Provider Profile
WILLOWBROOK
Assisted Living Facility
FACILITY PROFILE
Street Address
- 1580 SOUTH MARION AVENUE
LAKE CITY, FL 32025
County: Columbia - Phone: (386) 752-4454
Mailing Address
- 1580 SOUTH MARION AVENUE
LAKE CITY, FL 32025
County: Columbia - Phone: (386) 752-4454
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Assisted Living in FloridaLong-Term Care
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Facility Information:
| Facility/Provider Type: | Assisted Living Facility | |||||||||
| Administrator: | JOHNATHAN COGHLAN | |||||||||
| Financial Officer: | EAMON L BURGESS | |||||||||
| Owner/Licensee: | ETS WILLOWBROOK AT MARION LLC | |||||||||
| Owner/Licensee Since: | 7/25/2014 | |||||||||
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| Profit Status: | For-Profit | |||||||||
| Management Company: | Not Available | |||||||||
| Manager Since: | Not Available | |||||||||
| Licensed Beds: | 100 | |||||||||
| Bed Types: | Extended Congregate Care: 0 Private: 100 Optional State Supplement: 0 Total Capacity: 100 | |||||||||
| AHCA Number (File Number): | 11965555 | |||||||||
| AHCA Field Office: | 03 | |||||||||
| License Number: | 9909 | |||||||||
| Current License Effective: | 10/23/2024 | |||||||||
| Current License Expires: | 10/22/2026 | |||||||||
| License Status: | LICENSED | |||||||||
Services/Characteristics
| Medicaid Services: | Assistive Care Services |
| Activities: | Arts and CraftsExercise ClassesGames/CardsGardeningMusic ProgramsShoppingSocial 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: | English |
| Nurse Availability: | Direct 24hr |
| Payment Forms Accepted: | Insurance and/or HMOMedicaidVA |
Emergency Power Plan Summary
| Onsite Alternate Power Source: | Fixed Generator |
| Emergency Power Supports: | Air ConditioningHeating SystemsLife Safety SystemsLightsRefrigeration |
| Plan Approval: | 8/14/2018 |
| Implementation Date: | 8/6/2018 |
| Implementation Extended Until: | 7/30/2018 |
| Cooling Method: | Air Conditioner |
| Areas Cooled: | Common AreasDining RoomHallwayLiving roomResident Rooms |
| Areas Cooled Location: | Within Facility |
| Square Footage Cooled: | 26261 |
| Number of People to use Cooled Space: | 20 |
Legal Actions
| Date Initiated | Case # | Case Type | Violation | Fine Amount | Date Imposed |
|---|---|---|---|---|---|
| 9/5/2023 | 2023013332 | Fine | Survey | $1,000.00 | 10/16/2023 |
| Change of ownership occurred 7/25/2014 | |||||
| 7/21/2014 | 2014007205 | Fine | Application | $5,000.00 | 8/28/2014 |
| Change of ownership occurred 4/30/2013 | |||||
| 4/11/2013 | 2013003923 | Fine | Application | $2,500.00 | 5/29/2013 |
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.