Reads as: riskier than 30.9% 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.
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
4.18
3.28
3.28
2.90–3.77
RN
0.80
0.34
0.39
0.25–0.58
Weekend total
3.89
3.10
3.11
—
Weekday total
4.29
3.36
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
93.7
4.18
0.80
1.33
2.05
3.89
0.0%
2025Q3
92
96.7
4.19
0.80
1.26
2.13
3.77
0.0%
2025Q2
91
92.1
4.25
0.78
1.34
2.13
3.78
0.0%
2025Q1
90
92.3
4.43
0.77
1.24
2.43
4.17
0.0%
2024Q4
92
94.4
4.28
0.71
1.17
2.41
4.08
0.0%
2024Q3
92
97.9
4.07
0.69
1.23
2.15
3.85
0.0%
2024Q2
91
95.9
3.91
0.60
1.32
1.99
3.58
0.0%
2024Q1
91
101.1
3.73
0.64
1.16
1.93
3.42
0.0%
2023Q4
92
96.4
3.97
0.77
1.12
2.08
3.51
0.0%
2023Q3
92
98.3
4.04
0.84
1.07
2.13
3.62
0.0%
2023Q2
91
98.6
4.10
0.83
1.08
2.19
3.65
0.0%
2023Q1
90
101.4
4.11
0.74
1.10
2.27
3.73
1.7%
2022Q4
92
99.9
4.57
0.67
1.26
2.64
4.28
12.8%
2022Q3
92
101.8
4.29
0.63
1.28
2.37
4.05
17.2%
2022Q2
91
103.3
4.28
0.61
1.20
2.47
3.94
20.1%
2022Q1
90
97.6
4.38
0.82
1.01
2.55
4.12
20.8%
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.
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2025-09-20
2025-08-06
Health · complaint
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2025-09-20
2025-08-06
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2025-09-20
2025-08-06
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2025-09-20
2025-08-06
Health · complaint
F0880
Provide and implement an infection prevention and control program.
D
2025-09-20
2024-03-25
Health · complaint
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
2024-03-21
2024-03-25
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2024-03-22
2024-03-25
Health · complaint
F0726
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
J
2024-03-21
2021-06-23
Health
F0558
Reasonably accommodate the needs and preferences of each resident.
D
2021-08-05
2021-06-23
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
2021-08-05
2021-06-23
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2021-08-05
2021-06-23
Health
F0880
Provide and implement an infection prevention and control program.
D
2021-08-05
2019-06-13
Health
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
G
2019-07-29
2019-06-13
Health
F0623
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
F
2019-07-09
2019-06-13
Health
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
G
2019-07-29
2019-06-13
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2019-07-29
2019-06-13
Health
F0732
Post nurse staffing information every day.
C
2019-07-09
2019-06-13
Health
F0773
Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
D
2019-07-09
2019-06-13
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
2019-07-09
2018-06-27
Health
F0693
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
D
2018-08-08
2018-06-27
Health
F0732
Post nurse staffing information every day.
C
2018-08-08
2018-06-27
Health
F0800
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
D
2018-08-08
2018-06-27
Health
F0880
Provide and implement an infection prevention and control program.
