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

Regency Oaks Post Acute Care Center 3850 E. Esther St., 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
Shoreline Healthcare Center 4029 East Anaheim Street, Long Beach, CA 90804
Marlora Post Acute Rehab Hosp 3801 E Anaheim St, Long Beach, CA 90804

Long Beach · Nursing Home

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

CA · Nursing Home

Surprise Valley Community Hospital D/p Snf 741 N. Main Street, Cedarville, CA 96104
University Park Healthcare Center 230 E Adams Blvd, Los Angeles, CA 90011
Atterdag Care Center 636 Atterdag Road, Solvang, CA 93463
Valley Memorial Hospital Snf 1111 E Stanley Boulevard, Livermore, CA 94550
Vacaville Convalescent & Rehab 585 Nut Tree Court, Vacaville, CA 95687
El Rancho Vista Health Care Center 8925 Mines Avenue, Pico Rivera, CA 90660
Northpointe Healthcare Centre 668 E. Bullard, Fresno, CA 93710
Mission Care Center 8487 Magnolia Avenue, Riverside, CA 92504
Dreier's Nursing Care Center 1400 West Glenoaks Blvd, Glendale, CA 91201
Lone Tree Convalescent Hospital 4001 Lone Tree Way, Antioch, CA 94509
Merced Nursing & Rehabilitation Ctr 510 West 26th Street, Merced, CA 95340
Brookdale Rancho Mirage 72-201 Country Club Drive, Rancho Mirage, CA 92270
Mercy Retirement & Care Center 3431 Foothill Blvd., Oakland, CA 94601
Golden Livingcenter - Napa 705 Trancas St., Napa, CA 94558
Hayward Healthcare & Wellness Center 1805 West Street, Hayward, CA 94545
Porterville Convalescent Hospital 1100 West Morton Avenue, Porterville, CA 93257
Raintree Convalescent Hospital 5265 East Huntington Avenue, Fresno, CA 93727
Folsom Care Center 510 Mill Street, Folsom, CA 95630
Wagner Heights Nursing & Rehabilitation Center 9289 Branstetter Place, Stockton, CA 95209
Hillcrest Manor Sanitarium 1889 National City Blvd., National City, CA 91950
Camden Postacute Care, Inc 1331 Camden Avenue, Campbell, CA 95008
Shadowbrook Post Acute 1 Gilmore Lane, Oroville, CA 95966
California Home for The Aged 6720 E. Kings Canyon, Fresno, CA 93727
Legacy Post-acute Rehabilitation 1335 N. Waterman Avenue, San Bernardino, CA 92404
Golden Living Center - Galt 144 F Street, Galt, CA 95632
Willow Pass Healthcare Center 3318 Willow Pass Road, Concord, CA 94519
Garden Park Care Center 12681 Haster Street, Garden Grove, CA 92840
Grancell Village of The Jewish Homes for The Aging 7150 Tampa Ave, Reseda, CA 91335
Selma Convalescent Hospital 2108 Stillman, Selma, CA 93662
Saint Claire's Nursing Center 6248 66th Avenue, Sacramento, CA 95823
Bancroft Convalescent Hospital 1475 Bancroft Avenue, San Leandro, CA 94577
Maywood Acres Healthcare 2641 South C St, Oxnard, CA 93033
Providence Little Comp of Mary Subacute Care Ctr 1322 West Sixth Street, San Pedro, CA 90732
Temple Park Convalescent Hosp 2411 W. Temple Street, Los Angeles, CA 90026
Pioneer House 415 P Street, Sacramento, CA 95814
Del Mar Convalescent Hospital 3136 North Del Mar Avenue, Rosemead, CA 91770
Meadowood A Health and Rehabilitation Center 3110 Wagner Heights Road, Stockton, CA 95209
Country Crest Post Acute 50 Concordia Lane, Oroville, CA 95966
Dos Palos Memorial Skilled Nursing Facility 2118 Marguerite St, Dos Palos, CA 93620
The Pines At Placerville Healthcare Center 1040 Marshall Way, Placerville, CA 95667