Reads as: riskier than 86.1% 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
1
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
8 chains
SELECT REHABILITATION LLC
50 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
MO median
National median
National p25–p75
Total nurse
3.15
2.41
3.28
2.90–3.77
RN
0.32
0.25
0.39
0.25–0.58
Weekend total
2.97
2.24
3.11
—
Weekday total
3.22
2.49
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
118.5
3.15
0.32
0.74
2.10
2.97
0.0%
2025Q3
92
128.6
3.72
0.37
0.67
2.68
3.49
0.0%
2025Q2
91
131.4
3.71
0.33
0.71
2.67
3.50
0.0%
2025Q1
90
125.5
3.64
0.41
0.65
2.58
3.22
0.0%
2024Q4
92
129.3
3.43
0.42
0.62
2.39
3.22
0.0%
2024Q3
92
128.4
3.40
0.43
0.64
2.33
3.20
0.0%
2024Q2
91
125.9
3.38
0.42
0.74
2.22
3.09
0.3%
2024Q1
91
125.2
3.23
0.50
0.65
2.08
3.10
0.1%
2023Q4
92
128.6
3.14
0.42
0.65
2.07
3.13
1.0%
2023Q3
92
124.3
3.19
0.40
0.71
2.09
2.98
9.7%
2023Q2
91
124.6
3.12
0.37
0.71
2.05
2.73
10.7%
2023Q1
90
122.3
3.13
0.41
0.87
1.84
2.72
5.4%
2022Q4
92
132.1
2.77
0.23
0.86
1.67
2.40
3.2%
2022Q3
92
131.8
2.77
0.18
0.97
1.62
2.56
5.9%
2022Q2
91
126.4
2.41
0.17
0.85
1.39
2.21
3.5%
2022Q1
90
138.2
2.38
0.21
0.74
1.43
2.21
11.5%
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 pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2026-04-03
2025-09-03
Health · complaint
F0585
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
D
2025-09-19
2025-07-23
Health
F0585
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
D
2025-09-19
2025-07-23
Health
F0641
Ensure each resident receives an accurate assessment.
D
2025-08-29
2025-07-23
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2025-08-29
2025-07-23
Health
F0679
Provide activities to meet all resident's needs.
E
2025-08-29
2025-04-11
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
2025-05-12
2025-04-11
Health · complaint
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
J
2025-04-09
2025-01-29
Health · complaint
F0660
Plan the resident's discharge to meet the resident's goals and needs.
D
2025-02-28
2025-01-29
Health · complaint
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
2025-02-28
2024-09-12
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-10-30
2024-05-23
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2024-06-13
2024-05-23
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2024-05-23
2024-03-13
Health · complaint
F0623
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
D
2024-04-05
2023-09-29
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.
D
2023-10-18
2023-09-29
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2023-10-27
2023-09-29
Health · complaint
F0759
Ensure medication error rates are not 5 percent or greater.
E
2023-10-27
2023-09-29
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.
D
2023-10-27
2023-09-29
Health
F0804
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
E
2023-10-27
2020-02-07
Health
F0554
Allow residents to self-administer drugs if determined clinically appropriate.
