Composite
56.1 / 100 percentile
| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| billing conduct | 94.8 | 65.2 | 0.30 | 0.2857 | 27.09 | in index |
| regulatory risk | 42.8 | 31.6 | 0.30 | 0.2857 | 12.23 | in index |
| financial risk | 34.4 | 36.4 | 0.30 | 0.2857 | 9.83 | in index |
| chow risk | 9.7 | 17.5 | 0.15 | 0.1429 | 1.39 | in index |
| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner spans multiple chains | 18 chains | ENSIGN SERVICES INC | 286 facilities |
| connection | Owner spans multiple chains | 17 chains | BURNAM SOON | 335 facilities |
| connection | Owner spans multiple chains | 17 chains | KEETCH CHAD | 283 facilities |
| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 65.2 | D | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 18.1 | A | 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 | 16.8 | A | v0.6 | default · in composite | |
| financial risk | 36.4 | B | 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 | 0.3 | — | 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 | 31.6 | B | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| financial risk | 95.2 | F | 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 | 75.2 | D | 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 | 53.3 | C | 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 | 40.0 | B | 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 | 31.5 | B | 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 | 31.5 | B | 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. |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Never sold on record | 0.00 | -1.62 | |
| Current owner tenure (years) | 5.57 | -1.31 | |
| Chain size (log) | 5.46 | +0.76 | |
| For-profit ownership | 1.00 | +0.69 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Deficiencies, last 12 months | 20.00 | +0.31 | |
| Total nurse staffing (HPRD) | 4.50 | -0.29 | |
| Ownership changes, last 5 years | 0.00 | +0.20 |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Deficiencies, last 12 months | 20.00 | -2.28 | |
| Chain size (log) | 5.46 | -1.98 | |
| For-profit ownership | 1.00 | -0.69 | |
| Total nurse staffing (HPRD) | 4.50 | -0.54 | |
| Occupancy | 0.65 | +0.41 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Never sold on record | 0.00 | -0.28 | |
| Current owner tenure (years) | 5.57 | -0.21 |
| 2025Q3 HPRD | This facility | CA median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 4.50 | 3.95 | 3.28 | 2.90–3.77 |
| RN | 0.89 | 0.38 | 0.39 | 0.25–0.58 |
| Weekend total | 3.91 | 3.79 | 3.11 | — |
| Weekday total | 4.73 | 4.01 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q3 | 92 | 64.5 | 4.50 | 0.89 | 1.14 | 2.46 | 3.91 | 15.1% |
| 2025Q2 | 91 | 2.4 | 18.46 | 3.82 | 6.70 | 7.95 | 7.30 | 0.0% |
| 2024Q1 | 91 | 22.1 | 5.10 | 0.64 | 1.96 | 2.49 | 4.03 | 0.0% |
| 2023Q4 | 92 | 89.0 | 4.65 | 0.56 | 1.67 | 2.41 | 4.20 | 1.1% |
| 2023Q3 | 92 | 89.8 | 4.70 | 0.54 | 1.55 | 2.61 | 4.16 | 11.3% |
| 2023Q2 | 91 | 90.4 | 4.39 | 0.52 | 1.54 | 2.33 | 3.91 | 11.7% |
| 2023Q1 | 90 | 91.9 | 4.37 | 0.60 | 1.46 | 2.31 | 3.72 | 10.7% |
| 2022Q4 | 92 | 86.6 | 4.43 | 0.56 | 1.43 | 2.44 | 3.88 | 19.1% |
| 2022Q3 | 92 | 86.1 | 4.06 | 0.57 | 1.23 | 2.27 | 3.73 | 21.7% |
| 2022Q2 | 91 | 84.8 | 3.95 | 0.51 | 1.20 | 2.24 | 3.73 | 20.5% |
| 2022Q1 | 90 | 84.8 | 4.00 | 0.75 | 1.07 | 2.18 | 3.75 | 11.5% |
| Date | Type | Fine | Source |
|---|---|---|---|
| 2026-02-19 | Payment Denial | — | CMS provider data |
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-04-22 | Health · complaint | F0557 | Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | D | 2026-05-06 |
| 2026-04-22 | 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 | 2026-05-06 |
| 2026-04-02 | 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 | 2026-04-23 |
| 2026-04-02 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2026-04-23 |
| 2026-02-19 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2026-03-13 |
| 2026-02-19 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2026-03-13 |
| 2025-08-28 | Health | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2025-09-27 |
| 2025-08-28 | Health | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | 2025-09-27 |
| 2025-08-28 | 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 | 2025-09-27 |
