01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-09-30 | 30 | 2024-09-30 | 3 |
| Cycle 2 | 2022-11-09 | 7 | 2022-11-09 | 5 |
| Cycle 3 | 2019-12-18 | 8 | 2019-12-18 | 3 |
CMS CCN 3656992026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Country Club Retirement Ctr Iv
55801 Conno-Mara Drive · Bellaire, OH 43906 · Belmont County
Certified beds62CMS provider file
Recent citation rows56current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
56 rows in the current release
4 rows carry G–L scope/severity codes; 1 carry J–L. 14 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-03-17 · HEALTHF0684Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2026-04-03 · complaint2026-03-17 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2026-04-16 · complaint2026-03-17 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2026-04-03 · complaint2026-03-17 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2026-04-03 · complaint2026-03-17 · HEALTHF0697Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2026-04-03 · complaint2026-03-17 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2026-04-16 · complaint2026-03-17 · HEALTHF0880Severity F · widespread; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2026-04-03 · complaint2026-03-17 · HEALTHF0881Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Implement a program that monitors antibiotic use.
Correction field: Deficient, Provider has date of correction · 2026-04-16 · complaint2026-03-17 · HEALTHF0882Severity F · widespread; potential for more than minimal harm
Infection Control Deficiencies
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Correction field: Deficient, Provider has date of correction · 2026-04-16 · complaint2026-03-17 · HEALTHF0919Severity F · widespread; potential for more than minimal harm
Environmental Deficiencies
Make sure that a working call system is available in each resident's bathroom and bathing area.
Correction field: Deficient, Provider has date of correction · 2026-04-03 · complaint2026-01-29 · FIREK0354Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Correction field: Deficient, Provider has date of correction · 2026-02-11 · complaint2026-01-26 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2026-02-17 · complaint2025-11-25 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2025-12-18 · complaint2025-11-25 · HEALTHF0677Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2025-12-18 · complaint2025-11-25 · HEALTHF0725Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Correction field: Deficient, Provider has date of correction · 2025-12-18 · complaint2025-11-25 · HEALTHF0755Severity F · widespread; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2025-12-18 · complaint2025-11-25 · HEALTHF0842Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2025-12-18 · complaint2025-11-25 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-12-18 · complaint2025-08-27 · HEALTHF0692Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2025-09-12 · complaint2025-03-12 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2025-03-21 · complaint2025-03-12 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2025-03-21 · complaint2024-09-30 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2024-10-09 · complaint2024-09-30 · HEALTHF0604Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Correction field: Deficient, Provider has date of correction · 2024-10-092024-09-30 · HEALTHF0644Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Correction field: Deficient, Provider has date of correction · 2024-10-0903 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- HOLLAND GROUP II, LTDOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST58% · since 01/23/2012
- HOLLAND, JOHNIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST22% · since 01/23/2012
- GRESOCK, JOSHUAIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST8% · since 01/01/2006
- HOLLAND, BENJAMINIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST8% · since 01/01/2006
- HOLLAND, NICHOLASIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST8% · since 01/01/2006
- HOLLAND, NOAHIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST8% · since 01/01/2006
- HOLLAND-GRESOCK, ADAMIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST8% · since 01/01/2006
- HOLLAND-GRESOCK, PATRICIAIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST8% · since 01/01/2006
- MUIRDEN-HOLLAND, JOHNIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST8% · since 01/01/2006
- HARRIS, JANETIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2008
- HARRIS, JANETIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2008
- KUREISHY, ZAVEENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2008
- MARONI, ANTHONYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2008
- HOLLAND GROUP II, LTDOrganization · ADP OF THE SNFNOT APPLICABLE · since 01/01/2012
- GRESOCK, JOSHUAIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2012
- HARRIS, JANETIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2012
- HOLLAND, BENJAMINIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2012
- HOLLAND, JOHNIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2012
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours—per resident day
RN hours—per resident day
Weekend nurse hours—per resident day
Staff turnover69.8%CMS reported field
06 / LOCAL RECORDS
Open the Ohio ledger →Other published facilities nearby
No second facility in the same city met the directory rule.