D
2018-08-08
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
40
Owner
Role
Pct
From
Status
Source
AKERS, CLARK
CORPORATE DIRECTOR
—
2024-03-13
current
pecos_ownership
BAILEY, JOHN
CORPORATE DIRECTOR
—
2013-03-01
current
pecos_ownership
DODSON, VICKI
OPERATIONAL/MANAGERIAL CONTROL
—
2019-06-01
current
pecos_ownership
FORTI, ROBERT
ADP OF THE SNF
—
2025-11-18
current
pecos_ownership
FORTI, ROBERT
OPERATIONAL/MANAGERIAL CONTROL
—
2023-03-08
current
pecos_ownership
GIOIA, MINNA
CORPORATE DIRECTOR
—
2024-05-08
current
pecos_ownership
HARRIS, HUNTER
ADP OF THE SNF
—
2025-11-18
current
pecos_ownership
HARRIS, HUNTER
OPERATIONAL/MANAGERIAL CONTROL
—
2018-10-22
current
pecos_ownership
HOLZMAN, BARBARA
CORPORATE DIRECTOR
—
2023-05-10
current
pecos_ownership
KIDD, BRIAN
OPERATIONAL/MANAGERIAL CONTROL
—
2019-01-01
current
pecos_ownership
MAY, LYNN
CORPORATE DIRECTOR
—
2010-03-01
current
pecos_ownership
MCNABB, PAUL
CORPORATE DIRECTOR
—
2021-05-05
current
pecos_ownership
NATIONAL HEALTHCARE CORPORATION
ADP OF THE SNF
—
1992-07-01
current
pecos_ownership
NHC-OP LP
OPERATIONAL/MANAGERIAL CONTROL
—
1992-07-01
current
pecos_ownership
SHELLY, TIMOTHY
OPERATIONAL/MANAGERIAL CONTROL
—
1998-06-01
current
pecos_ownership
TARLETON, BENNETT
CORPORATE DIRECTOR
—
2025-05-14
current
pecos_ownership
TENNESSEE HEALTHCARE ADVISORS, LLC
ADP OF THE SNF
—
2025-11-19
current
pecos_ownership
TENNESSEE HEALTHCARE ADVISORS, LLC
OPERATIONAL/MANAGERIAL CONTROL
—
1992-07-01
current
pecos_ownership
THOMPSON, INDIANNA
OPERATIONAL/MANAGERIAL CONTROL
—
2012-10-30
current
pecos_ownership
VINCENT, BRANDON
OPERATIONAL/MANAGERIAL CONTROL
—
2024-08-19
current
pecos_ownership
WERT, JANE
CORPORATE DIRECTOR
—
2024-05-08
current
pecos_ownership
WILSON, BLAIR
CORPORATE DIRECTOR
—
2004-05-01
current
pecos_ownership
BARBARA HOLZMAN
CORPORATE DIRECTOR
—
2023-05-10
ended 2026-05-18
pecos_ownership
BENNETT TARLETON
CORPORATE DIRECTOR
—
2025-05-14
ended 2026-05-18
pecos_ownership
BLAIR WILSON
CORPORATE OFFICER
—
2004-05-01
ended 2026-05-18
pecos_ownership
BRANDON VINCENT
OPERATIONAL/MANAGERIAL CONTROL
—
2024-08-19
ended 2026-05-18
pecos_ownership
BRIAN KIDD
OPERATIONAL/MANAGERIAL CONTROL
—
2019-01-01
ended 2026-05-18
pecos_ownership
CLARK AKERS
CORPORATE DIRECTOR
—
2024-03-13
ended 2026-05-18
pecos_ownership
HUNTER HARRIS
ADP OF THE SNF
—
2025-11-18
ended 2026-05-18
pecos_ownership
HUNTER HARRIS
OPERATIONAL/MANAGERIAL CONTROL
—
2018-10-22
ended 2026-05-18
pecos_ownership
INDIANNA THOMPSON
OPERATIONAL/MANAGERIAL CONTROL
—
2012-10-30
ended 2026-05-18
pecos_ownership
JANE WERT
CORPORATE DIRECTOR
—
2024-05-08
ended 2026-05-18
pecos_ownership
JOHN BAILEY
CORPORATE DIRECTOR
—
2013-03-01
ended 2026-05-18
pecos_ownership
LYNN MAY
CORPORATE DIRECTOR
—
2010-03-01
ended 2026-05-18
