Reads as: riskier than 31.3% 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
anomaly
Federal penalty spike
21.3x prior
this facility
2026-07-29
connection
Owner spans multiple chains
20 chains
CLIFTONLARSONALLEN LLP
98 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 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
IA median
National median
National p25–p75
Total nurse
4.40
3.15
3.28
2.90–3.77
RN
0.99
0.46
0.39
0.25–0.58
Weekend total
4.21
2.96
3.11
—
Weekday total
4.48
3.20
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
139.0
4.40
0.99
0.49
2.92
4.21
1.1%
2025Q3
92
136.1
4.11
0.92
0.48
2.71
3.90
1.3%
2025Q2
91
127.3
3.90
0.91
0.44
2.55
3.72
1.0%
2025Q1
90
124.0
3.96
0.97
0.49
2.50
3.87
0.4%
2024Q4
92
109.8
4.28
1.10
0.46
2.71
4.09
0.4%
2024Q3
92
102.1
4.18
1.09
0.40
2.69
3.96
0.1%
2024Q2
91
100.0
4.18
0.98
0.44
2.76
3.94
2.1%
2024Q1
91
96.0
4.22
1.08
0.38
2.76
3.96
6.0%
2023Q4
92
89.6
4.04
0.96
0.40
2.67
3.80
6.6%
2023Q3
92
87.4
4.22
0.92
0.54
2.76
3.89
9.6%
2023Q2
91
86.5
4.20
1.04
0.47
2.69
3.88
16.3%
2023Q1
90
86.3
3.89
1.11
0.43
2.35
3.65
11.0%
2022Q4
92
88.9
3.98
1.15
0.45
2.38
3.78
9.5%
2022Q3
92
91.9
4.16
1.11
0.40
2.65
3.85
9.4%
2022Q2
91
97.4
3.88
1.02
0.00
2.86
3.72
15.6%
2022Q1
90
94.7
3.71
1.03
0.00
2.68
3.46
5.9%
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.
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
J
2025-12-22
2025-10-30
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2025-11-13
2025-06-26
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2025-07-03
2025-05-01
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2025-05-23
2025-05-01
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2025-05-23
2025-05-01
Health · complaint
F0610
Respond appropriately to all alleged violations.
D
2025-05-23
2025-05-01
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
2025-05-23
2025-05-01
Health · complaint
F0804
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
D
2025-05-23
2024-11-13
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2024-12-05
2024-06-13
Health
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2024-07-12
2024-06-13
Health
F0804
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
E
2024-07-12
2023-03-16
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.
D
2023-04-13
2023-03-16
Health
F0836
Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.
E
2023-04-13
2023-03-16
Health
F0880
Provide and implement an infection prevention and control program.
D
2023-04-13
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
60
Owner
Role
Pct
From
Status
Source
GREAT RIVER HEALTH SYSTEM INC
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2018-08-01
current
pecos_ownership
ALEXANDER, JEREMY
ADP OF THE SNF
—
2019-09-16
current
pecos_ownership
ANDERSON, JOY
CORPORATE DIRECTOR
—
2021-03-01
current
pecos_ownership
ARAMARK HEALTHCARE SUPPORT SERVICES LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-02-23
current
pecos_ownership
ARAMARK HEALTHCARE SUPPORT SERVICES LLC
ADP OF THE SNF
—
2025-02-19
current
pecos_ownership
BARR, DEANNA
OPERATIONAL/MANAGERIAL CONTROL
—
2021-03-01
current
pecos_ownership
