3641 MEMORIAL BLVD, KINGSPORT, TN 37664 · CCN 445295
Composite
81.9 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
204
Model
v1.2
Reads as: riskier than 81.9% of the 14,684 facilities in the snf peer group. percentile within peer group, 100 = highest risk. Grade bands are fixed percentile cuts (F is the top 5% of peer risk), so a grade is a position, not an absolute level.
weighted_contribution sums to pre_rank_index over rows where counts_toward_index is true. The composite is the facility's percentile position of that index within its peer group, so contributions explain the input, and the rank explains the score.
ML signals — parallel engine
1
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
8 chains
HERZKA YISROEL
70 facilities
Findings from the always-on scanning layer: anomalies on this facility, connections through its current owners and past buyers. Runs beside the deterministic composite, never inside it. Full board on the ML Lab page.
Change-of-ownership footprint in the CMS Provider of Services file: control-family, legal-name and address deltas across quarterly snapshots, plus certification reset recency and Medicare tenure.
R23/W4-3. Deterministic logistic p(Medicare termination within 12m), SNF only. Label = first POS termination date (any code: voluntary closure, involuntary termination, merger exit); facilities already terminated by the panel date are excluded, not counted as safe. Trained on panels 2024-07/2024-10/2025-01 (n=46,466, 283 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.971, top-decile lift 9.5x, top-decile capture 95.4% of the 65 terminations that followed. Separability is high because closures announce themselves in the data: collapsing occupancy is the strongest signal, and the learned NEGATIVE weight on 12m deficiency counts is the surveys-stop signature of a facility winding down, not a claim that clean inspections are dangerous. Same 15 as-of-date features and anti-leakage chassis as p_chow_12m; SFF entry rejected as a label (only one month of SFF history exists, so as-of transitions cannot be reconstructed). Score = probability x 100; grade NULL. Not in any composite.
R22/W4-2. Deterministic logistic p(CHOW within 12m), SNF only. Trained on panels 2024-07/2024-10/2025-01 (n=50,700, 1,207 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.874, top-decile lift 5.0x (top 10% of predictions captured 49.6% of the CHOWs that actually closed in the next 12 months). Shipped coefficients are the evaluated ones; no post-holdout refit. Caveat: holdout positives (133) run below the training base rate because recent CHOWs surface in public records with a lag, so measured lift is conservative. Features are as-of-date public records: PBJ staffing level/trend/contract share (quarterly history to 2022Q1), deficiency and CMP counts (12m), ownership tenure and churn from CHOW-evidenced transactions, beds, occupancy, ownership type, chain size. Chain membership and ownership type are current-state (history not published). SFF and star ratings deliberately excluded (no as-of history). Notable learned direction: long ownership tenure RAISES sale odds and a recent prior CHOW lowers them. Score = probability x 100; grade is NULL because a probability is not a quality letter. Not in any composite.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Rows with counts_toward_composite false come from models that are addressable or retracted rather than default. They exist and may be informative, but they did not enter the published composite and must not be summed as though they had.
p_adverse_action_12m: probability the facility's Medicare participation terminates within 12 months (any POS termination code; already-terminated facilities are excluded, not scored safe). Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.971, top-decile lift 9.5x. Closures announce themselves: collapsing occupancy dominates, and fewer recent surveys is a winding-down signature. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models. | p_chow_12m: probability of a change of ownership within 12 months. Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.874, top-decile lift 5.0x. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models for full notes.
Probability the facility's Medicare participation ends within 12 months, from public records only. Red bars raise exit odds. A negative pull from deficiencies is the winding-down signature — surveys stop as a facility empties — not evidence that clean inspections are dangerous.
