Composite
72.6 / 100 percentile
| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 79.8 | 76.5 | 0.30 | 0.2308 | 18.42 | in index |
| staffing risk | 87.5 | 87.5 | 0.25 | 0.1923 | 16.83 | in index |
| financial risk | 70.7 | 59.6 | 0.30 | 0.2308 | 16.32 | in index |
| chow risk | 47.9 | 46.0 | 0.15 | 0.1154 | 5.53 | in index |
| billing conduct | 0.0 | 0.0 | 0.30 | 0.2308 | 0.00 | in index |
| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 0.0 | A | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 25.0 | B | v0.1-pos | default · in composite | 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. |
| chow risk | 67.0 | D | v0.6 | default · in composite | |
| financial risk | 59.6 | C | v0.5 | default · in composite | R18. |
| p adverse action 12m | 0.0 | — | v0.1 | default · in composite | 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. |
| p chow 12m | 5.1 | — | v0.1 | default · in 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. |
| regulatory risk | 76.5 | D | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 87.5 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 78.2 | D | v0.1 | superseded | 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. |
| financial risk | 58.2 | C | v0.2 | superseded | 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. |
| financial risk | 65.3 | D | v0.3 | superseded | 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. |
| financial risk | 60.0 | C | v0.4 | superseded | 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. |
| regulatory risk | 76.4 | D | v0.1 | superseded | 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. |
| regulatory risk | 76.4 | D | v0.2 | superseded | 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. |
| staffing risk | 87.5 | F | v0.1 | superseded | 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. |
| staffing risk | 87.5 | F | v0.2 | superseded | 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. |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Occupancy | 0.94 | -0.69 | |
| For-profit ownership | 1.00 | +0.69 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Chain size (log) | 3.43 | +0.33 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Deficiencies, last 12 months | 11.00 | +0.10 |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Chain size (log) | 3.43 | -0.80 | |
| Occupancy | 0.94 | -0.79 | |
| For-profit ownership | 1.00 | -0.69 | |
| Deficiencies, last 12 months | 11.00 | -0.61 | |
| Fine amount, 12m (log) | 10.52 | -0.59 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Total nurse staffing (HPRD) | 2.62 | +0.25 | |
| Never sold on record | 1.00 | +0.12 |
| 2025Q4 HPRD | This facility | IA median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 2.62 | 3.15 | 3.28 | 2.90–3.77 |
| RN | 0.28 | 0.46 | 0.39 | 0.25–0.58 |
| Weekend total | 2.48 | 2.96 | 3.11 | — |
| Weekday total | 2.67 | 3.20 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 74.9 | 2.62 | 0.28 | 0.35 | 1.99 | 2.48 | 1.0% |
| 2025Q3 | 92 | 72.6 | 2.92 | 0.37 | 0.40 | 2.15 | 2.73 | 4.8% |
| 2025Q2 | 91 | 71.6 | 3.03 | 0.33 | 0.42 | 2.28 | 2.68 | 3.9% |
| 2025Q1 | 90 | 73.0 | 2.90 | 0.31 | 0.49 | 2.10 | 2.72 | 1.3% |
| 2024Q4 | 92 | 77.1 | 2.79 | 0.37 | 0.47 | 1.95 | 2.58 | 5.8% |
| 2024Q3 | 92 | 72.2 | 2.59 | 0.25 | 0.59 | 1.75 | 2.27 | 3.8% |
| 2024Q2 | 91 | 67.8 | 2.94 | 0.27 | 0.63 | 2.04 | 2.66 | 0.0% |
| 2024Q1 | 91 | 67.3 | 3.00 | 0.30 | 0.62 | 2.08 | 2.92 | 0.0% |
| 2023Q4 | 92 | 71.6 | 2.86 | 0.34 | 0.60 | 1.92 | 2.47 | 0.0% |
| 2023Q3 | 92 | 70.7 | 2.98 | 0.38 | 0.46 | 2.15 | 2.76 | 0.0% |
| 2023Q2 | 91 | 68.4 | 2.78 | 0.19 | 0.50 | 2.09 | 2.44 | 0.0% |
| 2023Q1 | 90 | 62.1 | 3.14 | 0.31 | 0.52 | 2.32 | 2.83 | 0.0% |
| 2022Q4 | 92 | 62.4 | 3.07 | 0.28 | 0.61 | 2.18 | 2.83 | 0.0% |
| 2022Q3 | 92 | 62.3 | 2.79 | 0.31 | 0.64 | 1.84 | 2.72 | 0.0% |
| 2022Q2 | 91 | 59.2 | 2.83 | 0.32 | 0.62 | 1.89 | 2.62 | 3.4% |
| 2022Q1 | 90 | 59.6 | 2.67 | 0.40 | 0.57 | 1.70 | 2.56 | 0.2% |
| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-07-31 | Fine | $37,177 | CMS provider data |
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-01-29 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2026-02-13 |
| 2026-01-29 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2026-02-13 |