CHELF, TODD
ADP OF THE SNF
—
2021-01-18
current
pecos_ownership
CLIFTONLARSONALLEN LLP
ADP OF THE SNF
—
2021-06-14
current
pecos_ownership
COLGAN, TERESA
CORPORATE OFFICER
—
2021-07-01
current
pecos_ownership
DEETS, RYAN
CORPORATE DIRECTOR
—
2026-01-27
current
pecos_ownership
DODD, NEAL
CORPORATE DIRECTOR
—
2022-01-01
current
pecos_ownership
DUNN, HOPE
ADP OF THE SNF
—
2022-06-27
current
pecos_ownership
ENGBERG, ROBERT
OPERATIONAL/MANAGERIAL CONTROL
—
2019-01-01
current
pecos_ownership
FLEMING, BETH
ADP OF THE SNF
—
2023-03-20
current
pecos_ownership
HAGAN, TOMI
ADP OF THE SNF
—
2018-12-03
current
pecos_ownership
HICKEY, MICHAEL
OPERATIONAL/MANAGERIAL CONTROL
—
2024-07-01
current
pecos_ownership
HUFFMAN, ROBERT
OPERATIONAL/MANAGERIAL CONTROL
—
2022-01-01
current
pecos_ownership
KLOPFENSTEIN, MARY
ADP OF THE SNF
—
2023-12-01
current
pecos_ownership
LINHART, DANIEL
ADP OF THE SNF
—
2021-01-01
current
pecos_ownership
MARTIN, DOUGLAS
CORPORATE DIRECTOR
—
2019-01-01
current
pecos_ownership
MCCOY, MICHAEL
OPERATIONAL/MANAGERIAL CONTROL
—
2022-11-16
current
pecos_ownership
MCCOY, MICHAEL
CORPORATE OFFICER
—
2022-10-12
current
pecos_ownership
MCKILLIP, JOHN
OPERATIONAL/MANAGERIAL CONTROL
—
2019-01-01
current
pecos_ownership
MCNAMEE, CARLA
CORPORATE DIRECTOR
—
2021-03-01
current
pecos_ownership
RASHID, JOHN
ADP OF THE SNF
—
2025-01-01
current
pecos_ownership
RIHERD, GINA
CORPORATE DIRECTOR
—
2025-07-01
current
pecos_ownership
RODRIGUEZ, RUSSELL
OPERATIONAL/MANAGERIAL CONTROL
—
2022-08-01
current
pecos_ownership
RYON, JOEL
OPERATIONAL/MANAGERIAL CONTROL
—
2023-01-23
current
pecos_ownership
SOUTHEAST IOWA REGIONAL MEDICAL CENTER INC
OPERATIONAL/MANAGERIAL CONTROL
—
2010-12-16
current
pecos_ownership
SOUTHEAST IOWA REGIONAL MEDICAL CENTER INC
ADP OF THE SNF
—
2013-04-01
current
pecos_ownership
STEPHENSON, VICTORIA
OPERATIONAL/MANAGERIAL CONTROL
—
2022-01-01
current
pecos_ownership
WEST, AMY
ADP OF THE SNF
—
2024-08-26
current
pecos_ownership
YOST, MICHAEL
OPERATIONAL/MANAGERIAL CONTROL
—
2023-02-13
current
pecos_ownership
DOUGLAS MARTIN
CORPORATE DIRECTOR
0%
2019-01-01
ended 2026-05-18
pecos_ownership
MICHAEL HICKEY
CORPORATE DIRECTOR
0%
2024-07-01
ended 2026-05-18
pecos_ownership
MICHAEL MCCOY
OPERATIONAL/MANAGERIAL CONTROL
0%
2022-11-16
ended 2026-05-18
pecos_ownership
MICHAEL MCCOY
CORPORATE OFFICER
0%
2022-10-12
ended 2026-05-18
pecos_ownership
ROBERT ENGBERG
CORPORATE DIRECTOR
0%
2019-01-01
ended 2026-05-18
pecos_ownership
AMY WEST
OPERATIONAL/MANAGERIAL CONTROL
—
2024-08-26
ended 2026-05-18
pecos_ownership
BETH FLEMING
OPERATIONAL/MANAGERIAL CONTROL
—
2023-03-20
ended 2026-05-18
pecos_ownership
CARLA MCNAMEE
OPERATIONAL/MANAGERIAL CONTROL
—
2021-03-01
ended 2026-05-18
pecos_ownership
DANIEL LINHART
ADP OF THE SNF
—
2021-01-01
ended 2026-05-18
pecos_ownership
DEANNA BARR
CORPORATE DIRECTOR
—
2021-03-01
ended 2026-05-18
pecos_ownership
GINA RIHERD
CORPORATE DIRECTOR
—
2025-07-01
ended 2026-05-18
pecos_ownership
HOPE DUNN
ADP OF THE SNF
—
2022-06-27
ended 2026-05-18
pecos_ownership
JEREMY ALEXANDER
ADP OF THE SNF
—
2019-09-16
ended 2026-05-18
pecos_ownership
JOEL RYON
