01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-02-25 | 14 | 2026-02-25 | 9 |
| Cycle 2 | 2024-11-29 | 10 | 2024-11-29 | 10 |
| Cycle 3 | 2023-08-23 | 2 | 2023-08-23 | 12 |
CMS CCN 5054882026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Richmond Beach Rehab
19235 - 15Th Avenue Northwest · Shoreline, WA 98177 · King County
Certified beds131CMS provider file
Recent citation rows57current CMS citation release
Penalty rows1current 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
57 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 11 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-04-21 · 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 · 2026-05-22 · complaint2026-02-25 · HEALTHF0552Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
Correction field: Deficient, Provider has date of correction · 2026-04-032026-02-25 · HEALTHF0554Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
Correction field: Deficient, Provider has date of correction · 2026-04-032026-02-25 · HEALTHF0557Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Correction field: Deficient, Provider has date of correction · 2026-04-032026-02-25 · HEALTHF0585Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2026-04-032026-02-25 · HEALTHF0637Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Assess the resident when there is a significant change in condition
Correction field: Deficient, Provider has date of correction · 2026-04-032026-02-25 · 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 · 2026-04-032026-02-25 · 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 · 2026-04-032026-02-25 · 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 · 2026-04-032026-02-25 · HEALTHF0695Severity E · pattern; 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 · 2026-04-032026-02-25 · HEALTHF0755Severity E · pattern; 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 · 2026-04-032026-02-25 · 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 · 2026-04-032026-02-25 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2026-04-03 · complaint2026-02-25 · HEALTHF0883Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Correction field: Deficient, Provider has date of correction · 2026-04-03 · complaint2026-02-25 · FIREK0321Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2026-03-232026-02-25 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2026-03-232026-02-25 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2026-03-232026-02-25 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2026-03-232026-02-25 · FIREK0374Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Correction field: Deficient, Provider has date of correction · 2026-03-232026-02-25 · FIREK0521Severity F · widespread; potential for more than minimal harm
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Correction field: Deficient, Provider has date of correction · 2026-03-232026-02-25 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2026-03-232026-02-25 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2026-03-232026-02-25 · FIREK0921Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure that testing and maintenance of electrical equipment is performed.
Correction field: Deficient, Provider has date of correction · 2026-03-232025-01-10 · HEALTHF0686Severity D · isolated; potential for more than minimal 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 · 2025-02-07 · complaint03 / 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 |
|---|---|---|---|
| 2023-08-23 | Fine | $44,753 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- ARISO LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/06/2006
- ARI OPERATIONS, LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/06/2006
- AVAMERE GROUP LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/06/2006
- KARL RICKARD MILLER JR REVOCABLE TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 07/11/2011
- MILLER, KARLIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 07/01/2003
- MIDCAP FINCO LLCOrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 01/22/2010
- CAVALLO, GLENIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- FEAKIN, CODYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- FUNDERBERG, MICHELLEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- HASKINS, DAMIENIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 09/01/2025
- HILL, KEVINIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- HOSKINS, TONIAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- INSKEEP, TODDIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- KOFSTAD, MARYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- MUNRO, JOLYNNIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- OKOLI, IKEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- POLSON, JUSTINIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- POWELSON, MICHELEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
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 hours4.05per resident day
RN hours0.65per resident day
Weekend nurse hours3.57per resident day
Staff turnover31.0%CMS reported field
06 / LOCAL RECORDS
Open the Shoreline ledger →