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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: SANDRA A RYCZEK
Financial Officer: RUSSELL D RAGLAND JR
Owner/Licensee: 3825 COUNTRYSIDE BOULEVARD OPERATIONS LLC
Owner/Licensee Since: 2/1/2012
NamePositionOwnership
EPSILON HEALTH CARE PROPERTIES, LLC 100%
SANDRA A RYCZEKBOARD 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%
RUSSELL D RAGLANDBOARD 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: 12/2/2016
Expires: 1/31/2018
License Status: LICENSED

Compare Quality and/or Pricing:

Services/Characteristics:

Current Daily Rate ($) of Semi-Private Room :  $245.00
Occupancy/Occupancy Rate :  110 / 91.43%
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, HIV Care, Hospice Care, Tracheotomy

Legal Actions

Date ImposedCase #Case TypeViolationFine Amount
05/17/2017 2016014165 Conditional LicenseSurvey N/A
05/17/2017 2016014165 FineSurvey $1,000.00
09/10/2014 2014003051 Conditional LicenseSurvey N/A
09/10/2014 2014003051 FineSurvey $2,500.00
01/25/2008 2007007090 FineSurvey $7,500.00
05/25/2007 2007007091 Conditional LicenseSurvey N/A
03/07/2007 2006010935 FineSurvey $2,500.00
10/19/2006 2006010936 Conditional LicenseSurvey N/A
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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