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450 NORTH MCDONALD AVENUE
DELAND, FL 32724
Phone: (386) 738-0212
County: Volusia

Mailing Address

450 NORTH MCDONALD AVENUE
DELAND, FL 32724
County: Volusia
Website: http://www.good-sam.com

Emergency Actions:

None
Facility/Provider Type: Nursing Home
Administrator: MARK BARGLOF
Financial Officer: GEORGE GRANT TRIBBLE
Owner/Licensee: EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Owner/Licensee Since: 6/21/1996
Profit Status: Not-For-Profit
Licensed Beds: 60
Bed Types:
Community Beds : 55
Sheltered Beds : 5
Pediatric Beds : 0
Private Rooms : 10
2-Bed Rooms : 25
3-Bed Rooms : 0
4-Bed Rooms : 0
AHCA Number (File Number): 35960881
AHCA Field Office: 04
License Number: 130470963
Current License Effective: 12/1/2017
Expires: 11/30/2019
License Status: LICENSED

Compare Quality and/or Pricing:

Services/Characteristics:

Current Daily Rate ($) of Semi-Private Room :  $281.00
Occupancy/Occupancy Rate :  51 / 84.83%
Continuing Care Retirement Community :  Yes
Adult Day Care Services :  No
Languages Spoken :  Filipino, German, Spanish
Payment Forms Accepted :  CHAMPUS/TRICARE, Insurance and/or HMO, Medicaid, Medicare, VA, Workers Compensation
Religious Affiliations :  Lutheran
Special Programs and Services :  24 hr Onsite RN Coverage, Alzheimer's, Dialysis, Eden Alternative, Hospice Care, Pet Therapy, Respite, Tracheotomy

Emergency Power Plan Summary:

Plan Approval :  Nov 06, 2017
Implementation Extended Until :  Dec 01, 2018

Legal Actions

Date InitiatedCase #Case TypeViolationFine AmountDate Imposed
10/19/2017 2017012563 Conditional LicenseSurvey N/A 07/13/2017
10/19/2017 2017012563 FineSurvey $1,000.00 05/04/2018
10/19/2017 2017012732 Rule Variance/WaiverAdministrative Rule N/A 11/16/2017
09/21/2017 2017010988 FineSurvey $3,000.00 05/04/2018
09/21/2017 2017010988 Conditional LicenseSurvey N/A 07/13/2017
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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