Staffing vs peers
16
2025Q4 HPRD
This facility
TN median
National median
National p25–p75
Total nurse
3.53
3.28
3.28
2.90–3.77
RN
0.17
0.34
0.39
0.25–0.58
Weekend total
3.37
3.10
3.11
—
Weekday total
3.59
3.36
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
135.5
3.53
0.17
1.05
2.31
3.37
29.8%
2025Q3
92
132.4
3.58
0.19
1.09
2.30
3.38
23.0%
2025Q2
91
132.2
3.60
0.12
1.06
2.43
3.45
16.5%
2025Q1
90
134.0
3.08
0.09
1.02
1.98
2.92
1.7%
2024Q4
92
126.7
3.48
0.04
1.13
2.32
3.35
6.7%
2024Q3
92
121.7
3.66
0.08
1.17
2.41
3.52
6.4%
2024Q2
91
118.4
3.63
0.12
1.17
2.34
3.42
2.7%
2024Q1
91
123.0
3.15
0.17
1.01
1.97
3.05
7.8%
2023Q4
92
115.2
3.03
0.26
0.85
1.92
2.88
6.1%
2023Q3
92
103.5
2.99
0.26
0.87
1.85
2.82
3.7%
2023Q2
91
98.3
2.72
0.28
0.93
1.51
2.53
9.3%
2023Q1
90
101.3
2.66
0.30
0.98
1.39
2.52
0.0%
2022Q4
92
93.5
3.00
0.33
0.99
1.68
2.75
0.0%
2022Q3
92
96.9
2.89
0.23
1.03
1.64
2.60
0.1%
2022Q2
91
94.1
2.96
0.24
1.02
1.70
2.52
1.9%
2022Q1
90
91.7
3.04
0.32
1.03
1.69
2.82
4.9%
HPRD is census-weighted: total hours over the quarter divided by total resident-days, not an average of daily ratios. Source is CMS Payroll-Based Journal daily records; only SNFs report PBJ, so other settings legitimately return zero rows.
Protect each resident from the wrongful use of the resident's belongings or money.
D
2025-12-05
2025-11-17
Health
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
2025-12-05
2025-11-17
Health
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
2025-12-05
2025-11-17
Health
F0657
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
2025-12-05
2025-11-17
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2025-12-05
2025-11-17
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2025-12-05
2025-11-17
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2025-12-05
2025-11-17
Health
F0814
Dispose of garbage and refuse properly.
E
2025-12-05
2025-11-17
Health
F0880
Provide and implement an infection prevention and control program.
E
2025-12-05
2024-03-05
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2024-04-01
2024-03-05
Health · complaint
F0641
Ensure each resident receives an accurate assessment.
D
2024-04-01
2024-03-05
Health
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
2024-04-01
2024-03-05
Health
F0657
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
2024-03-25
2024-03-05
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-04-01
2024-03-05
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-04-01
2024-03-05
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2024-03-25
2024-03-05
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2024-03-25
2024-03-05
Health
F0849
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
D
2024-04-01
2024-03-05
Health
F0880
Provide and implement an infection prevention and control program.
D
2024-04-01
2023-11-09
Health · complaint
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
D
2023-12-20
2020-01-14
Health
F0553
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
D
2020-02-28
2020-01-14
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2020-02-28
2020-01-14
Health
F0770
Provide timely, quality laboratory services/tests to meet the needs of residents.
D
2020-02-28
scope_severity uses the CMS letter grid: A is least serious, L most. J, K and L are immediate jeopardy. Rows are the surveyor's findings of record, not the model's opinion.
Licensure actions
0
No licensure actions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Ownership
19
Owner
Role
Pct
From
Status
Source
FH SNF OPERATIONS HOLDING LLC
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2022-01-01
current
pecos_ownership
CH FH HOLDING LLC
ADP OF THE SNF
—
2022-01-01
current
pecos_ownership
FH OPCO MANAGER LLC
ADP OF THE SNF
—
2025-12-30
current
pecos_ownership
FH OPCO MANAGER LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2022-01-01
current
pecos_ownership
GOODMAN, MENUCHA
OPERATIONAL/MANAGERIAL CONTROL
—
2025-12-01
current
pecos_ownership
HERZKA, YISROEL
ADP OF THE SNF
—
2022-01-01
current
pecos_ownership
KELLY, JOHNATHAN
OPERATIONAL/MANAGERIAL CONTROL
—
2024-10-14
current
pecos_ownership
MELB OPCO MANAGER LLC
ADP OF THE SNF
—
2025-12-29
current
pecos_ownership
MELB OPCO MANAGER LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2025-12-01
current
pecos_ownership
MS FH HOLDINGS LLC
5% OR GREATER INDIRECT OWNERSHIP INTEREST
—
2022-01-01
current
pecos_ownership
SS FH HOLDINGS LLC
5% OR GREATER INDIRECT OWNERSHIP INTEREST
—
2022-01-01
current
pecos_ownership
STRAUSS, SUSAN
INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
—
2025-12-30
current
pecos_ownership
THEERATHORN, PITCHAR
ADP OF THE SNF
—
2025-06-30
current
pecos_ownership
VERTEX FINANCIAL SERVICES LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
current
pecos_ownership
VERTEX FINANCIAL SERVICES LLC
ADP OF THE SNF
—
2025-12-30
current
pecos_ownership
MARK DEFLUITER
W-2 MANAGING EMPLOYEE
100%
2023-06-29
ended 2026-05-18
pecos_ownership
YISROEL HERZKA
5% OR GREATER INDIRECT OWNERSHIP INTEREST
45%
2022-01-01
ended 2026-05-18
pecos_ownership
MOSES STRAUSS
5% OR GREATER INDIRECT OWNERSHIP INTEREST
18%
2022-01-01
ended 2026-05-18
pecos_ownership
SUSAN STRAUSS
5% OR GREATER INDIRECT OWNERSHIP INTEREST
18%
2022-01-01
ended 2026-05-18
pecos_ownership
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.
