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3825 COUNTRYSIDE BLVD N
PALM HARBOR, FL 34684-4928
Phone: (727) 784-2848
County: Pinellas

Mailing Address

3825 COUNTRYSIDE BLVD N
PALM HARBOR, FL 34684-4928
County: Pinellas
Website: http://www.consulatehealthcare.com

Emergency Actions:

None
Facility/Provider Type: Nursing Home
Administrator: STEPHEN LOMONICO
Financial Officer: STEPHEN LOMONICO
Owner/Licensee: 3825 COUNTRYSIDE BOULEVARD OPERATIONS LLC
Owner/Licensee Since: 2/1/2012
NamePositionOwnership
EPSILON HEALTH CARE PROPERTIES, LLC 100%
CHRISTOPHER R BRYSONBOARD MEMBER/OFFICER0%
DANIEL E DIASBOARD MEMBER/OFFICER0%
KENNETH USSERYBOARD MEMBER/OFFICER0%
STEVEN A VAN CAMPBOARD MEMBER/OFFICER0%
TODD B MEHAFFEYBOARD MEMBER/OFFICER0%
Profit Status: For-Profit
Management Company: CMC II, LLC
Manager Since: 12/30/2011
NamePositionOwnership
LAVIE CARE CENTERS, LLC 100%
CHRISTOPHER R BRYSONBOARD MEMBER/OFFICER0%
DANIEL E DIASBOARD MEMBER/OFFICER0%
KENNETH USSERYBOARD MEMBER/OFFICER0%
STEVEN A VAN CAMPBOARD MEMBER/OFFICER0%
TODD B MEHAFFEYBOARD MEMBER/OFFICER0%
Licensed Beds: 120
Bed Types:
Community Beds : 120
Sheltered Beds : 0
Pediatric Beds : 0
Private Rooms : 10
2-Bed Rooms : 55
3-Bed Rooms : 0
4-Bed Rooms : 0
AHCA Number (File Number): 55263
AHCA Field Office: 05
License Number: 11060962
Current License Effective: 2/1/2018
Expires: 1/31/2020
License Status: LICENSED

Compare Quality and/or Pricing:

Services/Characteristics:

Current Daily Rate ($) of Semi-Private Room :  $271.00
Occupancy/Occupancy Rate :  114 / 94.82%
Continuing Care Retirement Community :  No
Adult Day Care Services :  No
Languages Spoken :  Spanish
Payment Forms Accepted :  CHAMPUS/TRICARE, Insurance and/or HMO, Medicaid, Medicare, Workers Compensation
Special Programs and Services :  24 hr Onsite RN Coverage, Alzheimer's, HIV Care, Hospice Care, Tracheotomy

Emergency Power Plan Summary:

Implementation Extended Until :  Jan 01, 2019

Legal Actions

Date InitiatedCase #Case TypeViolationFine AmountDate Imposed
10/31/2017 2017013314 Rule Variance/WaiverAdministrative Rule N/A 11/29/2017
12/09/2016 2016014165 Conditional LicenseSurvey N/A 11/02/2016
12/09/2016 2016014165 FineSurvey $1,000.00 05/17/2017
03/27/2014 2014003051 FineSurvey $2,500.00 09/10/2014
03/27/2014 2014003051 Conditional LicenseSurvey N/A 09/10/2014
Change of ownership occurred 3/16/2012
06/07/2007 2007007090 FineSurvey $7,500.00 01/25/2008
06/07/2007 2007007091 Conditional LicenseSurvey N/A 05/25/2007
11/08/2006 2006010935 FineSurvey $2,500.00 03/07/2007
11/08/2006 2006010936 Conditional LicenseSurvey N/A 10/19/2006
Please note the legal actions above may have been issued to a prior owner. The Final Order displays the name of the licensee responsible for the legal action that was taken.

Consumer Guides:



Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.
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