Reads as: riskier than 53.6% 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
5 chains
GRAF ANDREW
7 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
PA median
National median
National p25–p75
Total nurse
3.41
3.38
3.28
2.90–3.77
RN
0.63
0.45
0.39
0.25–0.58
Weekend total
3.17
3.27
3.11
—
Weekday total
3.50
3.43
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
100.4
3.41
0.63
0.88
1.90
3.17
14.8%
2025Q3
92
103.1
3.66
0.57
0.97
2.13
3.52
27.0%
2025Q2
91
103.7
3.62
0.56
0.95
2.11
3.41
31.7%
2025Q1
90
104.2
3.41
0.62
0.81
1.99
3.27
21.1%
2024Q4
92
99.5
3.47
0.67
0.79
2.00
3.25
18.2%
2024Q3
92
99.5
3.57
0.65
0.93
2.00
3.36
26.2%
2024Q2
91
100.2
3.48
0.65
0.87
1.96
3.22
35.8%
2024Q1
91
102.6
3.39
0.64
0.91
1.84
3.15
41.9%
2023Q4
92
101.5
3.38
0.61
0.81
1.96
3.23
38.6%
2023Q3
92
102.1
3.25
0.61
0.78
1.86
3.04
42.1%
2023Q2
91
101.7
3.29
0.51
0.88
1.91
3.16
43.3%
2023Q1
90
92.7
2.47
0.64
0.73
1.10
2.15
0.0%
2022Q4
92
85.8
2.50
0.68
0.75
1.07
2.22
0.0%
2022Q3
92
78.9
2.60
0.70
0.81
1.09
2.31
0.0%
2022Q2
91
81.1
2.67
0.68
0.87
1.13
2.38
0.0%
2022Q1
90
75.7
3.19
0.73
1.00
1.46
2.93
0.0%
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.
Penalties
0
No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
14
D × 12E × 2
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2026-04-14
Health · complaint
F0760
Ensure that residents are free from significant medication errors.
D
2026-04-23
2025-06-06
Health
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2025-06-18
2025-06-06
Health
F0610
Respond appropriately to all alleged violations.
D
2025-06-18
2025-06-06
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2025-06-18
2025-06-06
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2025-06-18
2024-05-31
Health
F0610
Respond appropriately to all alleged violations.
E
2024-06-19
2024-05-31
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
E
2024-06-19
2024-05-31
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-06-19
2024-05-31
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2024-06-19
2024-05-31
Health
F0757
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
2024-06-19
2023-09-15
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2023-10-03
2023-06-30
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2023-07-25
2023-06-30
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2023-07-25
2023-06-30
Health
F0756
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
D
2023-07-25
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
45
Owner
Role
Pct
From
Status
Source
HICKORY HOUSE RE INV
Individual has financial interest in both related organization and provider
100%
2024-01-01
current
hcris_a_8_1
HICKORY HOUSE RE INV
Individual has financial interest in both related organization and provider
100%
2023-01-01
current
hcris_a_8_1
ADIO, OLAYEMI
OPERATIONAL/MANAGERIAL CONTROL
—
2023-12-27
current
pecos_ownership
CAMPBELL, KELLI
ADP OF THE SNF
—
2025-04-03
current
pecos_ownership
CAMPBELL, KELLI
OPERATIONAL/MANAGERIAL CONTROL
—
2022-10-26
current
pecos_ownership
CROSS, CINDY
CORPORATE OFFICER
—
1994-04-21
current
pecos_ownership
DEVELOPERS INVESTMENT COMPANY INC
OPERATIONAL/MANAGERIAL CONTROL
—
1993-09-26
current
pecos_ownership
FLETCHER, TODD
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
current
pecos_ownership
GRAF, ANDREW
OPERATIONAL/MANAGERIAL CONTROL
—
2023-10-01
current
pecos_ownership
GRAF, ANDREW
ADP OF THE SNF
—
2025-04-03
current
pecos_ownership
HENRY, TERRY
CORPORATE OFFICER
—
1999-08-16
current
pecos_ownership
HONEY BROOK MEDICAL INVESTORS LP
ADP OF THE SNF
—
2003-10-10
current
pecos_ownership
HONEY BROOK MEDICAL INVESTORS LP
OPERATIONAL/MANAGERIAL CONTROL
—
—
current
pecos_ownership
LAY, LISA
CORPORATE OFFICER
—
2018-02-09
current
pecos_ownership
LIFE CARE AFFILIATES II
ADP OF THE SNF
—
2003-10-10
current
pecos_ownership
LIFE CARE AFFILIATES II
GENERAL PARTNERSHIP INTEREST
—
1993-09-26
current
pecos_ownership
LIFE CARE CENTERS OF AMERICA, INC.
