Aviata at Countryside — nursing home in Palm Harbor, FL

Facility type: Nursing home · SNF / NF
CMS provider type: Medicare and Medicaid
Certified beds: 120 CMS-certified beds (not state-licensed beds)
Licensed beds: State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead.
Average residents per day: 112.9 CMS, MDS-derived
CMS Certification Number: 105587
Certification status: Active CMS certification Verified
First approved (Medicare/Medicaid): Oct 19, 1987
Ownership type: For profit - Individual
Operator (legal business name): Countryside Blvd Opco LLC
CMS chain: Aviata Health Group 50 facilities
Phone: (727) 784-2848
Resident & family council: Resident
Sprinklers in all required areas: Yes
Official profile: Medicare Care Compare ↗

Inspection record · CMS window

Verified

Inspections

8

latest Feb 19, 2025

Citations

27

16 health · 11 fire

Harm or worse

0

no immediate jeopardy

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K·	L·
Actual harm	G·	H·	I·
Potential harm	D26	E1	F·
Minimal	A·	B·	C·

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

CMS Five-Star ratings

Federal · CMS

Overall

Health inspections

Staffing

Quality measures

Penalties · about the last 3 years

Fines

0

$0

Payment denials

0

Latest

—

Federal certification

Federal · CMS

Authority: Centers for Medicare & Medicaid Services (CMS), surveyed by the state survey agency
CCN: 105587
Program: Medicare and Medicaid
Medicare (SNF): Certified
Medicaid (NF): Certified
Certified beds: 120
First approved: Oct 19, 1987
Located in a hospital: No
Status: Active CMS certification as of CMS release Oct 1, 2026
Evidence: Verified

State license

State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead. State coverage for Florida.

Federal certification and the state license are different records. A nursing home is licensed by the state and, separately, certified by CMS to bill Medicare and/or Medicaid. We link them by the CCN when the state publishes it; otherwise by exact address, house number and street, or exact name within the same ZIP, and label that link as inferred. Never by name alone.

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

Date	Domain	Survey types	Citations	Most severe	Open
Feb 19, 2025	Health	Health Complaint	1	Potential harm	—	Open →
Sep 19, 2024	Fire safety	Fire Safety Standard	3	Potential harm	—	Open →
Sep 19, 2024	Health	Health Standard	5	Potential harm	—	Open →
Mar 20, 2024	Health	Health Complaint	1	Potential harm	—	Open →
Sep 22, 2022	Fire safety	Fire Safety Standard	1	Potential harm	—	Open →
Sep 22, 2022	Health	Health Standard	8	Potential harm	—	Open →
Mar 17, 2021	Fire safety	Fire Safety Standard	7	Potential harm	—	Open →
Mar 17, 2021	Health	Health Standard	1	Potential harm	—	Open →

Enforcement

Penalties

Civil money penalties and denials of payment for new admissions, as published by CMS (about the last three years). Amounts may change on appeal.

No fines or payment denials in the CMS Penalties file for this CCN.

Scope × severity

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K·	L·
Actual harm	G·	H·	I·
Potential harm	D26	E1	F·
Minimal	A·	B·	C·

