Composite
85.9 / 100 percentile
Screener / 165601
D
Harmony West Des Moines
snfIASFF: SFF Candidate
5010 Grand Ridge Drive, West Des Moines, IA 50265 · CCN 165601 · chain CHAIM RAJCHENBACH DESCENDANTS TR UA 04282008
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
113
Model
v1.2
Reads as: riskier than 85.9% 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.
Score model5ML signals5Components16CHOW radar1Distress radar1Staffing16Penalties0Deficiencies65Licensure0Ownership10Related party5Transactions1Comps12Market rent35
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| financial risk | 81.6 | 68.4 | 0.30 | 0.2308 | 18.83 | in index |
| billing conduct | 63.8 | 45.0 | 0.30 | 0.2308 | 14.72 | in index |
| staffing risk | 68.4 | 68.4 | 0.25 | 0.1923 | 13.15 | in index |
| regulatory risk | 52.2 | 41.7 | 0.30 | 0.2308 | 12.05 | in index |
| chow risk | 43.2 | 41.4 | 0.15 | 0.1154 | 4.98 | in index |
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
5| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +31.4 vs natl | GPN FAMILY TRUST U A D 4 28 08 | 74 facilities |
| connection | Owner fleet risk far above national | +30.1 vs natl | DOROS GENERATION TRUST U A D 1 3 12 | 72 facilities |
| connection | Owner fleet risk far above national | +26.2 vs natl | LEGACY HEALTHCARE FINANCIAL SERVICES LLC | 79 facilities |
| connection | Owner fleet risk far above national | +25.1 vs natl | OAKWAY OPERATIONS LLC | 44 facilities |
| connection | Owner fleet risk far above national | +24.2 vs natl | SHABAT MENACHEM | 85 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.
Component scores and registry models
16| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 45.0 | B | 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 | 57.8 | C | v0.6 | default · in composite | |
| financial risk | 68.4 | D | 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 | 0.0 | — | 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 | 41.7 | B | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 68.4 | D | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 90.5 | 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 | 70.5 | 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 | 61.6 | 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 | 69.9 | D | 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 | 41.6 | 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 | 41.6 | 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. |
| staffing risk | 68.4 | D | 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 | 68.4 | D | 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. |
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.
CHOW radar — 12-month sale probability
full board →p(CHOW, 12m)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
7.0
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Never sold on record | 0.00 | -1.62 | |
| Current owner tenure (years) | 3.33 | -1.52 | |
| Ownership changes, last 5 years | 1.00 | -0.87 | |
| For-profit ownership | 1.00 | +0.69 | |
| Chain size (log) | 4.49 | +0.55 | |
| Occupancy | 0.87 | -0.51 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Deficiencies, last 12 months | 1.00 | -0.15 |
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.
Distress radar — 12-month termination probability
full board →p(termination, 12m)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
20.0
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Chain size (log) | 4.49 | -1.41 | |
| Deficiencies, last 12 months | 1.00 | +1.24 | |
| For-profit ownership | 1.00 | -0.69 | |
| Occupancy | 0.87 | -0.52 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Never sold on record | 0.00 | -0.28 | |
| Current owner tenure (years) | 3.33 | -0.25 | |
| Ownership changes, last 5 years | 1.00 | +0.23 |
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 | IA median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 3.01 | 3.15 | 3.28 | 2.90–3.77 |
| RN | 0.41 | 0.46 | 0.39 | 0.25–0.58 |
| Weekend total | 3.00 | 2.96 | 3.11 | — |
| Weekday total | 3.01 | 3.20 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 98.6 | 3.01 | 0.41 | 0.58 | 2.02 | 3.00 | 9.7% |
| 2025Q3 | 92 | 96.1 | 3.03 | 0.47 | 0.57 | 1.99 | 2.88 | 14.8% |
| 2025Q2 | 91 | 93.5 | 3.10 | 0.47 | 0.46 | 2.16 | 3.02 | 15.1% |
| 2025Q1 | 90 | 94.5 | 3.03 | 0.52 | 0.49 | 2.03 | 2.99 | 16.6% |
| 2024Q4 | 92 | 92.2 | 2.96 | 0.54 | 0.46 | 1.96 | 2.91 | 11.7% |
| 2024Q3 | 92 | 89.4 | 3.30 | 0.40 | 0.69 | 2.20 | 3.29 | 13.5% |
| 2024Q2 | 91 | 92.6 | 3.00 | 0.30 | 0.69 | 2.01 | 2.98 | 19.8% |
| 2024Q1 | 91 | 87.4 | 3.15 | 0.41 | 0.61 | 2.14 | 3.07 | 18.5% |
| 2023Q4 | 92 | 83.9 | 3.25 | 0.45 | 0.52 | 2.28 | 3.11 | 11.9% |
| 2023Q3 | 92 | 76.3 | 3.01 | 0.39 | 0.51 | 2.12 | 2.98 | 12.1% |
| 2023Q2 | 91 | 87.7 | 2.78 | 0.34 | 0.54 | 1.91 | 2.62 | 26.9% |
| 2023Q1 | 90 | 97.2 | 2.80 | 0.33 | 0.60 | 1.87 | 2.72 | 31.2% |
| 2022Q4 | 92 | 86.4 | 2.99 | 0.48 | 0.54 | 1.98 | 2.83 | 24.8% |
| 2022Q3 | 92 | 91.6 | 2.75 | 0.55 | 0.56 | 1.65 | 2.62 | 34.0% |
| 2022Q2 | 91 | 95.0 | 2.46 | 0.28 | 0.65 | 1.53 | 2.26 | 23.8% |
| 2022Q1 | 90 | 90.8 | 2.73 | 0.30 | 0.73 | 1.70 | 2.57 | 48.1% |
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.
Penalties