Related-party costs
5
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$800,987
—
$783,591
—
$3,983
1
—
2023-12-31
$647,570
—
—
—
—
1
—
2022-12-31
$817,414
—
—
—
—
1
—
2021-12-31
$314,524
—
—
—
—
1
—
2020-12-31
$368,517
—
—
—
—
1
—
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
Most recent same-state, same-setting trades. Most CHOW-derived trades carry no disclosed consideration, so price, $/bed, and cap rate show only where a sale price was resolved from a deed or filing — blanks are honest, not missing data.
Market rent context
35
Geo
Kind
BR
Amount
As of
Source
county 47163
acs median gross
0
$413
2024-12-31
CENSUS_ACS5
county 47163
fmr
0
$720
2025-10-01
HUD_USER_FMR
county 47163
acs median gross
1
$648
2024-12-31
CENSUS_ACS5
county 47163
fmr
1
$818
2025-10-01
HUD_USER_FMR
county 47163
acs median gross
2
$926
2024-12-31
CENSUS_ACS5
county 47163
fmr
2
$1,044
2025-10-01
HUD_USER_FMR
county 47163
acs median gross
3
$957
2024-12-31
CENSUS_ACS5
county 47163
fmr
3
$1,338
2025-10-01
HUD_USER_FMR
county 47163
acs median gross
4
$961
2024-12-31
CENSUS_ACS5
county 47163
fmr
4
$1,464
2025-10-01
HUD_USER_FMR
county 47163
acs median gross
5
$1,030
2024-12-31
CENSUS_ACS5
county 47163
acs median gross
$889
2024-12-31
CENSUS_ACS5
county 47163
acs recent mover gross
$1,160
2024-12-31
CENSUS_ACS5
zcta 37664
acs median gross
0
$472
2024-12-31
CENSUS_ACS5
zcta 37664
acs median gross
1
$639
2024-12-31
CENSUS_ACS5
zcta 37664
acs median gross
2
$843
2024-12-31
CENSUS_ACS5
zcta 37664
acs median gross
3
$978
2024-12-31
CENSUS_ACS5
zcta 37664
acs median gross
4
$783
2024-12-31
CENSUS_ACS5
zcta 37664
acs median gross
$850
2024-12-31
CENSUS_ACS5
zcta 37664
acs recent mover gross
$1,270
2024-12-31
CENSUS_ACS5
zip 37664
payment standard 110
0
$748
2025-10-01
HUD_USER_SAFMR
zip 37664
payment standard 90
0
$612
2025-10-01
HUD_USER_SAFMR
zip 37664
safmr
0
$680
2025-10-01
HUD_USER_SAFMR
zip 37664
payment standard 110
1
$858
2025-10-01
HUD_USER_SAFMR
zip 37664
payment standard 90
1
$702
2025-10-01
HUD_USER_SAFMR
zip 37664
safmr
1
$780
2025-10-01
HUD_USER_SAFMR
zip 37664
payment standard 110
2
$1,089
2025-10-01
HUD_USER_SAFMR
zip 37664
payment standard 90
2
$891
2025-10-01
HUD_USER_SAFMR
zip 37664
safmr
2
$990
2025-10-01
HUD_USER_SAFMR
zip 37664
payment standard 110
3
$1,397
2025-10-01
HUD_USER_SAFMR
zip 37664
payment standard 90
3
$1,143
2025-10-01
HUD_USER_SAFMR
zip 37664
safmr
3
$1,270
2025-10-01
HUD_USER_SAFMR
zip 37664
payment standard 110
4
$1,529
2025-10-01
HUD_USER_SAFMR
zip 37664
payment standard 90
4
$1,251
2025-10-01
HUD_USER_SAFMR
zip 37664
safmr
4
$1,390
2025-10-01
HUD_USER_SAFMR
ACS median gross rents and HUD FMR/SAFMR for the facility's county and ZIP. Context for underwriting, not facility pricing.