Provider Profile
FRESH WATER AT HUDSON ALF, LLC
Assisted Living Facility
FACILITY PROFILE
Street Address
- 14108 OLD DIXIE HWY
HUDSON, FL 34667-1362
County: Pasco - Phone: (727) 379-1746
Mailing Address
- 10115 HOLY DR APT U10
EVERETT, WA 98204
County: - Phone: (727) 379-1746
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Facility Information:
| Facility/Provider Type: | Assisted Living Facility | ||||||
| Administrator: | TONY TO | ||||||
| Financial Officer: | TONY TO | ||||||
| Owner/Licensee: | FRESH WATER AT HUDSON ALF, LLC | ||||||
| Owner/Licensee Since: | 4/14/2022 | ||||||
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| Profit Status: | For-Profit | ||||||
| Management Company: | Not Available | ||||||
| Manager Since: | Not Available | ||||||
| Licensed Beds: | 17 | ||||||
| Bed Types: | Optional State Supplement: 0 Total Capacity: 17 Extended Congregate Care: 0 Private: 17 | ||||||
| AHCA Number (File Number): | 11964511 | ||||||
| AHCA Field Office: | 05 | ||||||
| License Number: | 9047 | ||||||
| Current License Effective: | 4/14/2023 | ||||||
| Current License Expires: | 4/13/2025 | ||||||
| License Status: | LICENSED | ||||||
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Services/Characteristics
| Medicaid Services: | Assisted Living Waiver |
| Activities: | Games/CardsShoppingSocial Events/Outings |
| Bed Hold Policy: | Facility will hold beds during a temporary absence |
| Adult Day Care Services: | No |
| Continuing Care Retirement Community: | No |
| Languages Spoken: | EnglishSpanish |
| Payment Forms Accepted: | MedicaidVA |
| Special Programs and Services: | Occupational TherapyPhysical Therapy |
Emergency Power Plan Summary
| Onsite Alternate Power Source: | Fixed Generator |
| Emergency Power Supports: | Air ConditioningLightsRefrigeration |
| Plan Approval: | 9/12/2018 |
| Implementation Date: | 5/30/2018 |
| Cooling Method: | Air Conditioner |
| Areas Cooled: | Entire Facility |
| Areas Cooled Location: | Within Facility |
| Square Footage Cooled: | 4000 |
| Number of People to use Cooled Space: | 17 |
Legal Actions
| Date Initiated | Case # | Case Type | Violation | Fine Amount | Date Imposed |
|---|---|---|---|---|---|
| 6/5/2024 | 2024007743 | Fine | Survey | $11,000.00 | 11/12/2024 |
| 6/5/2024 | 2024007746 | Fine | Survey | $1,000.00 | 11/12/2024 |
| 1/12/2024 | 2024000548 | Fine | Survey | $2,000.00 | 4/1/2024 |
| 11/7/2023 | 2023016637 | Fine | Survey | $5,000.00 | 4/1/2024 |
| 10/17/2023 | 2023015715 | Fine | Survey | $2,500.00 | 2/5/2024 |
| 10/10/2023 | 2023015295 | Fine | Survey | $5,000.00 | 4/1/2024 |
| Change of ownership occurred 4/14/2023 | |||||
| 9/16/2019 | 2019014454 | Fine | Survey | $1,000.00 | 11/26/2019 |
| 9/16/2019 | 2019014459 | Fine | Survey | $500.00 | 11/26/2019 |
| 9/16/2019 | 2019014458 | Fine | Survey | $3,500.00 | 11/26/2019 |
| 4/26/2019 | 2019008422 | Fine | Survey | $1,000.00 | 11/26/2019 |
| 4/26/2019 | 2019008423 | Fine | Survey | $1,000.00 | 11/26/2019 |
| 4/8/2019 | 2019012280 | Fine | Reporting | $500.00 | 9/6/2019 |
| 4/8/2019 | 2019012281 | Fine | Reporting | $500.00 | 9/30/2019 |
| 2/20/2019 | 2019002752 | Fine | Survey | $2,000.00 | 11/26/2019 |
| 12/17/2018 | 2019002757 | Fine | Survey | $1,000.00 | 11/26/2019 |
| 10/24/2018 | 2019014450 | Fine | Survey | $500.00 | 11/26/2019 |
| 5/11/2016 | 2016008568 | Fine | Survey | $500.00 | 3/20/2018 |
| 5/20/2014 | 2014004998 | Fine | Survey | $1,000.00 | 7/1/2014 |
| Change of ownership occurred 5/2/2014 | |||||
| Change of ownership occurred 6/8/2006 | |||||
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.