400 TRI-COUNTY LANE, RICHLAND, MO 65556 · CCN 265755
Composite
23.1 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
86
Model
v1.2
Reads as: riskier than 23.1% 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
MO median
National median
National p25–p75
Total nurse
2.54
2.41
3.28
2.90–3.77
RN
0.24
0.25
0.39
0.25–0.58
Weekend total
2.36
2.24
3.11
—
Weekday total
2.61
2.49
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
40.7
2.54
0.24
0.74
1.56
2.36
0.0%
2025Q3
92
38.9
2.72
0.20
0.82
1.70
2.60
0.0%
2025Q2
91
40.7
2.86
0.07
0.86
1.93
2.79
0.0%
2025Q1
90
32.4
3.19
0.08
1.10
2.02
3.03
0.0%
2024Q4
92
31.3
3.02
0.09
1.23
1.70
2.89
0.0%
2024Q3
92
32.9
2.46
0.06
1.11
1.29
2.21
0.0%
2024Q2
91
30.7
1.86
0.05
0.80
1.01
1.58
0.0%
2024Q1
91
32.5
2.32
0.09
0.75
1.48
2.38
0.3%
2023Q4
92
34.0
1.69
0.09
0.72
0.88
1.53
0.0%
2023Q3
92
31.1
2.09
0.16
0.97
0.96
1.87
0.0%
2023Q2
91
28.4
2.97
0.25
1.04
1.67
2.66
0.5%
2023Q1
90
27.9
2.92
0.08
1.07
1.78
2.52
0.0%
2022Q4
92
30.5
2.56
0.10
0.87
1.58
2.23
0.9%
2022Q3
92
32.2
2.28
0.13
0.84
1.31
2.02
0.0%
2022Q2
91
27.4
2.84
0.09
1.11
1.64
2.37
0.3%
2022Q1
90
26.9
2.73
0.07
1.05
1.60
2.23
0.0%
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.
Penalties
0
No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
12
C × 2D × 3E × 5F × 2
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2024-09-20
Health
F0568
Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
E
2024-10-11
2024-09-20
Health
F0569
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
C
2024-10-11
2024-09-20
Health
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
D
2024-10-10
2024-09-20
Health
F0804
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
E
2024-10-07
2024-09-20
Health
F0880
Provide and implement an infection prevention and control program.
F
2024-10-11
2023-12-07
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2024-01-05
2023-12-07
Health · complaint
F0610
Respond appropriately to all alleged violations.
D
2024-01-05
2023-05-24
Health
F0575
Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.
C
2023-07-08
2023-05-24
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2023-07-08
2023-05-24
Health
F0880
Provide and implement an infection prevention and control program.
E
2023-07-08
2020-10-08
Health
F0759
Ensure medication error rates are not 5 percent or greater.
E
2020-11-02
2020-10-08
Health
F0880
Provide and implement an infection prevention and control program.
E
2020-11-02
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
27
Owner
Role
Pct
From
Status
Source
ALEXANDER, JEANNE
CORPORATE DIRECTOR
—
2009-06-01
current
pecos_ownership
AVILA, JULIE
OPERATIONAL/MANAGERIAL CONTROL
—
2024-09-25
current
pecos_ownership
AVILA, JULIE
ADP OF THE SNF
—
2024-09-26
current
pecos_ownership
BELSHE, TIMOTHY
TRUSTEE OF THE SNF
—
2021-06-01
current
pecos_ownership
FREDERICK, LYNN
CORPORATE DIRECTOR
—
2024-01-01
current
pecos_ownership
HOWLETT, DAVID
CORPORATE DIRECTOR
—
2021-08-01
current
pecos_ownership
JACOBSON, DOUGLAS
CORPORATE DIRECTOR
—
2016-06-01
current
pecos_ownership
MITSCHELE, SHIRLEY
CORPORATE DIRECTOR
—
2011-06-01
current
pecos_ownership
OURSBOURN, WILMA
CORPORATE DIRECTOR
—
2021-09-01
current
pecos_ownership
PREWETT, JOHNNY
CORPORATE DIRECTOR
—
2004-05-01
current
pecos_ownership
RICHLAND CARE CENTER, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
—
current
pecos_ownership