| 2026-01-29 | Health · complaint | F0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | E | 2026-02-13 |
| 2025-07-31 | Health · complaint | F0641 | Ensure each resident receives an accurate assessment. | E | 2025-08-01 |
| 2025-07-31 | 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 | 2025-08-01 |
| 2025-07-31 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-08-01 |
| 2025-07-31 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2025-08-01 |
| 2025-07-31 | 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 | 2025-08-01 |
| 2025-07-31 | Health | F0760 | Ensure that residents are free from significant medication errors. | D | 2025-08-01 |
| 2025-07-31 | Health · complaint | F0851 | Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. | D | 2025-08-01 |
| 2025-07-31 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2025-08-01 |
| 2025-04-03 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2025-04-19 |
| 2025-04-03 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | 2025-04-19 |
| 2025-04-03 | Health · complaint | 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 | 2025-04-19 |
| 2025-04-03 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2025-04-19 |
| 2025-03-03 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2025-03-04 |
| 2025-03-03 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-03-04 |
| 2025-03-03 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | 2025-04-19 |
| 2025-01-15 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2025-02-13 |
| 2025-01-15 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2025-02-13 |
| 2025-01-15 | Health · complaint | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | E | 2025-02-13 |
| 2025-01-15 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2025-02-13 |
| 2024-08-28 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-09-20 |
| 2024-08-28 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2024-09-20 |
| 2024-08-28 | 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 | 2024-09-20 |
| 2024-08-28 | 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 | 2024-09-20 |
| 2024-08-28 | Health · complaint | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | E | 2024-09-20 |
| 2024-08-28 | 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 | 2024-09-20 |
| 2024-08-28 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2024-09-20 |
| 2024-05-08 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-05-31 |
| 2024-05-08 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-05-31 |
| 2024-05-08 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2024-05-31 |
| 2023-08-10 | Health · complaint | 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. | D | 2023-08-31 |
| 2023-06-15 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2023-07-07 |
| 2023-06-15 | 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 | 2023-07-07 |
| 2023-06-15 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2023-07-07 |
| 2023-06-15 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2023-06-29 |
| 2023-06-15 | Health | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | D | 2023-07-07 |
| 2023-06-15 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2023-07-07 |
| 2023-06-15 | Health | F0791 | Provide or obtain dental services for each resident. | D | 2023-07-07 |
| 2023-06-15 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2023-07-07 |
| 2023-06-15 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2023-07-07 |
| 2023-06-15 | Health · complaint | F0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | D | 2023-07-07 |
| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| FIRST INTERSTATE BANK | 5% OR GREATER MORTGAGE INTEREST | 100% | 2002-06-01 | ended 2026-05-18 | pecos_ownership |
| KEVIN BABB | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 49% | 2015-12-02 | ended 2026-05-18 | pecos_ownership |
| ROBERT CONNER | CORPORATE DIRECTOR | 49% | 2015-12-02 | ended 2026-05-18 | pecos_ownership |
| JENNIFER CONNER | CORPORATE OFFICER | 1% | 2015-12-02 | ended 2026-05-18 | pecos_ownership |
| AMERICAN HEALTHCARE MANAGEMENT SERVICES LLC | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-01-01 | ended 2026-05-18 | pecos_ownership |
| AMERICAN HEALTHCARE MANAGEMENT SERVICES LLC | ADP OF THE SNF | — | 2025-12-23 | ended 2026-05-18 | pecos_ownership |
