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501 S PALM AVE
PALATKA, FL 32177
Phone: (386) 328-1472
County: Putnam

Mailing Address

501 S PALM AVE
PALATKA, FL 32177
County: Putnam

Emergency Actions:

Legal SanctionStatusBegin DateEnd Date
Moratorium Active 08/30/2019
Facility/Provider Type: Nursing Home
Administrator: BRENDA SMITH
Financial Officer: ANDREA HOBERG
Owner/Licensee: CRESTWOOD NURSING CENTER, INC
Owner/Licensee Since: 7/1/2005
NamePositionOwnership
ROBERT W HAGANBOARD MEMBER/OFFICER100%
Profit Status: For-Profit
Management Company: CARDINAL RESOURCES, LLC
Manager Since: 2/1/2013
NamePositionOwnership
ROBERT W HAGANBOARD MEMBER/OFFICER100%
MARY LU FLORYBOARD MEMBER/OFFICER0%
Licensed Beds: 65
Bed Types:
Community Beds : 65
Sheltered Beds : 0
Pediatric Beds : 0
Private Rooms : 1
2-Bed Rooms : 32
3-Bed Rooms : 0
4-Bed Rooms : 0
AHCA Number (File Number): 35402
AHCA Field Office: 03
License Number: 1454096
Current License Effective: 7/1/2019
Expires: 6/30/2020
License Status: CONDITIONAL

Compare Quality and/or Pricing:

Services/Characteristics:

Current Daily Rate ($) of Semi-Private Room :  $200.00
Continuing Care Retirement Community :  No
Adult Day Care Services :  No
Languages Spoken :  French, Other Language, Spanish
Payment Forms Accepted :  Insurance and/or HMO, Medicaid, Medicare, Workers Compensation
Special Programs and Services :  HIV Care, Hospice Care, Pet Therapy, Respite, Tracheotomy

Emergency Power Plan Summary:

Onsite Alternate Power Source :  Fixed Generator
Emergency Power Supports :  Air Conditioning, Life Safety Systems, Lights, Refrigeration
Plan Approval :  May 18, 2018
Implementation Extended Until :  Jan 01, 2019
Cooling Method :  Air Conditioner
Areas Cooled :  Resident Rooms
Areas Cooled Location :  Within Facility
Number of People to use Cooled Space :  65

Legal Actions

Date InitiatedCase #Case TypeViolationFine AmountDate Imposed
08/30/2019 2019013677 MoratoriumSurvey N/A 08/30/2019
05/31/2019 2019008665 Rule Variance/WaiverAdministrative Rule N/A 06/28/2019
12/07/2018 2018017911 Rule Variance/WaiverAdministrative Rule N/A 01/07/2019
10/18/2017 2017012459 Rule Variance/WaiverAdministrative Rule N/A 11/17/2017
04/02/2012 2012003647 FineSurvey $12,500.00 04/08/2013
04/02/2012 2012003647 Conditional LicenseSurvey N/A 04/08/2013
03/07/2011 2011002396 FineSurvey $2,500.00 09/16/2011
03/07/2011 2011002397 Conditional LicenseSurvey N/A 01/13/2011
05/06/2008 2008006036 FineApplication $500.00 10/29/2008
05/22/2007 2007005647 FineApplication $500.00 12/13/2007
04/11/2006 2006005545 FineSurvey $1,875.00 03/08/2007
03/08/2006 2006003897 FineSurvey $1,400.00 03/28/2007
03/08/2006 2006003898 Conditional LicenseSurvey N/A 03/02/2006
01/19/2006 2005010987 FineApplication $5,000.00 11/20/2006
Change of ownership occurred 12/30/2005
11/16/2005 2005009817 FineApplication $5,000.00 02/21/2006
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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