Country Villa Belmont Heights
1730 Grand Ave, Long Beach, CA 90804


Country Villa Belmont Heights is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 055077. The address is 1730 Grand Ave, Long Beach, CA 90804. The zip code is 90804. The phone number is 5625978817.


Country Villa Belmont Heights · 1730 Grand Ave, Long Beach, CA 90804

Federal Provider Number 055077
Provider Name COUNTRY VILLA BELMONT HEIGHTS
Address 1730 GRAND AVE
LONG BEACH, CA 90804
Phone Number 5625978817
SSA County Code 200
County Name Los Angeles
Ownership Type For profit - Partnership
Certified Beds 104
Certified Beds Residents 97
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name COUNTRY VILLA SOUTH BAY, LLC
Date First Approved to Provide Medicare Medicaid Services 10/09/1985
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 1
Health Inspection Rating 1
Quality Measure Rating 3
Staffing Rating 3
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 2.43608
Reported LPN Staffing Hours per Resident per Day 1.35103
Reported RN Staffing Hours per Resident per Day 0.69845
Reported Licensed Staffing Hours per Resident per Day 2.04948
Reported Total Nurse Staffing Hours per Resident per Day 4.48556
Reported Physical Therapist Staffing Hours per Resident Per Day 0.04485
Expected CNA Staffing Hours per Resident per Day 2.56494
Expected LPN Staffing Hours per Resident per Day 0.8174
Expected RN Staffing Hours per Resident per Day 1.26091
Expected Total Nurse Staffing Hours per Resident per Day 4.64325
Adjusted CNA Staffing Hours per Resident per Day 2.33043
Adjusted LPN Staffing Hours per Resident per Day 1.37185
Adjusted RN Staffing Hours per Resident per Day 0.41389
Adjusted Total Nurse Staffing Hours per Resident per Day 3.89401
Cycle 1 Total Number of Health Deficiencies 33
Cycle 1 Number of Standard Health Deficiencies 14
Cycle 1 Number of Complaint Health Deficiencies 21
Cycle 1 Health Deficiency Score 172
Cycle 1 Standard Survey Health Date 05/10/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 172
Cycle 2 Total Number of Health Deficiencies 27
Cycle 2 Number of Standard Health Deficiencies 20
Cycle 2 Number of Complaint Health Deficiencies 11
Cycle 2 Health Deficiency Score 156
Cycle 2 Standard Health Survey Date 05/06/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 156
Cycle 3 Total Number of Health Deficiencies 8
Cycle 3 Number of Standard Health Deficiencies 7
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 40
Cycle 3 Standard Health Survey Date 02/18/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 40
Total Weighted Health Survey Score 144.667
Number of Facility Reported Incidents 11
Number of Substantiated Complaints 36
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Country Villa Belmont Heights

Owner Name Role Association Date
COUNTRY VILLA SOUTH BAY, LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2011
DACS VENTURE HOLDINGS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2011
JAG VENTURE HOLDINGS (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2011
PETTERSON, CHERYL (Individual) MANAGING EMPLOYEE since 01/01/2011
REISSMAN FAMILY TRUST (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2011
REISSMAN IRRV 1989 TR 050189 (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2011
REISSMAN, DIANE (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2011
REISSMAN, STEPHEN (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2011
REISSMAN, STEPHEN (Individual) OFFICER since 02/07/2014
ROWLES, EDDIE (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 09/01/1998
SALTZBURG FAMILY TRUST (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2011
SALTZBURG, JOEL (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2011
TORGAN FAMILY TRUST (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2011
TORGAN, MICHAEL (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2011

90804 · Nursing Home

Pacific Palms Healthcare 1020 Termino Avenue, Long Beach, CA 90804
Marlora Post Acute Rehab Hosp 3801 E Anaheim St, Long Beach, CA 90804
Shoreline Healthcare Center 4029 East Anaheim Street, Long Beach, CA 90804
Regency Oaks Post Acute Care Center 3850 E. Esther St., Long Beach, CA 90804
Bel Vista Healthcare Center 5001 East Anaheim Street, East Long Beach, CA 90804

