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3612 E 138TH AVE
TAMPA, FL 33613
Phone: (813) 972-8775
County: Hillsborough

Mailing Address

3612 E 138TH AVE
TAMPA, FL 33613
County: Hillsborough
Website: http://www.palmgarden.com

Emergency Actions:

None
Facility/Provider Type: Nursing Home
Administrator: MICHELE L FORNEY
Financial Officer: MICHELE L FORNEY
Owner/Licensee: PALM GARDEN OF TAMPA LLC
Owner/Licensee Since: 11/1/2013
NamePositionOwnership
PALM GARDEN HEALTHCARE HOLDINGS, LLC 100%
ROBERT D. GREENEBOARD MEMBER/OFFICER0%
Profit Status: For-Profit
Management Company: PALM HEALTHCARE MANAGEMENT
Manager Since: 10/1/2014
NamePositionOwnership
PALM GARDEN HEALTHCARE HOLDINGS, LLC 100%
JEFFREY D. BOMBERGERBOARD MEMBER/OFFICER0%
JIM CHALMERSBOARD MEMBER/OFFICER0%
PATSY E MCCARVER TRUSTBOARD MEMBER/OFFICER0%
ROBERT D. GREENEBOARD MEMBER/OFFICER0%
Licensed Beds: 120
Bed Types:
Community Beds : 120
Sheltered Beds : 0
Pediatric Beds : 0
Private Rooms : 4
2-Bed Rooms : 58
3-Bed Rooms : 0
4-Bed Rooms : 0
AHCA Number (File Number): 62922
AHCA Field Office: 06
License Number: 1420095
Current License Effective: 11/1/2017
Expires: 10/31/2019
License Status: LICENSED

Compare Quality and/or Pricing:

Services/Characteristics:

Current Daily Rate ($) of Semi-Private Room :  $250.00
Occupancy/Occupancy Rate :  114 / 95.22%
Continuing Care Retirement Community :  No
Adult Day Care Services :  No
Languages Spoken :  Creole, French, Spanish
Payment Forms Accepted :  Insurance and/or HMO, Medicaid, Medicare, VA, Workers Compensation
Religious Affiliations :  Other
Special Programs and Services :  24 hr Onsite RN Coverage, HIV Care, Hospice Care, Pet Therapy, Respite, Tracheotomy

Emergency Power Plan Summary:

Onsite Alternate Power Source :  Fixed Generator
Emergency Power Supports :  Air Conditioning, Heating Systems, Life Safety Systems, Lights, washer and dryer, Refrigeration
Plan Approval :  Nov 01, 2017
Implementation Date :  May 22, 2018
Cooling Method :  Air Conditioner, Fans
Areas Cooled :  Dining Room, therapy gym, room 201, 203, 205, 207, Resident Rooms
Areas Cooled Location :  Within Facility
Square Footage Cooled :  4,288
Number of People to use Cooled Space :  120

Legal Actions

Date InitiatedCase #Case TypeViolationFine AmountDate Imposed
10/18/2017 2017012638 Rule Variance/WaiverAdministrative Rule N/A 11/28/2017
Change of ownership occurred 11/21/2013
02/05/2008 2008001523 FineReporting $500.00 04/21/2008
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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