0No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
65D × 42E × 8F × 5G × 3H × 1J × 2K × 2L × 2
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-03-05 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | — |
| 2025-02-20 | Health | F0553 | Allow resident to participate in the development and implementation of his or her person-centered plan of care. | D | 2025-03-21 |
| 2025-02-20 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2025-03-21 |
| 2025-02-20 | Health | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | 2025-03-21 |
| 2025-02-20 | Health | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | 2025-03-21 |
| 2025-02-20 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2025-03-21 |
| 2025-02-20 | 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 | 2025-03-21 |
| 2025-02-20 | 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 | 2025-03-21 |
| 2025-02-20 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2025-03-21 |
| 2025-02-20 | Health | F0758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | 2025-03-21 |
| 2025-02-20 | Health | F0800 | Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. | E | 2025-03-21 |
| 2025-02-20 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2025-03-21 |
| 2025-02-20 | Health | F0865 | Have a plan that describes the process for conducting QAPI and QAA activities. | F | 2025-03-21 |
| 2025-02-20 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2025-03-21 |
| 2024-11-20 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-12-16 |
| 2024-11-20 | Health · complaint | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | 2024-12-16 |
| 2024-11-20 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-12-16 |
| 2024-11-20 | 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 | 2024-12-16 |
| 2024-07-29 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-08-17 |
| 2024-07-29 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2024-08-17 |
| 2024-07-29 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2024-08-17 |
| 2023-12-11 | Health | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2024-01-09 |
| 2023-12-11 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2024-01-09 |
| 2023-12-11 | 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 | 2024-01-09 |
| 2023-12-11 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-01-09 |
| 2023-12-11 | 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. | E | 2024-01-09 |
| 2023-12-11 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2024-01-09 |
| 2023-12-11 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2024-01-09 |
| 2023-10-04 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-10-23 |
| 2023-10-03 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2023-10-23 |
| 2023-10-03 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-10-23 |
| 2023-06-08 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2023-07-17 |
| 2023-06-08 | Health · complaint | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | 2023-07-17 |
| 2023-06-08 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | K | 2023-07-17 |
| 2023-06-08 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | H | 2023-07-17 |
| 2023-06-08 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2023-07-17 |
| 2023-06-08 | Health · complaint | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2023-07-17 |
| 2023-06-08 | Health · complaint | 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. | G | 2023-07-17 |
| 2023-06-08 | 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. | L | 2023-07-17 |
| 2023-06-08 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | E | 2023-07-17 |
| 2023-06-08 | Health · complaint | F0835 | Administer the facility in a manner that enables it to use its resources effectively and efficiently. | L | 2023-07-17 |
| 2023-06-08 | 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. | F | 2023-07-17 |
| 2023-06-08 | Health · complaint | 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. | K | 2023-07-17 |
| 2023-06-08 | Health · complaint | F0865 | Have a plan that describes the process for conducting QAPI and QAA activities. | F | 2023-07-17 |
| 2023-06-08 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | F | 2023-07-17 |
| 2023-06-08 | Health · complaint | F0882 | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | F | 2023-07-17 |
| 2023-06-08 | Health · complaint | F0947 | Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | D | 2023-07-17 |
| 2023-03-14 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2023-04-12 |
| 2023-03-14 | Health | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-04-12 |
| 2023-03-14 | Health | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | 2023-04-12 |
| 2023-03-14 | Health | F0625 | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. | D | 2023-04-12 |
| 2023-03-14 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2023-04-12 |
| 2023-03-14 | 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 | 2023-04-12 |
| 2023-03-14 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2023-04-12 |
| 2023-03-14 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2023-04-12 |
| 2023-03-14 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | 2023-07-17 |
