The bipartisan Ohio Casino Control Commission was created in 2011 to develop rules for casino gaming in Ohio, to license operators and to regulate and ensure the integrity of operations. Portions of the tax revenue are designated for public school districts the four host cities all 88 state counties the Ohio State Racing Commission law enforcement training and research and treatment of problem gambling and substance abuse. Gross casino revenues are taxed at 33 percent, one of the highest rates in the nation for a resort casino with this level of investment. Rock Ohio Caesars also developed Horseshoe Casino Cincinnati, which opened on March 4, 2013.

Hollywood Casino Toledo, developed and operated by Penn National Gaming, opened on May 29, followed by Hollywood Columbus, which opened on October 8, 2012. It was developed by Rock Ohio Caesars, a joint venture between Caesars Entertainment and Dan Gilbert's Rock Gaming, and managed is by Caesars. Horseshoe Cleveland opened on May 14, 2012, as the first casino in the state of Ohio. It was the fifth statewide vote to legalize gambling in Ohio over 20 years. Ohio voters approved (53%) a state constitutional amendment in November 2009 authorizing casinos in the state’s four largest cities: Cleveland, Cincinnati, Columbus and Toledo. Since the casino has limited dining options, it has partnered with nearly a dozen downtown Cleveland restaurants. The casino is open 24 hours a day and is completely smoke-free, compliant with Ohio law. The casino has teamed with the Renaissance, the Ritz-Carlton, and the Marriott at Key Center to offer rooms to its guests, and Rock Ohio Caesars purchased the Ritz-Carlton from Forest City Enterprises.

The casino is accessible from Public Square, but is also accessible from the Terminal Tower and the Tower City Center shopping mall. The casino has 1,609 slot machines, 119 table games, 28 poker tables, and 35 electronic table games. Jack Cleveland Casino is located in the former Higbee Building at Tower City Center in downtown Cleveland. Jack Cleveland Casino (formerly Horseshoe Cleveland) is a casino in the downtown core of Cleveland, Ohio, United States, owned by Vici Properties and operated by Jack Entertainment.

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