OPERATIONAL/MANAGERIAL CONTROL
—
2023-01-23
ended 2026-05-18
pecos_ownership
JOHN MCKILLIP
CORPORATE DIRECTOR
—
2019-01-01
ended 2026-05-18
pecos_ownership
JOHN RASHID
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
ended 2026-05-18
pecos_ownership
JOY ANDERSON
CORPORATE DIRECTOR
—
2021-03-01
ended 2026-05-18
pecos_ownership
MARY KLOPFENSTEIN
ADP OF THE SNF
—
2023-12-01
ended 2026-05-18
pecos_ownership
MICHAEL YOST
ADP OF THE SNF
—
2023-02-13
ended 2026-05-18
pecos_ownership
NEAL DODD
CORPORATE DIRECTOR
—
2022-01-01
ended 2026-05-18
pecos_ownership
ROBERT HUFFMAN
OPERATIONAL/MANAGERIAL CONTROL
—
2022-01-01
ended 2026-05-18
pecos_ownership
RUSSELL RODRIGUEZ
OPERATIONAL/MANAGERIAL CONTROL
—
2022-08-01
ended 2026-05-18
pecos_ownership
RYAN DEETS
OPERATIONAL/MANAGERIAL CONTROL
—
2026-01-27
ended 2026-05-18
pecos_ownership
TERESA COLGAN
OPERATIONAL/MANAGERIAL CONTROL
—
2021-07-01
ended 2026-05-18
pecos_ownership
TODD CHELF
OPERATIONAL/MANAGERIAL CONTROL
—
2021-01-18
ended 2026-05-18
pecos_ownership
TOMI HAGAN
OPERATIONAL/MANAGERIAL CONTROL
—
2018-12-03
ended 2026-05-18
pecos_ownership
VICTORIA STEPHENSON
CORPORATE DIRECTOR
—
2022-01-01
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
32
Geo
Kind
BR
Amount
As of
Source
county 19057
acs median gross
0
$535
2024-12-31
CENSUS_ACS5
county 19057
fmr
0
$733
2025-10-01
HUD_USER_FMR
county 19057
acs median gross
1
$613
2024-12-31
CENSUS_ACS5
county 19057
fmr
1
$810
2025-10-01
HUD_USER_FMR
county 19057
acs median gross
2
$979
2024-12-31
CENSUS_ACS5
county 19057
fmr
2
$1,063
2025-10-01
HUD_USER_FMR
county 19057
acs median gross
3
$1,206
2024-12-31
CENSUS_ACS5
county 19057
fmr
3
$1,369
2025-10-01
HUD_USER_FMR
county 19057
acs median gross
4
$1,333
2024-12-31
CENSUS_ACS5
county 19057
fmr
4
$1,426
2025-10-01
HUD_USER_FMR
county 19057
acs median gross
$904
2024-12-31
CENSUS_ACS5
county 19057
acs recent mover gross
$872
2024-12-31
CENSUS_ACS5
zcta 52655
acs median gross
1
$660
2024-12-31
CENSUS_ACS5
zcta 52655
acs median gross
2
$909
2024-12-31
CENSUS_ACS5
zcta 52655
acs median gross
3
$1,276
2024-12-31
CENSUS_ACS5
zcta 52655
acs median gross
$862
2024-12-31
CENSUS_ACS5
zcta 52655
acs recent mover gross
$946
2024-12-31
CENSUS_ACS5
zip 52655
payment standard 110
0
$770
2025-10-01
HUD_USER_SAFMR
zip 52655
payment standard 90
0
$630
2025-10-01
HUD_USER_SAFMR
zip 52655
safmr
0
$700
2025-10-01
HUD_USER_SAFMR
zip 52655
payment standard 110
1
$847
2025-10-01
HUD_USER_SAFMR
zip 52655
payment standard 90
1
$693
2025-10-01
HUD_USER_SAFMR
zip 52655
safmr
1
$770
2025-10-01
HUD_USER_SAFMR
zip 52655
payment standard 110
2
$1,111
2025-10-01
HUD_USER_SAFMR
zip 52655
payment standard 90
2
$909
2025-10-01
HUD_USER_SAFMR
zip 52655
safmr
2
$1,010
2025-10-01
HUD_USER_SAFMR
zip 52655
payment standard 110
3
$1,430
2025-10-01
HUD_USER_SAFMR
zip 52655
payment standard 90
3
$1,170
2025-10-01
HUD_USER_SAFMR
zip 52655
safmr
3
$1,300
2025-10-01
HUD_USER_SAFMR
zip 52655
payment standard 110
4
$1,496
2025-10-01
HUD_USER_SAFMR
zip 52655
payment standard 90
4
$1,224
2025-10-01
HUD_USER_SAFMR
zip 52655
safmr
4
$1,360
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.