Screener / 445108

NHC HEALTHCARE, MURFREESBORO

snfTN

420 N UNIVERSITY ST, MURFREESBORO, TN 37130 · CCN 445108 · chain NATIONAL HEALTHCARE CORPORATION

Composite

34.0 / 100 percentile

Peer group

snf n = 14,684

Evidence depth

deep

Certified beds

181

Model

v1.2

Reads as: riskier than 34.0% 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 model5 ML signals1 Components16 CHOW radar1 Distress radar1 Staffing16 Penalties0 Deficiencies7 Licensure0 Ownership25 Related party5 Transactions0 Comps12 Market rent36

Composite explanation

Component	Percentile	Raw	Weight	Weight share	Contribution	Counts
billing conduct	73.2	49.2	0.30	0.2308	16.89	in index
financial risk	49.5	45.2	0.30	0.2308	11.42	in index
staffing risk	53.7	53.7	0.25	0.1923	10.33	in index
chow risk	21.3	26.9	0.15	0.1154	2.46	in index
regulatory risk	5.5	3.4	0.30	0.2308	1.27	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

Kind	Finding	Signal	Subject	First seen
connection	Owner spans multiple chains	6 chains	SMITHERS JEFFREY	10 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

Score type	Score	Grade	Model	Status	Registry model notes
billing conduct	49.2	C	v0.1-pacpuf-snf	default · in composite	R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup.
chow risk	13.9	A	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	39.8	B	v0.6	default · in composite
financial risk	45.2	C	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	6.9	—	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	3.4	A	v0.3	default · in composite	Deficiency-based, SNF population. Runs alongside v0.5-pos.
staffing risk	53.7	C	v0.3	default · in composite	Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS.
financial risk	76.9	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	56.9	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	40.9	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	50.8	C	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	3.4	A	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	3.4	A	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	53.7	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	53.7	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)

6.9%

model v0.1 · computed 2026-07-29

Percentile among SNFs

94.3

100 = most likely to sell

Holdout AUC

0.874

evaluated before shipping, never refit

Driver	Value	Pull on odds
For-profit ownership	1.00	+0.69
Never sold on record	1.00	+0.62
Current owner tenure (years)	25.00	+0.57
Chain size (log)	4.54	+0.56
No PBJ staffing report	0.00	+0.42
Ownership changes, last 5 years	0.00	+0.20
Deficiencies, last 12 months	0.00	-0.17
Occupancy	0.64	+0.17

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

49.0

100 = most likely to lose certification

Holdout AUC

0.971

top decile caught 95% of actual exits

Driver	Value	Pull on odds
Chain size (log)	4.54	-1.44
Deficiencies, last 12 months	0.00	+1.43
For-profit ownership	1.00	-0.69
Occupancy	0.64	+0.46
No PBJ staffing report	0.00	+0.39
Staffing trend, last 4 quarters	0.63	+0.27
Fine amount, 12m (log)	0.00	+0.18
Facility size (log beds)	5.20	-0.18

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

2025Q4 HPRD	This facility	TN median	National median	National p25–p75
Total nurse	3.23	3.28	3.28	2.90–3.77
RN	0.63	0.34	0.39	0.25–0.58
Weekend total	3.07	3.10	3.11	—
Weekday total	3.29	3.36	3.35	—

Quarter	Days	Avg census	Total HPRD	RN	LPN	CNA	Weekend	Contract %
2025Q4	92	115.9	3.23	0.63	0.59	2.01	3.07	0.0%
2025Q3	92	116.9	3.16	0.61	0.58	1.98	2.89	0.0%
2025Q2	91	116.8	3.16	0.59	0.61	1.96	3.06	0.0%
2025Q1	90	117.6	3.11	0.56	0.69	1.86	3.03	0.0%
2024Q4	92	119.4	2.60	0.54	0.65	1.41	2.32	0.0%
2024Q3	92	119.0	2.74	0.54	0.66	1.54	2.45	0.0%
2024Q2	91	118.6	3.06	0.63	0.67	1.76	2.76	4.6%
2024Q1	91	118.1	3.12	0.63	0.68	1.81	2.86	16.0%
2023Q4	92	118.8	3.12	0.66	0.57	1.90	2.96	17.2%
2023Q3	92	122.8	3.04	0.58	0.70	1.75	2.77	0.4%
2023Q2	91	122.4	2.94	0.61	0.66	1.67	2.77	11.2%
2023Q1	90	123.1	2.59	0.50	0.76	1.34	2.43	17.3%
2022Q4	92	120.3	2.99	0.27	1.06	1.66	2.72	36.5%
2022Q3	92	119.9	2.88	0.23	1.08	1.56	2.73	32.4%
2022Q2	91	123.0	2.81	0.23	1.01	1.57	2.65	36.8%
2022Q1	90	122.4	2.98	0.25	0.96	1.76	2.74	28.9%

