Composite
87.6 / 100 percentile
Screener / 265727
D
CARMEL HILLS WELLNESS & REHABILITATION
snfMO
810 EAST WALNUT, INDEPENDENCE, MO 64050 · CCN 265727 · chain FIRST SWEETZER HOLDINGS LLC
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
194
Model
v1.2
Reads as: riskier than 87.6% 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 signals25Components16CHOW radar1Distress radar1Staffing16Penalties1Deficiencies82Licensure0Ownership29Related party6Transactions1Comps12Market rent35
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| staffing risk | 98.0 | 98.0 | 0.25 | 0.1923 | 18.85 | in index |
| regulatory risk | 81.5 | 78.3 | 0.30 | 0.2308 | 18.81 | in index |
| billing conduct | 74.1 | 49.6 | 0.30 | 0.2308 | 17.10 | in index |
| chow risk | 56.4 | 54.7 | 0.15 | 0.1154 | 6.51 | in index |
| financial risk | 16.2 | 24.4 | 0.30 | 0.2308 | 3.74 | 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
25| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +36.7 vs natl | RIMPAU HOLDINGS TRUST | 14 facilities |
| connection | Owner fleet risk far above national | +33.9 vs natl | STERNSHEIN JENNIFER | 49 facilities |
| connection | Owner fleet risk far above national | +33.8 vs natl | HAGINS ELIZABETH | 52 facilities |
| connection | Owner fleet risk far above national | +32.6 vs natl | TADAKAMALLA SRINATH | 10 facilities |
| connection | Owner fleet risk far above national | +32.5 vs natl | ZIMMERMAN CAROLINE | 35 facilities |
| connection | Owner fleet risk far above national | +32.4 vs natl | GIBRALTAR TRUST | 28 facilities |
| connection | Owner fleet risk far above national | +32.1 vs natl | GARETZ DAVID | 66 facilities |
| connection | Owner fleet risk far above national | +31.6 vs natl | CALIBER ADVISORS LLC | 13 facilities |
| connection | Owner fleet risk far above national | +31.0 vs natl | SASEM INVESTMENTS LLC | 21 facilities |
| connection | Owner fleet risk far above national | +30.5 vs natl | KAPLAN ESTHER | 55 facilities |
| connection | Owner fleet risk far above national | +30.0 vs natl | KAPLAN MORDECHAI | 38 facilities |
| connection | Owner fleet risk far above national | +29.4 vs natl | KAPLAN MOSHA | 23 facilities |
| connection | Owner fleet risk far above national | +29.0 vs natl | FIRST SWEETZER HOLDINGS LLC | 26 facilities |
| connection | Owner fleet risk far above national | +29.0 vs natl | CRESTVIEW TRUST | 8 facilities |
| connection | Owner fleet risk far above national | +28.9 vs natl | UNGER JEFFREY | 46 facilities |
| connection | Owner fleet risk far above national | +28.3 vs natl | MONTGOMERY SKY TRUST | 17 facilities |
| connection | Owner fleet risk far above national | +28.0 vs natl | JUBILEE MASTER HOLDINGS LLC | 7 facilities |
| connection | Owner fleet risk far above national | +27.5 vs natl | OZARK HEALTHCARE REALTY LLC | 6 facilities |
| connection | Owner fleet risk far above national | +27.5 vs natl | EMERALD PROPERTY PARTNERS LLC | 6 facilities |
| connection | Owner fleet risk far above national | +27.5 vs natl | EL DORADO NURSING AND REHABILITATION LLC | 6 facilities |
| connection | Owner fleet risk far above national | +27.4 vs natl | ESDOV INVESTMENTS LLC | 18 facilities |
| connection | Owner fleet risk far above national | +26.2 vs natl | HATTERAS INVESTMENTS LLC | 19 facilities |
| connection | Owner spans multiple chains | 12 chains | GARETZ DAVID | 61 facilities |
| connection | Owner spans multiple chains | 11 chains | KAPLAN ESTHER | 54 facilities |
| connection | Owner spans multiple chains | 11 chains | HAGINS ELIZABETH | 48 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 | 49.6 | 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 | 84.4 | F | v0.6 | default · in composite | |
| financial risk | 24.4 | 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 | 0.0 | — | 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 | 78.3 | D | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 98.0 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 59.4 | C | 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 | 39.4 | B | 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 | 28.4 | 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 | 29.9 | B | 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 | 78.2 | 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 | 78.2 | 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 | 98.0 | F | 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 | 98.0 | F | 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)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
7.0
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) | 3.63 | -1.49 | |
| Ownership changes, last 5 years | 1.00 | -0.87 | |
| For-profit ownership | 1.00 | +0.69 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Occupancy | 0.80 | -0.30 | |
| Chain size (log) | 3.09 | +0.25 | |
| Total nurse staffing (HPRD) | 2.00 | +0.21 |
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
44.6
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 | 1.00 | +1.24 | |
| For-profit ownership | 1.00 | -0.69 | |
| Chain size (log) | 3.09 | -0.60 | |
| Total nurse staffing (HPRD) | 2.00 | +0.51 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Never sold on record | 0.00 | -0.28 | |
| Current owner tenure (years) | 3.63 | -0.24 | |
| Ownership changes, last 5 years | 1.00 | +0.23 |
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 | 2.00 | 2.41 | 3.28 | 2.90–3.77 |
| RN | 0.20 | 0.25 | 0.39 | 0.25–0.58 |
| Weekend total | 1.79 | 2.24 | 3.11 | — |
| Weekday total | 2.08 | 2.49 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 155.7 | 2.00 | 0.20 | 0.39 | 1.41 | 1.79 | 0.0% |
| 2025Q3 | 92 | 154.3 | 1.87 | 0.12 | 0.41 | 1.34 | 1.76 | 0.0% |
| 2025Q2 | 91 | 151.1 | 1.81 | 0.15 | 0.42 | 1.23 | 1.66 | 0.0% |
| 2025Q1 | 90 | 158.0 | 1.86 | 0.09 | 0.49 | 1.28 | 1.78 | 0.0% |
