COUNTRY CLUB RETIREMENT CENTER IV, INC
NPI 1447841572
Assisted Living Facility in Bellaire, OH
About Country Club Retirement Center Iv, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COUNTRY CLUB RETIREMENT CENTER IV, INC (NPI 1447841572), doing business as County Club Retirement Center, is a healthcare organization registered as an assisted living facility in Bellaire, Ohio and active in the NPI registry since February 2021. The organization holds a CLIA Waiver certificate valid through August 16, 2026 and lists Paul Adamic, Corp Controller, as its authorized official.Information from the official NPPES registry record, last updated February 1, 2021.
NPPES Registry Identity
★ Primary Specialty
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and… Show more
Also on File with NPPES
Nursing Home Quality Information
The Centers for Medicare and Medicaid Services publishes the Nursing Home Compare star rating data to provide consumers an easy way to compare nursing home's quality of care.
| Overall Quality Rating | - 3 out of 5 stars - Average |
| The overall star rating is based on a nursing homes's performance on health inspections, staffing and quality measures. | |
| Health Inspection Rating | Not Available |
| The health inspection star rating is based on a nursing home’s weighted score from the most recent health inspections. | |
| Quality Measures Rating | - 5 out of 5 stars - Much Above Average |
| The quality measures star rating is based on data from a select set of clinical measures. | |
| Long-Stay Quality Measures Rating | - 5 out of 5 stars - Much Above Average |
| The long-stay quality of care rating is based on the quality of care delivered to long-term residents only. | |
| Short-Stay Quality Measures Rating | - 2 out of 5 stars - Below Average |
| The short-stay quality of care rating is based on the quality of care delivered to temporary residents only. | |
| Staffing Rating | - 3 out of 5 stars - Average |
| The staffing rating is based on the star rating based on the nursing home’s staffing hours for Registered Nurses (RNs), Licensed Practice Nurses (LPNs), Licensed Vocational Nurses (LVNs) and Nurse aides. | |
| Nurse Aide Staffing Hours | 2.11 hours per resident per day |
| Nurse aide hours per resident per day. Higher number of hours are better. | |
| RN Staffing Hours | 0.67 hours per resident per day |
| Resgistered nurse hours per resident per day. Higher number of hours are better. | |
| RN Staff Turnover | 30% |
| Resgistered nurse turnover is the percentage of registered nursing staff who stop working at the facility within a given year. | |
| Administrator Turnover | 1 |
| Number of administrators who left the nursing home within a given year. | |
| Ownership Type | For profit - Individual |
| Is the facility private for profit, not-for profit or publicly owned. | |
| Number of Certified Beds | 62 beds |
| Number of beds in the nursing home that have been approved by the federal government to participate in the Medicare or Medicaid programs. | |
| Residents per Day | 54 residents |
| Average number of residents living in the facility per day. | |
| Automatic Sprinkler Systems | Yes |
| Does the facility have automatic sprinkler systems in all required areas? | |
| Facility Reported Incidents | 0 incidents |
| Number of facility-reported incidents in the past 3 years. A lower number is better. | |
| Substantiated Complaints | 5 complaints |
| Number of substantiated complaints in the past 3 years. A lower number is better. | |
| Citations from Inspections | citations after infection control inspection |
| Number of citations from infection control inspections in the past 3 years. A lower number is better. | |
| Total Number of Penalties | 0 penalties from a serious health, fire safety or long-term unresolved citation |
| The Medicare program may impose penalties on a facilty when there's serious health or fire safety citations or if the facility fails to correct a citation for a long period of time. | |
| Number of Fines | 0 fines |
| Toal number of fines in the last 3 years. A penalty can be a fine against the facility or denied payments from Medicare. | |
| Amount of Fines | $0.00 |
| Total monetary amount of fine imposed on the facility in the last 3 years. | |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 36D2011498
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- August 17, 2024
- Certificate Expiration Date
- August 16, 2026
- Laboratory Director
- TONY MARONI
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Country Club Retirement Center Iv, Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
BELLAIRE, OH 43906
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1447841572, enumerated as an "organization" on February 01, 2021.
The provider is located at 55801 CONNO MARA DR BELLAIRE, OH 43906 and the phone number is (740) 676-2300.
Assisted Living Facility with taxonomy code 310400000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