| 2025-08-28 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-09-27 |
| 2025-08-28 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2025-09-27 |
| 2025-08-28 | Health | F0679 | Provide activities to meet all resident's needs. | D | 2025-09-27 |
| 2025-08-28 | 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 | 2025-09-27 |
| 2025-08-28 | Health | F0694 | Provide for the safe, appropriate administration of IV fluids for a resident when needed. | D | 2025-09-27 |
| 2025-08-28 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2025-09-27 |
| 2025-08-28 | Health | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | D | 2025-09-27 |
| 2025-08-28 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2025-09-27 |
| 2025-08-28 | Health | F0757 | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | 2025-09-27 |
| 2025-08-28 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2025-09-27 |
| 2025-08-28 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2025-09-27 |
| 2023-06-02 | Health · complaint | F0838 | Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies. | E | 2023-06-30 |
| 2021-10-21 | Health | 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 | 2021-11-19 |
| 2021-10-21 | 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 | 2021-11-19 |
| 2021-10-21 | 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 | 2021-11-19 |
| 2021-10-21 | Health | F0803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | D | 2021-11-19 |
| 2021-10-21 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2021-11-19 |
| 2019-10-10 | 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 | 2019-11-06 |
| 2019-10-10 | Health | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | 2019-11-06 |
| 2019-10-10 | Health | F0660 | Plan the resident's discharge to meet the resident's goals and needs. | D | 2019-11-06 |
| 2019-10-10 | Health | F0676 | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | 2019-11-06 |
| 2019-10-10 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2019-11-06 |
| 2019-10-10 | 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 | 2019-11-06 |
| 2019-10-10 | Health | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | D | 2019-11-06 |
| 2019-10-10 | Health | F0800 | Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. | D | 2019-11-06 |
| 2019-10-10 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2019-11-06 |
| 2019-10-10 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2019-11-06 |
| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| AFSHAR, POUYA | ADP OF THE SNF | — | 2025-06-21 | current | pecos_ownership |
| AFSHAR, POUYA | MANAGING CONTROL - GOVERNING BODY | — | 2022-07-01 | current | pecos_ownership |
| ALKEMA, SHAUN | OPERATIONAL/MANAGERIAL CONTROL | — | 2021-01-01 | current | pecos_ownership |
| ALKEMA, SHAUN | ADP OF THE SNF | — | 2025-06-21 | current | pecos_ownership |
| BURNAM, SOON | CORPORATE OFFICER | — | 2019-01-24 | current | pecos_ownership |
| ENSIGN SERVICES INC | ADP OF THE SNF | — | 2019-01-24 | current | pecos_ownership |
| GOLDEN HILL REAL ESTATE COMPANY, LLC | ADP OF THE SNF | — | 2021-01-01 | current | pecos_ownership |
| KEETCH, CHAD | CORPORATE OFFICER | — | 2011-03-01 | current | pecos_ownership |
| PORT, BARRY | CORPORATE OFFICER | — | 2024-09-09 | current | pecos_ownership |
| SATO, AMI | CORPORATE OFFICER | — | 2024-09-20 | current | pecos_ownership |
| WILLITS, ADAM | CORPORATE DIRECTOR | — | 2019-01-24 | current | pecos_ownership |
| FLAGSTONE HEALTHCARE SOUTH LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2019-01-24 | ended 2026-05-18 | pecos_ownership |
| THE ENSIGN GROUP INC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2019-01-24 | ended 2026-05-18 | pecos_ownership |
| BARRY PORT | CORPORATE OFFICER | 0% | 2024-09-09 | ended 2026-05-18 | pecos_ownership |
| SHAUN ALKEMA | OPERATIONAL/MANAGERIAL CONTROL | 0% | 2021-01-01 | ended 2026-05-18 | pecos_ownership |
| ADAM WILLITS | CORPORATE DIRECTOR | — | 2019-01-24 | ended 2026-05-18 | pecos_ownership |
| AMI SATO | CORPORATE OFFICER | — | 2024-09-20 | ended 2026-05-18 | pecos_ownership |
| CHAD KEETCH | CORPORATE OFFICER | — | 2011-03-01 | ended 2026-05-18 | pecos_ownership |
| POUYA AFSHAR | ADP OF THE SNF | — | 2025-06-21 | ended 2026-05-18 | pecos_ownership |