pecos_ownership
MINNA GIOIA
CORPORATE DIRECTOR
—
2024-05-08
ended 2026-05-18
pecos_ownership
PAUL MCNABB
CORPORATE DIRECTOR
—
2021-05-05
ended 2026-05-18
pecos_ownership
ROBERT FORTI
ADP OF THE SNF
—
2025-11-18
ended 2026-05-18
pecos_ownership
ROBERT FORTI
OPERATIONAL/MANAGERIAL CONTROL
—
2023-03-08
ended 2026-05-18
pecos_ownership
TIMOTHY SHELLY
OPERATIONAL/MANAGERIAL CONTROL
—
1998-06-01
ended 2026-05-18
pecos_ownership
VICKI DODSON
ADP OF THE SNF
—
2019-06-01
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
0
No related-party cost years on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
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 47037
acs median gross
0
$1,414
2024-12-31
CENSUS_ACS5
county 47037
fmr
0
$1,507
2025-10-01
HUD_USER_FMR
county 47037
acs median gross
1
$1,421
2024-12-31
CENSUS_ACS5
county 47037
fmr
1
$1,578
2025-10-01
HUD_USER_FMR
county 47037
acs median gross
2
$1,562
2024-12-31
CENSUS_ACS5
county 47037
fmr
2
$1,730
2025-10-01
HUD_USER_FMR
county 47037
acs median gross
3
$1,938
2024-12-31
CENSUS_ACS5
county 47037
fmr
3
$2,211
2025-10-01
HUD_USER_FMR
county 47037
acs median gross
4
$2,183
2024-12-31
CENSUS_ACS5
county 47037
fmr
4
$2,696
2025-10-01
HUD_USER_FMR
county 47037
acs median gross
5
$2,135
2024-12-31
CENSUS_ACS5
county 47037
acs median gross
$1,582
2024-12-31
CENSUS_ACS5
county 47037
acs recent mover gross
$1,787
2024-12-31
CENSUS_ACS5
zcta 37205
acs median gross
0
$3,501
2024-12-31
CENSUS_ACS5
zcta 37205
acs median gross
1
$1,462
2024-12-31
CENSUS_ACS5
zcta 37205
acs median gross
2
$1,920
2024-12-31
CENSUS_ACS5
zcta 37205
acs median gross
3
$2,495
2024-12-31
CENSUS_ACS5
zcta 37205
acs median gross
4
$2,833
2024-12-31
CENSUS_ACS5
zcta 37205
acs median gross
$1,920
2024-12-31
CENSUS_ACS5
zcta 37205
acs recent mover gross
$2,077
2024-12-31
CENSUS_ACS5
zip 37205
payment standard 110
0
$2,134
2025-10-01
HUD_USER_SAFMR
zip 37205
payment standard 90
0
$1,746
2025-10-01
HUD_USER_SAFMR
zip 37205
safmr
0
$1,940
2025-10-01
HUD_USER_SAFMR
zip 37205
payment standard 110
1
$2,233
2025-10-01
HUD_USER_SAFMR
zip 37205
payment standard 90
1
$1,827
2025-10-01
HUD_USER_SAFMR
zip 37205
safmr
1
$2,030
2025-10-01
HUD_USER_SAFMR
zip 37205
payment standard 110
2
$2,453
2025-10-01
HUD_USER_SAFMR
zip 37205
payment standard 90
2
$2,007
2025-10-01
HUD_USER_SAFMR
zip 37205
safmr
2
$2,230
2025-10-01
HUD_USER_SAFMR
zip 37205
payment standard 110
3
$3,135
2025-10-01
HUD_USER_SAFMR
zip 37205
payment standard 90
3
$2,565
2025-10-01
HUD_USER_SAFMR
zip 37205
safmr
3
$2,850
2025-10-01
HUD_USER_SAFMR
zip 37205
payment standard 110
4
$3,817
2025-10-01
HUD_USER_SAFMR
zip 37205
payment standard 90
4
$3,123
2025-10-01
HUD_USER_SAFMR
zip 37205
safmr
4
$3,470
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.