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
16
2025Q4 HPRD
This facility
FL median
National median
National p25–p75
Total nurse
3.61
3.42
3.28
2.90–3.77
RN
0.40
0.45
0.39
0.25–0.58
Weekend total
3.44
3.31
3.11
—
Weekday total
3.67
3.48
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
217.4
3.61
0.40
0.80
2.41
3.44
0.0%
2025Q3
92
216.6
3.64
0.45
0.77
2.41
3.45
0.0%
2025Q2
91
219.0
3.63
0.46
0.76
2.42
3.49
0.0%
2025Q1
90
218.5
3.61
0.41
0.80
2.40
3.48
0.0%
2024Q4
92
221.4
3.54
0.44
0.79
2.31
3.49
0.0%
2024Q3
92
217.8
3.53
0.42
0.83
2.27
3.43
0.0%
2024Q2
91
218.5
3.48
0.38
0.79
2.31
3.31
0.0%
2024Q1
91
223.0
3.50
0.35
0.86
2.29
3.36
0.1%
2023Q4
92
213.1
3.69
0.33
0.94
2.42
3.50
6.7%
2023Q3
92
216.9
3.47
0.34
0.86
2.26
3.28
4.0%
2023Q2
91
215.3
3.39
0.37
0.79
2.23
3.22
0.2%
2023Q1
90
219.7
3.42
0.34
0.82
2.26
3.31
0.0%
2022Q4
92
222.8
3.36
0.28
0.87
2.21
3.24
0.2%
2022Q3
92
203.0
3.49
0.36
0.89
2.24
3.29
8.6%
2022Q2
91
202.6
3.39
0.40
0.78
2.21
3.26
10.5%
2022Q1
90
190.6
3.60
0.40
0.81
2.39
3.49
14.2%
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 safe, appropriate pain management for a resident who requires such services.
G
2025-09-21
2025-08-21
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2025-09-21
2025-08-21
Health
F0919
Make sure that a working call system is available in each resident's bathroom and bathing area.
D
2025-09-21
2025-07-16
Health · complaint
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
2025-08-16
2025-07-16
Health · complaint
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2025-08-16
2024-07-17
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
E
2024-08-17
2024-07-17
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
E
2024-08-17
2023-08-18
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
K
2023-09-21
2023-08-18
Health · complaint
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
E
2023-10-23
2023-08-18
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
2023-10-23
2023-08-18
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
J
2023-09-21
2023-08-18
Health · complaint
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
G
2023-09-21
2023-08-18
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
K
2023-09-21
2023-08-18
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
2023-09-21
2023-08-18
Health · complaint
F0835
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
K
2023-09-21
2023-08-18
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
J
2023-09-21
2021-12-02
Health
F0554
Allow residents to self-administer drugs if determined clinically appropriate.
D
2022-01-03
2021-12-02
Health
F0561
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
D
2022-01-03
2021-12-02
Health
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.
E
2022-01-03
2021-12-02
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2022-01-03
2021-12-02
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2022-01-03
2021-12-02
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
2022-01-03
2021-12-02
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2022-01-03
2021-12-02
Health
F0697
Provide safe, appropriate pain management for a resident who requires such services.
D
2022-01-03
2021-12-02
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2022-01-03
2021-12-02
Health
F0880
Provide and implement an infection prevention and control program.
D
2022-01-03
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
47
Owner
Role
Pct
From
Status
Source
ALTAMONTE SPRINGS MED INV LLC
Individual has financial interest in both related organization and provider
100%
2022-10-01
current
hcris_a_8_1
ALTAMONTE SPRINGS MED INV LLC
Individual has financial interest in both related organization and provider
100%
2023-10-01
current
hcris_a_8_1
CHAUDHRY, AZHAR
OPERATIONAL/MANAGERIAL CONTROL
—
2022-01-01
current
pecos_ownership
CHAUDHRY, AZHAR
ADP OF THE SNF
—
2025-03-04
current
pecos_ownership
CROSS, CINDY
INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
—
2025-10-19
current
pecos_ownership
CROSS, CINDY
CORPORATE OFFICER
—
1994-04-21
current
pecos_ownership
FLETCHER, TODD
CORPORATE DIRECTOR
—
2021-05-01
current
pecos_ownership
FLETCHER, TODD
CORPORATE OFFICER
—
2020-11-02
current
pecos_ownership
GONZALEZ, FRANCISCO
ADP OF THE SNF
—
2025-03-04
current
pecos_ownership
GONZALEZ, FRANCISCO
OPERATIONAL/MANAGERIAL CONTROL
—
2018-11-12
current
pecos_ownership
HENRY, TERRY
CORPORATE OFFICER
—
1999-08-16
current
pecos_ownership
LAY, LISA
CORPORATE OFFICER
—
2018-02-09
current
pecos_ownership
LAY, LISA
OPERATIONAL/MANAGERIAL CONTROL
—
2017-04-24
current
pecos_ownership
LIFE CARE CENTERS OF AMERICA, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
—
current
pecos_ownership
LIFE CARE CENTERS OF AMERICA, INC.
