Tag 0641 · Severity D
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · Deficient, Provider has plan of correction 2026-07-11For-profit
Lake Port Square Health Center
701 Lake Port Blvd, Leesburg, FL 34748
(352) 728-3366 · Healthpeak Properties, INC.
At a glance
CMS data snapshot: 2026-08-01 · Sources and limitations
| Ownership | For profit - Limited Liability company | Certified beds | 80 |
|---|---|---|---|
| Estimated occupancy | 93.6% | Latest inspection | 2026-06-11 |
County and Florida comparison
Navy: facility · Teal: county · Gray: Florida
Overall rating
Facility: 3 of 5
Health-inspection score
Facility: 35.0 points
Total nurse staffing
Facility: 4.03 hours/day
RN staffing
Facility: 0.82 hours/day
Staff turnover
Facility: 51.2%
Latest health deficiencies
Facility: 9 deficiencies
View data table
| Metric | Facility | County | Florida |
|---|---|---|---|
| Overall rating | 3 of 5 | 4 of 5 | 3 of 5 |
| Health-inspection score | 35.0 points | 35.0 points | 38.5 points |
| Total nurse staffing | 4.03 hours/day | 3.66 hours/day | 3.63 hours/day |
| RN staffing | 0.82 hours/day | 0.51 hours/day | 0.62 hours/day |
| Staff turnover | 51.2% | 46.0% | 41.8% |
| Latest health deficiencies | 9 deficiencies | 7 deficiencies | 6 deficiencies |
Comparisons describe CMS data; they are not recommendations.
Inspection history
2026-06-11
9 deficiencies
Highest severity: D
Immediate-jeopardy citations: 0
Tag 0644 · Severity D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Resident Assessment and Care Planning Deficiencies · Deficient, Provider has plan of correction 2026-07-11Tag 0684 · Severity D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · Deficient, Provider has plan of correction 2026-07-11Tag 0692 · Severity D
Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care Deficiencies · Deficient, Provider has plan of correction 2026-07-11Tag 0695 · Severity D
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · Deficient, Provider has plan of correction 2026-07-11Tag 0761 · Severity D
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 · Deficient, Provider has plan of correction 2026-07-11Tag 0812 · Severity D
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · Deficient, Provider has plan of correction 2026-07-11Tag 0814 · Severity D
Dispose of garbage and refuse properly.
Nutrition and Dietary Deficiencies · Deficient, Provider has plan of correction 2026-07-11Tag 0842 · Severity D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · Deficient, Provider has plan of correction 2026-07-112025-02-13
7 deficiencies
Highest severity: D
Immediate-jeopardy citations: 0
Tag 0641 · Severity D
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction 2025-03-25Tag 0656 · Severity D
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 · Deficient, Provider has date of correction 2025-03-25Tag 0695 · Severity D
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2025-03-25Tag 0761 · Severity D
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 · Deficient, Provider has date of correction 2025-03-25Tag 0812 · Severity D
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction 2025-03-25Tag 0842 · Severity D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction 2025-03-25Tag 0880 · Severity D
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · Deficient, Provider has date of correction 2025-03-252023-10-25
12 deficiencies
Highest severity: E
Immediate-jeopardy citations: 0
Tag 0695 · Severity E
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2023-11-28Tag 0756 · Severity E
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Pharmacy Service Deficiencies · Deficient, Provider has date of correction 2023-11-28Tag 0641 · Severity D
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction 2023-11-28Tag 0656 · Severity D
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 · Deficient, Provider has date of correction 2023-11-28Tag 0686 · Severity D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2023-11-28Tag 0689 · Severity D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2023-11-28Tag 0761 · Severity D
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 · Deficient, Provider has date of correction 2023-11-28Tag 0770 · Severity D
Provide timely, quality laboratory services/tests to meet the needs of residents.
Administration Deficiencies · Deficient, Provider has date of correction 2023-11-28Tag 0842 · Severity D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction 2023-11-28Tag 0880 · Severity D
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · Deficient, Provider has date of correction 2023-11-28Tag 0732 · Severity C
Post nurse staffing information every day.
Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction 2023-11-28Staffing composition
2.27 hours/dayNurse aide
0.94 hours/dayLPN
0.82 hours/dayRN
- Total staffing
- 4.03 hours/day
- County median
- 3.66 hours/day
- Florida median
- 3.63 hours/day
- Weekend total
- 3.65 hours/day
- Staff turnover
- 51.2%
- RN turnover
- 68.4%
Reported averages, not a real-time staffing schedule.
Resident outcomes
Lower is generally better
Hospitalizations
1.7 per 1,000 daysbetterFlorida: 2.1 per 1,000 days · County: 1.8 per 1,000 days20250101-20251231
Emergency-department visits
1.2 per 1,000 daysworseFlorida: 1.0 per 1,000 days · County: 1.3 per 1,000 days20250101-20251231
Falls with major injury
2.0%betterFlorida: 2.2% · County: 1.8%2025Q2-2026Q1
Pressure ulcers
6.8%worseFlorida: 4.2% · County: 4.6%2025Q2-2026Q1
Urinary tract infections
0.0%unavailableFlorida: 0.0% · County: 0.0%2025Q2-2026Q1
Antipsychotic medication use
2.7%betterFlorida: 7.0% · County: 5.1%2025Q2-2026Q1
These group measures do not predict an individual resident’s experience.