By concept

Date	Tag	Deficiency	Scope / severity	Correction	Flags
Feb 19, 2025	F-0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Mar 19, 2025	Complaint
Sep 19, 2024	E-0024	Establish policies and procedures for volunteers. Emergency Preparedness Deficiencies · Emergency preparedness	D · Potential harm Isolated	Corrected Oct 10, 2024
Sep 19, 2024	K-0345	Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Oct 10, 2024
Sep 19, 2024	K-0741	Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Miscellaneous Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Oct 10, 2024
Sep 19, 2024	F-0578	Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Oct 14, 2024
Sep 19, 2024	F-0759	Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Oct 14, 2024
Sep 19, 2024	F-0761	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Oct 14, 2024
Sep 19, 2024	F-0791	Provide or obtain dental services for each resident. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Oct 14, 2024
Sep 19, 2024	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention	E · Potential harm Pattern	Corrected Oct 14, 2024
Mar 20, 2024	F-0585	Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Apr 12, 2024	Complaint
Sep 22, 2022	K-0920	Ensure proper usage of power strips and extension cords. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Oct 28, 2022
Sep 22, 2022	F-0550	Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Oct 22, 2022
Sep 22, 2022	F-0582	Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Oct 22, 2022
Sep 22, 2022	F-0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Oct 22, 2022
Sep 22, 2022	F-0685	Assist a resident in gaining access to vision and hearing services. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Oct 22, 2022
Sep 22, 2022	F-0695	Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Oct 22, 2022
Sep 22, 2022	F-0759	Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Oct 22, 2022
Sep 22, 2022	F-0761	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Oct 22, 2022
Sep 22, 2022	F-0885	Report COVID19 data to residents and families. Infection Control Deficiencies · Infection prevention	D · Potential harm Isolated	Corrected Oct 22, 2022
Mar 17, 2021	K-0291	Install emergency lighting that can last at least 1 1/2 hours. Egress Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Apr 15, 2021
Mar 17, 2021	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Apr 15, 2021
Mar 17, 2021	K-0355	Properly select, install, inspect, or maintain portable fire extinguishes. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Apr 15, 2021
Mar 17, 2021	K-0712	Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Apr 15, 2021
Mar 17, 2021	K-0761	To conduct inspection, testing and maintenance of fire doors by qualified individuals. Miscellaneous Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Apr 15, 2021
Mar 17, 2021	K-0914	Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Apr 15, 2021
Mar 17, 2021	K-0918	Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Apr 15, 2021
Mar 17, 2021	F-0580	Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Apr 8, 2021

“Corrected” does not erase a citation: the historical finding stays listed with its disposition. Narrative statements of deficiencies are not part of the CMS dataset; see Care Compare for the official inspection report.

Five-Star ratings

Federal · CMS

Overallstate 3.3

Health inspectionsstate 2.9

Staffingstate 3.3

Quality measuresstate 4.3

Long-stay QM

Short-stay QM

CMS ratings apply to CMS-certified nursing homes only and are relative within each state. They are not a guarantee of any individual resident’s experience.

Nurse staffing · hours per resident per day

Total nurse staffing3.50

State avg 3.86US avg 3.90

Registered nurse (RN)0.78

State avg 0.73US avg 0.69

Licensed practical nurse0.56

State avg 0.80US avg 0.86

Nurse aide2.16

State avg 2.33US avg 2.35

Weekend total nurse3.25

State avg 3.51US avg 3.43

Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 3.75 (case-mix index 1.31).

Staff turnover

Total nursing staff turnover33.3%

State avg 41.5%US avg 45.3%

Registered nurse turnover53.1%

State avg 46.1%US avg 42.5%

Administrators who left1

State avg 1US avg 1

Health survey score

Cycle 1 standard survey: Sep 19, 2024
Cycle 1 health score: 24
Total weighted score: 28

Operating entity

Countryside Blvd Opco LLC

CMS legal business name of the certified provider. Operates this facility only.

VerifiedLinked by exact legal name

CMS chain

Aviata Health Group

50 facilities in 1 states. CMS chain ID 745.

VerifiedAssigned by CMS

Chain average overall rating (CMS): 2.3

Ownership disclosures

Disclosures

15

Organizations

3

Individuals

12

Direct & indirect ownership

Owners of record

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Countryside Parent LLC	Organization	Direct owner	DIRECT OWNERSHIP INTEREST	not provided	Sep 1, 2023
Palm Harbor Holdco LLC	Organization	Indirect owner	INDIRECT OWNERSHIP INTEREST	not provided	Sep 1, 2023

CMS Ownership file

All disclosed roles

Operator, owners, managers, officers and lenders are distinct roles and are never flattened into one entity. Organizations link across facilities by exact normalized legal name; individuals are listed per facility only.