ADP OF THE SNF
—
2000-08-31
current
pecos_ownership
MOORMAN, TERESITA
MANAGING CONTROL - GOVERNING BODY
—
2005-05-01
current
pecos_ownership
PRESTON, AARON
OPERATIONAL/MANAGERIAL CONTROL
—
2018-11-01
current
pecos_ownership
PRESTON, AUBREY
OPERATIONAL/MANAGERIAL CONTROL
—
2024-11-27
current
pecos_ownership
PRESTON, FORREST
ADP OF THE SNF
—
2000-08-31
current
pecos_ownership
PRESTON, FORREST
OPERATIONAL/MANAGERIAL CONTROL
—
—
current
pecos_ownership
SWANKER, RICHARD
CORPORATE OFFICER
—
2011-04-01
current
pecos_ownership
SWANKER, RICHARD
OPERATIONAL/MANAGERIAL CONTROL
—
2022-01-01
current
pecos_ownership
THURMOND, JOAN
CORPORATE OFFICER
—
2000-09-22
current
pecos_ownership
ZIEGLER, JAMES
CORPORATE DIRECTOR
—
2001-09-18
current
pecos_ownership
ZIEGLER, JAMES
CORPORATE OFFICER
—
1999-08-16
current
pecos_ownership
ALTAMONTE SPRINGS MED INV. LLC
Individual has financial interest in both related organization and provider
100%
2021-10-01
ended 2022-09-30
hcris_a_8_1
ALTAMONTE SPRINGS MED INV. LLC
Individual has financial interest in both related organization and provider
100%
2020-10-01
ended 2021-09-30
hcris_a_8_1
FORREST PRESTON
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
—
ended 2026-05-18
pecos_ownership
CINDY CROSS
CORPORATE OFFICER
0%
1994-04-21
ended 2026-05-18
pecos_ownership
JOAN THURMOND
CORPORATE OFFICER
0%
2000-09-22
ended 2026-05-18
pecos_ownership
TERRY HENRY
CORPORATE OFFICER
0%
1999-08-16
ended 2026-05-18
pecos_ownership
AARON PRESTON
MANAGING CONTROL - GOVERNING BODY
—
2018-11-01
ended 2026-05-18
pecos_ownership
AUBREY PRESTON
OPERATIONAL/MANAGERIAL CONTROL
—
2024-11-27
ended 2026-05-18
pecos_ownership
AZHAR CHAUDHRY
ADP OF THE SNF
—
2025-03-04
ended 2026-05-18
pecos_ownership
AZHAR CHAUDHRY
OPERATIONAL/MANAGERIAL CONTROL
—
2022-01-01
ended 2026-05-18
pecos_ownership
FORREST PRESTON
ADP OF THE SNF
—
2000-08-31
ended 2026-05-18
pecos_ownership
FRANCISCO GONZALEZ
ADP OF THE SNF
—
2025-03-04
ended 2026-05-18
pecos_ownership
FRANCISCO GONZALEZ
MANAGING CONTROL - GOVERNING BODY
—
2018-11-12
ended 2026-05-18
pecos_ownership
JAMES ZIEGLER
CORPORATE DIRECTOR
—
2001-09-18
ended 2026-05-18
pecos_ownership
JAMES ZIEGLER
CORPORATE OFFICER
—
1999-08-16
ended 2026-05-18
pecos_ownership
LISA LAY
CORPORATE OFFICER
—
2018-02-09
ended 2026-05-18
pecos_ownership
LISA LAY
OPERATIONAL/MANAGERIAL CONTROL
—
2017-04-24
ended 2026-05-18
pecos_ownership
RICHARD SWANKER
OPERATIONAL/MANAGERIAL CONTROL
—
2022-01-01
ended 2026-05-18
pecos_ownership
RICHARD SWANKER
CORPORATE OFFICER
—
2011-04-01
ended 2026-05-18
pecos_ownership
TERESITA MOORMAN
OPERATIONAL/MANAGERIAL CONTROL
—
2005-05-01
ended 2026-05-18
