Reads as: riskier than 23.6% 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
1
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
47 chains
FORVIS MAZARS LLP
251 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
15
2025Q4 HPRD
This facility
MO median
National median
National p25–p75
Total nurse
2.73
2.41
3.28
2.90–3.77
RN
0.16
0.25
0.39
0.25–0.58
Weekend total
2.51
2.24
3.11
—
Weekday total
2.82
2.49
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
63.9
2.73
0.16
0.63
1.94
2.51
0.0%
2025Q3
92
62.7
2.83
0.20
0.63
1.99
2.46
0.0%
2025Q2
91
60.5
2.83
0.30
0.60
1.93
2.41
0.0%
2024Q4
92
60.1
2.21
0.21
0.61
1.40
1.78
0.0%
2024Q3
92
62.3
1.94
0.16
0.58
1.20
1.69
0.0%
2024Q2
91
59.9
2.00
0.15
0.64
1.22
1.61
0.0%
2024Q1
91
64.8
1.41
0.20
0.62
0.59
1.21
0.0%
2023Q4
92
63.8
1.37
0.25
0.51
0.61
1.15
0.0%
2023Q3
92
62.0
1.50
0.22
0.50
0.78
1.24
0.0%
2023Q2
91
64.4
1.55
0.15
0.47
0.93
1.35
0.0%
2023Q1
90
64.7
1.53
0.13
0.42
0.97
1.32
0.0%
2022Q4
92
63.1
1.48
0.13
0.47
0.88
1.24
0.0%
2022Q3
92
60.7
1.48
0.16
0.48
0.84
1.34
0.0%
2022Q2
91
58.4
1.20
0.16
0.47
0.57
1.09
0.0%
2022Q1
90
56.3
1.15
0.14
0.47
0.53
1.09
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
19
D × 18E × 1
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2026-03-19
Health
F0558
Reasonably accommodate the needs and preferences of each resident.
D
2026-05-02
2026-03-19
Health
F0582
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
D
2026-05-02
2026-03-19
Health
F0732
Post nurse staffing information every day.
D
2026-05-02
2026-03-19
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2026-05-02
2026-03-19
Health
F0880
Provide and implement an infection prevention and control program.
D
2026-05-02
2024-12-18
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
2025-01-31
2024-12-18
Health
F0584
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
D
2025-01-31
2024-12-18
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
2025-01-31
2024-12-18
Health
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2025-01-31
2024-12-18
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
2025-01-31
2024-12-18
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
2025-01-31
2024-12-18
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-01-31
2024-12-18
Health
F0883
Develop and implement policies and procedures for flu and pneumonia vaccinations.
D
2025-01-31
2023-11-09
Health
F0577
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
D
2023-12-28
2023-11-09
Health
F0584
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
E
2023-12-28
2023-11-09
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
2023-12-28
2023-11-09
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2023-12-28
2023-11-09
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
2023-12-28
2023-11-09
Health
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
2023-12-28
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
28
Owner
Role
Pct
From
Status
Source
PACK INVESTMENTS LLC
Individual has financial interest in both related organization and provider
100%
2024-01-01
current
hcris_a_8_1
PACK INVESTMENTS LLC
Individual has financial interest in both related organization and provider
100%
2023-01-01
current
hcris_a_8_1
GIDEON HEALTH CARE INC
Individual has financial interest in both related organization and provider
50%
2024-01-01
current
hcris_a_8_1
GIDEON HEALTH CARE INC
Individual has financial interest in both related organization and provider
50%
2023-01-01
current
hcris_a_8_1
ARMSTRONG, MCKENZIE
ADP OF THE SNF
—
2023-06-16
current
pecos_ownership
FORVIS MAZARS LLP
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
current
pecos_ownership
FORVIS MAZARS LLP
ADP OF THE SNF
—
2025-02-27
current
pecos_ownership
GIDEON HEALTH CARE CENTER, INC.
