Composite
58.2 / 100 percentile
Screener / 215164
B
SHADY GROVE NURSING AND REHABILITATION CENTER
snfMD
9701 MEDICAL CENTER DRIVE, ROCKVILLE, MD 20850 · CCN 215164 · chain RMA EQUITY LLC
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
154
Model
v1.2
Reads as: riskier than 58.2% 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.
Score model5ML signals1Components16CHOW radar1Distress radar1Staffing16Penalties1Deficiencies85Licensure0Ownership9Related party5Transactions1Comps12Market rent36
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| billing conduct | 87.5 | 57.7 | 0.30 | 0.2308 | 20.19 | in index |
| regulatory risk | 79.3 | 75.9 | 0.30 | 0.2308 | 18.30 | in index |
| staffing risk | 46.6 | 46.6 | 0.25 | 0.1923 | 8.96 | in index |
| financial risk | 9.4 | 18.6 | 0.30 | 0.2308 | 2.17 | in index |
| chow risk | 15.4 | 15.1 | 0.15 | 0.1154 | 1.78 | in index |
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 fleet enforcement cluster | 40% fined | KOHN AVROHOM | 5 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.
Component scores and registry models
16| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 57.7 | C | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 25.0 | B | v0.1-pos | default · in composite | 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. |
| chow risk | 5.3 | A | v0.6 | default · in composite | |
| financial risk | 18.6 | A | v0.5 | default · in composite | R18. |
| p adverse action 12m | 0.1 | — | v0.1 | default · in composite | 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. |
| p chow 12m | 0.1 | — | v0.1 | default · in 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. |
| regulatory risk | 75.9 | D | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 46.6 | C | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 65.9 | D | v0.1 | superseded | 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. |
| financial risk | 45.9 | C | v0.2 | superseded | 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. |
| financial risk | 40.2 | B | v0.3 | superseded | 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. |
| financial risk | 24.2 | A | v0.4 | superseded | 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. |
| regulatory risk | 75.8 | D | v0.1 | superseded | 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. |
| regulatory risk | 75.8 | D | v0.2 | superseded | 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. |
| staffing risk | 46.6 | C | v0.1 | superseded | 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. |
| staffing risk | 46.6 | C | v0.2 | superseded | 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.
CHOW radar — 12-month sale probability
full board →p(CHOW, 12m)
0.1%
model v0.1 · computed 2026-07-29
Percentile among SNFs
17.6
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Never sold on record | 0.00 | -1.62 | |
| Current owner tenure (years) | 7.99 | -1.07 | |
| For-profit ownership | 1.00 | +0.69 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Occupancy | 0.84 | -0.41 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Facility size (log beds) | 5.04 | -0.11 | |
| Deficiencies, last 12 months | 3.00 | -0.10 |
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.
Distress radar — 12-month termination probability
full board →p(termination, 12m)
0.1%
model v0.1 · computed 2026-07-29
Percentile among SNFs
38.3
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Deficiencies, last 12 months | 3.00 | +0.87 | |
| For-profit ownership | 1.00 | -0.69 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Occupancy | 0.84 | -0.38 | |
| Never sold on record | 0.00 | -0.28 | |
| Chain size (log) | 1.61 | +0.26 | |
| Fine amount, 12m (log) | 0.00 | +0.18 | |
| Current owner tenure (years) | 7.99 | -0.17 |
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 | MD median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 3.34 | 3.32 | 3.28 | 2.90–3.77 |
| RN | 0.39 | 0.47 | 0.39 | 0.25–0.58 |
| Weekend total | 3.23 | 3.17 | 3.11 | — |
| Weekday total | 3.38 | 3.36 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 129.3 | 3.34 | 0.39 | 1.06 | 1.89 | 3.23 | 0.0% |
| 2025Q3 | 92 | 132.1 | 3.08 | 0.37 | 0.96 | 1.74 | 2.94 | 0.0% |
| 2025Q2 | 91 | 132.0 | 3.18 | 0.41 | 0.96 | 1.82 | 3.02 | 0.0% |
| 2025Q1 | 90 | 135.9 | 3.02 | 0.40 | 0.92 | 1.70 | 2.93 | 0.0% |
| 2024Q4 | 92 | 133.6 | 3.14 | 0.35 | 0.95 | 1.84 | 3.10 | 0.0% |
| 2024Q3 | 92 | 133.3 | 3.12 | 0.32 | 0.93 | 1.87 | 2.98 | 0.0% |
| 2024Q2 | 91 | 136.5 | 3.15 | 0.28 | 0.98 | 1.89 | 3.00 | 0.0% |
| 2024Q1 | 91 | 138.1 | 2.82 | 0.26 | 0.84 | 1.72 | 2.70 | 0.0% |
| 2023Q4 | 92 | 135.8 | 2.74 | 0.25 | 0.82 | 1.66 | 2.63 | 0.0% |
| 2023Q3 | 92 | 137.8 | 2.83 | 0.32 | 0.85 | 1.66 | 2.65 | 0.0% |
| 2023Q2 | 91 | 138.5 | 2.94 | 0.34 | 0.77 | 1.82 | 2.63 | 11.1% |
| 2023Q1 | 90 | 138.7 | 2.89 | 0.30 | 0.79 | 1.81 | 2.49 | 14.9% |