| POUYA AFSHAR | OPERATIONAL/MANAGERIAL CONTROL | — | 2022-07-01 | ended 2026-05-18 | pecos_ownership |
| SHAUN ALKEMA | ADP OF THE SNF | — | 2025-06-21 | ended 2026-05-18 | pecos_ownership |
| SOON BURNAM | CORPORATE OFFICER | — | 2019-01-24 | ended 2026-05-18 | pecos_ownership |
| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2021-01-01 | — | DEVONSHIRE HEALTHCARE INC | WINDSOR HEALTHCARE GOLDEN PALMS LLC | chow |
| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-08-01 | Turlock Nursing & Rehabilitation Center | — | — | — | 144 | TRACY RIDGE HEALTHCARE, INC. |
| 2025-04-01 | ALAMITOS WEST HEALTH & REHABILITATION | — | — | — | 150 | MALCOLM HEALTHCARE, INC. |
| 2025-04-01 | PACIFIC HAVEN SUBACUTE AND HEALTHCARE CENTER | — | — | — | 99 | STRAWBERRY POND HEALTHCARE LLC |
| 2025-01-16 | GOLDEN HARBOR HEALTHCARE CENTER | — | — | — | 99 | CEYLON HOLDINGS LLC |
| 2024-12-30 | GRASS VALLEY HEALTHCARE CENTER | — | — | — | 86 | HEISMAN LLC |
| 2024-10-01 | REDWOOD GROVE POST ACUTE | — | — | — | 144 | SOQUEL CARE LLC |
| 2024-09-01 | OAK GROVE POST ACUTE | — | — | — | 119 | 4545 SHELLEY COURT OPCO, LLC |
| 2024-08-01 | WE CARE SKILLED NURSING - FREMONT | — | — | — | 99 | WE CARE SKILLED NURSING-FREMONT, LLC |
| 2024-05-01 | MAJESTIC MOUNTAIN CARE CENTER | — | — | — | 66 | OAKHURST SKILLED CARE LLC |
| 2024-04-01 | THE BRADLEY GARDENS | — | — | — | 44 | GHC OF SAN JACINTO LLC |
| 2024-04-01 | SANTA FE POST-ACUTE | — | — | — | 187 | SKILLED BOBIER LLC |
| 2024-04-01 | BAYSHIRE SAN DIMAS POST-ACUTE | — | — | — | 45 | SKILLED SAN DIMAS LLC |
| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 06073 | acs median gross | 0 | $1,761 | 2024-12-31 | CENSUS_ACS5 |
| county 06073 | fmr | 0 | $2,288 | 2025-10-01 | HUD_USER_FMR |
| county 06073 | acs median gross | 1 | $1,888 | 2024-12-31 | CENSUS_ACS5 |
| county 06073 | fmr | 1 | $2,459 | 2025-10-01 | HUD_USER_FMR |
| county 06073 | acs median gross | 2 | $2,290 | 2024-12-31 | CENSUS_ACS5 |
| county 06073 | fmr | 2 | $3,001 | 2025-10-01 | HUD_USER_FMR |
| county 06073 | acs median gross | 3 | $2,826 | 2024-12-31 | CENSUS_ACS5 |
| county 06073 | fmr | 3 | $3,998 | 2025-10-01 | HUD_USER_FMR |
| county 06073 | acs median gross | 4 | $3,451 | 2024-12-31 | CENSUS_ACS5 |
| county 06073 | fmr | 4 | $4,845 | 2025-10-01 | HUD_USER_FMR |
| county 06073 | acs median gross | 5 | $3,501 | 2024-12-31 | CENSUS_ACS5 |
| county 06073 | acs median gross | $2,246 | 2024-12-31 | CENSUS_ACS5 | |
| county 06073 | acs recent mover gross | $2,729 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 92102 | acs median gross | 0 | $1,553 | 2024-12-31 | CENSUS_ACS5 |
| zcta 92102 | acs median gross | 1 | $1,800 | 2024-12-31 | CENSUS_ACS5 |
| zcta 92102 | acs median gross | 2 | $2,121 | 2024-12-31 | CENSUS_ACS5 |
| zcta 92102 | acs median gross | 3 | $2,653 | 2024-12-31 | CENSUS_ACS5 |
| zcta 92102 | acs median gross | 4 | $2,467 | 2024-12-31 | CENSUS_ACS5 |
| zcta 92102 | acs median gross | $1,940 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 92102 | acs recent mover gross | $2,268 | 2024-12-31 | CENSUS_ACS5 | |
| zip 92102 | payment standard 110 | 0 | $2,343 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | payment standard 90 | 0 | $1,917 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | safmr | 0 | $2,130 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | payment standard 110 | 1 | $2,519 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | payment standard 90 | 1 | $2,061 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | safmr | 1 | $2,290 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | payment standard 110 | 2 | $3,080 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | payment standard 90 | 2 | $2,520 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | safmr | 2 | $2,800 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | payment standard 110 | 3 | $4,103 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | payment standard 90 | 3 | $3,357 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | safmr | 3 | $3,730 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | payment standard 110 | 4 | $4,972 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | payment standard 90 | 4 | $4,068 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92102 | safmr | 4 | $4,520 | 2025-10-01 | HUD_USER_SAFMR |