Reads as: riskier than 86.4% 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
4
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+21.2 vs natl
EMANUEL YOSEF
12 facilities
connection
Owner fleet risk far above national
+20.5 vs natl
ALLIANCE HEALTH GROUP LLC
10 facilities
connection
Owner fleet enforcement cluster
60% fined
ALLIANCE HEALTH GROUP LLC
10 facilities
connection
Owner fleet enforcement cluster
50% fined
EMANUEL YOSEF
12 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
NC median
National median
National p25–p75
Total nurse
2.68
3.08
3.28
2.90–3.77
RN
0.13
0.30
0.39
0.25–0.58
Weekend total
2.54
2.93
3.11
—
Weekday total
2.73
3.14
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
103.8
2.68
0.13
0.82
1.73
2.54
0.0%
2025Q3
92
99.5
2.88
0.14
0.89
1.85
2.79
0.0%
2025Q2
91
102.0
2.99
0.13
0.79
2.08
2.92
0.0%
2025Q1
90
101.4
2.69
0.08
0.76
1.85
2.63
12.4%
2024Q4
92
97.1
2.75
0.16
0.70
1.89
2.57
16.7%
2024Q3
92
97.9
2.79
0.26
0.70
1.82
2.54
21.0%
2024Q2
91
94.2
2.83
0.25
0.78
1.80
2.48
20.7%
2024Q1
91
89.1
2.81
0.19
0.91
1.71
2.42
21.1%
2023Q4
92
94.0
2.80
0.26
0.83
1.70
2.55
37.7%
2023Q3
92
93.4
2.96
0.23
0.91
1.82
2.72
55.4%
2023Q2
91
97.0
2.79
0.21
0.92
1.66
2.69
57.9%
2023Q1
90
99.7
2.89
0.20
0.93
1.76
2.70
55.7%
2022Q4
92
90.7
3.32
0.22
0.93
2.17
3.19
55.1%
2022Q3
92
82.5
2.54
0.14
0.61
1.78
2.04
32.3%
2022Q2
91
83.9
2.65
0.13
0.70
1.82
2.37
39.0%
2022Q1
90
82.3
3.17
0.25
0.60
2.32
2.78
46.1%
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.
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
2025-11-24
2025-11-18
Health
F0727
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
F
2025-11-24
2025-11-18
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
2025-11-24
2025-07-18
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
—
2025-03-06
Health · complaint
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
D
2025-02-22
2024-07-11
Health · complaint
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
2024-08-02
2024-05-21
Health · complaint
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
E
2024-06-11
2024-05-21
Health · complaint
F0558
Reasonably accommodate the needs and preferences of each resident.
D
2024-06-11
2024-05-21
Health · complaint
F0565
Honor the resident's right to organize and participate in resident/family groups in the facility.
E
2024-06-11
2024-05-21
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-06-11
2024-05-21
Health · complaint
F0867
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
E
2024-06-11
2023-07-20
Health · complaint
F0558
Reasonably accommodate the needs and preferences of each resident.
