Reads as: riskier than 83.2% 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
19
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+38.1 vs natl
TUTERA MARIAN
5 facilities
connection
Owner fleet risk far above national
+34.1 vs natl
JOSEPH CHARLES TUTERA 2013 FAMILY IRREVOCIABLE TRUST AGREEMENT
6 facilities
connection
Owner fleet risk far above national
+33.4 vs natl
MARIAN OLANDER TUTERA 2020 MRTL TR
5 facilities
connection
Owner fleet risk far above national
+30.6 vs natl
FLANAGAN MICHAEL
19 facilities
connection
Owner fleet risk far above national
+29.9 vs natl
TUTERA INVESTMENTS LLC
10 facilities
connection
Owner fleet risk far above national
+29.3 vs natl
TUTERA JOSEPH
22 facilities
connection
Owner fleet risk far above national
+27.2 vs natl
WALNUT CREEK MANAGEMENT COMPANY LLC
22 facilities
connection
Owner fleet risk far above national
+26.8 vs natl
BROOKS KILEY
29 facilities
connection
Owner fleet risk far above national
+25.0 vs natl
BLOOM RANDALL
15 facilities
connection
Owner spans multiple chains
5 chains
FLANAGAN MICHAEL
17 facilities
connection
Owner fleet enforcement cluster
83% fined
JOSEPH CHARLES TUTERA 2013 FAMILY IRREVOCIABLE TRUST AGREEMENT
6 facilities
connection
Owner fleet enforcement cluster
80% fined
TUTERA MARIAN
5 facilities
connection
Owner fleet enforcement cluster
80% fined
MARIAN OLANDER TUTERA 2020 MRTL TR
5 facilities
connection
Owner fleet enforcement cluster
60% fined
TUTERA INVESTMENTS LLC
10 facilities
connection
Owner fleet enforcement cluster
59% fined
TUTERA JOSEPH
22 facilities
connection
Owner fleet enforcement cluster
53% fined
BLOOM RANDALL
15 facilities
connection
Owner fleet enforcement cluster
48% fined
BROOKS KILEY
29 facilities
connection
Owner fleet enforcement cluster
47% fined
FLANAGAN MICHAEL
19 facilities
connection
Owner fleet enforcement cluster
46% fined
WALNUT CREEK MANAGEMENT COMPANY LLC
22 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
IL median
National median
National p25–p75
Total nurse
3.02
3.13
3.28
2.90–3.77
RN
0.55
0.49
0.39
0.25–0.58
Weekend total
2.80
2.93
3.11
—
Weekday total
3.10
3.23
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
78.7
3.02
0.55
0.55
1.92
2.80
1.2%
2025Q3
92
75.6
3.14
0.58
0.60
1.96
2.83
3.5%
2025Q2
91
84.0
2.95
0.56
0.52
1.87
2.64
1.4%
2025Q1
90
82.9
2.98
0.54
0.56
1.88
2.67
2.4%
2024Q4
92
84.7
2.84
0.49
0.50
1.85
2.55
4.0%
2024Q3
92
74.4
2.85
0.47
0.55
1.84
2.66
3.6%
2024Q2
91
78.0
2.84
0.42
0.55
1.86
2.66
0.5%
2024Q1
91
78.7
2.77
0.43
0.55
1.79
2.56
0.1%
2023Q4
92
75.2
2.80
0.46
0.65
1.69
2.53
0.2%
2023Q3
92
74.9
2.80
0.39
0.66
1.75
2.56
1.5%
2023Q2
91
72.2
2.89
0.49
0.60
1.80
2.53
3.2%
2023Q1
90
71.0
3.16
0.63
0.59
1.95
2.69
2.1%
2022Q4
92
68.3
3.09
0.65
0.59
1.85
2.72
5.5%
2022Q3
92
73.1
2.86
0.57
0.58
1.71
2.66
9.8%
2022Q2
91
74.2
2.63
0.47
0.60
1.56
2.42
12.6%
2022Q1
90
72.0
2.48
0.43
0.73
1.32
2.22
6.5%
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.
