Provider Profile
BONIFAY NURSING AND REHAB CENTER
Nursing Home
FACILITY PROFILE
Street Address
- 306 WEST BROCK AVENUE
BONIFAY, FL 32425
County: Holmes - Phone: (850) 547-9289
Mailing Address
- 306 WEST BROCK AVENUE
BONIFAY, FL 32425
County: Holmes - Phone: (850) 547-9289
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Facility Information:
| Facility/Provider Type: | Nursing Home | |||||||||
| Administrator: | ROBERT H BROWN | |||||||||
| Financial Officer: | DONALD K MELTON | |||||||||
| Owner/Licensee: | SOVEREIGN HEALTHCARE OF BONIFAY, LLC | |||||||||
| Owner/Licensee Since: | 10/1/2003 | |||||||||
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| Profit Status: | For-Profit | |||||||||
| Management Company: | SOUTHERN HEALTHCARE MANAGEMENT LLC | |||||||||
| Manager Since: | 10/1/2003 | |||||||||
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| Licensed Beds: | 180 | |||||||||
| Bed Types: | Total Capacity: 180 Community Beds: 180 Sheltered Beds: 0 Pediatric Beds: 0 Private Rooms: 12 2-Bed Rooms: 84 3-Bed Rooms: 0 4-Bed Rooms: 0 | |||||||||
| AHCA Number (File Number): | 22302 | |||||||||
| AHCA Field Office: | 02 | |||||||||
| License Number: | 10570961 | |||||||||
| Current License Effective: | 12/30/2024 | |||||||||
| Current License Expires: | 12/29/2026 | |||||||||
| License Status: | LICENSED | |||||||||
Services/Characteristics
| Current Daily Rate: | 280.00 |
| Adult Day Care Services: | No |
| Continuing Care Retirement Community: | No |
| Languages Spoken: | FilipinoSpanish |
| Payment Forms Accepted: | CHAMPUS/TRICAREInsurance and/or HMOMedicaidMedicareVAWorkers Compensation |
| Special Programs and Services: | Alzheimer'sDialysisHIV CareHospice CareJCAHO accredited Long Term Care ProgramRespiteTracheotomy |
Emergency Power Plan Summary
| Plan Approval: | 5/1/2018 |
| Implementation Date: | 4/25/2019 |
| Implementation Extended Until: | 1/1/2019 |
Legal Actions
| Date Initiated | Case # | Case Type | Violation | Fine Amount | Date Imposed |
|---|---|---|---|---|---|
| 5/2/2019 | 2019006878 | Rule Variance/Waiver | Administrative Rule | $0.00 | 6/13/2019 |
| 9/27/2018 | 2018014678 | Rule Variance/Waiver | Administrative Rule | $0.00 | 12/14/2018 |
| 7/17/2018 | 2018010353 | Conditional License | Survey | $0.00 | 6/13/2018 |
| 7/17/2018 | 2018010353 | Fine | Survey | $4,000.00 | 11/13/2019 |
| 10/13/2017 | 2017012182 | Rule Variance/Waiver | Administrative Rule | $0.00 | 11/9/2017 |
| 10/24/2016 | 2016012269 | Conditional License | Survey | $0.00 | 9/13/2016 |
| 10/24/2016 | 2016012269 | Fine | Survey | $2,500.00 | 10/5/2018 |
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.