D
2023-08-17
2023-07-20
Health
F0582
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
D
2023-08-17
2023-07-20
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
2023-08-17
2023-07-20
Health
F0637
Assess the resident when there is a significant change in condition
D
2023-08-17
2023-07-20
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
2023-08-17
2023-07-20
Health · complaint
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
2023-08-17
2023-07-20
Health · complaint
F0808
Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
D
2023-08-17
2023-07-20
Health
F0867
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
D
2023-08-17
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
7
Owner
Role
Pct
From
Status
Source
ALLIANCE HEALTH GROUP LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-11-22
current
pecos_ownership
EMANUEL, YOSEF
CORPORATE OFFICER
—
2024-08-01
current
pecos_ownership
PARKER, ERIC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-08-01
current
pecos_ownership
ALIGNMENT HOLDCO LLC
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2024-08-01
ended 2026-05-18
pecos_ownership
COALITION GROUP LLC
5% OR GREATER INDIRECT OWNERSHIP INTEREST
100%
2024-08-01
ended 2026-05-18
pecos_ownership
YOSEF EMANUEL
5% OR GREATER INDIRECT OWNERSHIP INTEREST
100%
2024-08-01
ended 2026-05-18
pecos_ownership
ERIC PARKER
OPERATIONAL/MANAGERIAL CONTROL
—
2024-08-01
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
7
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$183,810
—
—
—
—
2
—
2024-07-31
$1,150,170
—
—
$296,328
—
8
—
2023-12-31
$1,952,164
—
—
$440,957
—
9
—
2022-12-31
$1,666,862
—
—
$338,757
$713
10
—
2021-12-31
$2,156,090
—
—
$318,289
$10,860
17
—
2020-12-31
$2,623,352
—
—
$503,783
—
8
—
2019-12-31
$191,104
—
—
—
—
4
—
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
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 37057
acs median gross
0
$858
2024-12-31
CENSUS_ACS5
county 37057
fmr
0
$816
2025-10-01
HUD_USER_FMR
county 37057
acs median gross
1
$762
2024-12-31
CENSUS_ACS5
county 37057
fmr
1
$876
2025-10-01
HUD_USER_FMR
county 37057
acs median gross
2
$808
2024-12-31
CENSUS_ACS5
county 37057
fmr
2
$960
2025-10-01
HUD_USER_FMR
county 37057
acs median gross
3
$1,067
2024-12-31
CENSUS_ACS5
county 37057
fmr
3
$1,316
2025-10-01
HUD_USER_FMR
county 37057
acs median gross
4
$1,187
2024-12-31
CENSUS_ACS5
county 37057
fmr
4
$1,591
2025-10-01
HUD_USER_FMR
county 37057
acs median gross
5
$1,388
2024-12-31
CENSUS_ACS5
county 37057
acs median gross
$901
2024-12-31
CENSUS_ACS5
county 37057
acs recent mover gross
$1,103
2024-12-31
CENSUS_ACS5
zcta 27360
acs median gross
0
$751
2024-12-31
CENSUS_ACS5
zcta 27360
acs median gross
1
$694
2024-12-31
CENSUS_ACS5
zcta 27360
acs median gross
2
$810
2024-12-31
CENSUS_ACS5
zcta 27360
acs median gross
3
$1,027
2024-12-31
CENSUS_ACS5
zcta 27360
acs median gross
4
$1,467
2024-12-31
CENSUS_ACS5
zcta 27360
acs median gross
$879
2024-12-31
CENSUS_ACS5
zcta 27360
acs recent mover gross
$1,026
2024-12-31
CENSUS_ACS5
zip 27360
payment standard 110
0
$946
2025-10-01
HUD_USER_SAFMR
zip 27360
payment standard 90
0
$774
2025-10-01
HUD_USER_SAFMR
zip 27360
safmr
0
$860
2025-10-01
HUD_USER_SAFMR
zip 27360
payment standard 110
1
$1,023
2025-10-01
HUD_USER_SAFMR
zip 27360
payment standard 90
1
$837
2025-10-01
HUD_USER_SAFMR
zip 27360
safmr
1
$930
2025-10-01
HUD_USER_SAFMR
zip 27360
payment standard 110
2
$1,111
2025-10-01
HUD_USER_SAFMR
zip 27360
payment standard 90
2
$909
2025-10-01
HUD_USER_SAFMR
zip 27360
safmr
2
$1,010
2025-10-01
HUD_USER_SAFMR
zip 27360
payment standard 110
3
$1,518
2025-10-01
HUD_USER_SAFMR
zip 27360
payment standard 90
3
$1,242
2025-10-01
HUD_USER_SAFMR
zip 27360
safmr
3
$1,380
2025-10-01
HUD_USER_SAFMR
zip 27360
payment standard 110
4
$1,837
2025-10-01
HUD_USER_SAFMR
zip 27360
payment standard 90
4
$1,503
2025-10-01
HUD_USER_SAFMR
zip 27360
safmr
4
$1,670
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.