| 2022Q4 | 92 | 130.7 | 3.09 | 0.39 | 0.80 | 1.90 | 2.75 | 12.2% |
| 2022Q3 | 92 | 129.0 | 3.12 | 0.31 | 0.74 | 2.07 | 2.74 | 6.5% |
| 2022Q2 | 91 | 125.1 | 3.37 | 0.34 | 0.81 | 2.22 | 3.02 | 4.1% |
| 2022Q1 | 90 | 120.9 | 3.44 | 0.32 | 0.98 | 2.13 | 3.19 | 5.9% |
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
1| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-06-16 | Fine | $8,278 | CMS provider data |
Total fines on record: $8,278
Deficiencies
85B × 2C × 1D × 65E × 13F × 3G × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-04-13 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2026-05-19 |
| 2025-12-19 | Health · complaint | 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 | 2026-01-27 |
| 2025-12-19 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2026-01-27 |
| 2025-07-17 | Health · complaint | F0659 | Provide care by qualified persons according to each resident's written plan of care. | D | 2025-08-11 |
| 2025-06-16 | Health · complaint | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | D | 2025-08-14 |
| 2025-06-16 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2025-08-14 |
| 2025-06-16 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2025-08-14 |
| 2025-06-16 | Health · complaint | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2025-08-14 |
| 2025-03-13 | Health | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2025-05-05 |
| 2025-03-13 | Health | F0561 | Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | D | 2025-05-05 |
| 2025-03-13 | 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 | 2025-05-05 |
| 2025-03-13 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2025-05-05 |
| 2025-03-13 | 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 | 2025-05-05 |
| 2025-03-13 | Health · complaint | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | 2025-05-05 |
| 2025-03-13 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | E | 2025-05-05 |
| 2025-03-13 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2025-05-05 |
| 2025-03-13 | Health | F0622 | Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | D | 2025-05-05 |
| 2025-03-13 | 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 | 2025-05-05 |
| 2025-03-13 | Health | F0624 | Prepare residents for a safe transfer or discharge from the nursing home. | D | 2025-05-05 |
| 2025-03-13 | 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. | D | 2025-05-05 |
| 2025-03-13 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2025-05-05 |
| 2025-03-13 | Health | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | 2025-05-05 |
| 2025-03-13 | Health | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | 2025-05-05 |
| 2025-03-13 | Health · complaint | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | F | 2025-05-05 |
| 2025-03-13 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | E | 2025-05-05 |
| 2025-03-13 | Health · complaint | F0660 | Plan the resident's discharge to meet the resident's goals and needs. | D | 2025-05-05 |
| 2025-03-13 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2025-05-05 |
| 2025-03-13 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-05-05 |
| 2025-03-13 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | 2025-05-05 |
| 2025-03-13 | 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 | 2025-05-05 |
| 2025-03-13 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2025-05-05 |
| 2025-03-13 | Health | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | D | 2025-05-05 |
| 2025-03-13 | 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. | D | 2025-05-05 |
| 2025-03-13 | Health | F0710 | Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care. | D | 2025-05-05 |
| 2025-03-13 | Health · complaint | F0711 | Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit. | D | 2025-05-05 |
| 2025-03-13 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2025-05-05 |
| 2025-03-13 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2025-05-05 |
| 2025-03-13 | 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. | D | 2025-05-05 |
| 2025-03-13 | Health | F0790 | Provide routine and 24-hour emergency dental care for each resident. | D | 2025-05-05 |
| 2025-03-13 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2025-05-05 |
| 2025-03-13 | Health · complaint | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | E | 2025-05-05 |
| 2025-03-13 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2025-05-05 |
| 2025-03-13 | Health | F0908 | Keep all essential equipment working safely. | D | 2025-05-05 |
| 2025-03-13 | 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. | D | 2025-05-05 |
| 2024-03-26 | Health · complaint | F0563 | Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing. | D | 2024-04-29 |
| 2024-03-26 | Health · complaint | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | 2024-04-29 |