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
G
2025-01-16
2024-11-23
Health · complaint
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
G
2024-11-25
2024-11-06
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2024-11-11
2024-10-23
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-10-24
2024-10-23
Health
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
E
2024-11-25
2024-10-23
Health
F0688
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
D
2024-10-24
2024-10-23
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2024-10-24
2024-10-23
Health
F0692
Provide enough food/fluids to maintain a resident's health.
G
2024-10-24
2024-10-23
Health · complaint
F0697
Provide safe, appropriate pain management for a resident who requires such services.
G
2024-10-24
2024-10-23
Health
F0740
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
D
2024-10-24
2024-10-23
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2024-10-24
2024-10-23
Health
F0758
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
D
2024-10-24
2024-10-23
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2024-10-24
2024-02-20
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2024-03-08
2023-12-21
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-01-12
2023-12-21
Health
F0690
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
D
2023-12-22
2023-12-21
Health
F0880
Provide and implement an infection prevention and control program.
D
2023-12-22
2023-10-19
Health · complaint
F0578
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
D
2023-10-20
2023-01-19
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2023-01-20
2023-01-19
Health
F0690
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
D
2023-01-19
2023-01-19
Health
F0880
Provide and implement an infection prevention and control program.
D
2023-01-26
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
26
Owner
Role
Pct
From
Status
Source
TI - DIXON LLC
Corporation, partnership or other organization has financial interest in provider
100%
2023-01-01
current
hcris_a_8_1
TI - DIXON LLC
Corporation, partnership or other organization has financial interest in provider
100%
2024-01-01
current
hcris_a_8_1
ARNOLD, TINA
ADP OF THE SNF
—
2025-05-01
current
pecos_ownership
BLOOM, RANDALL
CORPORATE OFFICER
—
2012-01-09
current
pecos_ownership
BROOKS, KILEY
CORPORATE OFFICER
—
2017-04-25
current
pecos_ownership
FLANAGAN, MICHAEL
INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
—
2025-04-12
current
pecos_ownership
JOSEPH CHARLES TUTERA 2013 FAMILY IRREVOCIABLE TRUST AGREEMENT
INDIRECT OWNERSHIP INTEREST
—
2012-01-09
current
pecos_ownership
LEBEDOWICZ, BOHDAN
OPERATIONAL/MANAGERIAL CONTROL
—
2025-05-01
current
pecos_ownership
MARIAN OLANDER TUTERA 2020 MRTL TR
INDIRECT OWNERSHIP INTEREST
—
2020-12-31
current
pecos_ownership
MEEKS, BETTY
ADP OF THE SNF
—
2025-05-01
current
pecos_ownership
TI-DIXON ILLINOIS, LLC
ADP OF THE SNF
—
2012-01-09
current
pecos_ownership
TUTERA INVESTMENTS, LLC
ADP OF THE SNF
—
2012-01-09
current
pecos_ownership
TUTERA, JOSEPH
OPERATIONAL/MANAGERIAL CONTROL
—
2012-01-09
current
pecos_ownership
TUTERA, MARIAN
INDIRECT OWNERSHIP INTEREST
—
2012-01-09
current
pecos_ownership
WALNUT CREEK MANAGEMENT COMPANY LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2012-01-09
current
