Reads as: riskier than 6.3% 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.
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
15
2025Q4 HPRD
This facility
MO median
National median
National p25–p75
Total nurse
4.24
2.41
3.28
2.90–3.77
RN
0.25
0.25
0.39
0.25–0.58
Weekend total
3.97
2.24
3.11
—
Weekday total
4.35
2.49
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
88.6
4.24
0.25
0.85
3.14
3.97
2.0%
2025Q3
92
89.4
4.44
0.28
0.80
3.36
4.25
0.3%
2025Q2
91
57.3
5.63
0.45
1.09
4.08
5.14
0.5%
2025Q1
90
58.6
2.42
0.14
0.48
1.79
2.30
8.4%
2024Q4
92
59.8
4.79
0.27
0.88
3.65
4.56
2.0%
2024Q3
92
61.6
5.15
0.33
0.71
4.11
4.80
3.9%
2024Q2
91
60.9
4.43
0.48
0.67
3.27
4.16
5.6%
2024Q1
91
61.2
3.25
0.50
0.41
2.34
3.03
0.0%
2023Q4
92
58.7
3.77
0.70
0.46
2.60
3.49
5.5%
2023Q3
92
50.2
3.48
0.87
0.49
2.12
3.02
0.0%
2023Q1
90
46.2
3.33
0.97
0.56
1.80
3.08
0.0%
2022Q4
92
47.5
3.24
0.75
0.74
1.76
2.93
0.0%
2022Q3
92
47.2
3.30
0.73
0.52
2.05
3.05
0.0%
2022Q2
91
48.8
3.52
0.75
0.54
2.23
3.16
0.0%
2022Q1
90
48.3
3.24
0.81
0.42
2.01
2.87
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
29
B × 1C × 1D × 16E × 9F × 1G × 1
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2025-10-17
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2025-11-12
2024-09-26
Health
F0554
Allow residents to self-administer drugs if determined clinically appropriate.
D
2024-11-08
2024-09-26
Health
F0637
Assess the resident when there is a significant change in condition
D
2024-11-08
2024-09-26
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2024-11-08
2024-09-26
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
E
2024-11-08
2024-09-26
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
2024-11-08
2024-09-26
Health
F0690
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
D
2024-11-08
2024-09-26
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2024-11-08
2024-09-26
Health
F0732
Post nurse staffing information every day.
C
2024-11-08
2024-09-26
Health
F0759
Ensure medication error rates are not 5 percent or greater.
E
2024-11-08
2024-09-26
Health
F0804
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
E
2024-11-08
2024-09-26
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2024-11-08
2024-09-26
Health
F0880
Provide and implement an infection prevention and control program.
E
2024-11-08
2024-09-26
Health
F0919
Make sure that a working call system is available in each resident's bathroom and bathing area.
D
2024-11-08
2024-04-18
Health · complaint
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
2024-05-23
2024-04-18
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2024-05-23
2023-05-12
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
2023-06-26
2023-05-12
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2023-07-09
2023-05-12
Health
F0690
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
D
2023-06-26
2023-05-12
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.
E
2023-06-26
2023-05-12
Health
F0732
Post nurse staffing information every day.
E
2023-06-26
2023-05-12
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2023-06-26
2023-05-12
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2023-06-26
2023-05-12
Health
F0880
Provide and implement an infection prevention and control program.
E
2023-06-26
2019-11-13
Health
F0576
Ensure residents have reasonable access to and privacy in their use of communication methods.
B
2019-12-05
2019-11-13
Health
F0610
Respond appropriately to all alleged violations.