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

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

D × 7

deficiencies by survey year

Survey	Type	Tag	Deficiency	Scope	Corrected
2024-08-02	Health · complaint	F0604	Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.	D	2024-08-21
2024-08-02	Health · complaint	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	2024-08-21
2024-08-02	Health · complaint	F0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	D	2024-08-21
2024-08-02	Health · complaint	F0689	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	D	2024-08-21
2020-02-20	Health	F0550	Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.	D	2020-03-09
2020-02-20	Health	F0600	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	D	2020-03-09
2020-02-20	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	2020-03-09

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

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

Owner	Role	Pct	From	Status	Source
NATIONAL HEALTH CORP LEVERAGED EMPLOYEE STOCK OWNERSHIP TRUST	5% OR GREATER DIRECT OWNERSHIP INTEREST	100%	—	current	pecos_ownership
DODSON, VICKI	ADP OF THE SNF	—	2019-06-01	current	pecos_ownership
FOSTER, LYNN	OPERATIONAL/MANAGERIAL CONTROL	—	2005-01-01	current	pecos_ownership
FOSTER, LYNN	ADP OF THE SNF	—	2025-08-21	current	pecos_ownership
KIDD, BRIAN	ADP OF THE SNF	—	2019-01-01	current	pecos_ownership
MARLOW, TAIESHA	OPERATIONAL/MANAGERIAL CONTROL	—	2024-01-22	current	pecos_ownership
NATIONAL HEALTHCARE CORPORATION	ADP OF THE SNF	—	2018-01-01	current	pecos_ownership
NHC-OP LP	OPERATIONAL/MANAGERIAL CONTROL	—	2018-01-01	current	pecos_ownership
SMITH, JEFFREY	OPERATIONAL/MANAGERIAL CONTROL	—	2008-12-15	current	pecos_ownership
TENNESSEE HEALTHCARE ADVISORS, LLC	ADP OF THE SNF	—	2025-08-21	current	pecos_ownership
TENNESSEE HEALTHCARE ADVISORS, LLC	OPERATIONAL/MANAGERIAL CONTROL	—	2018-01-01	current	pecos_ownership
USSERY, ROBERT	OPERATIONAL/MANAGERIAL CONTROL	—	2025-07-23	current	pecos_ownership
USSERY, ROBERT	CORPORATE OFFICER	—	2008-01-01	current	pecos_ownership
VOLLMER, DONALD	OPERATIONAL/MANAGERIAL CONTROL	—	2017-10-01	current	pecos_ownership
VOLLMER, DONALD	ADP OF THE SNF	—	2025-08-22	current	pecos_ownership
BRIAN KIDD	CORPORATE OFFICER	—	2019-01-01	ended 2026-05-18	pecos_ownership
DONALD VOLLMER	ADP OF THE SNF	—	2025-08-22	ended 2026-05-18	pecos_ownership
DONALD VOLLMER	OPERATIONAL/MANAGERIAL CONTROL	—	2017-10-01	ended 2026-05-18	pecos_ownership
JEFFREY SMITH	CORPORATE OFFICER	—	2008-12-15	ended 2026-05-18	pecos_ownership
LYNN FOSTER	ADP OF THE SNF	—	2025-08-21	ended 2026-05-18	pecos_ownership
LYNN FOSTER	OPERATIONAL/MANAGERIAL CONTROL	—	2005-01-01	ended 2026-05-18	pecos_ownership
ROBERT USSERY	CORPORATE OFFICER	—	2008-01-01	ended 2026-05-18	pecos_ownership
ROBERT USSERY	ADP OF THE SNF	—	2025-07-23	ended 2026-05-18	pecos_ownership
TAIESHA MARLOW	OPERATIONAL/MANAGERIAL CONTROL	—	2024-01-22	ended 2026-05-18	pecos_ownership
VICKI DODSON	ADP OF THE SNF	—	2019-06-01	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.

Related-party costs

FY end	Total allowable	Rent	Home office	Therapy	Staffing	Counterparties	PropCo
2024-12-31	$1,229,833	—	$752,094	—	—	1	—
2023-12-31	$336,951	—	—	—	—	2	—
2022-12-31	$1,153,070	—	—	$699,138	—	2	—
2021-12-31	$1,539,127	—	—	$846,775	$7,457	2	—
2020-12-31	$1,413,929	—	—	$845,119	$52,755	2	—

Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.

Transactions

No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.