| BRIGHTON CONSULTING GROUP LLC | ADP OF THE SNF | — | 2002-01-01 | ended 2026-05-18 | pecos_ownership |
| KAYLYN FISHER | ADP OF THE SNF | — | 2024-10-07 | ended 2026-05-18 | pecos_ownership |
| KEVIN BABB | ADP OF THE SNF | — | 2017-04-12 | ended 2026-05-18 | pecos_ownership |
| LISA TOTI | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-01-01 | ended 2026-05-18 | pecos_ownership |
| MARTENS & COMPANY CPA, LLP | ADP OF THE SNF | — | 2017-01-01 | ended 2026-05-18 | pecos_ownership |
| ROBERT CONNER | ADP OF THE SNF | — | 2001-01-01 | ended 2026-05-18 | pecos_ownership |
| TED LENEAVE | ADP OF THE SNF | — | 2024-01-01 | ended 2026-05-18 | pecos_ownership |
| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-09-01 | St Luke's Regional Medical Center SNF | — | — | — | 20 | NORTHWEST IOWA HOSPITAL CORPORATION |
| 2025-08-01 | Crystal Heights Care Center | — | — | — | 72 | CANFIELD RIVER HEALTHCARE LLC |
| 2025-06-01 | AMS Memorial-Greene | — | — | — | 31 | AMS MEMORIAL-GREENE LLC |
| 2025-02-05 | Chapters Living of Council Bluffs | — | — | — | 102 | CHAPTERS COUNCIL BLUFFS OPCO LLC |
| 2025-02-01 | Osage Rehab and Health Care Center | — | — | — | 46 | OPCO OSAGE IA LLC |
| 2025-02-01 | Iowa City Rehab & Health Care | — | — | — | 89 | OPCO IOWA CITY IA LLC |
| 2025-02-01 | Accura Healthcare of Creston | — | — | — | 31 | ACCURA HEALTHCARE OF CRESTON LLC |
| 2025-02-01 | Casa De Paz Health Care Center | — | — | — | 71 | OPCO 19TH ST SIOUX CITY IA LLC |
| 2025-02-01 | Pleasant Acres Care Center | — | — | — | 46 | OPCO HULL IA LLC |
| 2025-02-01 | Cedar Falls Health Care Center | — | — | — | 70 | OPCO CEDAR FALLS IA LLC |
| 2025-02-01 | Accura Healthcare of Onawa | — | — | — | 46 | ACCURA HEALTHCARE OF ONAWA LLC |
| 2025-02-01 | Grundy Care Center | — | — | — | 40 | OPCO GRUNDY CENTER IA LLC |
| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 19181 | fmr | 0 | $1,063 | 2025-10-01 | HUD_USER_FMR |
| county 19181 | acs median gross | 1 | $605 | 2024-12-31 | CENSUS_ACS5 |
| county 19181 | fmr | 1 | $1,109 | 2025-10-01 | HUD_USER_FMR |
| county 19181 | acs median gross | 2 | $963 | 2024-12-31 | CENSUS_ACS5 |
| county 19181 | fmr | 2 | $1,318 | 2025-10-01 | HUD_USER_FMR |
| county 19181 | acs median gross | 3 | $1,487 | 2024-12-31 | CENSUS_ACS5 |
| county 19181 | fmr | 3 | $1,794 | 2025-10-01 | HUD_USER_FMR |
| county 19181 | acs median gross | 4 | $1,741 | 2024-12-31 | CENSUS_ACS5 |
| county 19181 | fmr | 4 | $1,841 | 2025-10-01 | HUD_USER_FMR |
| county 19181 | acs median gross | 5 | $1,701 | 2024-12-31 | CENSUS_ACS5 |
| county 19181 | acs median gross | $973 | 2024-12-31 | CENSUS_ACS5 | |
| county 19181 | acs recent mover gross | $864 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 50047 | acs median gross | 1 | $713 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50047 | acs median gross | 2 | $924 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50047 | acs median gross | 3 | $1,381 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50047 | acs median gross | $1,227 | 2024-12-31 | CENSUS_ACS5 | |
| zip 50047 | payment standard 110 | 0 | $1,298 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | payment standard 90 | 0 | $1,062 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | safmr | 0 | $1,180 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | payment standard 110 | 1 | $1,353 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | payment standard 90 | 1 | $1,107 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | safmr | 1 | $1,230 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | payment standard 110 | 2 | $1,606 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | payment standard 90 | 2 | $1,314 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | safmr | 2 | $1,460 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | payment standard 110 | 3 | $2,189 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | payment standard 90 | 3 | $1,791 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | safmr | 3 | $1,990 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | payment standard 110 | 4 | $2,244 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | payment standard 90 | 4 | $1,836 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50047 | safmr | 4 | $2,040 | 2025-10-01 | HUD_USER_SAFMR |