137 North Elk Street, Sandusky, MI 48471 · CCN 235157
Composite
50.7 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
104
Model
v1.2
Reads as: riskier than 50.7% 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
16
2025Q4 HPRD
This facility
MI median
National median
National p25–p75
Total nurse
3.74
3.52
3.28
2.90–3.77
RN
0.11
0.47
0.39
0.25–0.58
Weekend total
3.59
3.32
3.11
—
Weekday total
3.80
3.61
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
75.5
3.74
0.11
0.92
2.71
3.59
5.4%
2025Q3
92
77.1
3.83
0.11
0.96
2.75
3.68
0.0%
2025Q2
91
77.1
3.96
0.10
0.99
2.88
3.81
0.0%
2025Q1
90
74.5
4.02
0.14
1.08
2.79
3.93
0.0%
2024Q4
92
71.3
4.07
0.04
1.02
3.01
3.87
0.0%
2024Q3
92
68.1
4.03
0.07
0.98
2.98
3.83
0.0%
2024Q2
91
70.3
4.32
0.12
0.98
3.22
4.07
0.0%
2024Q1
91
71.1
4.13
0.10
0.90
3.13
4.02
0.0%
2023Q4
92
70.6
3.96
0.06
0.83
3.07
3.78
0.0%
2023Q3
92
71.5
3.98
0.12
0.90
2.96
3.83
0.0%
2023Q2
91
71.4
4.10
0.07
0.99
3.05
3.93
0.0%
2023Q1
90
67.8
4.28
0.04
0.99
3.25
4.09
0.0%
2022Q4
92
62.7
4.32
0.10
1.05
3.17
4.09
0.0%
2022Q3
92
63.2
4.21
0.17
1.00
3.04
3.98
0.0%
2022Q2
91
60.1
4.25
0.21
1.06
2.99
3.92
0.0%
2022Q1
90
56.3
4.49
0.36
1.05
3.07
4.00
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.
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
—
2025-08-21
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2025-09-30
2025-08-21
Health
F0645
PASARR screening for Mental disorders or Intellectual Disabilities
D
2025-09-30
2025-08-21
Health
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2025-09-30
2025-08-21
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
2025-09-30
2025-08-21
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
2025-09-30
2025-08-21
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
2025-09-30
2025-08-21
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2025-09-30
2025-08-21
Health
F0921
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
F
2025-09-30
2024-07-01
Health
F0552
Ensure that residents are fully informed and understand their health status, care and treatments.
D
2024-07-30
2024-07-01
Health
F0561
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
D
2024-07-30
2024-07-01
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
2024-07-30
2024-07-01
Health · complaint
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
E
2024-07-30
2024-07-01
Health · complaint
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2024-07-30
2024-07-01
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-07-30
2024-07-01
Health · complaint
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
G
2024-07-30
2024-07-01
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2024-07-30
2024-07-01
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2024-07-30
2024-07-01
Health
F0698
Provide safe, appropriate dialysis care/services for a resident who requires such services.
D
2024-07-30
2024-07-01
Health · complaint
F0758
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
D
2024-07-30
2024-07-01
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2024-07-30
2024-07-01
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
2024-07-30
2024-07-01
Health
F0880
Provide and implement an infection prevention and control program.
E
2024-07-30
2024-07-01
Health
F0881
Implement a program that monitors antibiotic use.
D
2024-07-30
2023-06-28
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
E
2023-08-18
2023-06-28
Health
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
2023-08-18
2023-06-28
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.
E
2023-08-18
2023-06-28
Health
F0757
Ensure each resident’s drug regimen must be free from unnecessary drugs.
E
2023-08-18
2023-06-28
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
2023-08-18
2023-06-28
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2023-08-18
2023-06-28
Health
F0865
Have a plan that describes the process for conducting QAPI and QAA activities.
F
2023-08-18
2023-06-28
Health
F0880
Provide and implement an infection prevention and control program.
D
2023-08-18
2023-06-28
Health
F0881
Implement a program that monitors antibiotic use.
