401 North 18th Street, Norfolk, NE 68701 · CCN 285160 · chain THE ENSIGN GROUP INC
Composite
90.8 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
83
Model
v1.2
Reads as: riskier than 90.8% 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
3
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+24.0 vs natl
GATEWAY HEALTHCARE LLC
12 facilities
connection
Owner spans multiple chains
17 chains
BURNAM SOON
335 facilities
connection
Owner spans multiple chains
12 chains
THE ENSIGN GROUP INC
123 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
NE median
National median
National p25–p75
Total nurse
2.24
2.88
3.28
2.90–3.77
RN
0.67
0.42
0.39
0.25–0.58
Weekend total
1.95
2.75
3.11
—
Weekday total
2.36
2.96
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
54.5
2.24
0.67
0.34
1.24
1.95
0.5%
2025Q3
92
50.2
2.52
0.46
0.55
1.51
2.22
14.5%
2025Q2
91
47.5
2.45
0.30
0.51
1.65
2.26
25.2%
2025Q1
90
47.7
2.67
0.32
0.52
1.82
2.52
20.7%
2024Q4
92
44.7
2.97
0.38
0.54
2.05
2.69
20.9%
2024Q3
92
44.5
2.52
0.45
0.56
1.51
2.15
0.0%
2024Q2
91
50.1
2.83
0.41
0.70
1.72
2.23
15.3%
2024Q1
91
46.8
2.82
0.43
0.79
1.61
2.23
21.4%
2023Q4
92
47.0
2.98
0.53
0.81
1.64
2.48
36.2%
2023Q3
92
47.4
1.00
0.00
0.64
0.37
0.99
100.0%
2023Q2
91
47.1
2.68
0.50
0.75
1.43
2.15
32.6%
2023Q1
90
44.3
2.94
0.43
0.84
1.66
2.50
29.0%
2022Q4
92
43.1
1.82
0.37
0.32
1.12
1.46
0.0%
2022Q3
92
48.9
2.79
0.78
0.80
1.21
2.20
23.3%
2022Q2
91
46.6
3.04
0.91
0.74
1.39
2.46
21.8%
2022Q1
90
48.0
2.74
0.92
0.60
1.22
2.35
20.0%
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
30
B × 1D × 16E × 9F × 4
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2026-04-29
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
—
2026-03-03
Health
F0565
Honor the resident's right to organize and participate in resident/family groups in the facility.
E
2026-03-31
2026-03-03
Health · complaint
F0628
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
B
2026-03-31
2026-03-03
Health
F0641
Ensure each resident receives an accurate assessment.
D
2026-03-31
2026-03-03
Health
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
2026-03-31
2026-03-03
Health · complaint
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2026-03-31
2026-03-03
Health
F0692
Provide enough food/fluids to maintain a resident's health.
D
2026-03-31
2026-03-03
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.
D
2026-03-31
2026-03-03
Health · complaint
F0804
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
E
2026-03-31
2026-03-03
Health · complaint
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2026-03-31
2026-03-03
Health · complaint
F0880
Provide and implement an infection prevention and control program.
E
2026-03-31
2026-03-03
Health · complaint
F0881
Implement a program that monitors antibiotic use.
F
2026-03-31
2026-03-03
Health · complaint
F0883
Develop and implement policies and procedures for flu and pneumonia vaccinations.
D
2026-03-31
2024-12-17
Health
F0580
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
D
2025-01-27
2024-12-17
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2025-01-27
2024-12-17
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
E
2025-01-27
2024-12-17
Health
F0757
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
2025-01-27
2024-12-17
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2025-01-27
2024-12-17
Health
F0880
Provide and implement an infection prevention and control program.
E
2025-01-27
2024-12-17
Health
F0883
Develop and implement policies and procedures for flu and pneumonia vaccinations.
E
2025-01-27
2024-12-17
Health
F0887
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
E
2025-01-27
2023-11-28
Health · complaint
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
E
2024-01-05
2023-11-28
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2024-01-05
2023-11-28
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
2024-01-05
2023-11-28
Health
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
2024-01-05
2023-11-28
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
2024-01-05
2023-11-28
Health
F0661
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
D
2024-01-05
2023-11-28
Health
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
2024-01-05
2023-11-28
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2024-01-05
2023-11-28
Health
F0880
Provide and implement an infection prevention and control program.