STRUCKHOFF, KENNETH
CORPORATE DIRECTOR
—
—
current
pecos_ownership
WARREN, DAVID
CORPORATE DIRECTOR
—
—
current
pecos_ownership
WINFREY, GLENDA
CORPORATE DIRECTOR
—
2019-05-01
current
pecos_ownership
DAVID HOWLETT
CORPORATE DIRECTOR
0%
2021-08-01
ended 2026-05-18
pecos_ownership
GLENDA WINFREY
CORPORATE DIRECTOR
0%
2019-05-01
ended 2026-05-18
pecos_ownership
JEANNE ALEXANDER
CORPORATE DIRECTOR
0%
2009-06-01
ended 2026-05-18
pecos_ownership
JOHNNY PREWETT
CORPORATE DIRECTOR
0%
2004-05-01
ended 2026-05-18
pecos_ownership
KENNETH STRUCKHOFF
CORPORATE DIRECTOR
0%
—
ended 2026-05-18
pecos_ownership
TIMOTHY BELSHE
CORPORATE DIRECTOR
0%
2021-06-01
ended 2026-05-18
pecos_ownership
WILMA OURSBOURN
CORPORATE DIRECTOR
0%
2021-09-01
ended 2026-05-18
pecos_ownership
DAVID WARREN
CORPORATE DIRECTOR
—
—
ended 2026-05-18
pecos_ownership
DOUGLAS JACOBSON
CORPORATE DIRECTOR
—
2016-06-01
ended 2026-05-18
pecos_ownership
JULIE AVILA
OPERATIONAL/MANAGERIAL CONTROL
—
2024-09-25
ended 2026-05-18
pecos_ownership
JULIE AVILA
ADP OF THE SNF
—
2024-09-26
ended 2026-05-18
pecos_ownership
LYNN FREDERICK
CORPORATE DIRECTOR
—
2024-01-01
ended 2026-05-18
pecos_ownership
SHIRLEY MITSCHELE
CORPORATE DIRECTOR
—
2011-06-01
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
0
No related-party cost years on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
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
33
Geo
Kind
BR
Amount
As of
Source
county 29169
acs median gross
0
$280
2024-12-31
CENSUS_ACS5
county 29169
fmr
0
$789
2025-10-01
HUD_USER_FMR
county 29169
acs median gross
1
$644
2024-12-31
CENSUS_ACS5
county 29169
fmr
1
$809
2025-10-01
HUD_USER_FMR
county 29169
acs median gross
2
$959
2024-12-31
CENSUS_ACS5
county 29169
fmr
2
$1,062
2025-10-01
HUD_USER_FMR
county 29169
acs median gross
3
$1,300
2024-12-31
CENSUS_ACS5
county 29169
fmr
3
$1,477
2025-10-01
HUD_USER_FMR
county 29169
acs median gross
4
$1,473
2024-12-31
CENSUS_ACS5
county 29169
fmr
4
$1,699
2025-10-01
HUD_USER_FMR
county 29169
acs median gross
5
$1,542
2024-12-31
CENSUS_ACS5
county 29169
acs median gross
$1,112
2024-12-31
CENSUS_ACS5
county 29169
acs recent mover gross
$1,341
2024-12-31
CENSUS_ACS5
zcta 65556
acs median gross
0
$281
2024-12-31
CENSUS_ACS5
zcta 65556
acs median gross
1
$456
2024-12-31
CENSUS_ACS5
zcta 65556
acs median gross
3
$988
2024-12-31
CENSUS_ACS5
zcta 65556
acs median gross
$478
2024-12-31
CENSUS_ACS5
zcta 65556
acs recent mover gross
$958
2024-12-31
CENSUS_ACS5
zip 65556
payment standard 110
0
$759
2025-10-01
HUD_USER_SAFMR
zip 65556
payment standard 90
0
$621
2025-10-01
HUD_USER_SAFMR
zip 65556
safmr
0
$690
2025-10-01
HUD_USER_SAFMR
zip 65556
payment standard 110
1
$759
2025-10-01
HUD_USER_SAFMR
zip 65556
payment standard 90
1
$621
2025-10-01
HUD_USER_SAFMR
zip 65556
safmr
1
$690
2025-10-01
HUD_USER_SAFMR
zip 65556
payment standard 110
2
$1,001
2025-10-01
HUD_USER_SAFMR
zip 65556
payment standard 90
2
$819
2025-10-01
HUD_USER_SAFMR
zip 65556
safmr
2
$910
2025-10-01
HUD_USER_SAFMR
zip 65556
payment standard 110
3
$1,397
2025-10-01
HUD_USER_SAFMR
zip 65556
payment standard 90
3
$1,143
2025-10-01
HUD_USER_SAFMR
zip 65556
safmr
3
$1,270
2025-10-01
HUD_USER_SAFMR
zip 65556
payment standard 110
4
$1,650
2025-10-01
HUD_USER_SAFMR
zip 65556
payment standard 90
4
$1,350
2025-10-01
HUD_USER_SAFMR
zip 65556
safmr
4
$1,500
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.