610 HIGHWAY O, GRAVOIS MILLS, MO 65037 · CCN 265737
Composite
40.1 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
108
Model
v1.2
Reads as: riskier than 40.1% 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
15
2025Q4 HPRD
This facility
MO median
National median
National p25–p75
Total nurse
1.85
2.41
3.28
2.90–3.77
RN
0.26
0.25
0.39
0.25–0.58
Weekend total
1.71
2.24
3.11
—
Weekday total
1.90
2.49
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
42.3
1.85
0.26
0.40
1.19
1.71
0.0%
2025Q3
92
44.2
2.02
0.23
0.57
1.22
1.74
0.0%
2025Q2
91
43.2
1.80
0.24
0.48
1.07
1.58
0.0%
2024Q4
92
41.6
2.08
0.30
0.53
1.24
2.06
0.0%
2024Q3
92
45.1
2.01
0.30
0.48
1.23
2.01
0.0%
2024Q2
91
47.8
1.60
0.22
0.29
1.09
1.52
0.0%
2024Q1
91
46.0
1.53
0.13
0.29
1.11
1.47
0.0%
2023Q4
92
41.2
1.90
0.14
0.48
1.27
1.80
0.0%
2023Q3
92
45.7
1.65
0.12
0.43
1.09
1.56
0.0%
2023Q2
91
46.5
1.65
0.13
0.43
1.09
1.53
0.0%
2023Q1
90
41.3
1.71
0.14
0.45
1.12
1.56
0.0%
2022Q4
92
45.4
1.77
0.15
0.43
1.19
1.60
0.0%
2022Q3
92
46.6
1.66
0.21
0.43
1.02
1.58
0.2%
2022Q2
91
45.7
1.57
0.36
0.39
0.83
1.55
0.0%
2022Q1
90
43.0
1.63
0.34
0.49
0.80
1.66
1.7%
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
12
C × 2D × 3E × 4F × 2G × 1
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2025-04-24
Health
F0625
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
D
2025-05-15
2025-04-24
Health
F0637
Assess the resident when there is a significant change in condition
D
2025-05-15
2025-04-24
Health
F0655
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
D
2025-05-15
2025-04-24
Health
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
E
2025-05-15
2025-04-24
Health
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.
C
2025-06-04
2025-04-24
Health
F0803
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
E
2025-05-14
2025-04-24
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2025-06-05
2025-04-24
Health
F0838
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.
C
2025-06-09
2024-04-01
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
G
2024-04-04
2023-02-10
Health
F0585
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.
E
2023-03-10
2023-02-10
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2023-03-15
2023-02-10
Health
F0880
Provide and implement an infection prevention and control program.
F
2023-03-20
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
13
Owner
Role
Pct
From
Status
Source
GOOD SHEPHERD NURSING HOME DISTRICT
OPERATIONAL/MANAGERIAL CONTROL
—
—
current
pecos_ownership
HUFFMAN, AMANDA
CORPORATE OFFICER
—
2011-04-26
current
pecos_ownership
MERRIOTT, LANA
CORPORATE OFFICER
—
2011-04-26
current
pecos_ownership
MERRIOTT, LANA
CORPORATE DIRECTOR
—
1998-04-13
current
pecos_ownership
SMITH, LANCE
CORPORATE OFFICER
—
2008-07-07
current
pecos_ownership
YPYA, PATRICIA
CORPORATE OFFICER
—
2021-10-11
current
pecos_ownership
YPYA, PATRICIA
OPERATIONAL/MANAGERIAL CONTROL
—
2021-10-20
current
pecos_ownership
LANCE SMITH
CORPORATE OFFICER
100%
2008-07-07
ended 2026-05-18
pecos_ownership
PATRICIA YPYA
CORPORATE OFFICER
100%
2021-10-11
ended 2026-05-18
pecos_ownership
PATRICIA YPYA
OPERATIONAL/MANAGERIAL CONTROL
100%
2021-10-20
ended 2026-05-18
pecos_ownership
AMANDA HUFFMAN
CORPORATE OFFICER
0%
2011-04-26
ended 2026-05-18
pecos_ownership
LANA MERRIOTT
CORPORATE DIRECTOR
0%
1998-04-13
ended 2026-05-18
pecos_ownership
LANA MERRIOTT
CORPORATE OFFICER
—
2011-04-26
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
2025-06-30
$184,508
—
—
—
—
1
—
2024-06-30
$188,333
—
—
—
—
1
—
2023-06-30
$158,737
—
—
—
—
1
—
2022-06-30
$128,361
—
—
—
—
1
—
2021-06-30
$129,363
—
—
—
—
1
—
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 29141
fmr
0
$660
2025-10-01
HUD_USER_FMR
county 29141
acs median gross
1
$555
2024-12-31
CENSUS_ACS5
county 29141
fmr
1
$745
2025-10-01
HUD_USER_FMR
county 29141
acs median gross
2
$679
2024-12-31
CENSUS_ACS5
county 29141
fmr
2
$888
2025-10-01
HUD_USER_FMR
county 29141
acs median gross
3
$1,056
2024-12-31
CENSUS_ACS5
county 29141
fmr
3
$1,171
2025-10-01
HUD_USER_FMR
county 29141
acs median gross
4
$432
2024-12-31
CENSUS_ACS5
county 29141
fmr
4
$1,176
2025-10-01
HUD_USER_FMR
county 29141
acs median gross
5
$211
2024-12-31
CENSUS_ACS5
county 29141
acs median gross
$721
2024-12-31
CENSUS_ACS5
county 29141
acs recent mover gross
$1,036
2024-12-31
CENSUS_ACS5
zcta 65037
acs median gross
1
$711
2024-12-31
CENSUS_ACS5
zcta 65037
acs median gross
2
$837
2024-12-31
CENSUS_ACS5
zcta 65037
acs median gross
3
$1,150
2024-12-31
CENSUS_ACS5
zcta 65037
acs median gross
$802
2024-12-31
CENSUS_ACS5
zcta 65037
acs recent mover gross
$1,125
2024-12-31
CENSUS_ACS5
zip 65037
payment standard 110
0
$781
2025-10-01
HUD_USER_SAFMR
zip 65037
payment standard 90
0
$639
2025-10-01
HUD_USER_SAFMR
zip 65037
safmr
0
$710
2025-10-01
HUD_USER_SAFMR
zip 65037
payment standard 110
1
$869
2025-10-01
HUD_USER_SAFMR
zip 65037
payment standard 90
1
$711
2025-10-01
HUD_USER_SAFMR
zip 65037
safmr
1
$790
2025-10-01
HUD_USER_SAFMR
zip 65037
payment standard 110
2
$1,056
2025-10-01
HUD_USER_SAFMR
zip 65037
payment standard 90
2
$864
2025-10-01
HUD_USER_SAFMR
zip 65037
safmr
2
$960
2025-10-01
HUD_USER_SAFMR
zip 65037
payment standard 110
3
$1,408
2025-10-01
HUD_USER_SAFMR
zip 65037
payment standard 90
3
$1,152
2025-10-01
HUD_USER_SAFMR
zip 65037
safmr
3
$1,280
2025-10-01
HUD_USER_SAFMR
zip 65037
payment standard 110
4
$1,430
2025-10-01
HUD_USER_SAFMR
zip 65037
payment standard 90
4
$1,170
2025-10-01
HUD_USER_SAFMR
zip 65037
safmr
4
$1,300
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.