01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-06-27 | 16 | 2025-06-27 | 18 |
| Cycle 2 | 2024-06-28 | 20 | 2024-06-28 | 12 |
| Cycle 3 | 2023-03-22 | 12 | 2023-03-22 | 24 |
CMS CCN 5055202026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Mirabella
116 Fairview Avenue N · Seattle, WA 98109 · King County
Certified beds46CMS provider file
Recent citation rows102current CMS citation release
Penalty rows3current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
102 rows in the current release
2 rows carry G–L scope/severity codes; 0 carry J–L. 29 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-04-29 · HEALTHF0686Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2026-06-12 · complaint2025-09-18 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2025-09-26 · complaint2025-06-27 · FIREE0004Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2025-06-272025-06-27 · FIREE0007Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Address patient/client population and determine types of services needed.
Correction field: Deficient, Provider has date of correction · 2025-09-102025-06-27 · FIREE0015Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Address subsistence needs for staff and patients.
Correction field: Deficient, Provider has date of correction · 2025-07-172025-06-27 · FIREE0020Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish policies and procedures including evacuation.
Correction field: Deficient, Provider has date of correction · 2025-07-102025-06-27 · FIREE0025Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Create arrangements with other facilities to receive patients.
Correction field: Deficient, Provider has date of correction · 2025-10-092025-06-27 · FIREE0030Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
List the names and contact information of those in the facility.
Correction field: Deficient, Provider has date of correction · 2025-08-122025-06-27 · FIREE0031Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Provide emergency officials' contact information.
Correction field: Deficient, Provider has date of correction · 2025-09-172025-06-27 · FIREE0034Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Provide a means of sharing information on occupancy/needs.
Correction field: Deficient, Provider has date of correction · 2025-07-162025-06-27 · FIREE0035Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Provide family notifications of emergency plan.
Correction field: Deficient, Provider has date of correction · 2025-07-102025-06-27 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2025-09-172025-06-27 · HEALTHF0578Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2025-07-092025-06-27 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2025-07-012025-06-27 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2025-07-182025-06-27 · HEALTHF0645Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Correction field: Deficient, Provider has date of correction · 2025-07-162025-06-27 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2025-07-082025-06-27 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2025-07-022025-06-27 · HEALTHF0700Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Correction field: Deficient, Provider has date of correction · 2025-07-022025-06-27 · HEALTHF0732Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Correction field: Deficient, Provider has date of correction · 2025-06-302025-06-27 · HEALTHF0756Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Correction field: Deficient, Provider has date of correction · 2025-07-022025-06-27 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2025-07-032025-06-27 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2025-07-172025-06-27 · HEALTHF0838Severity C · widespread; potential for minimal harm
Administration Deficiencies
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Correction field: Deficient, Provider has date of correction · 2025-07-0303 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2026-04-29 | Fine | $15,185 | 0 |
| 2025-06-27 | Payment Denial | $0 | 12 |
| 2025-05-14 | Fine | $8,278 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- BURNSIDE, LEEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/01/2024
- ZASLAVSKY, OLEGIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/01/2024
- BURNSIDE, LEEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/01/2024
- CANDALLA, ALEXIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/21/2026
- ZASLAVSKY, OLEGIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2024
- PACIFIC RETIREMENT SERVICES INCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/04/2005
- CANDALLA, ALEXIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/21/2026
- FANG, AARONIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/01/2025
- FULLER, ELISEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/17/2025
- KIERNAN, JANETIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/16/2023
- SABATINI, ANTHONYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/20/2024
- PACIFIC RETIREMENT SERVICES INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 03/04/2005
- CANDALLA, ALEXIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/21/2026
- FANG, AARONIndividual · ADP OF THE SNFNOT APPLICABLE · since 11/01/2025
- FULLER, ELISEIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/17/2025
- KIERNAN, JANETIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/16/2023
- SABATINI, ANTHONYIndividual · ADP OF THE SNFNOT APPLICABLE · since 12/20/2024
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours4.38per resident day
RN hours1.51per resident day
Weekend nurse hours3.85per resident day
Staff turnover36.6%CMS reported field
06 / LOCAL RECORDS
Open the Seattle ledger →Other published facilities nearby
Avamere Rehabilitation At Park West137 beds · CMS overall 2/599 citation rowsAvamere Rehabilitation Of Shoreline115 beds · CMS overall 2/5141 citation rowsBailey-Boushay House35 beds · CMS overall 3/584 citation rowsBallard Center142 beds · CMS overall 2/5172 citation rowsCaroline Kline Galland Home205 beds · CMS overall 3/566 citation rowsCascades Of St Anne47 beds · CMS overall 2/5122 citation rowsColumbia Lutheran Home116 beds · CMS overall 4/573 citation rowsFircrest Nursing Facility110 beds · CMS overall 5/588 citation rows