pecos_ownership
WALNUT CREEK MANAGEMENT COMPANY LLC
ADP OF THE SNF
—
2025-04-12
current
pecos_ownership
TI - DIXON LLC
Corporation, partnership or other organization has financial interest in provider
100%
2022-01-01
ended 2022-12-31
hcris_a_8_1
TI - DIXON LLC
Corporation, partnership or other organization has financial interest in provider
100%
2020-01-01
ended 2020-12-31
hcris_a_8_1
TI - DIXON LLC
Corporation, partnership or other organization has financial interest in provider
100%
2021-01-01
ended 2021-12-31
hcris_a_8_1
KILEY BROOKS
CORPORATE OFFICER
25%
2017-04-25
ended 2026-05-18
pecos_ownership
RANDALL BLOOM
CORPORATE OFFICER
25%
2012-01-09
ended 2026-05-18
pecos_ownership
JOSEPH TUTERA
OPERATIONAL/MANAGERIAL CONTROL
15%
2012-01-09
ended 2026-05-18
pecos_ownership
MARIAN TUTERA
INDIRECT OWNERSHIP INTEREST
6%
2012-01-09
ended 2026-05-18
pecos_ownership
BETTY MEEKS
ADP OF THE SNF
—
2025-05-01
ended 2026-05-18
pecos_ownership
BOHDAN LEBEDOWICZ
ADP OF THE SNF
—
2025-05-01
ended 2026-05-18
pecos_ownership
TINA ARNOLD
ADP OF THE SNF
—
2025-05-01
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
$864,870
—
—
$10,510
$6,360
15
propco
2023-12-31
$959,364
—
—
$24,966
$13,804
15
propco
2022-12-31
$881,250
—
—
$21,205
$1,345
17
propco
2021-12-31
$890,172
—
—
$9,555
$2,525
15
propco
2020-12-31
$861,966
—
—
$12,730
$1,858
19
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
32
Geo
Kind
BR
Amount
As of
Source
county 17103
fmr
0
$632
2025-10-01
HUD_USER_FMR
county 17103
acs median gross
1
$547
2024-12-31
CENSUS_ACS5
county 17103
fmr
1
$810
2025-10-01
HUD_USER_FMR
county 17103
acs median gross
2
$810
2024-12-31
CENSUS_ACS5
county 17103
fmr
2
$916
2025-10-01
HUD_USER_FMR
county 17103
acs median gross
3
$1,090
2024-12-31
CENSUS_ACS5
county 17103
fmr
3
$1,274
2025-10-01
HUD_USER_FMR
county 17103
acs median gross
4
$993
2024-12-31
CENSUS_ACS5
county 17103
fmr
4
$1,395
2025-10-01
HUD_USER_FMR
county 17103
acs median gross
5
$855
2024-12-31
CENSUS_ACS5
county 17103
acs median gross
$894
2024-12-31
CENSUS_ACS5
county 17103
acs recent mover gross
$743
2024-12-31
CENSUS_ACS5
zcta 61021
acs median gross
1
$543
2024-12-31
CENSUS_ACS5
zcta 61021
acs median gross
2
$795
2024-12-31
CENSUS_ACS5
zcta 61021
acs median gross
3
$1,084
2024-12-31
CENSUS_ACS5
zcta 61021
acs median gross
$879
2024-12-31
CENSUS_ACS5
zcta 61021
acs recent mover gross
$905
2024-12-31
CENSUS_ACS5
zip 61021
payment standard 110
0
$704
2025-10-01
HUD_USER_SAFMR
zip 61021
payment standard 90
0
$576
2025-10-01
HUD_USER_SAFMR
zip 61021
safmr
0
$640
2025-10-01
HUD_USER_SAFMR
zip 61021
payment standard 110
1
$880
2025-10-01
HUD_USER_SAFMR
zip 61021
payment standard 90
1
$720
2025-10-01
HUD_USER_SAFMR
zip 61021
safmr
1
$800
2025-10-01
HUD_USER_SAFMR
zip 61021
payment standard 110
2
$1,012
2025-10-01
HUD_USER_SAFMR
zip 61021
payment standard 90
2
$828
2025-10-01
HUD_USER_SAFMR
zip 61021
safmr
2
$920
2025-10-01
HUD_USER_SAFMR
zip 61021
payment standard 110
3
$1,386
2025-10-01
HUD_USER_SAFMR
zip 61021
payment standard 90
3
$1,134
2025-10-01
HUD_USER_SAFMR
zip 61021
safmr
3
$1,260
2025-10-01
HUD_USER_SAFMR
zip 61021
payment standard 110
4
$1,529
2025-10-01
HUD_USER_SAFMR
zip 61021
payment standard 90
4
$1,251
2025-10-01
HUD_USER_SAFMR
zip 61021
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.