pecos_ownership
TODD FLETCHER
OPERATIONAL/MANAGERIAL CONTROL
—
2021-05-01
ended 2026-05-18
pecos_ownership
TODD FLETCHER
CORPORATE OFFICER
—
2020-11-02
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
2024-09-30
$3,579,360
$755,074
—
—
$1,607,272
6
propco
2023-09-30
$3,536,656
$842,502
—
—
$1,353,057
6
propco
2022-09-30
$3,577,183
$660,043
—
—
$1,366,822
6
propco
2021-09-30
$3,894,379
$562,307
—
—
$1,539,125
6
propco
2020-09-30
$3,712,004
$569,042
—
—
$87,159
6
—
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 12117
acs median gross
0
$1,494
2024-12-31
CENSUS_ACS5
county 12117
fmr
0
$1,650
2025-10-01
HUD_USER_FMR
county 12117
acs median gross
1
$1,617
2024-12-31
CENSUS_ACS5
county 12117
fmr
1
$1,731
2025-10-01
HUD_USER_FMR
county 12117
acs median gross
2
$1,764
2024-12-31
CENSUS_ACS5
county 12117
fmr
2
$1,972
2025-10-01
HUD_USER_FMR
county 12117
acs median gross
3
$1,991
2024-12-31
CENSUS_ACS5
county 12117
fmr
3
$2,476
2025-10-01
HUD_USER_FMR
county 12117
acs median gross
4
$2,284
2024-12-31
CENSUS_ACS5
county 12117
fmr
4
$2,924
2025-10-01
HUD_USER_FMR
county 12117
acs median gross
5
$3,252
2024-12-31
CENSUS_ACS5
county 12117
acs median gross
$1,783
2024-12-31
CENSUS_ACS5
county 12117
acs recent mover gross
$1,922
2024-12-31
CENSUS_ACS5
zcta 32701
acs median gross
0
$1,407
2024-12-31
CENSUS_ACS5
zcta 32701
acs median gross
1
$1,657
2024-12-31
CENSUS_ACS5
zcta 32701
acs median gross
2
$1,735
2024-12-31
CENSUS_ACS5
zcta 32701
acs median gross
3
$1,826
2024-12-31
CENSUS_ACS5
zcta 32701
acs median gross
4
$2,237
2024-12-31
CENSUS_ACS5
zcta 32701
acs median gross
$1,715
2024-12-31
CENSUS_ACS5
zcta 32701
acs recent mover gross
$1,692
2024-12-31
CENSUS_ACS5
zip 32701
payment standard 110
0
$1,727
2025-10-01
HUD_USER_SAFMR
zip 32701
payment standard 90
0
$1,413
2025-10-01
HUD_USER_SAFMR
zip 32701
safmr
0
$1,570
2025-10-01
HUD_USER_SAFMR
zip 32701
payment standard 110
1
$1,815
2025-10-01
HUD_USER_SAFMR
zip 32701
payment standard 90
1
$1,485
2025-10-01
HUD_USER_SAFMR
zip 32701
safmr
1
$1,650
2025-10-01
HUD_USER_SAFMR
zip 32701
payment standard 110
2
$2,068
2025-10-01
HUD_USER_SAFMR
zip 32701
payment standard 90
2
$1,692
2025-10-01
HUD_USER_SAFMR
zip 32701
safmr
2
$1,880
2025-10-01
HUD_USER_SAFMR
zip 32701
payment standard 110
3
$2,596
2025-10-01
HUD_USER_SAFMR
zip 32701
payment standard 90
3
$2,124
2025-10-01
HUD_USER_SAFMR
zip 32701
safmr
3
$2,360
2025-10-01
HUD_USER_SAFMR
zip 32701
payment standard 110
4
$3,069
2025-10-01
HUD_USER_SAFMR
zip 32701
payment standard 90
4
$2,511
2025-10-01
HUD_USER_SAFMR
zip 32701
safmr
4
$2,790
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.