| 2024-03-26 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-04-29 |
| 2024-03-26 | Health · complaint | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | 2024-04-29 |
| 2024-03-26 | Health · complaint | 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 | 2024-04-29 |
| 2024-03-26 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-04-29 |
| 2024-03-26 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-04-29 |
| 2024-03-26 | Health · complaint | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | D | 2024-04-29 |
| 2024-03-26 | Health · complaint | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2024-04-29 |
| 2024-03-26 | Health · complaint | F0923 | Have enough outside ventilation via a window or mechanical ventilation, or both. | D | 2024-04-29 |
| 2021-01-15 | 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 | 2021-03-05 |
| 2021-01-15 | Health | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | 2021-03-05 |
| 2021-01-15 | 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 | 2021-03-05 |
| 2021-01-15 | 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 | 2021-03-05 |
| 2021-01-15 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2021-03-05 |
| 2021-01-15 | Health | F0678 | Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives. | E | 2021-03-05 |
| 2021-01-15 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | E | 2021-03-05 |
| 2021-01-15 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2021-03-05 |
| 2021-01-15 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2021-03-05 |
| 2021-01-15 | Health | F0693 | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | E | 2021-03-05 |
| 2021-01-15 | Health | F0726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | F | 2021-03-05 |
| 2021-01-15 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2021-03-05 |
| 2021-01-15 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2021-03-05 |
| 2021-01-15 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2021-03-05 |
| 2019-04-12 | Health | F0561 | Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | D | 2019-05-24 |
| 2019-04-12 | 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 | 2019-05-24 |
| 2019-04-12 | Health | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | 2019-05-24 |
| 2019-04-12 | Health | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2019-05-24 |
| 2019-04-12 | 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 | 2019-05-24 |
| 2019-04-12 | Health | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | 2019-05-24 |
| 2019-04-12 | 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 | 2019-05-24 |
| 2019-04-12 | 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 | 2019-05-24 |
| 2019-04-12 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2019-05-24 |
| 2019-04-12 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2019-05-24 |
| 2019-04-12 | Health | 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 | 2019-05-24 |
| 2019-04-12 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2019-05-24 |
| 2019-04-12 | 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 | 2019-05-24 |
| 2019-04-12 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | C | 2019-05-24 |
| 2019-04-12 | Health | F0840 | Employ or obtain outside professional resources to provide services in the nursing home when the facility does not employ a qualified professional to furnish a required service. | D | 2019-05-24 |
| 2019-04-12 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | B | 2019-05-24 |
| 2019-04-12 | Health | F0880 | Provide and implement an infection prevention and control program. | F | 2019-05-24 |
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
0No 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
9| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| THUNDER HEALTH HOLDCO LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2018-07-01 | current | pecos_ownership |
| BIRNBAUM, ISRAEL | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 37% | 2021-05-01 | current | pecos_ownership |
| KOHN, AVROHOM | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 10% | 2018-08-01 | current | pecos_ownership |
| RMA EQUITY LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 10% | 2023-07-13 | current | pecos_ownership |
| BIRNBAUM, ISRAEL | W-2 MANAGING EMPLOYEE | — | 2018-08-01 | current | pecos_ownership |
| ISRAEL BIRNBAUM | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 37% | 2021-05-01 | ended 2026-05-18 | pecos_ownership |
| MICHELE NETZER | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 37% | 2021-05-01 | ended 2026-05-18 | pecos_ownership |
| AVROHOM KOHN | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 10% | 2018-08-01 | ended 2026-05-18 | pecos_ownership |
| ISRAEL BIRNBAUM | W-2 MANAGING EMPLOYEE | — | 2018-08-01 | 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.
