1260 NORTH JOHNSON STREET, KAHOKA, MO 63445 · CCN 265485
Composite
60.2 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
99
Model
v1.2
Reads as: riskier than 60.2% 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
15
2025Q4 HPRD
This facility
MO median
National median
National p25–p75
Total nurse
2.44
2.41
3.28
2.90–3.77
RN
0.28
0.25
0.39
0.25–0.58
Weekend total
2.38
2.24
3.11
—
Weekday total
2.47
2.49
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
51.3
2.44
0.28
0.22
1.94
2.38
0.0%
2025Q3
92
53.6
2.46
0.29
0.14
2.03
2.51
0.0%
2025Q2
91
57.8
2.30
0.32
0.15
1.84
2.27
0.0%
2025Q1
90
56.6
2.56
0.30
0.17
2.09
2.53
0.0%
2024Q4
92
62.6
2.64
0.33
0.28
2.04
2.64
0.0%
2024Q3
92
59.3
2.61
0.27
0.17
2.18
2.56
0.0%
2024Q2
91
59.8
2.41
0.20
0.34
1.87
2.30
0.0%
2024Q1
91
58.7
1.94
0.20
0.19
1.54
1.89
0.0%
2023Q4
92
57.4
2.11
0.27
0.32
1.52
1.98
0.0%
2023Q3
92
56.8
2.27
0.22
0.38
1.67
2.23
0.0%
2023Q2
91
57.4
2.01
0.14
0.40
1.47
1.90
0.0%
2023Q1
90
58.1
2.39
0.24
0.34
1.81
2.33
0.0%
2022Q4
92
60.0
2.78
0.22
0.33
2.23
2.59
0.0%
2022Q3
92
61.6
3.27
0.37
0.28
2.63
3.35
0.0%
2022Q2
91
63.4
1.87
0.50
0.01
1.37
1.84
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
27
B × 3D × 9E × 12F × 3
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2026-02-03
Health · complaint
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2026-03-04
2025-03-04
Health · complaint
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2025-04-09
2025-01-29
Health
F0604
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
D
2025-03-07
2025-01-29
Health
F0623
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
B
2025-03-07
2025-01-29
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.
B
2025-03-07
2025-01-29
Health
F0637
Assess the resident when there is a significant change in condition
E
2025-03-07
2025-01-29
Health
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
E
2025-03-07
2025-01-29
Health
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
2025-03-07
2025-01-29
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
2025-03-07
2025-01-29
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
E
2025-03-07
2025-01-29
Health
F0699
Provide care or services that was trauma informed and/or culturally competent.
D
2025-03-07
2025-01-29
Health
F0700
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
E
2025-03-07
2025-01-29
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.
E
2025-03-07
2025-01-29
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2025-03-07
2025-01-29
Health
F0880
Provide and implement an infection prevention and control program.
F
2025-03-07
2023-05-04
Health
F0655
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
B
2023-06-30
2023-05-04
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.
E
2023-06-30
2023-05-04
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
E
2023-06-30
2023-05-04
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2023-06-30
2023-05-04
Health
F0700
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
E
2023-06-30
2023-05-04
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2023-06-30
2023-05-04
Health
F0880
Provide and implement an infection prevention and control program.
E
2023-06-30
2023-05-04
Health
F0883
Develop and implement policies and procedures for flu and pneumonia vaccinations.
E
2023-06-30
2023-05-04
Health
F0909
Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.
E
2023-06-30
2019-09-19
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
E
2019-10-17
2019-09-19
Health
F0760
Ensure that residents are free from significant medication errors.
D
2019-10-17
2019-09-19
Health
F0880
Provide and implement an infection prevention and control program.
D
2019-10-17
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
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
10
Owner
Role
Pct
From
Status
Source
CLARK COUNTY NURSING HOME
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
1992-01-30
current
pecos_ownership
CLARK COUNTY NURSING HOME
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-18
current
pecos_ownership
DAVIS, JEFFREY
ADP OF THE SNF
—
2017-03-01
current
pecos_ownership
HOPP, DAKOTA
OPERATIONAL/MANAGERIAL CONTROL
—
2021-06-17
current
pecos_ownership
MCDANIEL-RAMSEY, TAMMY
CORPORATE OFFICER
—
2009-06-26
current
pecos_ownership
SAXTON, LARRY
CORPORATE DIRECTOR
—
2006-04-18
current
pecos_ownership
LARRY SAXTON
CORPORATE DIRECTOR
17%
2006-04-18
ended 2026-05-18
pecos_ownership
DAKOTA HOPP
ADP OF THE SNF
—
2021-06-17
ended 2026-05-18
pecos_ownership
JEFFREY DAVIS
ADP OF THE SNF
—
2017-03-01
ended 2026-05-18
pecos_ownership
TAMMY MCDANIEL-RAMSEY
ADP OF THE SNF
—
2009-06-26
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 29045
acs median gross
0
$423
2024-12-31
CENSUS_ACS5
county 29045
fmr
0
$660
2025-10-01
HUD_USER_FMR
county 29045
acs median gross
1
$408
2024-12-31
CENSUS_ACS5
county 29045
fmr
1
$677
2025-10-01
HUD_USER_FMR
county 29045
acs median gross
2
$625
2024-12-31
CENSUS_ACS5
county 29045
fmr
2
$888
2025-10-01
HUD_USER_FMR
county 29045
acs median gross
3
$781
2024-12-31
CENSUS_ACS5
county 29045
fmr
3
$1,154
2025-10-01
HUD_USER_FMR
county 29045
acs median gross
4
$1,092
2024-12-31
CENSUS_ACS5
county 29045
fmr
4
$1,320
2025-10-01
HUD_USER_FMR
county 29045
acs median gross
$612
2024-12-31
CENSUS_ACS5
county 29045
acs recent mover gross
$913
2024-12-31
CENSUS_ACS5
zcta 63445
acs median gross
0
$429
2024-12-31
CENSUS_ACS5
zcta 63445
acs median gross
1
$453
2024-12-31
CENSUS_ACS5
zcta 63445
acs median gross
2
$588
2024-12-31
CENSUS_ACS5
zcta 63445
acs median gross
3
$774
2024-12-31
CENSUS_ACS5
zcta 63445
acs median gross
$552
2024-12-31
CENSUS_ACS5
zip 63445
payment standard 110
0
$726
2025-10-01
HUD_USER_SAFMR
zip 63445
payment standard 90
0
$594
2025-10-01
HUD_USER_SAFMR
zip 63445
safmr
0
$660
2025-10-01
HUD_USER_SAFMR
zip 63445
payment standard 110
1
$748
2025-10-01
HUD_USER_SAFMR
zip 63445
payment standard 90
1
$612
2025-10-01
HUD_USER_SAFMR
zip 63445
safmr
1
$680
2025-10-01
HUD_USER_SAFMR
zip 63445
payment standard 110
2
$979
2025-10-01
HUD_USER_SAFMR
zip 63445
payment standard 90
2
$801
2025-10-01
HUD_USER_SAFMR
zip 63445
safmr
2
$890
2025-10-01
HUD_USER_SAFMR
zip 63445
payment standard 110
3
$1,265
2025-10-01
HUD_USER_SAFMR
zip 63445
payment standard 90
3
$1,035
2025-10-01
HUD_USER_SAFMR
zip 63445
safmr
3
$1,150
2025-10-01
HUD_USER_SAFMR
zip 63445
payment standard 110
4
$1,452
2025-10-01
HUD_USER_SAFMR
zip 63445
payment standard 90
4
$1,188
2025-10-01
HUD_USER_SAFMR
zip 63445
safmr
4
$1,320
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.