D
2020-03-06
2020-02-07
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
2020-03-06
2020-02-07
Health
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2020-03-06
2020-02-07
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
2020-03-06
2020-02-07
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2020-03-06
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
47
Owner
Role
Pct
From
Status
Source
BETHESDA HEALTH GROUP INC
ADP OF THE SNF
—
2025-09-02
current
pecos_ownership
BETHESDA HEALTH GROUP INC
OPERATIONAL/MANAGERIAL CONTROL
—
1999-07-08
current
pecos_ownership
BETHESDA LONG TERM CARE INC
DIRECT OWNERSHIP INTEREST
—
2006-04-01
current
pecos_ownership
BRINKER, JOSEPH
CORPORATE DIRECTOR
—
2010-07-01
current
pecos_ownership
BRINKER, JOSEPH
CORPORATE OFFICER
—
2010-07-10
current
pecos_ownership
BYRNE, ROGER
OPERATIONAL/MANAGERIAL CONTROL
—
2014-02-10
current
pecos_ownership
CWIKLOWSKI, RENEE
OPERATIONAL/MANAGERIAL CONTROL
—
2023-05-04
current
pecos_ownership
DEMBIEC, SCOTT
ADP OF THE SNF
—
2025-03-01
current
pecos_ownership
ESTHER, JAMES
CORPORATE DIRECTOR
—
2018-01-01
current
pecos_ownership
FALKER, FRED
MANAGING CONTROL - GOVERNING BODY
—
2022-01-01
current
pecos_ownership
HUTCHISON, PHILIP
CORPORATE OFFICER
—
2020-01-01
current
pecos_ownership
KELLER, JOSEPH
CORPORATE DIRECTOR
—
2019-01-01
current
pecos_ownership
KIMBALL, MICHELE
ADP OF THE SNF
—
2021-02-21
current
pecos_ownership
KLINGLER, KEVIN
MANAGING CONTROL - GOVERNING BODY
—
2024-01-01
current
pecos_ownership
MAYES, GARY
MANAGING CONTROL - GOVERNING BODY
—
2023-01-01
current
pecos_ownership
MCDONNELL, VERONICA
MANAGING CONTROL - GOVERNING BODY
—
2025-04-25
current
pecos_ownership
MCINTOSH, JESSICA
OPERATIONAL/MANAGERIAL CONTROL
—
2025-02-10
current
pecos_ownership
MEIER, JOHN
CORPORATE OFFICER
—
2019-01-01
current
pecos_ownership
PEREGRIN, KIEL
OPERATIONAL/MANAGERIAL CONTROL
—
2020-02-23
current
pecos_ownership
POPP, JENNIFER
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-31
current
pecos_ownership
ROONEY, PATRICK
MANAGING CONTROL - GOVERNING BODY
—
2021-01-01
current
pecos_ownership
ROONEY, PATRICK
CORPORATE OFFICER
—
2026-01-01
current
pecos_ownership
ROWE, JOHN
CORPORATE DIRECTOR
—
2025-01-01
current
pecos_ownership
SELECT REHABILITATION, LLC
ADP OF THE SNF
—
2025-07-10
current
pecos_ownership
SELECT REHABILITATION, LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2015-12-15
current
pecos_ownership
TEIBEL, SAMANTHA
CORPORATE DIRECTOR
—
2025-02-27
current
pecos_ownership
FRED FALKER
MANAGING CONTROL - GOVERNING BODY
—
2022-01-01
ended 2026-05-18
pecos_ownership
GARY MAYES
MANAGING CONTROL - GOVERNING BODY
—
2023-01-01
ended 2026-05-18
pecos_ownership
JAMES ESTHER
MANAGING CONTROL - GOVERNING BODY
—
2018-01-01
ended 2026-05-18
pecos_ownership
JENNIFER POPP
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-31
ended 2026-05-18
pecos_ownership
JESSICA MCINTOSH
OPERATIONAL/MANAGERIAL CONTROL
—
2025-02-10
ended 2026-05-18
pecos_ownership
JOHN MEIER
MANAGING CONTROL - GOVERNING BODY
—
2019-01-01