ADP OF THE SNF
—
2025-03-14
current
pecos_ownership
HUTCHINSON, DALEN
OPERATIONAL/MANAGERIAL CONTROL
—
2022-11-01
current
pecos_ownership
JONES, ANGELA
ADP OF THE SNF
—
2024-10-01
current
pecos_ownership
JONES, ANGELA
OPERATIONAL/MANAGERIAL CONTROL
—
2022-08-01
current
pecos_ownership
MRV BANKS
ADP OF THE SNF
—
2025-03-03
current
pecos_ownership
MRV BANKS
5% OR GREATER MORTGAGE INTEREST
—
2022-09-23
current
pecos_ownership
PARADIGM REHAB SERVICES LLC
ADP OF THE SNF
—
2025-02-27
current
pecos_ownership
PARADIGM REHAB SERVICES LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-09-01
current
pecos_ownership
PARADIGM SENIOR MANAGEMENT LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2022-08-01
current
pecos_ownership
PARADIGM SENIOR MANAGEMENT LLC
ADP OF THE SNF
—
2025-02-25
current
pecos_ownership
SELLS, BENJAMIN
OPERATIONAL/MANAGERIAL CONTROL
—
2022-08-01
current
pecos_ownership
UNDERWOOD, HOLLY
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-27
current
pecos_ownership
ANGELA JONES
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
2022-08-01
ended 2026-05-18
pecos_ownership
BENJAMIN SELLS
CORPORATE OFFICER
50%
2022-08-01
ended 2026-05-18
pecos_ownership
GIDEON HEALTHCARE INC
Individual has financial interest in both related organization and provider
50%
2022-01-01
ended 2022-12-31
hcris_a_8_1
DALEN HUTCHINSON
CORPORATE OFFICER
10%
2022-11-01
ended 2026-05-18
pecos_ownership
ANGELA JONES
ADP OF THE SNF
—
2024-10-01
ended 2026-05-18
pecos_ownership
GIDEON HEALTHCARE INC
Individual has financial interest in both related organization and provider
—
2021-01-01
ended 2021-12-31
hcris_a_8_1
GIDEON HEALTHCARE INC
Individual has financial interest in both related organization and provider
—
2020-01-01
ended 2020-12-31
hcris_a_8_1
HOLLY UNDERWOOD
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-27
ended 2026-05-18
pecos_ownership
MCKENZIE ARMSTRONG
OPERATIONAL/MANAGERIAL CONTROL
—
2023-06-16
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
5
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$746,037
$47,318
$267,091
$138,502
$271,175
13
propco
2023-12-31
$669,459
$45,303
$223,185
—
$225,388
11
propco
2022-12-31
$858,565
$207,132
$269,941
—
$376,036
7
propco
2021-12-31
$333,977
$149,480
—
—
—
2
propco
2020-12-31
$295,657
$162,166
—
—
—
2
propco
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
31
Geo
Kind
BR
Amount
As of
Source
county 29143
acs median gross
0
$325
2024-12-31
CENSUS_ACS5
county 29143
fmr
0
$661
2025-10-01
HUD_USER_FMR
county 29143
acs median gross
1
$435
2024-12-31
CENSUS_ACS5
county 29143
fmr
1
$678
2025-10-01
HUD_USER_FMR
county 29143
acs median gross
2
$719
2024-12-31
CENSUS_ACS5
county 29143
fmr
2
$890
2025-10-01
HUD_USER_FMR
county 29143
acs median gross
3
$825
2024-12-31
CENSUS_ACS5
county 29143
fmr
3
$1,067
2025-10-01
HUD_USER_FMR
county 29143
acs median gross
4
$760
2024-12-31
CENSUS_ACS5
county 29143
fmr
4
$1,178
2025-10-01
HUD_USER_FMR
county 29143
acs median gross
$729
2024-12-31
CENSUS_ACS5
county 29143
acs recent mover gross
$720
2024-12-31
CENSUS_ACS5
zcta 63848
acs median gross
1
$500
2024-12-31
CENSUS_ACS5
zcta 63848
acs median gross
2
$531
2024-12-31
CENSUS_ACS5
zcta 63848
acs median gross
3
$480
2024-12-31
CENSUS_ACS5
zcta 63848
acs median gross
$481
2024-12-31
CENSUS_ACS5
zip 63848
payment standard 110
0
$726
2025-10-01
HUD_USER_SAFMR
zip 63848
payment standard 90
0
$594
2025-10-01
HUD_USER_SAFMR
zip 63848
safmr
0
$660
2025-10-01
HUD_USER_SAFMR
zip 63848
payment standard 110
1
$748
2025-10-01
HUD_USER_SAFMR
zip 63848
payment standard 90
1
$612
2025-10-01
HUD_USER_SAFMR
zip 63848
safmr
1
$680
2025-10-01
HUD_USER_SAFMR
zip 63848
payment standard 110
2
$979
2025-10-01
HUD_USER_SAFMR
zip 63848
payment standard 90
2
$801
2025-10-01
HUD_USER_SAFMR
zip 63848
safmr
2
$890
2025-10-01
HUD_USER_SAFMR
zip 63848
payment standard 110
3
$1,166
2025-10-01
HUD_USER_SAFMR
zip 63848
payment standard 90
3
$954
2025-10-01
HUD_USER_SAFMR
zip 63848
safmr
3
$1,060
2025-10-01
HUD_USER_SAFMR
zip 63848
payment standard 110
4
$1,298
2025-10-01
HUD_USER_SAFMR
zip 63848
payment standard 90
4
$1,062
2025-10-01
HUD_USER_SAFMR
zip 63848
safmr
4
$1,180
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.