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1500 SOUTHGATE DRIVE
KISSIMMEE, FL 34746
Phone: (407) 846-7201
County: Osceola

Mailing Address

1500 SOUTHGATE DRIVE
KISSIMMEE, FL 34746
County: Osceola
Website: http://www.good-sam.com

Emergency Actions:

None
Facility/Provider Type: Nursing Home
Administrator: ROLAND MENEZIL
Financial Officer: SANDRA MONTALVO
Owner/Licensee: EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Owner/Licensee Since: 1/1/1996
Profit Status: Not-For-Profit
Licensed Beds: 170
Bed Types:
Community Beds : 170
Sheltered Beds : 0
Pediatric Beds : 0
Private Rooms : 20
2-Bed Rooms : 59
3-Bed Rooms : 8
4-Bed Rooms : 2
AHCA Number (File Number): 74902
AHCA Field Office: 07
License Number: 1267096
Current License Effective: 8/1/2018
Expires: 7/31/2020
License Status: LICENSED

Compare Quality and/or Pricing:

Services/Characteristics:

Current Daily Rate ($) of Semi-Private Room :  $281.00
Occupancy/Occupancy Rate :  156 / 91.80%
Continuing Care Retirement Community :  No
Adult Day Care Services :  No
Languages Spoken :  Creole, German, Other Language, Spanish
Payment Forms Accepted :  Insurance and/or HMO, Medicaid, Medicare, VA, Workers Compensation
Religious Affiliations :  Lutheran
Special Programs and Services :  24 hr Onsite RN Coverage, Alzheimer's, Alzheimers Secured Unit, Hospice Care, Pet Therapy, Respite

Emergency Power Plan Summary:

Onsite Alternate Power Source :  Fixed Generator
Emergency Power Supports :  Air Conditioning, Heating Systems, Life Safety Systems, Lights, Data & Phones, Refrigeration
Plan Approval :  May 24, 2018
Implementation Date :  Dec 28, 2017
Cooling Method :  Air Conditioner
Areas Cooled :  Common Areas, Dining Room, Entire Facility, Hallway, Living room
Areas Cooled Location :  Within Facility
Square Footage Cooled :  40,000
Number of People to use Cooled Space :  240

Legal Actions

Date InitiatedCase #Case TypeViolationFine AmountDate Imposed
02/08/2018 2018002080 Conditional LicenseSurvey N/A 04/18/2018
02/08/2018 2018002080 FineSurvey $2,500.00 04/18/2018
12/13/2017 2018008844 FineReporting $500.00 07/10/2018
10/19/2017 2017012729 Rule Variance/WaiverAdministrative Rule N/A 11/16/2017
08/22/2015 2015008976 Conditional LicenseSurvey N/A 06/22/2016
08/22/2015 2015008976 FineSurvey $2,500.00 06/22/2016
04/10/2014 2014003542 Conditional LicenseSurvey N/A 02/12/2014
04/10/2014 2014003542 FineSurvey $43,500.00 02/11/2015
04/10/2014 2014003542 Six month survey cycleSurvey N/A 02/12/2014
06/15/2005 2005005064 FineApplication $5,000.00 12/29/2005
08/02/2004 2004007283 FineSurvey $5,000.00 07/05/2005
08/02/2004 2004008349 Conditional LicenseSurvey N/A 07/15/2004
05/27/2004 2004004966 FineApplication $3,750.00 08/23/2004
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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