24-hour emergency dental care for each resident. / Implement a program that monitors antibiotic use.D
2022-11-09F0725Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.F
2022-11-09F0645, F0677, F0684, F0690PASARR screening for Mental disorders or Intellectual Disabilities / Provide care and assistance to perform activities of daily living for any resident who is unable. / Provide appropriate treatment and care according to orders, resident’s preferences and goals. / Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.D
2019-12-18F0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.J
2019-12-18F0881Implement a program that monitors antibiotic use.F
2019-12-18F0609, F0676, F0684, F0688, F0791, F0880Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. / Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. / Provide appropriate treatment and care according to orders, resident’s preferences and goals. / Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. / Provide or obtain dental services for each resident. / Provide and implement an infection prevention and control program.D

How is COUNTRY CLUB RETIREMENT CTR IV staffed?

MeasureThis facilityOH average
Total nursing staff turnover (%)69.848.7
Average number of residents per day42.673.7

Who owns COUNTRY CLUB RETIREMENT CTR IV, and what chain is it in?

COUNTRY CLUB RETIREMENT CTR IV is registered with CMS as For profit - Limited Liability company, operates under the legal business name COUNTRY CLUB RETIREMENT CENTER IV, INC and belongs to the COUNTRY CLUB REHABILITATION CAMPUS chain.

RoleOwnerAssociation date
5% OR GREATER DIRECT OWNERSHIP INTERESTHOLLAND GROUP II, LTD, HOLLAND, JOHNsince 01/23/2012
5% OR GREATER INDIRECT OWNERSHIP INTERESTGRESOCK, JOSHUA, HOLLAND, BENJAMIN, HOLLAND, NICHOLAS, HOLLAND, NOAH, HOLLAND-GRESOCK, ADAM, HOLLAND-GRESOCK, PATRICIA, MUIRDEN-HOLLAND, JOHNsince 01/01/2006
CORPORATE OFFICERHARRIS, JANETsince 01/01/2008
OPERATIONAL/MANAGERIAL CONTROLHARRIS, JANET, KUREISHY, ZAVEEN, MARONI, ANTHONYsince 01/01/2008
ADP OF THE SNFHOLLAND GROUP II, LTD, GRESOCK, JOSHUA, HARRIS, JANET, HOLLAND, BENJAMIN, HOLLAND, JOHN, HOLLAND, NICHOLAS, HOLLAND, NOAH, HOLLAND-GRESCOCK, TERESA, HOLLAND-GRESOCK, ADAM, HOLLAND-GRESOCK, PATRICIA, KUREISHY, ZAVEEN, MARONI, ANTHONY, MUIRDEN-HOLLAND, JOHNsince 01/01/2008

Were you or a family member harmed at COUNTRY CLUB RETIREMENT CTR IV?