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

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

Long Beach · Nursing Home

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

CA · Nursing Home

Grand Valley Health Care Center 13524 Sherman Way, Van Nuys, CA 91405
Calimesa Post Acute 13542 Second St., Yucaipa, CA 92399
Antioch Convalescent Hospital 1210 A Street, Antioch, CA 94509
Saint Vincent Med Ctr Dp Snf 2131 West 3rd Street, Los Angeles, CA 90057
Sunnyvale Post-acute Center 1291 S Bernardo Avenue, Sunnyvale, CA 94087
Hayward Hills Health Care Center 1768 B Street, Hayward, CA 94541
Twin Oaks Rehabilitation & Nursing Center 897 North M Street, Tulare, CA 93274
Stonebrook Health and Rehabilitation 350 De Soto Drive, Los Gatos, CA 95030
Pleasanton Nursing and Rehabilitation Center 300 Neal Street, Pleasanton, CA 94566
Eskaton Care Center Greenhaven 455 Florin Road, Sacramento, CA 95831
Southern Inyo Hospital D/p Snf 501 E Locust, Lone Pine, CA 93545
Villa Maria Healthcare Center 425 E Barcellus Ave, Santa Maria, CA 93454
Community Care On Palm 4768 Palm Avenue, Riverside, CA 92501
St Christopher Convalescent Hospital 22822 Myrtle Street, Hayward, CA 94541
Creekside Care Center 35253 Avenue H, Yucaipa, CA 92399
Thousand Oaks Healthcare Center 93 W Avenida De Los Arboles, Thousand Oaks, CA 91360
Royal Oaks Care Center 3565 E. Imperial Hwy., Lynwood, CA 90262
Kindred Transitional Care & Rehab - Valley Gardens 1517 East Knickerbocker Drive, Stockton, CA 95210
Vale Healthcare Center 13484 San Pablo Avenue, San Pablo, CA 94806
Mountain Manor Senior Residence 6101 Fair Oaks Boulevard, Carmichael, CA 95608
Valle Vista Convalescent Hospital 1025 W. Second Avenue, Escondido, CA 92025
St Francis Extended Care 718 Bartlett Ave., Hayward, CA 94541
Wolf Creek Care Center 107 Catherine Lane, Grass Valley, CA 95945
Paramount Meadows Nursing Center 7039 Alondra Blvd, Paramount, CA 90723
Vista Cove Care Center At Santa Paula 250 March St, Santa Paula, CA 93060
Rio Hondo Subacute & Nursing Center 273 E Beverly Boulevard, Montebello, CA 90640
Kindred Transitional Care & Rehab - Siena 11600 Education Street, Auburn, CA 95603
Mayflower Care Center 5043 Peck Rd, El Monte, CA 91732
Arrowhead Healthcare Center, LLC 4343 N. Sierra Way, San Bernardino, CA 92407
Applewood Post Acute 1090 Rio Lane, Sacramento, CA 95822
Fountain View Subacute and Nursing Center 5310 Fountain Ave, Los Angeles, CA 90029
Parkway Hills Nursing & Rehabilitation 7760 Parkway Drive, La Mesa, CA 91942
Palomar Vista Healthcare Center 201 N Fig Street, Escondido, CA 92025
Windsor El Camino Care Center 2540 Carmichael Way, Carmichael, CA 95608
Courtyard Care Center 1880 Dawson Avenue, Signal Hill, CA 90806
Windsor Gardens Healthcare of The Valley 13000 Victory Blvd,, North Hollywood, CA 91606
Bellaken Skilled Nursing Center 2780 26th Avenue, Oakland, CA 94601
Cypress Gardens Care Center 9025 Colorado Avenue, Riverside, CA 92503
Hollywood Presbyterian Medical Center D/p Snf 4636 Fountain Avenue, Los Angeles, CA 90029
Hillview Convalescent Hospital 530 West Dunne Avenue & La Selva, Morgan Hill, CA 95037