All citations for Country Club Retirement Ctr IV

State inspectors check nursing homes that take Medicare or Medicaid against federal rules, usually about once a year, and also look into complaints. Each rule a home did not meet is a citation.

Back to Country Club Retirement Ctr IV

Last standard health inspection on record

June 9, 2026

Showing 1 to 10 of 10 citations

  1. No harm, with potential for more than minimal harm

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

    Widespread (many residents). CMS level F.

    Health citation F-0725, Nursing and Physician Services Deficiencies. Inspection of November 9, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 29, 2022).

  2. No harm, with potential for more than minimal harm

    Have approved installation, maintenance and testing program for fire alarm systems.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0345, Smoke Deficiencies. Inspection of November 9, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 29, 2022).

  3. No harm, with potential for more than minimal harm

    Install smoke barrier doors that can resist smoke for at least 20 minutes.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0374, Smoke Deficiencies. Inspection of November 9, 2022. Found during a standard inspection.

    A waiver was granted (March 30, 2023).

  4. No harm, with potential for more than minimal harm

    Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0521, Services Deficiencies. Inspection of November 9, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 29, 2022).

  5. No harm, with potential for more than minimal harm

    Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

    Pattern (more than a few residents). CMS level E.

    Fire safety citation K-0372, Smoke Deficiencies. Inspection of November 9, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 29, 2022).

  6. No harm, with potential for more than minimal harm

    Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

    Pattern (more than a few residents). CMS level E.

    Fire safety citation K-0741, Miscellaneous Deficiencies. Inspection of November 9, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 29, 2022).

  7. No harm, with potential for more than minimal harm

    PASARR screening for Mental disorders or Intellectual Disabilities

    Isolated (one or a few residents). CMS level D.

    Health citation F-0645, Resident Assessment and Care Planning Deficiencies. Inspection of November 9, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 29, 2022).

  8. No harm, with potential for more than minimal harm

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

    Isolated (one or a few residents). CMS level D.

    Health citation F-0677, Quality of Life and Care Deficiencies. Inspection of November 9, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 29, 2022).

  9. No harm, with potential for more than minimal harm

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

    Isolated (one or a few residents). CMS level D.

    Health citation F-0684, Quality of Life and Care Deficiencies. Inspection of November 9, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 29, 2022).

  10. No harm, with potential for more than minimal harm

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

    Isolated (one or a few residents). CMS level D.

    Health citation F-0690, Quality of Life and Care Deficiencies. Inspection of November 9, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 29, 2022).

Source: CMS Provider Information, Fire Safety Deficiencies, Health Deficiencies, Citation Code Look-up, data as of October 1, 2026. Inspection results describe the home at the time of each inspection.