Reads as: riskier than 38.6% 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.
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
NC median
National median
National p25–p75
Total nurse
3.10
3.08
3.28
2.90–3.77
RN
0.25
0.30
0.39
0.25–0.58
Weekend total
2.86
2.93
3.11
—
Weekday total
3.20
3.14
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
99.5
3.10
0.25
0.70
2.15
2.86
0.2%
2025Q3
92
101.9
3.15
0.29
0.69
2.17
2.85
0.1%
2025Q2
91
93.8
3.44
0.26
0.73
2.44
3.10
0.1%
2025Q1
90
93.4
3.42
0.21
0.78
2.43
3.13
0.1%
2024Q4
92
95.0
3.29
0.32
0.65
2.32
2.99
0.1%
2024Q3
92
95.5
3.38
0.26
0.75
2.38
3.20
0.1%
2024Q2
91
96.1
3.26
0.24
0.73
2.28
3.11
0.1%
2024Q1
91
94.7
3.48
0.35
0.74
2.38
3.27
0.2%
2023Q4
92
97.2
3.33
0.37
0.76
2.21
2.99
0.1%
2023Q3
92
95.9
3.37
0.39
0.79
2.19
3.02
0.2%
2023Q2
91
89.9
3.23
0.36
0.87
1.99
2.75
0.7%
2023Q1
90
87.0
3.12
0.31
0.94
1.88
2.75
0.8%
2022Q4
92
91.2
2.96
0.31
0.88
1.77
2.56
0.8%
2022Q3
92
89.7
2.95
0.36
0.78
1.81
2.60
2.9%
2022Q2
91
90.5
3.10
0.38
0.77
1.95
2.88
2.4%
2022Q1
90
90.9
3.21
0.41
0.75
2.05
2.87
0.1%
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
11
D × 9E × 2
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2024-09-11
Health · complaint
F0554
Allow residents to self-administer drugs if determined clinically appropriate.
D
2024-09-12
2024-09-11
Health · complaint
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
2024-09-12
2024-09-11
Health · complaint
F0919
Make sure that a working call system is available in each resident's bathroom and bathing area.
D
2024-09-12
2023-06-16
Health · complaint
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2023-07-06
2023-06-16
Health · complaint
F0558
Reasonably accommodate the needs and preferences of each resident.
D
2023-06-21
2023-06-16
Health · complaint
F0583
Keep residents' personal and medical records private and confidential.
D
2023-07-06
2023-06-16
Health · complaint
F0584
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
D
2023-07-14
2023-06-16
Health · complaint
F0756
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
E
2023-07-12
2023-06-16
Health · complaint
F0760
Ensure that residents are free from significant medication errors.
E
2023-06-16
2023-06-16
Health · complaint
F0761
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.
D
2023-07-06
2023-06-16
Health · complaint
F0867
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
D
2023-06-30
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
28
Owner
Role
Pct
From
Status
Source
ARDENT HEALTH AND REHABILITATION CO
5% OR GREATER INDIRECT OWNERSHIP INTEREST
50%
2008-08-01
current
pecos_ownership
BLUESKY HEALTHCARE INC
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
2008-05-09
current
pecos_ownership
FLAT ROCK MANAGEMENT COMPANY
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
2008-08-01
current
pecos_ownership
SPRENGER, NICOLE
5% OR GREATER INDIRECT OWNERSHIP INTEREST
15%
2008-08-01
current
pecos_ownership
SPRENGER, TRACEY
5% OR GREATER INDIRECT OWNERSHIP INTEREST
15%
2008-08-01
current
pecos_ownership
MALANOWSKI, KENNETH
5% OR GREATER INDIRECT OWNERSHIP INTEREST
10%
2008-08-01
current
pecos_ownership
HUTSENPILLER, WENDIE
5% OR GREATER INDIRECT OWNERSHIP INTEREST
9%
2008-08-01
current
pecos_ownership
FREEMAN, CARMEN
ADP OF THE SNF
—
2016-09-22
current
pecos_ownership
HENDERSONVILLE HEALTH & REHABILITATI
Corporation, partnership or other organization has financial interest in provider
—
2024-01-01
current
hcris_a_8_1
HENDERSONVILLE HEALTH & REHABILITATI
Corporation, partnership or other organization has financial interest in provider
—
2023-01-01
current
hcris_a_8_1
JENNINGS, MARK
ADP OF THE SNF
—
2024-11-19
current
pecos_ownership
RUSSELL, LARRY
OPERATIONAL/MANAGERIAL CONTROL
—
2011-12-13
current
pecos_ownership
SANSTONE MANAGEMENT COMPANY, LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-11-19
current
pecos_ownership
SPRENGER, ANDREW
ADP OF THE SNF
—
2023-04-09
current