Comparable trades — TN snf

Close	Facility	Price	$/bed	Cap rate	Beds	Buyer
2025-05-01	WEXFORD HOUSE	—	—	—	174	WEXFORD OPERATING GROUP LLC
2025-05-01	LAUGHLIN HEALTH CARE CENTER	—	—	—	90	LAUGHLIN OPERATING GROUP LLC
2025-02-01	EATON CREEK POST ACUTE	—	—	—	124	NASHVILLE SNF HEALTHCARE LLC
2025-01-01	APPLINGWOOD POST ACUTE	—	—	—	78	DOHENY BEACH HOLDINGS LLC
2025-01-01	Meadowbrook Healthcare and Rehabilitation Center	—	—	—	83	BIG CREEK HEALTHCARE, INC.
2025-01-01	Westwood Nursing and Rehabilitation	—	—	—	90	BLACK WOLF HEALTHCARE LLC
2025-01-01	SHELBY OAKS POST ACUTE	—	—	—	77	EAGLE LAKE HOLDINGS LLC
2025-01-01	Stone River Post Acute	—	—	—	68	MURFREESBORO SNF HEALTHCARE LLC
2025-01-01	UNION CITY HEALTH AND REHABILITATION	—	—	—	115	TURNER HEALTHCARE INC
2025-01-01	Decatur County Healthcare	—	—	—	125	BEAR CREEK HEALTHCARE LLC
2025-01-01	COVINGTON POST ACUTE	—	—	—	98	FLORIDA BAY HOLDINGS LLC
2025-01-01	CYPRESS GROVE POST ACUTE	—	—	—	170	GOODHOPE BAY HOLDINGS 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

Geo	Kind	BR	Amount	As of	Source
county 47149	acs median gross	0	$1,081	2024-12-31	CENSUS_ACS5
county 47149	fmr	0	$1,507	2025-10-01	HUD_USER_FMR
county 47149	acs median gross	1	$1,253	2024-12-31	CENSUS_ACS5
county 47149	fmr	1	$1,578	2025-10-01	HUD_USER_FMR
county 47149	acs median gross	2	$1,452	2024-12-31	CENSUS_ACS5
county 47149	fmr	2	$1,730	2025-10-01	HUD_USER_FMR
county 47149	acs median gross	3	$1,771	2024-12-31	CENSUS_ACS5
county 47149	fmr	3	$2,211	2025-10-01	HUD_USER_FMR
county 47149	acs median gross	4	$2,111	2024-12-31	CENSUS_ACS5
county 47149	fmr	4	$2,696	2025-10-01	HUD_USER_FMR
county 47149	acs median gross	5	$1,970	2024-12-31	CENSUS_ACS5
county 47149	acs median gross		$1,502	2024-12-31	CENSUS_ACS5
county 47149	acs recent mover gross		$1,770	2024-12-31	CENSUS_ACS5
zcta 37130	acs median gross	0	$790	2024-12-31	CENSUS_ACS5
zcta 37130	acs median gross	1	$1,070	2024-12-31	CENSUS_ACS5
zcta 37130	acs median gross	2	$1,305	2024-12-31	CENSUS_ACS5
zcta 37130	acs median gross	3	$1,426	2024-12-31	CENSUS_ACS5
zcta 37130	acs median gross	4	$1,101	2024-12-31	CENSUS_ACS5
zcta 37130	acs median gross	5	$2,710	2024-12-31	CENSUS_ACS5
zcta 37130	acs median gross		$1,204	2024-12-31	CENSUS_ACS5
zcta 37130	acs recent mover gross		$1,351	2024-12-31	CENSUS_ACS5
zip 37130	payment standard 110	0	$1,408	2025-10-01	HUD_USER_SAFMR
zip 37130	payment standard 90	0	$1,152	2025-10-01	HUD_USER_SAFMR
zip 37130	safmr	0	$1,280	2025-10-01	HUD_USER_SAFMR
zip 37130	payment standard 110	1	$1,474	2025-10-01	HUD_USER_SAFMR
zip 37130	payment standard 90	1	$1,206	2025-10-01	HUD_USER_SAFMR
zip 37130	safmr	1	$1,340	2025-10-01	HUD_USER_SAFMR
zip 37130	payment standard 110	2	$1,617	2025-10-01	HUD_USER_SAFMR
zip 37130	payment standard 90	2	$1,323	2025-10-01	HUD_USER_SAFMR
zip 37130	safmr	2	$1,470	2025-10-01	HUD_USER_SAFMR
zip 37130	payment standard 110	3	$2,068	2025-10-01	HUD_USER_SAFMR
zip 37130	payment standard 90	3	$1,692	2025-10-01	HUD_USER_SAFMR
zip 37130	safmr	3	$1,880	2025-10-01	HUD_USER_SAFMR
zip 37130	payment standard 110	4	$2,519	2025-10-01	HUD_USER_SAFMR
zip 37130	payment standard 90	4	$2,061	2025-10-01	HUD_USER_SAFMR
zip 37130	safmr	4	$2,290	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.