E
2024-01-05
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
16
Owner
Role
Pct
From
Status
Source
BURNAM, SOON
CORPORATE OFFICER
—
2024-07-22
current
pecos_ownership
GATEWAY HEALTHCARE LLC
DIRECT OWNERSHIP INTEREST
—
2024-07-22
current
pecos_ownership
HELENTHAL, TARA
MANAGING CONTROL - GOVERNING BODY
—
2024-07-22
current
pecos_ownership
JORGENSEN, DAVID
MANAGING CONTROL - GOVERNING BODY
—
2024-07-22
current
pecos_ownership
MILLER, BLAKE
ADP OF THE SNF
—
2025-04-18
current
pecos_ownership
MILLER, BLAKE
OPERATIONAL/MANAGERIAL CONTROL
—
2024-10-01
current
pecos_ownership
RECOB, SAMUEL
ADP OF THE SNF
—
2024-10-01
current
pecos_ownership
SATO, AMI
MANAGING CONTROL - GOVERNING BODY
—
2024-09-09
current
pecos_ownership
THE ENSIGN GROUP INC
INDIRECT OWNERSHIP INTEREST
—
2024-07-22
current
pecos_ownership
SOON BURNAM
CORPORATE OFFICER
0%
2024-07-22
ended 2026-05-18
pecos_ownership
AMI SATO
MANAGING CONTROL - GOVERNING BODY
—
2024-09-09
ended 2026-05-18
pecos_ownership
BLAKE MILLER
ADP OF THE SNF
—
2025-04-18
ended 2026-05-18
pecos_ownership
BLAKE MILLER
OPERATIONAL/MANAGERIAL CONTROL
—
2024-10-01
ended 2026-05-18
pecos_ownership
DAVID JORGENSEN
MANAGING CONTROL - GOVERNING BODY
—
2024-07-22
ended 2026-05-18
pecos_ownership
SAMUEL RECOB
OPERATIONAL/MANAGERIAL CONTROL
—
2024-10-01
ended 2026-05-18
pecos_ownership
TARA HELENTHAL
MANAGING CONTROL - GOVERNING BODY
—
2024-07-22
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.
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
36
Geo
Kind
BR
Amount
As of
Source
county 31119
acs median gross
0
$594
2024-12-31
CENSUS_ACS5
county 31119
fmr
0
$684
2025-10-01
HUD_USER_FMR
county 31119
acs median gross
1
$739
2024-12-31
CENSUS_ACS5
county 31119
fmr
1
$758
2025-10-01
HUD_USER_FMR
county 31119
acs median gross
2
$920
2024-12-31
CENSUS_ACS5
county 31119
fmr
2
$992
2025-10-01
HUD_USER_FMR
county 31119
acs median gross
3
$1,087
2024-12-31
CENSUS_ACS5
county 31119
fmr
3
$1,285
2025-10-01
HUD_USER_FMR
county 31119
acs median gross
4
$1,358
2024-12-31
CENSUS_ACS5
county 31119
fmr
4
$1,524
2025-10-01
HUD_USER_FMR
county 31119
acs median gross
5
$1,075
2024-12-31
CENSUS_ACS5
county 31119
acs median gross
$881
2024-12-31
CENSUS_ACS5
county 31119
acs recent mover gross
$1,019
2024-12-31
CENSUS_ACS5
zcta 68701
acs median gross
0
$594
2024-12-31
CENSUS_ACS5
zcta 68701
acs median gross
1
$745
2024-12-31
CENSUS_ACS5
zcta 68701
acs median gross
2
$931
2024-12-31
CENSUS_ACS5
zcta 68701
acs median gross
3
$1,102
2024-12-31
CENSUS_ACS5
zcta 68701
acs median gross
4
$1,386
2024-12-31
CENSUS_ACS5
zcta 68701
acs median gross
5
$1,313
2024-12-31
CENSUS_ACS5
zcta 68701
acs median gross
$886
2024-12-31
CENSUS_ACS5
zcta 68701
acs recent mover gross
$1,020
2024-12-31
CENSUS_ACS5
zip 68701
payment standard 110
0
$770
2025-10-01
HUD_USER_SAFMR
zip 68701
payment standard 90
0
$630
2025-10-01
HUD_USER_SAFMR
zip 68701
safmr
0
$700
2025-10-01
HUD_USER_SAFMR
zip 68701
payment standard 110
1
$858
2025-10-01
HUD_USER_SAFMR
zip 68701
payment standard 90
1
$702
2025-10-01
HUD_USER_SAFMR
zip 68701
safmr
1
$780
2025-10-01
HUD_USER_SAFMR
zip 68701
payment standard 110
2
$1,122
2025-10-01
HUD_USER_SAFMR
zip 68701
payment standard 90
2
$918
2025-10-01
HUD_USER_SAFMR
zip 68701
safmr
2
$1,020
2025-10-01
HUD_USER_SAFMR
zip 68701
payment standard 110
3
$1,441
2025-10-01
HUD_USER_SAFMR
zip 68701
payment standard 90
3
$1,179
2025-10-01
HUD_USER_SAFMR
zip 68701
safmr
3
$1,310
2025-10-01
HUD_USER_SAFMR
zip 68701
payment standard 110
4
$1,705
2025-10-01
HUD_USER_SAFMR
zip 68701
payment standard 90
4
$1,395
2025-10-01
HUD_USER_SAFMR
zip 68701
safmr
4
$1,550
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.