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COUNTRY CLUB RETIREMENT CENTER II
NPI 1598831869
Skilled Nursing Facility in Mount Vernon, OH

Active since November 28, 2006CLIA 36D0875695 · Waiver
2/5
Overall Rating
1350 YAUGER RD, MOUNT VERNON, OH 43050(740) 397-2350(740) 393-0546 Get Directions Write a Review

NPPES record last updated: April 12, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Country Club Retirement Center Ii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRY CLUB RETIREMENT CENTER II (NPI 1598831869) is a healthcare organization registered as a skilled nursing facility in Mount Vernon, Ohio and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through August 29, 2027 and lists Tracy Head, Administrator, as its authorized official.

NPPES Registry Identity

NPI1598831869
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameMOUNT VERNON ELDERLY SERVICES LLC
Location Address1350 YAUGER RDMount Vernon, OH 43050-9233
Mailing Address1350 Yauger RdMount Vernon, OH 43050-9233 · (740) 397-2350 · Fax (740) 393-0546
Phone(740) 397-2350
Fax(740) 393-0546
Organization SubpartNo
Authorized OfficialTracy HeadAdministrator · (740) 397-2350
Enumeration DateNovember 28, 2006
Last NPPES UpdateApril 12, 2017
✔ NPI 1598831869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License✔ Licensed in OH · 2866
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
1350 YAUGER RD, Mount Vernon, OH 43050
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Other Names 1

Doing Business AsCountry Club Retirement Center Ii

Other Identifiers 2

Medicare ID-Type Unspecified365815OH
Medicaid0396218OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D0875695

Country Club Retirement Center II · Mount Vernon, OH
Active · expires Aug 29, 2027
CLIA Number36D0875695
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateAugust 30, 2025
Certificate Expiration DateAugust 29, 2027
Laboratory Phone(614) 397-2350
Laboratory LocationCountry Club Retirement Center II1350 Yauger Rd, Mount Vernon, OH 43050
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Country Club Retirement Center (CMS certification number 365815), from CMS Care Compare.

Country Club Retirement Center

Nursing home · Mount Vernon, OH
2/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number365815
Certified Beds76 beds62 residents per day on average
Medicare & Medicaid Participant SinceDecember 20, 1990
Resident & Family CouncilResident council
Continuing care retirement community Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
3/5
Long-Stay Quality
Quality of care delivered to long-term residents.
4/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
3/5
Staffing
Based on nursing staff hours relative to resident needs.
3/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
88.67
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 1.69 · LPN 0.55 · RN 0.72
2.95 hrs per resident per day
Weekend Nurse Staffing
2.64 hrs per resident per day
Physical Therapist Staffing
0.07 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
39.2%
Registered Nurse Turnover
11.1%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
3
Infection-Control Citations
0
Fines
0
Medicare Payment Denials
0
Total Penalties
0
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOUNT VERNON ELDERLY SERVICES LLC
Assisted Living Facility
1350 YAUGER RD
MOUNT VERNON, OH 43050
Knox County (740) 397-2350

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mount Vernon Elderly Services LLC's NPI number?

The NPI number for Mount Vernon Elderly Services LLC is 1598831869. It was assigned to this organization in the NPPES registry on November 28, 2006. The provider is doing business as Country Club Retirement Center II.

Where is Mount Vernon Elderly Services LLC located?

Mount Vernon Elderly Services LLC is located at 1350 Yauger Rd, Mount Vernon, OH 43050. The listed phone number is (740) 397-2350.

What is Mount Vernon Elderly Services LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Mount Vernon Elderly Services LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D0875695) is associated with this NPI, valid through August 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Mount Vernon Elderly Services LLC a Medicare-certified nursing home?

Yes. Country Club Retirement Center is a Medicare-certified nursing home with 76 certified beds.

What quality rating does Mount Vernon Elderly Services LLC have?

CMS rates Country Club Retirement Center 2 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Mount Vernon Elderly Services LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Mount Vernon Elderly Services LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mount Vernon Elderly Services LLC was last updated on April 12, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.