Provider Profile

LAKE EUSTIS HEALTHCARE AND REHABILITATION CENTER

Nursing Home

FACILITY PROFILE

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Facility Information:
Facility/Provider Type:Nursing Home
Administrator:DAVID ALPHONSO MCMILLON
Financial Officer:JOLENE BAKER
Owner/Licensee:LAKE EUSTIS OPERATING INVESTMENTS LLC
Owner/Licensee Since:4/1/2022

NamePositionOwnership
LAKE EUSTIS OPERATING HOLDINGS, LLC100%
Profit Status:For-Profit
Management Company:Not Available
Manager Since:Not Available
Licensed Beds:90
Bed Types:Total Capacity: 90
Community Beds: 90
Sheltered Beds: 0
Pediatric Beds: 0
Private Rooms: 4
2-Bed Rooms: 37
3-Bed Rooms: 4
4-Bed Rooms: 0
AHCA Number (File Number):33502
AHCA Field Office:03
License Number:12710951
Current License Effective:1/1/2025
Current License Expires:3/31/2026
License Status:LICENSED
Services/Characteristics
Current Daily Rate:375.00
Adult Day Care Services:No
Continuing Care Retirement Community:No
Languages Spoken:CreoleFilipinoSign LanguageSpanish
Payment Forms Accepted:Insurance and/or HMOMedicaidMedicareWorkers Compensation
Special Programs and Services:24 hr Onsite RN CoverageAlzheimer'sHIV CareHospice CareJCAHO accredited Long Term Care ProgramPet TherapyRespiteTracheotomyWeight Training
Emergency Power Plan Summary
Onsite Alternate Power Source:Fixed Generator
Emergency Power Supports:Air ConditioningHeating Systems
Plan Approval:8/21/2019
Implementation Date:8/26/2019
Implementation Extended Until:12/31/2018
Cooling Method:Air Conditioner
Areas Cooled:Common AreasHallwayResident Rooms
Square Footage Cooled:5000
Number of People to use Cooled Space:115
Legal Actions
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.
Date Initiated Case # Case Type Violation Fine Amount Date Imposed
3/10/20232023003971FineSurvey$500.007/5/2023
Change of ownership occurred 4/1/2022
8/25/20212021011988FineSurvey$500.009/20/2021
7/30/20192019012042Rule Variance/WaiverAdministrative Rule$0.008/26/2019
5/7/20192019007159Rule Variance/WaiverAdministrative Rule$0.006/11/2019
12/27/20182018018787Rule Variance/WaiverAdministrative Rule$0.002/4/2019
10/24/20172017012885Rule Variance/WaiverAdministrative Rule$0.0011/22/2017
Change of ownership occurred 12/4/2008

Important information and facility/provider definitions can be found in the Glossary.

Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.