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
Marlora Post Acute Rehab Hosp 3801 E Anaheim St, 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
Pacific Palms Healthcare 1020 Termino Avenue, Long Beach, CA 90804

Long Beach · Nursing Home

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

CA · Nursing Home

Jacob Health Care Center, LLC 4075 54th St., San Diego, CA 92105
Windsor The Ridge Rehabilitation Center 350 Iris Drive, Salinas, CA 93906
Copper Ridge Care Center 201 Hartnell Avenue, Redding, CA 96002
Manorcare Health Services (sunnyvale) 1150 Tilton Drive, Sunnyvale, CA 94087
Marina Pointe Healthcare & Subacute 5240 Sepulveda Blvd, Culver City, CA 90230
Meadowood Nursing Center 3805 Dexter Lane, Clearlake, CA 95422
Country Villa Rehabilitation Center 340 South Alvarado Street, Los Angeles, CA 90057
El Monte Convalescent Hospital 4096 Easy Street, El Monte, CA 91731
Palazzo Post Acute 5400 Fountain Ave, Los Angeles, CA 90029
Kindred Transitional Care and Rehab - Smith Ranch 1550 Silveira Parkway, San Rafael, CA 94903
Chandler Convalescent Hospital 525 South Central Avenue, Glendale, CA 91204
Atherton Baptist Home 214 South Atlantic Blvd., Alhambra, CA 91801
Garden View Post- Acute Rehabilitation 14475 Garden View Lane, Baldwin Park, CA 91706
Golden Livingcenter - Fresno 2715 Fresno Street, Fresno, CA 93721
Bishop Care Center 151 Pioneer Lane, Bishop, CA 93514
New Vista Nursing and Rehabilitation Center 8647 Fenwick Street., Sunland, CA 91040
Peninsula Post-acute 1609 Trousdale Drive, Burlingame, CA 94010
Kindred Transitional Care & Rehabilitation-lawton 1575 7th Avenue, San Francisco, CA 94122
Shasta View Estates 445 Park Street, Weed, CA 96094
Brookdale Rancho Mirage 72-201 Country Club Drive, Rancho Mirage, CA 92270
Riviera Healthcare Center 8203 Telegraph Rd, Pico Rivera, CA 90660
Modoc Medical Center D/p Snf 228 W Mc Dowell Ave, Alturas, CA 96101
Providence All Saint's Maubert 15731 Maubert Avenue, San Leandro, CA 94578
Madera Rehabilitation & Nursing Center 517 South A Street, Madera, CA 93638
St Jude Care Center 469 East North Street, Manteca, CA 95336
Evergreen Arvin Healthcare 323 Campus Drive, Arvin, CA 93203
Mercy Retirement & Care Center 3431 Foothill Blvd., Oakland, CA 94601
Raintree Convalescent Hospital 5265 East Huntington Avenue, Fresno, CA 93727
Golden Living Center - Hillcrest 3672 North First Street, Fresno, CA 93726
Sea Cliff Healthcare Center 18811 Florida St, Huntington Beach, CA 92648
Hillside Senior Care 38650 Mission Boulevard, Fremont, CA 94536
Veterans Home of California - Chula Vista 700 East Naples Court, Chula Vista, CA 91911
Arcadia Health Care Center 1601 S Baldwin Ave., Arcadia, CA 91006
Mission Care Center 8487 Magnolia Avenue, Riverside, CA 92504
Lake Park Retirement Residence 1850 Alice Street, Oakland, CA 94612
Professional Post Acute Center 81 Professional Center Parkway, San Rafael, CA 94903
Vista Pacifica Convalescent Hospital 3662 Pacific Avenue, Riverside, CA 92509
Dreier's Nursing Care Center 1400 West Glenoaks Blvd, Glendale, CA 91201
Arroyo Grande Care Center 1212 Farroll Ave, Arroyo Grande, CA 93420
Merced Nursing & Rehabilitation Ctr 510 West 26th Street, Merced, CA 95340