COUNTRY CLUB CENTER V, INC
478 S SANDUSKY ST
DELAWARE, OH, 43015
7403698741
CCN: 366026
5
Overall4
Health3
Staffing5
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
| Name | Role | % |
|---|---|---|
| HOLLAND GROUP II, LTD | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 70% |
| HARRIS, JANET | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 30% |
| HOLLAND, BENJAMIN | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 10% |
| HOLLAND, NICHOLAS | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 10% |
| HOLLAND, NOAH | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 10% |
| HOLLAND-GRESOCK, ADAM | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 10% |
| MUIRDEN-HOLLAND, JOHN | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 10% |
| HOLLAND-GRESOCK, PATRICIA | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 10% |
| GRESOCK, JOSHUA | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 10% |
| HARRIS, JANET | CORPORATE DIRECTOR | NOT APPLICABLE |
| HARRIS, JANET | CORPORATE OFFICER | NOT APPLICABLE |
| HARRIS, JANET | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| OLSON, LYLE | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| ORTMAN, DIANNA | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
Health Deficiencies (15)
2025-08-28 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F805 · Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
D
F800 · Nutrition and Dietary Deficiencies
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
D
F757 · Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
F561 · Resident Rights Deficiencies
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
D
F558 · Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
2025-02-28 · Health
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2025-01-16 · Health
D
F580 · Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
2023-05-17 · Health
D
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
2022-05-12 · Health
D
F759 · Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2019-08-15 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
C
F814 · Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
F623 · Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
4.32
RN Hrs/Resident/Day0.54
1.06
LPN Hrs/Resident/Day0.81
1.07
CNA Hrs/Resident/Day2.33
2.19
PT Hrs/Resident/Day0.12
0.01
Data as of 2026-03-01