D
2023-08-18
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
SANILAC COUNTY
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
—
current
pecos_ownership
BUTTAR, NICK
OPERATIONAL/MANAGERIAL CONTROL
—
2024-04-01
current
pecos_ownership
BUTTAR, NICK
ADP OF THE SNF
—
2024-02-02
current
pecos_ownership
CARINGI, HEATHER
ADP OF THE SNF
—
2022-04-29
current
pecos_ownership
DUNSMORE-GANLEY, RACHEL
OPERATIONAL/MANAGERIAL CONTROL
—
2024-04-23
current
pecos_ownership
JOHNSON, TAMMI
ADP OF THE SNF
—
2023-10-01
current
pecos_ownership
LABA, TERI
ADP OF THE SNF
—
1998-10-26
current
pecos_ownership
MILLER, LINDSEY
OPERATIONAL/MANAGERIAL CONTROL
—
2022-05-31
current
pecos_ownership
MILLER, NICOLE
ADP OF THE SNF
—
2024-07-15
current
pecos_ownership
POWELL, LISA
OPERATIONAL/MANAGERIAL CONTROL
—
—
current
pecos_ownership
SHERMAN, CARI
ADP OF THE SNF
—
2025-03-09
current
pecos_ownership
CARI SHERMAN
ADP OF THE SNF
—
2025-03-09
ended 2026-05-18
pecos_ownership
HEATHER CARINGI
ADP OF THE SNF
—
2022-04-29
ended 2026-05-18
pecos_ownership
LINDSEY MILLER
ADP OF THE SNF
—
2022-05-31
ended 2026-05-18
pecos_ownership
LISA POWELL
OPERATIONAL/MANAGERIAL CONTROL
—
—
ended 2026-05-18
pecos_ownership
NICK BUTTAR
ADP OF THE SNF
—
2024-02-02
ended 2026-05-18
pecos_ownership
NICK BUTTAR
OPERATIONAL/MANAGERIAL CONTROL
—
2024-04-01
ended 2026-05-18
pecos_ownership
NICOLE MILLER
OPERATIONAL/MANAGERIAL CONTROL
—
2024-07-15
ended 2026-05-18
pecos_ownership
RACHEL DUNSMORE-GANLEY
OPERATIONAL/MANAGERIAL CONTROL
—
2024-04-23
ended 2026-05-18
pecos_ownership
TAMMI JOHNSON
OPERATIONAL/MANAGERIAL CONTROL
—
2023-10-01
ended 2026-05-18
pecos_ownership
TERI LABA
OPERATIONAL/MANAGERIAL CONTROL
—
1998-10-26
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
5
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$47,581
—
—
—
—
1
—
2023-12-31
$62,221
—
—
—
—
1
—
2022-12-31
$4,098
—
—
—
—
1
—
2021-12-31
$19,603
—
—
—
—
1
—
2020-12-31
$48,458
—
—
—
—
1
—
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
35
Geo
Kind
BR
Amount
As of
Source
county 26151
acs median gross
0
$414
2024-12-31
CENSUS_ACS5
county 26151
fmr
0
$671
2025-10-01
HUD_USER_FMR
county 26151
acs median gross
1
$601
2024-12-31
CENSUS_ACS5
county 26151
fmr
1
$742
2025-10-01
HUD_USER_FMR
county 26151
acs median gross
2
$835
2024-12-31
CENSUS_ACS5
county 26151
fmr
2
$973
2025-10-01
HUD_USER_FMR
county 26151
acs median gross
3
$961
2024-12-31
CENSUS_ACS5
county 26151
fmr
3
$1,253
2025-10-01
HUD_USER_FMR
county 26151
acs median gross
4
$836
2024-12-31
CENSUS_ACS5
county 26151
fmr
4
$1,316
2025-10-01
HUD_USER_FMR
county 26151
acs median gross
5
$1,068
2024-12-31
CENSUS_ACS5
county 26151
acs median gross
$807
2024-12-31
CENSUS_ACS5
county 26151
acs recent mover gross
$818
2024-12-31
CENSUS_ACS5
zcta 48471
acs median gross
1
$573
2024-12-31
CENSUS_ACS5
zcta 48471
acs median gross
2
$797
2024-12-31
CENSUS_ACS5
zcta 48471
acs median gross
3
$952
2024-12-31
CENSUS_ACS5
zcta 48471
acs median gross
4
$860
2024-12-31
CENSUS_ACS5
zcta 48471
acs median gross
5
$1,025
2024-12-31
CENSUS_ACS5
zcta 48471
acs median gross
$795
2024-12-31
CENSUS_ACS5
zcta 48471
acs recent mover gross
$593
2024-12-31
CENSUS_ACS5
zip 48471
payment standard 110
0
$737
2025-10-01
HUD_USER_SAFMR
zip 48471
payment standard 90
0
$603
2025-10-01
HUD_USER_SAFMR
zip 48471
safmr
0
$670
2025-10-01
HUD_USER_SAFMR
zip 48471
payment standard 110
1
$814
2025-10-01
HUD_USER_SAFMR
zip 48471
payment standard 90
1
$666
2025-10-01
HUD_USER_SAFMR
zip 48471
safmr
1
$740
2025-10-01
HUD_USER_SAFMR
zip 48471
payment standard 110
2
$1,067
2025-10-01
HUD_USER_SAFMR
zip 48471
payment standard 90
2
$873
2025-10-01
HUD_USER_SAFMR
zip 48471
safmr
2
$970
2025-10-01
HUD_USER_SAFMR
zip 48471
payment standard 110
3
$1,375
2025-10-01
HUD_USER_SAFMR
zip 48471
payment standard 90
3
$1,125
2025-10-01
HUD_USER_SAFMR
zip 48471
safmr
3
$1,250
2025-10-01
HUD_USER_SAFMR
zip 48471
payment standard 110
4
$1,452
2025-10-01
HUD_USER_SAFMR
zip 48471
payment standard 90
4
$1,188
2025-10-01
HUD_USER_SAFMR
zip 48471
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.