pecos_ownership
SPRENGER, TRACEY
GENERAL PARTNERSHIP INTEREST
—
2008-05-09
current
pecos_ownership
HENDERSONVILLE PHYSICIAN & ASSOCIATE
Corporation, partnership or other organization has financial interest in provider
100%
2021-01-01
ended 2021-12-31
hcris_a_8_1
HENDERSONVILLE PHYSICIAN & ASSOCIATE
Corporation, partnership or other organization has financial interest in provider
100%
2020-01-01
ended 2020-12-31
hcris_a_8_1
CHRISTOPHER SPRENGER
5% OR GREATER INDIRECT OWNERSHIP INTEREST
50%
2008-08-01
ended 2026-05-18
pecos_ownership
NICOLE SPRENGER
5% OR GREATER INDIRECT OWNERSHIP INTEREST
15%
2008-08-01
ended 2026-05-18
pecos_ownership
TRACEY SPRENGER
5% OR GREATER INDIRECT OWNERSHIP INTEREST
15%
2008-08-01
ended 2026-05-18
pecos_ownership
KENNETH MALANOWSKI
5% OR GREATER INDIRECT OWNERSHIP INTEREST
10%
2008-08-01
ended 2026-05-18
pecos_ownership
WENDIE HUTSENPILLER
5% OR GREATER INDIRECT OWNERSHIP INTEREST
9%
2008-08-01
ended 2026-05-18
pecos_ownership
ANDREW SPRENGER
ADP OF THE SNF
—
2023-04-09
ended 2026-05-18
pecos_ownership
CARMEN FREEMAN
ADP OF THE SNF
—
2016-09-22
ended 2026-05-18
pecos_ownership
HENDERSONVILLE PHYSICIAN & ASSOCIATE
Corporation, partnership or other organization has financial interest in provider
—
2022-01-01
ended 2022-12-31
hcris_a_8_1
LARRY RUSSELL
OPERATIONAL/MANAGERIAL CONTROL
—
2011-12-13
ended 2026-05-18
pecos_ownership
MARK JENNINGS
ADP OF THE SNF
—
2024-11-19
ended 2026-05-18
pecos_ownership
TRACEY SPRENGER
GENERAL PARTNERSHIP INTEREST
—
2008-05-09
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
6
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$3,099,703
—
$855,555
$1,350,536
—
5
propco
2023-12-31
$2,699,501
—
$703,446
$1,205,773
—
4
propco
2022-12-31
$2,099,491
—
$627,794
$1,075,771
—
13
propco
2021-12-31
$2,141,005
—
$568,779
$1,207,105
—
20
propco
2020-12-31
$2,773,322
—
—
$830,693
$391,727
27
propco
2019-12-31
$1,043,075
—
—
$519,357
$164,466
15
—
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
32
Geo
Kind
BR
Amount
As of
Source
county 37089
acs median gross
0
$1,340
2024-12-31
CENSUS_ACS5
county 37089
fmr
0
$1,227
2025-10-01
HUD_USER_FMR
county 37089
acs median gross
1
$1,110
2024-12-31
CENSUS_ACS5
county 37089
fmr
1
$1,429
2025-10-01
HUD_USER_FMR
county 37089
acs median gross
2
$1,144
2024-12-31
CENSUS_ACS5
county 37089
fmr
2
$1,567
2025-10-01
HUD_USER_FMR
county 37089
acs median gross
3
$1,191
2024-12-31
CENSUS_ACS5
county 37089
fmr
3
$1,905
2025-10-01
HUD_USER_FMR
county 37089
acs median gross
4
$1,622
2024-12-31
CENSUS_ACS5
county 37089
fmr
4
$2,629
2025-10-01
HUD_USER_FMR
county 37089
acs median gross
5
$2,184
2024-12-31
CENSUS_ACS5
county 37089
acs median gross
$1,187
2024-12-31
CENSUS_ACS5
county 37089
acs recent mover gross
$1,367
2024-12-31
CENSUS_ACS5
zcta 28731
acs median gross
2
$759
2024-12-31
CENSUS_ACS5
zcta 28731
acs median gross
3
$1,635
2024-12-31
CENSUS_ACS5
zcta 28731
acs median gross
$1,005
2024-12-31
CENSUS_ACS5
zcta 28731
acs recent mover gross
$1,213
2024-12-31
CENSUS_ACS5
zip 28731
payment standard 110
0
$1,287
2025-10-01
HUD_USER_SAFMR
zip 28731
payment standard 90
0
$1,053
2025-10-01
HUD_USER_SAFMR
zip 28731
safmr
0
$1,170
2025-10-01
HUD_USER_SAFMR
zip 28731
payment standard 110
1
$1,496
2025-10-01
HUD_USER_SAFMR
zip 28731
payment standard 90
1
$1,224
2025-10-01
HUD_USER_SAFMR
zip 28731
safmr
1
$1,360
2025-10-01
HUD_USER_SAFMR
zip 28731
payment standard 110
2
$1,639
2025-10-01
HUD_USER_SAFMR
zip 28731
payment standard 90
2
$1,341
2025-10-01
HUD_USER_SAFMR
zip 28731
safmr
2
$1,490
2025-10-01
HUD_USER_SAFMR
zip 28731
payment standard 110
3
$1,991
2025-10-01
HUD_USER_SAFMR
zip 28731
payment standard 90
3
$1,629
2025-10-01
HUD_USER_SAFMR
zip 28731
safmr
3
$1,810
2025-10-01
HUD_USER_SAFMR
zip 28731
payment standard 110
4
$2,750
2025-10-01
HUD_USER_SAFMR
zip 28731
payment standard 90
4
$2,250
2025-10-01
HUD_USER_SAFMR
zip 28731
safmr
4
$2,500
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.