D
2019-11-26
2019-11-13
Health
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
2019-11-26
2019-11-13
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
2019-11-26
2019-11-13
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2019-11-26
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
21
Owner
Role
Pct
From
Status
Source
BULLER, TIMOTHY
OPERATIONAL/MANAGERIAL CONTROL
—
2015-09-01
current
pecos_ownership
CERNY, JAN
CORPORATE OFFICER
—
2021-04-02
current
pecos_ownership
FOTHERINGHAM, JEREMY
CORPORATE OFFICER
—
2021-04-02
current
pecos_ownership
KAISER, LAURA
CORPORATE OFFICER
—
2017-05-01
current
pecos_ownership
LAMM, EILEEN
CORPORATE OFFICER
—
2020-03-23
current
pecos_ownership
LONG, DOUGLAS
CORPORATE OFFICER
—
2019-06-01
current
pecos_ownership
SMITH, KEVIN
CORPORATE OFFICER
—
2023-10-01
current
pecos_ownership
SSM HEALTH CARE CORPORATION
5% OR GREATER INDIRECT OWNERSHIP INTEREST
—
2015-09-01
current
pecos_ownership
SSM HEALTH CARE ST LOUIS
5% OR GREATER INDIRECT OWNERSHIP INTEREST
—
2015-09-01
current
pecos_ownership
ST LOUIS UNIVERSITY
5% OR GREATER INDIRECT OWNERSHIP INTEREST
—
2015-09-01
current
pecos_ownership
ST. ANDREW'S MANAGEMENT SERVICES
OPERATIONAL/MANAGERIAL CONTROL
—
2012-07-05
current
pecos_ownership
THE SARAH COMMUNITY
OPERATIONAL/MANAGERIAL CONTROL
—
2012-07-05
current
pecos_ownership
VOYLES, TRACY
CONTRACTED MANAGING EMPLOYEE
—
2016-05-02
current
pecos_ownership
DOUGLAS LONG
CORPORATE OFFICER
—
2019-06-01
ended 2026-05-18
pecos_ownership
EILEEN LAMM
CORPORATE OFFICER
—
2020-03-23
ended 2026-05-18
pecos_ownership
JAN CERNY
CORPORATE OFFICER
—
2021-04-02
ended 2026-05-18
pecos_ownership
JEREMY FOTHERINGHAM
CORPORATE OFFICER
—
2021-04-02
ended 2026-05-18
pecos_ownership
KEVIN SMITH
CORPORATE OFFICER
—
2023-10-01
ended 2026-05-18
pecos_ownership
LAURA KAISER
CORPORATE OFFICER
—
2017-05-01
ended 2026-05-18
pecos_ownership
TIMOTHY BULLER
OPERATIONAL/MANAGERIAL CONTROL
—
2015-09-01
ended 2026-05-18
pecos_ownership
TRACY VOYLES
CONTRACTED MANAGING EMPLOYEE
—
2016-05-02
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
33
Geo
Kind
BR
Amount
As of
Source
county 29189
acs median gross
0
$1,067
2024-12-31
CENSUS_ACS5
county 29189
fmr
0
$955
2025-10-01
HUD_USER_FMR
county 29189
acs median gross
1
$995
2024-12-31
CENSUS_ACS5
county 29189
fmr
1
$995
2025-10-01
HUD_USER_FMR
county 29189
acs median gross
2
$1,216
2024-12-31
CENSUS_ACS5
county 29189
fmr
2
$1,218
2025-10-01
HUD_USER_FMR
county 29189
acs median gross
3
$1,446
2024-12-31
CENSUS_ACS5
county 29189
fmr
3
$1,568
2025-10-01
HUD_USER_FMR
county 29189
acs median gross
4
$1,742
2024-12-31
CENSUS_ACS5
county 29189
fmr
4
$1,812
2025-10-01
HUD_USER_FMR
county 29189
acs median gross
5
$1,850
2024-12-31
CENSUS_ACS5
county 29189
acs median gross
$1,209
2024-12-31
CENSUS_ACS5
county 29189
acs recent mover gross
$1,369
2024-12-31
CENSUS_ACS5
zcta 63044
acs median gross
1
$667
2024-12-31
CENSUS_ACS5
zcta 63044
acs median gross
2
$1,151
2024-12-31
CENSUS_ACS5
zcta 63044
acs median gross
3
$1,186
2024-12-31
CENSUS_ACS5
zcta 63044
acs median gross
$1,145
2024-12-31
CENSUS_ACS5
zcta 63044
acs recent mover gross
$1,431
2024-12-31
CENSUS_ACS5
zip 63044
payment standard 110
0
$990
2025-10-01
HUD_USER_SAFMR
zip 63044
payment standard 90
0
$810
2025-10-01
HUD_USER_SAFMR
zip 63044
safmr
0
$900
2025-10-01
HUD_USER_SAFMR
zip 63044
payment standard 110
1
$1,034
2025-10-01
HUD_USER_SAFMR
zip 63044
payment standard 90
1
$846
2025-10-01
HUD_USER_SAFMR
zip 63044
safmr
1
$940
2025-10-01
HUD_USER_SAFMR
zip 63044
payment standard 110
2
$1,265
2025-10-01
HUD_USER_SAFMR
zip 63044
payment standard 90
2
$1,035
2025-10-01
HUD_USER_SAFMR
zip 63044
safmr
2
$1,150
2025-10-01
HUD_USER_SAFMR
zip 63044
payment standard 110
3
$1,628
2025-10-01
HUD_USER_SAFMR
zip 63044
payment standard 90
3
$1,332
2025-10-01
HUD_USER_SAFMR
zip 63044
safmr
3
$1,480
2025-10-01
HUD_USER_SAFMR
zip 63044
payment standard 110
4
$1,881
2025-10-01
HUD_USER_SAFMR
zip 63044
payment standard 90
4
$1,539
2025-10-01
HUD_USER_SAFMR
zip 63044
safmr
4
$1,710
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.