ADP OF THE SNF
—
2025-04-03
current
pecos_ownership
LIFE CARE CENTERS OF AMERICA, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
—
current
pecos_ownership
LONG, ZOFIA
OPERATIONAL/MANAGERIAL CONTROL
—
2004-03-15
current
pecos_ownership
PRESTON, AUBREY
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
current
pecos_ownership
PRESTON, FORREST
LIMITED PARTNERSHIP INTEREST
—
—
current
pecos_ownership
PRESTON, FORREST
ADP OF THE SNF
—
2003-10-10
current
pecos_ownership
SWANKER, RICHARD
CORPORATE OFFICER
—
2011-04-01
current
pecos_ownership
THURMOND, JOAN
CORPORATE OFFICER
—
2000-09-22
current
pecos_ownership
ZIEGLER, JAMES
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
current
pecos_ownership
HICKOR HOUSE RE INV
Individual has financial interest in both related organization and provider
100%
2022-01-01
ended 2022-12-31
hcris_a_8_1
HICKORY HOUSE RE INV
Individual has financial interest in both related organization and provider
100%
2021-01-01
ended 2021-12-31
hcris_a_8_1
HICKORY HOUSE RE INV
Individual has financial interest in both related organization and provider
100%
2020-01-01
ended 2020-12-31
hcris_a_8_1
FORREST PRESTON
5% OR GREATER INDIRECT OWNERSHIP INTEREST
99%
1993-09-26
ended 2026-05-18
pecos_ownership
FORREST PRESTON
LIMITED PARTNERSHIP INTEREST
1%
—
ended 2026-05-18
pecos_ownership
ANDREW GRAF
OPERATIONAL/MANAGERIAL CONTROL
—
2023-10-01
ended 2026-05-18
pecos_ownership
ANDREW GRAF
ADP OF THE SNF
—
2025-04-03
ended 2026-05-18
pecos_ownership
AUBREY PRESTON
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
ended 2026-05-18
pecos_ownership
CINDY CROSS
CORPORATE OFFICER
—
1994-04-21
ended 2026-05-18
pecos_ownership
FORREST PRESTON
ADP OF THE SNF
—
2003-10-10
ended 2026-05-18
pecos_ownership
JAMES ZIEGLER
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
ended 2026-05-18
pecos_ownership
JOAN THURMOND
CORPORATE OFFICER
—
2000-09-22
ended 2026-05-18
pecos_ownership
KELLI CAMPBELL
MANAGING CONTROL - GOVERNING BODY
—
2022-10-26
ended 2026-05-18
pecos_ownership
KELLI CAMPBELL
ADP OF THE SNF
—
2025-04-03
ended 2026-05-18
pecos_ownership
LISA LAY
CORPORATE OFFICER
—
2018-02-09
ended 2026-05-18
pecos_ownership
OLAYEMI ADIO
MANAGING CONTROL - GOVERNING BODY
—
2023-12-27
ended 2026-05-18
pecos_ownership
RICHARD SWANKER
CORPORATE OFFICER
—
2011-04-01
ended 2026-05-18
pecos_ownership
TERRY HENRY
CORPORATE OFFICER
—
1999-08-16
ended 2026-05-18
pecos_ownership
TODD FLETCHER
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
ended 2026-05-18
pecos_ownership
ZOFIA LONG
OPERATIONAL/MANAGERIAL CONTROL
—