Long Beach · Nursing Home

Santa Fe Convalescent Hospital 3294 Santa Fe Avenue, Long Beach, CA 90810
Pacific Palms Healthcare 1020 Termino Avenue, Long Beach, CA 90804
Atlantic Memorial Healthcare Center 2750 Atlantic Ave., Long Beach, CA 90806
Shoreline Healthcare Center 4029 East Anaheim Street, Long Beach, CA 90804
Alamitos Belmont Rehab Hospita 3901 E Fourth Street, Long Beach, CA 90814
Long Beach Post Acute 1201 Walnut Avenue, Long Beach, CA 90813
Pacific Villa, Inc 3501 Cedar Avenue, Long Beach, CA 90807
Windsor Convalescent Center of North Long Beach 260 E Market St, Long Beach, CA 90805
Villa Serena Healthcare Center 723 E 9th Street, Long Beach, CA 90813
Catered Manor Nursing Center 4010 Virginia Rd., Long Beach, CA 90807
Edgewater Skilled Nursing Center 2625 East Fourth Street, Long Beach, CA 90814
Grandell Rehabilitation and Nursing Center 645 W Broadway, Long Beach, NY 11561
Beach Terrace Care Center 640 West Broadway, Long Beach, NY 11561
Marlora Post Acute Rehab Hosp 3801 E Anaheim St, Long Beach, CA 90804
Long Beach Nursing and Rehabilitation Center 375 East Bay Drive, Long Beach, NY 11561
Colonial Care Center 1913 E 5th Street, Long Beach, CA 90802
Intercommunity Care Center 2626 Grand Avenue, Long Beach, CA 90815
Royal Care Skilled Nursing Ctr 2725 Pacific Avenue, Long Beach, CA 90806
Long Beach Care Center, Inc 2615 Grand Avenue, Long Beach, CA 90815
Park Avenue Extended Care Facility 425 National Boulevard, Long Beach, NY 11561
Pacific Care Nursing Center 3355 Pacific Place, Long Beach, CA 90806
Broadway By The Sea 2725 E. Broadway, Long Beach, CA 90803
Windsor Gardens Conv Long Beac 3232 E. Artesia Blvd., Long Beach, CA 90805
Regency Oaks Post Acute Care Center 3850 E. Esther St., Long Beach, CA 90804
Vista Cove Care Center At Long Beach 3401 Cedar Avenue, Long Beach, CA 90807
Country Villa Bay Vista Hcc 5901 Downey Ave, Long Beach, CA 90805
Bixby Knolls Towers Health Care & Rehab Center 3747 Atlantic Avenue, Long Beach, CA 90807

CA · Nursing Home

Maywood Skilled Nursing & Wellness Centre 6025 Pine Ave, Maywood, CA 90270
Country Manor La Mesa Healthcare Center 5696 Lake Murray Blvd, La Mesa, CA 91942
Clear View Convalescent Center 15823 So. Western Ave., Gardena, CA 90247
Park Anaheim Healthcare Center 3435 W Ball Road, Anaheim, CA 92804
Kaiser Foundation Hospital Manteca D/p Snf 1777 West Yosemite Avenue, Manteca, CA 95337
Parkview Healthcare Center 27350 Tampa Avenue, Hayward, CA 94544
Danish Care Center 10805 El Camino Real, Atascadero, CA 93422
Advanced Rehab Center of Tustin 2210 E. First Street, Santa Ana, CA 92705
Marysville Post-acute 1617 Ramirez Street, Marysville, CA 95901
Arlington Gardens Care Center 3688 Nye Avenue, Riverside, CA 92505
Country Oaks Care Center 215 W Pearl St, Pomona, CA 91768
Brookdale Carlsbad 3140 El Camino Real, Carlsbad, CA 92008
Lake Park Retirement Residence 1850 Alice Street, Oakland, CA 94612
East Bay Post-acute 20259 Lake Chabot Road, Castro Valley, CA 94546
Kings Nursing & Rehabilitation Center 851 Leslie Lane, Hanford, CA 93230
Tracy Nursing and Rehabilitation Center 545 West Beverly Place, Tracy, CA 95376
Providence Mcclure 2910 Mcclure Street, Oakland, CA 94609
Alta Vista Healthcare & Wellness Centre 9020 Garfield Street, Riverside, CA 92503
Landmark Medical Center 2030 N. Garey Ave., Pomona, CA 91767
Brier Oak On Sunset 5154 Sunset Blvd, Los Angeles, CA 90027
Garfield Neurobehavioral Center 1451 28th Avenue, Oakland, CA 94601
Our Lady of Fatima Villa 20400 Saratoga-los Gatos Rd, Saratoga, CA 95070
University Retirement Community At Davis 1515 Shasta Drive, Davis, CA 95616
Palomar Vista Healthcare Center 201 N Fig Street, Escondido, CA 92025
Friends House 684 Benicia Drive, Santa Rosa, CA 95409
Windsor Gardens Rehabilitation Center of Salinas 637 East Romie Lane, Salinas, CA 93901
Pacific Post Acute 1323 17th Street, Santa Monica, CA 90404
Huntington Healthcare Center 4515 Huntington Drive South, Los Angeles, CA 90032
Imperial Heights Healthcare & Wellness Centre, LLC 320 Cattle Call Dr., Brawley, CA 92227
The Earlwood 20820 Earl Street, Torrance, CA 90503
Mountain View Conv Hosp 13333 Fenton Avenue, Sylmar, CA 91342
Beacon Healthcare Center 919 N Sunset Ave, West Covina, CA 91790
St Christopher Convalescent Hospital 22822 Myrtle Street, Hayward, CA 94541
Temple City Healthcare 5101 Tyler Avenue, Temple City, CA 91780
The Rehabilitation Centre of Beverly Hills 580 South San Vicente Blvd., Los Angeles, CA 90048
Hollywood Presbyterian Medical Center D/p Snf 4636 Fountain Avenue, Los Angeles, CA 90029
Royal Palms Post Acute 630 W. Broadway, Glendale, CA 91204
Morton Bakar Center 494 Blossom Way, Hayward, CA 94541
Tahoe Forest Hospital D/p Snf 10121 Pine Ave., Truckee, CA 96160
Buena Park Nursing Center 8520 Western Avenue, Buena Park, CA 90620