Country Club Retirement CTR IV

Certification

Medicare-certified.

Ratings

Inspection history (45)

Records from December 2019 to March 2026.

• September 30, 2024

  Tag F0580

  Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected October 9, 2024.

• September 30, 2024

  Tag F0757

  Ensure each resident’s drug regimen must be free from unnecessary drugs.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected October 9, 2024.

• September 30, 2024

  Tag F0695

  Provide safe and appropriate respiratory care for a resident when needed.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected October 9, 2024.

• September 30, 2024

  Tag F0758

  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 l….

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected October 9, 2024.

• September 30, 2024

  Tag F0881

  Implement a program that monitors antibiotic use.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected October 9, 2024.

• September 30, 2024

  Tag F0790

  Provide routine and 24-hour emergency dental care for each resident.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected October 9, 2024.

• September 30, 2024

  Tag F0684

  Provide appropriate treatment and care according to orders, resident’s preferences and goals.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected October 9, 2024.

• September 30, 2024

  Tag F0644

  Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected October 9, 2024.

• September 30, 2024

  Tag F0688

  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.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected October 9, 2024.

• September 30, 2024

  Tag F0604

  Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected October 9, 2024.

• September 30, 2024

  Tag F0645

  PASARR screening for Mental disorders or Intellectual Disabilities.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected October 9, 2024.

• September 30, 2024

  Tag F0756

  Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected October 9, 2024.

• November 9, 2022

  Tag F0684

  Provide appropriate treatment and care according to orders, resident’s preferences and goals.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected November 29, 2022.

• November 9, 2022

  Tag F0690

  Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected November 29, 2022.

• November 9, 2022

  Tag F0645

  PASARR screening for Mental disorders or Intellectual Disabilities.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected November 29, 2022.

• November 9, 2022

  Tag F0677

  Provide care and assistance to perform activities of daily living for any resident who is unable.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected November 29, 2022.

• November 9, 2022

  Tag F0725

  Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

  Severity F: widespread, no actual harm, potential for more than minimal harm. Corrected November 29, 2022.

• December 18, 2019

  Tag F0609

  Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected February 1, 2020.

• December 18, 2019

  Tag F0684

  Provide appropriate treatment and care according to orders, resident’s preferences and goals.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected February 1, 2020.

• December 18, 2019

  Tag F0676

  Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.

  Severity D: isolated, no actual harm, potential for more than minimal harm. Corrected February 1, 2020.

Penalties (3)

• June 9, 2026 · Fine

  CMS recorded a civil money penalty of $53,060 against this nursing home on June 9, 2026.

• March 17, 2026 · Payment Denial

  CMS recorded a Medicare/Medicaid payment denial for new admissions starting April 8, 2026, lasting 8 days (triggered by inspection on March 17, 2026).

• March 17, 2026 · Fine

  CMS recorded a civil money penalty of $41,420 against this nursing home on March 17, 2026.

Staffing

3.49 nurse hours per resident per day in Q2 2026, down from 3.60 in Q4 2025.

From the payroll records nursing homes file with CMS.

Ownership

For profit