Aviata at Orange Park — nursing home in Orange Park, 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: 115.3 CMS, MDS-derived
CMS Certification Number: 105653
Certification status: Active CMS certification Verified
First approved (Medicare/Medicaid): Jan 9, 1990
Ownership type: Non profit - Corporation
Operator (legal business name): 1215 Kingsley Ave Opco LLC
CMS chain: Aviata Health Group 50 facilities
Phone: (904) 269-8922
Resident & family council: Resident
Sprinklers in all required areas: Yes
Official profile: Medicare Care Compare ↗

Inspection record · CMS window

Verified

Inspections

7

latest Nov 20, 2025

Citations

17

9 health · 8 fire

Harm or worse

0

no immediate jeopardy

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K·	L·
Actual harm	G·	H·	I·
Potential harm	D11	E5	F1
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: 105653
Program: Medicare and Medicaid
Medicare (SNF): Certified
Medicaid (NF): Certified
Certified beds: 120
First approved: Jan 9, 1990
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
Nov 20, 2025	Fire safety	Fire Safety Standard	5	Potential harm	—	Open →
Nov 20, 2025	Health	Health Standard	2	Potential harm	—	Open →
Jul 24, 2025	Health	Health Complaint	1	Potential harm	—	Open →
Nov 9, 2023	Fire safety	Fire Safety Standard	3	Potential harm	—	Open →
Nov 9, 2023	Health	Health Standard	1	Potential harm	—	Open →
Jan 21, 2022	Fire safety	Fire Safety Standard	0	No citations	—	Open →
Jan 21, 2022	Health	Health Standard	5	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	D11	E5	F1
Minimal	A·	B·	C·

By concept

Date	Tag	Deficiency	Scope / severity	Correction	Flags
Nov 20, 2025	K-0345	Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Dec 21, 2025
Nov 20, 2025	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Dec 21, 2025
Nov 20, 2025	K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Dec 21, 2025
Nov 20, 2025	K-0712	Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Dec 21, 2025
Nov 20, 2025	K-0761	To conduct inspection, testing and maintenance of fire doors by qualified individuals. Miscellaneous Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Dec 21, 2025
Nov 20, 2025	F-0803	Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. Nutrition and Dietary Deficiencies · Food, nutrition & hydration	D · Potential harm Isolated	Corrected Feb 16, 2026
Nov 20, 2025	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration	E · Potential harm Pattern	Corrected Feb 16, 2026
Jul 24, 2025	F-0600	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Sep 12, 2025	Complaint
Nov 9, 2023	K-0761	To conduct inspection, testing and maintenance of fire doors by qualified individuals. Miscellaneous Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Dec 14, 2023
Nov 9, 2023	K-0911	Meet requirements for the installation and maintenance of electrical systems. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Dec 14, 2023
Nov 9, 2023	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 Dec 14, 2023
Nov 9, 2023	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration	F · Potential harm Widespread	Corrected Dec 14, 2023
Jan 21, 2022	F-0565	Honor the resident's right to organize and participate in resident/family groups in the facility. Resident Rights Deficiencies · Resident rights & abuse/neglect	E · Potential harm Pattern	Corrected Mar 1, 2022
Jan 21, 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 Mar 1, 2022
Jan 21, 2022	F-0684	Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Mar 1, 2022
Jan 21, 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 Mar 1, 2022
Jan 21, 2022	F-0755	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Mar 1, 2022

“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 staffing3.33

State avg 3.86US avg 3.90

Registered nurse (RN)0.28

State avg 0.73US avg 0.69

Licensed practical nurse1.00

State avg 0.80US avg 0.86

Nurse aide2.06

State avg 2.33US avg 2.35

Weekend total nurse3.10

State avg 3.51US avg 3.43

Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 3.40 (case-mix index 1.37).

Staff turnover

Total nursing staff turnover55.6%

State avg 41.5%US avg 45.3%

Registered nurse turnover76.5%

State avg 46.1%US avg 42.5%

Administrators who left0

State avg 1US avg 1

Health survey score

Cycle 1 standard survey: Nov 20, 2025
Cycle 1 health score: 12
Total weighted score: 14

Operating entity

1215 Kingsley Ave 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
1215 Kingsley Ave Opco Parent LLC	Organization	Direct owner	DIRECT OWNERSHIP INTEREST	not provided	Dec 1, 2023
1215 Kingsley Ave Opco Holdco LLC	Organization	Indirect owner	INDIRECT OWNERSHIP INTEREST	not provided	Dec 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
1215 Kingsley Ave Opco Parent LLC	Organization	Direct owner	DIRECT OWNERSHIP INTEREST	not provided	Dec 1, 2023
1215 Kingsley Ave Opco Holdco LLC	Organization	Indirect owner	INDIRECT OWNERSHIP INTEREST	not provided	Dec 1, 2023
Amitai Dagan	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Jun 27, 2025
Abraham Goldberger	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Jun 27, 2025
Faigy Goldberger	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Jun 27, 2025
Eliezer Herskowitz	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Jun 27, 2025
Yaakov Herskowitz	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Jun 27, 2025
Aaron Travitsky	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Jun 27, 2025
Kalisha Boese	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Dec 4, 2024
Nochum Freund	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Dec 1, 2023
Samira Khazravan	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Oct 1, 2024
Nochum Freund	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Dec 1, 2023
Aspire Mgt LLC	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Dec 1, 2023
Kalisha Boese	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Dec 4, 2024
Samira Khazravan	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Oct 1, 2024

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: 1215 Kingsley Ave, Orange Park, FL 32073
ZIP: 32073
County: Clay County FIPS 12019
State: Florida
Urban / rural (CMS): Urban

Within ~25 km

Nearby nursing homes

Facility	Distance	Beds	Last inspection	Citations (window)	Fines
Oak View Health and Rehabilitation Center 833 Kingsley Ave, Orange Park, FL 32073 CCN 105586	0.8 km	120	Feb 27, 2025	27	—
Moosehaven 1701 Park Avenue, Orange Park, FL 32073 CCN 106077	1.8 km	72	Jun 5, 2026	2	—
Orange Park Rehabilitation and Nursing Center 2029 Professional Center Dr, Orange Park, FL 32073 CCN 105381	2.1 km	105	May 15, 2025	24	—
Life Care Center of Orange Park 2145 Kingsley Ave, Orange Park, FL 32073 CCN 105928	2.2 km	180	Feb 6, 2025	9	—
Life Care Center at Wells Crossing 355 Crossing Blvd, Orange Park, FL 32073 CCN 105962	2.2 km	120	Sep 11, 2025	17	—
Vivo Healthcare Orange Park 570 Wells Rd, Orange Park, FL 32073 CCN 105692	2.7 km	120	Nov 21, 2024	221 harm	—
Cedar Hill Nursing and Rehab Center 5888 Blanding Blvd, Jacksonville, FL 32244 CCN 105721	8.9 km	120	Apr 30, 2026	272 IJ	$22k
Pruitthealth - Fleming Island 2040 Town Center Blvd, Fleming Island, FL 32003 CCN 106124	9.2 km	97	Apr 15, 2026	103 IJ	$16k

Source	Record	Facts	Evidence	Source release	Retrieved
CMS Provider Information US-CMS	105653	name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain	Verified	Oct 1, 2026	Nov 7, 2026
CMS Provider Information US-CMS	105653	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 105653

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