| 2023-03-14 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2023-07-17 |
| 2023-03-14 | 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 | 2023-04-12 |
| 2023-03-14 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2023-04-12 |
| 2023-03-14 | Health | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | J | 2023-04-12 |
| 2023-03-14 | Health | 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 | 2023-07-17 |
| 2023-03-14 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2023-04-12 |
| 2023-03-14 | Health | F0760 | Ensure that residents are free from significant medication errors. | E | 2023-07-17 |
| 2023-03-14 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2023-04-12 |
| 2023-03-14 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2023-07-17 |
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
0No 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
10| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| GPN FAMILY TRUST U/A/D 4/28/08 | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 60% | 2023-04-01 | current | pecos_ownership |
| DOROS GENERATION TRUST U/A/D 1/3/12 | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 26% | 2023-04-01 | current | pecos_ownership |
| OAKWAY OPERATIONS LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 15% | 2023-04-01 | current | pecos_ownership |
| LEGACY HEALTHCARE FINANCIAL SERVICES LLC | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-04-01 | current | pecos_ownership |
| SHABAT, MENACHEM | CORPORATE OFFICER | — | 2023-04-01 | current | pecos_ownership |
| SMITH, SAMMARRA | W-2 MANAGING EMPLOYEE | — | 2023-04-01 | current | pecos_ownership |
| CHAIM RAJCHENBACH DESCENDANTS TR UA 04282008 | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 60% | 2023-04-01 | ended 2026-05-18 | pecos_ownership |
| GPN FAM TR UA 04282008 | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 60% | 2023-04-01 | ended 2026-04-01 | pecos_ownership |
| MENACHEM SHABAT | CORPORATE OFFICER | — | 2023-04-01 | ended 2026-05-18 | pecos_ownership |
| SAMMARRA SMITH | W-2 MANAGING EMPLOYEE | — | 2023-04-01 | 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.
Transactions
1| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2023-04-01 | — | DES MOINES SKILLED NURSING FACILITY LLC | MANOR CARE OF WEST DES MOINES IA LLC | chow |
Comparable trades — IA snf
12| 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 |
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 19153 | acs median gross | 0 | $926 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 0 | $1,063 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 1 | $963 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 1 | $1,109 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 2 | $1,169 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 2 | $1,318 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 3 | $1,497 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 3 | $1,794 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 4 | $1,605 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 4 | $1,841 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 5 | $1,834 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | acs median gross | $1,149 | 2024-12-31 | CENSUS_ACS5 | |
| county 19153 | acs recent mover gross | $1,235 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 50265 | acs median gross | 0 | $1,107 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50265 | acs median gross | 1 | $977 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50265 | acs median gross | 2 | $1,107 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50265 | acs median gross | 3 | $1,506 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50265 | acs median gross | 4 | $2,138 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50265 | acs median gross | $1,106 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 50265 | acs recent mover gross | $1,317 | 2024-12-31 | CENSUS_ACS5 | |
| zip 50265 | payment standard 110 | 0 | $1,122 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | payment standard 90 | 0 | $918 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | safmr | 0 | $1,020 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | payment standard 110 | 1 | $1,177 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | payment standard 90 | 1 | $963 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | safmr | 1 | $1,070 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | payment standard 110 | 2 | $1,397 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | payment standard 90 | 2 | $1,143 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | safmr | 2 | $1,270 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | payment standard 110 | 3 | $1,903 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | payment standard 90 | 3 | $1,557 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | safmr | 3 | $1,730 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | payment standard 110 | 4 | $1,947 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | payment standard 90 | 4 | $1,593 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50265 | safmr | 4 | $1,770 | 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.