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 12 of 12 citations

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

    Provide properly protected cooking facilities.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0324, Smoke Deficiencies. Inspection of June 9, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 29, 2026).

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

    Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0354, Smoke Deficiencies. Inspection of January 29, 2026. Found during a complaint inspection.

    The home gave a date the problem would be corrected (February 11, 2026).

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

    Have simulated fire drills held at unexpected times.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0712, Miscellaneous Deficiencies. Inspection of September 30, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 9, 2024).

  4. 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).

  5. 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).

  6. 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).

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

    Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

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

    Fire safety citation K-0222, Egress Deficiencies. Inspection of June 9, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 29, 2026).

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

    Properly select, install, inspect, or maintain portable fire extinguishes.

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

    Fire safety citation K-0355, Smoke Deficiencies. Inspection of June 9, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 29, 2026).

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

    Have proper power supply for life support equipment.

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

    Fire safety citation K-0915, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of June 9, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 29, 2026).

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

    Ensure proper usage of power strips and extension cords.

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

    Fire safety citation K-0920, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of September 30, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 9, 2024).

  11. 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).

  12. 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).

Source: CMS Provider Information, Fire Safety Deficiencies, Health Deficiencies, Citation Code Look-up, data as of September 30, 2026. Inspection results describe the home at the time of each inspection.