Transactions
1| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2018-08-01 | — | SHADY GROVE SNF LLC | 9701 MEDICAL CENTER DRIVE OPERATIONS LLC | chow |
Comparable trades — MD snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-03-01 | FROSTBURG REHAB CENTER | — | — | — | 122 | KAYLOR FROSTBURG LLC |
| 2025-03-01 | SOUTH MOUNTAIN REHAB CENTER | — | — | — | 157 | SM REHAB |
| 2024-12-01 | ST. ELIZABETH REHABILITATION & NURSING CENTER | — | — | — | 162 | ST. ELIZABETH OPCO LLC |
| 2024-10-01 | SNOW HILL REHABILITATION & HEALTHCARE CENTER | — | — | — | 69 | SNOW HILL SNF OPERATIONS LLC |
| 2024-10-01 | DENNETT REHAB CENTER | — | — | — | 99 | DENNETT SNF |
| 2024-09-01 | FREDERICK CROSSING OF JOURNEY | — | — | — | 120 | FREDERICK CROSSING OF JOURNEY LLC |
| 2024-07-01 | BAY HARBOR POST ACUTE HEALTHCARE CENTER | — | — | — | 305 | BAY HARBOR OPERATOR LLC |
| 2024-04-01 | GREEN ACRES NURSING AND REHAB | — | — | — | 170 | 10200 LA PLATA OPCO LLC |
| 2024-03-01 | COPPER RIDGE NURSING AND ASSISTED LIVING CENTER | — | — | — | 66 | CARROLL MD OPCO LLC |
| 2024-01-01 | RESORTS OF AUGSBURG | — | — | — | 131 | RESORTS OF AUGSBURG CORP |
| 2023-12-01 | ROSSVILLE REHABILITATION AND HEALTHCARE CENTER | — | — | — | 172 | ROSSVILLE SNF OPERATIONS LLC |
| 2023-12-01 | TOWSON REHABILITATION AND HEALTHCARE CENTER | — | — | — | 132 | TOWSON SNF OPERATIONS LLC |
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 24031 | acs median gross | 0 | $1,685 | 2024-12-31 | CENSUS_ACS5 |
| county 24031 | fmr | 0 | $1,953 | 2025-10-01 | HUD_USER_FMR |
| county 24031 | acs median gross | 1 | $1,819 | 2024-12-31 | CENSUS_ACS5 |
| county 24031 | fmr | 1 | $2,015 | 2025-10-01 | HUD_USER_FMR |
| county 24031 | acs median gross | 2 | $2,113 | 2024-12-31 | CENSUS_ACS5 |
| county 24031 | fmr | 2 | $2,246 | 2025-10-01 | HUD_USER_FMR |
| county 24031 | acs median gross | 3 | $2,515 | 2024-12-31 | CENSUS_ACS5 |
| county 24031 | fmr | 3 | $2,835 | 2025-10-01 | HUD_USER_FMR |
| county 24031 | acs median gross | 4 | $3,095 | 2024-12-31 | CENSUS_ACS5 |
| county 24031 | fmr | 4 | $3,332 | 2025-10-01 | HUD_USER_FMR |
| county 24031 | acs median gross | 5 | $3,501 | 2024-12-31 | CENSUS_ACS5 |
| county 24031 | acs median gross | $2,068 | 2024-12-31 | CENSUS_ACS5 | |
| county 24031 | acs recent mover gross | $2,226 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 20850 | acs median gross | 0 | $1,770 | 2024-12-31 | CENSUS_ACS5 |
| zcta 20850 | acs median gross | 1 | $2,096 | 2024-12-31 | CENSUS_ACS5 |
| zcta 20850 | acs median gross | 2 | $2,499 | 2024-12-31 | CENSUS_ACS5 |
| zcta 20850 | acs median gross | 3 | $3,021 | 2024-12-31 | CENSUS_ACS5 |
| zcta 20850 | acs median gross | 4 | $3,501 | 2024-12-31 | CENSUS_ACS5 |
| zcta 20850 | acs median gross | 5 | $3,345 | 2024-12-31 | CENSUS_ACS5 |
| zcta 20850 | acs median gross | $2,309 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 20850 | acs recent mover gross | $2,495 | 2024-12-31 | CENSUS_ACS5 | |
| zip 20850 | payment standard 110 | 0 | $2,618 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | payment standard 90 | 0 | $2,142 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | safmr | 0 | $2,380 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | payment standard 110 | 1 | $2,706 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | payment standard 90 | 1 | $2,214 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | safmr | 1 | $2,460 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | payment standard 110 | 2 | $3,014 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | payment standard 90 | 2 | $2,466 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | safmr | 2 | $2,740 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | payment standard 110 | 3 | $3,806 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | payment standard 90 | 3 | $3,114 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | safmr | 3 | $3,460 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | payment standard 110 | 4 | $4,466 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | payment standard 90 | 4 | $3,654 | 2025-10-01 | HUD_USER_SAFMR |
| zip 20850 | safmr | 4 | $4,060 | 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.