Questions to ask
Use these prompts during a tour or phone call
What is driving staff turnover, and what is being done to retain nurses and aides?
Suggested because of: staff turnoverHow does the care team prevent and treat pressure injuries?
Suggested because of: pressure ulcersHow will the care plan be developed, reviewed, and shared with our family?
Suggested because of: general care planning
Facility Details
- County
- Lake County
- Certified beds
- 80
- Average daily residents
- 74.9
- Ownership
- For profit - Limited Liability company
- Provider type
- Medicare and Medicaid
- In hospital
- No
- Date certified
- 1990-08-27
- CCN
- 105705
Staffing Data
| Reported measure | Value |
|---|---|
| Nurse aide hours | 2.27335 |
| Lpn hours | 0.94013 |
| Rn hours | 0.81971 |
| Reported total hours | 4.03319 |
| Weekend total hours | 3.6531 |
| Weekend rn hours | 0.46207 |
| Adjusted total hours | 4.00768 |
| Total turnover percent | 51.2 |
| Rn turnover percent | 68.4 |
| Administrators left | 2 |
Hours are per resident per day; turnover values are percentages. Missing values are not zero.
Penalties & Enforcement
$0.00Total fines
0Number of fines
0Payment denials
No matching penalties in the supplied CMS records.
Totals reflect the supplied CMS records, not a lifetime total.
Citations
9Health citations
8Fire safety citations
Health counts describe the latest rating cycle. Fire counts cover supplied fire-safety records.
Serious Deficiencies
FL counts scope/severity G–L as serious deficiencies. Immediate jeopardy is J–L; these are not interchangeable.
0
Ownership & Operators
| Name | Role | Share |
|---|---|---|
| CCRC OPCO VENTURES, LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% |
| HCP MA3 GP HOLDING, LLC | INDIRECT OWNERSHIP INTEREST | NOT APPLICABLE |
| HCP VENTURES II TRS LLC | INDIRECT OWNERSHIP INTEREST | NOT APPLICABLE |
| JANUS LIVING TRS LLC | INDIRECT OWNERSHIP INTEREST | NOT APPLICABLE |
| JANUS LIVING OP LLC | 5% OR GREATER SECURITY INTEREST | NOT APPLICABLE |
| CHENG, PATRICK | MANAGING CONTROL - GOVERNING BODY | NOT APPLICABLE |
| MOHADEO, TRISTAN | MANAGING CONTROL - GOVERNING BODY | NOT APPLICABLE |
| RUSSO, FRANK | MANAGING CONTROL - GOVERNING BODY | NOT APPLICABLE |
| LIFE CARE SERVICES LLC | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| BUETTNER, MARKUS | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| MARTINEZ IRIZARRY, AXEL | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| MOHADEO, TRISTAN | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| VALLEJO AGUDELO, ANDRES | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| HCP MA3, LP | LIMITED PARTNERSHIP INTEREST | NOT APPLICABLE |
| HCP PARTNERS LP | LIMITED PARTNERSHIP INTEREST | NOT APPLICABLE |
| BLACKROCK INC | ADP OF THE SNF | NOT APPLICABLE |
| CCRC PROPCO VENTURES, LLC | ADP OF THE SNF | NOT APPLICABLE |
| HCP MA3, LP | ADP OF THE SNF | NOT APPLICABLE |
| HCP PARTNERS LP | ADP OF THE SNF | NOT APPLICABLE |
| HCP S-H 2014 MEMBER LLC | ADP OF THE SNF | NOT APPLICABLE |
| HCP VENTURES II PARTNER LLC | ADP OF THE SNF | NOT APPLICABLE |
| HCP/LS 2011 REIT, LLC | ADP OF THE SNF | NOT APPLICABLE |
| HEALTHPEAK OP LLC | ADP OF THE SNF | NOT APPLICABLE |
| HEALTHPEAK PROPERTIES INC | ADP OF THE SNF | NOT APPLICABLE |
| JANUS LIVING OP LLC | ADP OF THE SNF | NOT APPLICABLE |
| JANUS LIVING, INC. | ADP OF THE SNF | NOT APPLICABLE |
| JANUS MEMBER, LLC | ADP OF THE SNF | NOT APPLICABLE |
| LIFE CARE SERVICES LLC | ADP OF THE SNF | NOT APPLICABLE |
| OCEAN ACQUISITION I LLC | ADP OF THE SNF | NOT APPLICABLE |
| STATE STREET CORPORATION | ADP OF THE SNF | NOT APPLICABLE |
| VANGUARD GROUP INC | ADP OF THE SNF | NOT APPLICABLE |
| MARTINEZ IRIZARRY, AXEL | ADP OF THE SNF | NOT APPLICABLE |
| MOHADEO, TRISTAN | ADP OF THE SNF | NOT APPLICABLE |
| VALLEJO AGUDELO, ANDRES | ADP OF THE SNF | NOT APPLICABLE |
Helpful resources
Educational information, not medical or legal advice. Data & methodology