2004-03-15
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
$1,471,111
$1,825
—
—
—
5
propco
2023-12-31
$1,396,088
$17,174
—
—
—
5
propco
2022-12-31
$1,328,626
$20,209
—
—
—
5
propco
2021-12-31
$1,468,161
$19,052
—
—
—
5
propco
2020-12-31
$1,687,908
—
—
—
$1,130,594
5
propco
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
Transactions
0
No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
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 42029
acs median gross
0
$1,440
2024-12-31
CENSUS_ACS5
county 42029
fmr
0
$1,397
2025-10-01
HUD_USER_FMR
county 42029
acs median gross
1
$1,604
2024-12-31
CENSUS_ACS5
county 42029
fmr
1
$1,520
2025-10-01
HUD_USER_FMR
county 42029
acs median gross
2
$1,870
2024-12-31
CENSUS_ACS5
county 42029
fmr
2
$1,810
2025-10-01
HUD_USER_FMR
county 42029
acs median gross
3
$1,942
2024-12-31
CENSUS_ACS5
county 42029
fmr
3
$2,170
2025-10-01
HUD_USER_FMR
county 42029
acs median gross
4
$1,944
2024-12-31
CENSUS_ACS5
county 42029
fmr
4
$2,423
2025-10-01
HUD_USER_FMR
county 42029
acs median gross
5
$2,291
2024-12-31
CENSUS_ACS5
county 42029
acs median gross
$1,763
2024-12-31
CENSUS_ACS5
county 42029
acs recent mover gross
$2,005
2024-12-31
CENSUS_ACS5
zcta 19344
acs median gross
1
$1,106
2024-12-31
CENSUS_ACS5
zcta 19344
acs median gross
2
$1,771
2024-12-31
CENSUS_ACS5
zcta 19344
acs median gross
3
$1,244
2024-12-31
CENSUS_ACS5
zcta 19344
acs median gross
4
$1,157
2024-12-31
CENSUS_ACS5
zcta 19344
acs median gross
5
$1,679
2024-12-31
CENSUS_ACS5
zcta 19344
acs median gross
$1,490
2024-12-31
CENSUS_ACS5
zcta 19344
acs recent mover gross
$1,455
2024-12-31
CENSUS_ACS5
zip 19344
payment standard 110
0
$1,265
2025-10-01
HUD_USER_SAFMR
zip 19344
payment standard 90
0
$1,035
2025-10-01
HUD_USER_SAFMR
zip 19344
safmr
0
$1,150
2025-10-01
HUD_USER_SAFMR
zip 19344
payment standard 110
1
$1,375
2025-10-01
HUD_USER_SAFMR
zip 19344
payment standard 90
1
$1,125
2025-10-01
HUD_USER_SAFMR
zip 19344
safmr
1
$1,250
2025-10-01
HUD_USER_SAFMR
zip 19344
payment standard 110
2
$1,650
2025-10-01
HUD_USER_SAFMR
zip 19344
payment standard 90
2
$1,350
2025-10-01
HUD_USER_SAFMR
zip 19344
safmr
2
$1,500
2025-10-01
HUD_USER_SAFMR
zip 19344
payment standard 110
3
$1,980
2025-10-01
HUD_USER_SAFMR
zip 19344
payment standard 90
3
$1,620
2025-10-01
HUD_USER_SAFMR
zip 19344
safmr
3
$1,800
2025-10-01
HUD_USER_SAFMR
zip 19344
payment standard 110
4
$2,200
2025-10-01
HUD_USER_SAFMR
zip 19344
payment standard 90
4
$1,800
2025-10-01
HUD_USER_SAFMR
zip 19344
safmr
4
$2,000
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.