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Countryside Parent LLC	Organization	Direct owner	DIRECT OWNERSHIP INTEREST	not provided	Sep 1, 2023
Palm Harbor Holdco LLC	Organization	Indirect owner	INDIRECT OWNERSHIP INTEREST	not provided	Sep 1, 2023
Amitai Dagan	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Jul 4, 2025
Abraham Goldberger	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Jul 4, 2025
Faigy Goldberger	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Jul 4, 2025
Eliezer Herskowitz	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Jul 4, 2025
Yaakov Herskowitz	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Jul 4, 2025
Aaron Travitsky	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Jul 4, 2025
Timothy Bailey	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Sep 1, 2023
Jeffrey Comandini	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Oct 19, 2023
Nochum Freund	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Sep 1, 2023
Nochum Freund	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Sep 1, 2023
Aspire Mgt LLC	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Sep 1, 2023
Timothy Bailey	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Sep 1, 2023
Jeffrey Comandini	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Oct 19, 2023

Same chain in Florida

All 49 in chain →

Facility	Beds	Last inspection	Citations (window)	Fines
Aviata at the Sea - Pasadena 1820 Shore Dr S, South Pasadena, FL 33707 CCN 105012	58	Feb 2, 2023	49	$41k
Aviata at Lakeside Oaks 1061 Virginia St, Dunedin, FL 34698 CCN 105132	93	Jul 30, 2026	291 harm	$8,788
Aviata at Emerald Shores 626 N Tyndall Pkwy, Callaway, FL 32404 CCN 105148	77	Jun 18, 2026	11	—
Aviata at Saint Lucie 611 S 13th St, Fort Pierce, FL 34950 CCN 105257	171	Jul 10, 2026	843 IJ	$65k
Aviata at the Sea - Pompano Beach 2401 NE 2nd Street, Pompano Beach, FL 33062 CCN 105258	83	Jul 1, 2025	50	—
Aviata at Sand Key 1980 Sunset Point Rd, Clearwater, FL 33765 CCN 105373	120	Aug 27, 2026	452 IJ1 harm1 open	$164k
Aviata at the Palms 2600 Highlands Blvd N, Palm Harbor, FL 34684 CCN 105394SFF CandidateAbuse icon	120	Jul 15, 2026	594 IJ	—
Aviata at Brooksville 1445 Howell Ave, Brooksville, FL 34601 CCN 105413	120	Sep 3, 2026	4615 open	—

No building or property record is linked to this facility yet. Parcel, assessor and building-permit joins will be added only where a valid site match exists.

Coordinates as published by CMS.

Address: 3825 Countryside Blvd N, Palm Harbor, FL 34684
ZIP: 34684
County: Pinellas County FIPS 12103
State: Florida
Urban / rural (CMS): Urban

Within ~25 km

Nearby nursing homes

Facility	Distance	Beds	Last inspection	Citations (window)	Fines
Palm Garden of Clearwater 3480 Mcmullen Booth Rd, Clearwater, FL 33761 CCN 105581	1.1 km	165	Jun 10, 2026	314 IJ	$17k
Westchester Gardens Health & Rehabilitation 3301 N Mcmullen Booth Rd, Clearwater, FL 33761 CCN 105654	1.8 km	120	Dec 3, 2025	15	—
Oakpark Health and Rehabilitation Center 2851 Tampa Rd, Palm Harbor, FL 34684 CCN 105708	2.1 km	180	Jan 12, 2026	35	—
St Mark Village 2655 Nebraska Ave, Palm Harbor, FL 34684 CCN 105378	3.3 km	80	May 28, 2026	9	—
Aviata at the Palms 2600 Highlands Blvd N, Palm Harbor, FL 34684 CCN 105394SFF CandidateAbuse icon	4.1 km	120	Jul 15, 2026	594 IJ	—
Aviata at Oldsmar 3865 Tampa Rd, Oldsmar, FL 34677 CCN 105419	4.4 km	120	Oct 21, 2024	471 harm	$23k
Aviata at the Harbor 1410 Dr Martin Luther King Jr St N, Safety Harbor, FL 34695 CCN 105549	5.9 km	120	Jun 10, 2026	44	—
Lake Haven Nursing and Rehab Center 1351 San Christopher Dr, Dunedin, FL 34698 CCN 105350	6.6 km	104	Aug 3, 2026	455 IJ2 harm	$282k

Source	Record	Facts	Evidence	Source release	Retrieved
CMS Provider Information US-CMS	105587	name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain	Verified	Oct 1, 2026	Nov 7, 2026
CMS Provider Information US-CMS	105587	ratings, staffing, health_survey_score Five-Star ratings and PBJ staffing apply to the CMS-certified universe only.	Verified	Oct 1, 2026	Nov 7, 2026

Record-level source links for CCN 105587

First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction