Reads as: riskier than 28.3% 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.
ML signals — parallel engine
2
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
17 chains
BURNAM SOON
335 facilities
connection
Owner fleet enforcement cluster
44% fined
ROCKY TOP HEALTHCARE LLC
9 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.
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
TN median
National median
National p25–p75
Total nurse
2.92
3.28
3.28
2.90–3.77
RN
0.27
0.34
0.39
0.25–0.58
Weekend total
2.78
3.10
3.11
—
Weekday total
2.97
3.36
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
70.0
2.92
0.27
0.90
1.75
2.78
30.0%
2025Q3
92
68.9
2.88
0.31
0.79
1.78
2.72
33.3%
2025Q2
91
64.5
2.78
0.19
0.88
1.71
2.61
29.5%
2025Q1
90
65.0
2.89
0.20
0.98
1.72
2.60
39.9%
2024Q4
92
62.4
2.59
0.21
0.97
1.40
2.43
33.4%
2024Q3
92
64.9
2.68
0.23
0.99
1.46
2.39
37.8%
2024Q2
91
63.3
2.60
0.24
0.83
1.52
2.37
28.8%
2024Q1
91
61.8
2.54
0.19
0.88
1.47
2.45
14.1%
2023Q4
92
56.6
2.81
0.18
1.04
1.58
2.77
0.1%
2023Q3
92
57.3
2.93
0.23
1.07
1.63
2.98
3.8%
2023Q2
91
61.9
2.82
0.09
1.10
1.63
2.80
13.7%
2023Q1
90
57.1
2.86
0.07
1.15
1.63
2.69
28.8%
2022Q4
92
58.5
2.82
0.27
1.01
1.55
2.64
13.6%
2022Q3
92
60.1
3.02
0.50
0.79
1.74
2.61
3.7%
2022Q2
91
59.0
2.75
0.48
0.66
1.60
2.27
0.0%
2022Q1
90
57.3
2.79
0.42
0.81
1.55
2.52
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
23
D × 17E × 2F × 4
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2025-11-17
Health
F0557
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
D
2025-12-04
2025-11-17
Health
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
2025-12-05
2025-11-17
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
2025-12-05
2025-11-17
Health
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
2025-12-05
2025-11-17
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2025-12-05
2025-11-17
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-12-05
2022-06-28
Health
F0636
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
D
2022-07-25
2022-06-28
Health
F0655
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
D
2022-07-25
2022-06-28
Health
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
E
2022-07-25
2022-06-28
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
E
2022-07-25
2022-06-28
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2022-07-25
2022-06-28
Health
F0692
Provide enough food/fluids to maintain a resident's health.
D
2022-07-25
2022-06-28
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.
F
2022-07-25
2022-06-28
Health
F0756
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
D
2022-07-25
2022-06-28
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
2022-07-25
2022-06-28
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2022-07-25
2019-10-22
Health
F0636
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
D
2019-12-03
2019-10-22
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
2019-12-03
2019-10-22
Health
F0685
Assist a resident in gaining access to vision and hearing services.
D
2019-12-03
2019-10-22
Health
F0790
Provide routine and 24-hour emergency dental care for each resident.
D
2019-12-03
2019-10-22
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2019-12-03
2019-10-22
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2019-12-03
2019-10-22
Health
F0880
Provide and implement an infection prevention and control program.
D
2019-12-03
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
19
Owner
Role
Pct
From
Status
Source
KNOXVILLE PROPCO LLC
Corporation, partnership or other organization has financial interest in provider
100%
2023-05-01
current
hcris_a_8_1
KNOXVILLE PROPCO LLC
Corporation, partnership or other organization has financial interest in provider
100%
2023-01-01
current
hcris_a_8_1
ROCKY TOP HEALTHCARE LLC
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2023-12-18
current
pecos_ownership
ALBRECHTSEN, TYLER
OPERATIONAL/MANAGERIAL CONTROL
—
2024-05-01
current
pecos_ownership
ALBRECHTSEN, TYLER
CORPORATE DIRECTOR
—
2023-12-18
current
pecos_ownership
BURNAM, SOON
CORPORATE OFFICER
—
2023-12-18
current
pecos_ownership
HASEMEIER, ERIC
ADP OF THE SNF
—
2024-05-01
current
pecos_ownership
SATO, AMI
CORPORATE OFFICER
—
2024-09-09
current
pecos_ownership
THATCHER, BRENT
CORPORATE DIRECTOR
—
2023-12-18
current
pecos_ownership
THATCHER, BRENT
OPERATIONAL/MANAGERIAL CONTROL
—
2024-05-01
current
pecos_ownership
KNOXVILLE PROPCO LLC
Corporation, partnership or other organization has financial interest in provider
100%
2022-01-01
ended 2022-12-31
hcris_a_8_1
THE ENSIGN GROUP INC
5% OR GREATER INDIRECT OWNERSHIP INTEREST
100%
2023-12-18
ended 2026-05-18
pecos_ownership
TYLER ALBRECHTSEN
CORPORATE DIRECTOR
100%
2023-12-18
ended 2026-05-18
pecos_ownership
TYLER ALBRECHTSEN
OPERATIONAL/MANAGERIAL CONTROL
100%
2024-05-01
ended 2026-05-18
pecos_ownership
SOON BURNAM
CORPORATE OFFICER
0%
2023-12-18
ended 2026-05-18
pecos_ownership
AMI SATO
CORPORATE OFFICER
—
2024-09-09
ended 2026-05-18
pecos_ownership
BRENT THATCHER
CORPORATE DIRECTOR
—
2023-12-18
ended 2026-05-18
pecos_ownership
BRENT THATCHER
OPERATIONAL/MANAGERIAL CONTROL
—
2024-05-01
ended 2026-05-18
pecos_ownership
ERIC HASEMEIER
ADP OF THE SNF
—
2024-05-01
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
6
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$653,208
—
$492,800
—
—
3
—
2024-04-30
$1,947,510
$1,316,609
—
$153,430
—
5
propco
2023-12-31
$2,365,223
$1,316,609
—
$445,569
—
5
propco
2022-12-31
$2,095,502
$1,060,232
—
$448,071
—
5
propco
2021-12-31
$2,388,856
$1,118,324
—
$438,448
—
5
—
2020-12-31
$2,216,213
—
—
$425,895
—
6
—
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
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 47093
acs median gross
0
$874
2024-12-31
CENSUS_ACS5
county 47093
fmr
0
$1,177
2025-10-01
HUD_USER_FMR
county 47093
acs median gross
1
$1,033
2024-12-31
CENSUS_ACS5
county 47093
fmr
1
$1,184
2025-10-01
HUD_USER_FMR
county 47093
acs median gross
2
$1,294
2024-12-31
CENSUS_ACS5
county 47093
fmr
2
$1,471
2025-10-01
HUD_USER_FMR
county 47093
acs median gross
3
$1,471
2024-12-31
CENSUS_ACS5
county 47093
fmr
3
$1,864
2025-10-01
HUD_USER_FMR
county 47093
acs median gross
4
$1,702
2024-12-31
CENSUS_ACS5
county 47093
fmr
4
$2,172
2025-10-01
HUD_USER_FMR
county 47093
acs median gross
5
$2,776
2024-12-31
CENSUS_ACS5
county 47093
acs median gross
$1,261
2024-12-31
CENSUS_ACS5
county 47093
acs recent mover gross
$1,533
2024-12-31
CENSUS_ACS5
zcta 37917
acs median gross
0
$384
2024-12-31
CENSUS_ACS5
zcta 37917
acs median gross
1
$657
2024-12-31
CENSUS_ACS5
zcta 37917
acs median gross
2
$1,279
2024-12-31
CENSUS_ACS5
zcta 37917
acs median gross
3
$1,267
2024-12-31
CENSUS_ACS5
zcta 37917
acs median gross
4
$1,408
2024-12-31
CENSUS_ACS5
zcta 37917
acs median gross
$1,127
2024-12-31
CENSUS_ACS5
zcta 37917
acs recent mover gross
$1,329
2024-12-31
CENSUS_ACS5
zip 37917
payment standard 110
0
$1,430
2025-10-01
HUD_USER_SAFMR
zip 37917
payment standard 90
0
$1,170
2025-10-01
HUD_USER_SAFMR
zip 37917
safmr
0
$1,300
2025-10-01
HUD_USER_SAFMR
zip 37917
payment standard 110
1
$1,441
2025-10-01
HUD_USER_SAFMR
zip 37917
payment standard 90
1
$1,179
2025-10-01
HUD_USER_SAFMR
zip 37917
safmr
1
$1,310
2025-10-01
HUD_USER_SAFMR
zip 37917
payment standard 110
2
$1,793
2025-10-01
HUD_USER_SAFMR
zip 37917
payment standard 90
2
$1,467
2025-10-01
HUD_USER_SAFMR
zip 37917
safmr
2
$1,630
2025-10-01
HUD_USER_SAFMR
zip 37917
payment standard 110
3
$2,277
2025-10-01
HUD_USER_SAFMR
zip 37917
payment standard 90
3
$1,863
2025-10-01
HUD_USER_SAFMR
zip 37917
safmr
3
$2,070
2025-10-01
HUD_USER_SAFMR
zip 37917
payment standard 110
4
$2,651
2025-10-01
HUD_USER_SAFMR
zip 37917
payment standard 90
4
$2,169
2025-10-01
HUD_USER_SAFMR
zip 37917
safmr
4
$2,410
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.