Consulate Health Care of Winter Haven
2701 Lake Alfred Rd, Winter Haven, FL 33881


Consulate Health Care of Winter Haven is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 105998. The address is 2701 Lake Alfred Rd, Winter Haven, FL 33881. The zip code is 33881. The phone number is 8632985000.


Consulate Health Care of Winter Haven · 2701 Lake Alfred Rd, Winter Haven, FL 33881

Federal Provider Number 105998
Provider Name CONSULATE HEALTH CARE OF WINTER HAVEN
Address 2701 LAKE ALFRED RD
WINTER HAVEN, FL 33881
Phone Number 8632985000
SSA County Code 520
County Name Polk
Ownership Type For profit - Corporation
Certified Beds 120
Certified Beds Residents 112
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name WINTER HAVEN FACILITY OPERATIONS LLC
Date First Approved to Provide Medicare Medicaid Services 10/02/1998
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 2
Health Inspection Rating 2
Quality Measure Rating 4
Staffing Rating 3
RN Staffing Rating 2
Reported CNA Staffing Hours per Resident per Day 2.82991
Reported LPN Staffing Hours per Resident per Day 1.05893
Reported RN Staffing Hours per Resident per Day 0.46339
Reported Licensed Staffing Hours per Resident per Day 1.52232
Reported Total Nurse Staffing Hours per Resident per Day 4.35223
Reported Physical Therapist Staffing Hours per Resident Per Day 0.08036
Expected CNA Staffing Hours per Resident per Day 2.3871
Expected LPN Staffing Hours per Resident per Day 0.65727
Expected RN Staffing Hours per Resident per Day 1.13954
Expected Total Nurse Staffing Hours per Resident per Day 4.1839
Adjusted CNA Staffing Hours per Resident per Day 2.90887
Adjusted LPN Staffing Hours per Resident per Day 1.33722
Adjusted RN Staffing Hours per Resident per Day 0.30385
Adjusted Total Nurse Staffing Hours per Resident per Day 4.19307
Cycle 1 Total Number of Health Deficiencies 9
Cycle 1 Number of Standard Health Deficiencies 4
Cycle 1 Number of Complaint Health Deficiencies 5
Cycle 1 Health Deficiency Score 36
Cycle 1 Standard Survey Health Date 01/27/2017
Cycle 1 Number of Health Revisits 2
Cycle 1 Health Revisit Score 18
Cycle 1 Total Health Score 54
Cycle 2 Total Number of Health Deficiencies 9
Cycle 2 Number of Standard Health Deficiencies 3
Cycle 2 Number of Complaint Health Deficiencies 6
Cycle 2 Health Deficiency Score 40
Cycle 2 Standard Health Survey Date 09/25/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 40
Cycle 3 Total Number of Health Deficiencies 9
Cycle 3 Number of Standard Health Deficiencies 4
Cycle 3 Number of Complaint Health Deficiencies 5
Cycle 3 Health Deficiency Score 36
Cycle 3 Standard Health Survey Date 06/06/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 36
Total Weighted Health Survey Score 46.333
Number of Substantiated Complaints 13
Number of Fines 3
Total Amount of Fines in Dollars $14136.00
Total Number of Penalties 3
Processing Date 08/01/2017

Owner or Manager · Consulate Health Care of Winter Haven

Owner Name Role Association Date
ALG LAVIE, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
BRYSON, CHRISTOPHER (Individual) OPERATIONAL/MANAGERIAL CONTROL since 09/01/2015
CMC II INVESTORS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
CMC II LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 07/31/2012
COLUMBIA PACIFIC OPPORTUNITY FUND (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
CONTE, JOSEPH (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
DIAS, DANIEL (Individual) OPERATIONAL/MANAGERIAL CONTROL since 09/01/2015
FC INVESTORS XXI, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
FC LV HOLDCO LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
HARTMAN, ROBERT (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
KASE, RICHARD (Individual) OFFICER since 10/03/2016
LAVIE CARE CENTERS, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
LOW, ASHER (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
LV CHC HOLDINGS I LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 10/01/2012
LV INVESTMENT, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
LV OPERATIONS I, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
LV OPERATIONS II, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
MCP LAVIE, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
MEHAFFEY, TODD (Individual) OPERATIONAL/MANAGERIAL CONTROL since 09/14/2016
NEUBERGER, ISAAC (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
RAGLAND, RUSSELL (Individual) OPERATIONAL/MANAGERIAL CONTROL since 07/01/2014
ROLAND, CARA (Individual) MANAGING EMPLOYEE since 03/14/2016
SAY LA VIE, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
SENIOR CARE LAVIE, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
THE 1995 DAVID REIS FAMILY TRUST (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2012
USSERY, KENNETH (Individual) OFFICER since 04/06/2016
USSERY, KENNETH (Individual) OPERATIONAL/MANAGERIAL CONTROL since 09/01/2015

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