ended 2026-05-18
pecos_ownership
JOHN ROWE
MANAGING CONTROL - GOVERNING BODY
—
2025-01-01
ended 2026-05-18
pecos_ownership
JOSEPH BRINKER
OPERATIONAL/MANAGERIAL CONTROL
—
2010-07-01
ended 2026-05-18
pecos_ownership
JOSEPH BRINKER
CORPORATE OFFICER
—
2010-07-10
ended 2026-05-18
pecos_ownership
JOSEPH KELLER
MANAGING CONTROL - GOVERNING BODY
—
2019-01-01
ended 2026-05-18
pecos_ownership
KEVIN KLINGLER
CORPORATE OFFICER
—
2024-01-01
ended 2026-05-18
pecos_ownership
KIEL PEREGRIN
ADP OF THE SNF
—
2020-02-23
ended 2026-05-18
pecos_ownership
MICHELE KIMBALL
OPERATIONAL/MANAGERIAL CONTROL
—
2021-02-21
ended 2026-05-18
pecos_ownership
PATRICK ROONEY
CORPORATE OFFICER
—
2026-01-01
ended 2026-05-18
pecos_ownership
PATRICK ROONEY
MANAGING CONTROL - GOVERNING BODY
—
2021-01-01
ended 2026-05-18
pecos_ownership
PHILIP HUTCHISON
MANAGING CONTROL - GOVERNING BODY
—
2020-01-01
ended 2026-05-18
pecos_ownership
RENEE CWIKLOWSKI
OPERATIONAL/MANAGERIAL CONTROL
—
2023-05-04
ended 2026-05-18
pecos_ownership
ROGER BYRNE
ADP OF THE SNF
—
2014-02-10
ended 2026-05-18
pecos_ownership
SAMANTHA TEIBEL
CORPORATE DIRECTOR
—
2025-02-27
ended 2026-05-18
pecos_ownership
SCOTT DEMBIEC
ADP OF THE SNF
—
2025-03-01
ended 2026-05-18
pecos_ownership
VERONICA MCDONNELL
CORPORATE DIRECTOR
—
2025-04-25
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
2025-06-30
$4,334,290
—
—
—
—
1
—
2024-06-30
$3,517,101
—
—
—
—
1
—
2023-06-30
$3,141,057
—
—
—
—
1
—
2022-06-30
$3,313,447
—
—
—
—
1
—
2021-06-30
$3,724,072
—
—
—
—
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
36
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 63122
acs median gross
0
$1,307
2024-12-31
CENSUS_ACS5
zcta 63122
acs median gross
1
$1,049
2024-12-31
CENSUS_ACS5
zcta 63122
acs median gross
2
$1,347
2024-12-31
CENSUS_ACS5
zcta 63122
acs median gross
3
$1,634
2024-12-31
CENSUS_ACS5
zcta 63122
acs median gross
4
$2,198
2024-12-31
CENSUS_ACS5
zcta 63122
acs median gross
5
$1,926
2024-12-31
CENSUS_ACS5
zcta 63122
acs median gross
$1,385
2024-12-31
CENSUS_ACS5
zcta 63122
acs recent mover gross
$1,663
2024-12-31
CENSUS_ACS5
zip 63122
payment standard 110
0
$1,221
2025-10-01
HUD_USER_SAFMR
zip 63122
payment standard 90
0
$999
2025-10-01
HUD_USER_SAFMR
zip 63122
safmr
0
$1,110
2025-10-01
HUD_USER_SAFMR
zip 63122
payment standard 110
1
$1,276
2025-10-01
HUD_USER_SAFMR
zip 63122
payment standard 90
1
$1,044
2025-10-01
HUD_USER_SAFMR
zip 63122
safmr
1
$1,160
2025-10-01
HUD_USER_SAFMR
zip 63122
payment standard 110
2
$1,562
2025-10-01
HUD_USER_SAFMR
zip 63122
payment standard 90
2
$1,278
2025-10-01
HUD_USER_SAFMR
zip 63122
safmr
2
$1,420
2025-10-01
HUD_USER_SAFMR
zip 63122
payment standard 110
3
$2,013
2025-10-01
HUD_USER_SAFMR
zip 63122
payment standard 90
3
$1,647
2025-10-01
HUD_USER_SAFMR
zip 63122
safmr
3
$1,830
2025-10-01
HUD_USER_SAFMR
zip 63122
payment standard 110
4
$2,321
2025-10-01
HUD_USER_SAFMR
zip 63122
payment standard 90
4
$1,899
2025-10-01
HUD_USER_SAFMR
zip 63122
safmr
4
$2,110
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.