| 2024Q4 | 92 | 153.1 | 2.04 | 0.11 | 0.51 | 1.42 | 1.87 | 0.0% |
| 2024Q3 | 92 | 156.3 | 2.08 | 0.13 | 0.45 | 1.50 | 1.82 | 0.0% |
| 2024Q2 | 91 | 160.4 | 2.05 | 0.14 | 0.39 | 1.52 | 1.84 | 0.0% |
| 2024Q1 | 91 | 152.1 | 2.19 | 0.18 | 0.37 | 1.64 | 1.93 | 0.0% |
| 2023Q4 | 92 | 148.6 | 2.31 | 0.23 | 0.33 | 1.74 | 1.95 | 0.0% |
| 2023Q3 | 92 | 151.1 | 2.26 | 0.22 | 0.39 | 1.65 | 2.03 | 0.0% |
| 2023Q2 | 91 | 154.5 | 2.17 | 0.26 | 0.47 | 1.45 | 1.89 | 0.1% |
| 2023Q1 | 90 | 154.7 | 1.00 | 0.24 | 0.18 | 0.58 | 0.84 | 1.1% |
| 2022Q4 | 92 | 158.1 | 1.89 | 0.23 | 0.47 | 1.19 | 1.69 | 0.0% |
| 2022Q3 | 92 | 164.7 | 2.20 | 0.36 | 0.43 | 1.41 | 1.87 | 0.1% |
| 2022Q2 | 91 | 166.4 | 1.76 | 0.25 | 0.42 | 1.08 | 1.28 | 2.4% |
| 2022Q1 | 90 | 162.1 | 1.82 | 0.26 | 0.40 | 1.15 | 1.45 | 6.2% |
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 |
|---|---|---|---|
| 2024-02-01 | Fine | $20,787 | CMS provider data |
Total fines on record: $20,787
Deficiencies
82D × 50E × 24F × 6G × 1J × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-03-31 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | — |
| 2025-05-21 | 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 | 2025-04-22 |
| 2025-05-21 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2025-07-02 |
| 2025-05-21 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-07-02 |
| 2025-05-21 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2025-07-02 |
| 2025-05-21 | Health · complaint | F0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | 2025-07-02 |
| 2025-05-21 | Health · complaint | F0809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | D | 2025-07-02 |
| 2025-05-21 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2025-07-02 |
| 2025-01-16 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2025-02-11 |
| 2025-01-16 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | D | 2025-02-11 |
| 2024-11-25 | Health | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2025-02-11 |
| 2024-11-25 | Health | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | D | 2025-01-09 |
| 2024-11-25 | 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 | 2025-01-09 |
| 2024-11-25 | 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 | 2025-01-09 |
| 2024-11-25 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2025-01-09 |
| 2024-11-25 | 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 | 2025-01-09 |
| 2024-11-25 | 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 | 2025-01-09 |
| 2024-11-25 | Health · complaint | F0660 | Plan the resident's discharge to meet the resident's goals and needs. | D | 2025-01-09 |
| 2024-11-25 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-01-09 |
| 2024-11-25 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-01-09 |
| 2024-11-25 | 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 | 2025-01-09 |
| 2024-11-25 | 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. | D | 2025-01-09 |
| 2024-11-25 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | 2025-01-09 |
| 2024-11-25 | Health | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | 2025-01-09 |
| 2024-11-25 | 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 | 2025-01-09 |
| 2024-11-25 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2025-01-09 |
| 2024-11-25 | Health | F0760 | Ensure that residents are free from significant medication errors. | D | 2025-01-09 |
| 2024-11-25 | 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 | 2025-01-09 |
| 2024-11-25 | Health | F0791 | Provide or obtain dental services for each resident. | D | 2025-01-09 |
| 2024-11-25 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2025-02-11 |
| 2024-11-25 | Health | F0880 | Provide and implement an infection prevention and control program. | F | 2025-01-09 |
| 2024-11-25 | Health | F0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | D | 2025-01-09 |
| 2024-11-25 | Health | F0887 | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | D | 2025-01-09 |
| 2024-10-16 | Health · complaint | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | E | 2024-09-11 |
| 2024-06-28 | 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 | 2024-07-19 |
| 2024-02-01 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-02-08 |
| 2024-02-01 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | 2024-02-08 |
| 2023-09-07 | 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 | 2023-09-08 |
| 2023-09-07 | Health · complaint | F0626 | Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. | D | 2023-09-08 |
| 2023-09-07 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2023-08-08 |
| 2023-03-29 | Health | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | E | 2023-05-13 |
| 2023-03-29 | Health | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2023-05-13 |
| 2023-03-29 | 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. | E | 2023-05-13 |
| 2023-03-29 | 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 | 2023-05-13 |
| 2023-03-29 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | E | 2023-05-13 |
| 2023-03-29 | Health | F0676 | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | E | 2023-05-13 |
| 2023-03-29 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2023-05-13 |
| 2023-03-29 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | 2023-05-13 |
| 2023-03-29 | Health | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | 2023-05-13 |
| 2023-03-29 | 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. | D | 2023-05-13 |
| 2023-03-29 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | 2023-05-13 |
| 2023-03-29 | Health | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | E | 2023-05-13 |
| 2023-03-29 | Health | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | 2023-05-13 |
| 2023-03-29 | 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. | F | 2023-05-13 |
| 2023-03-29 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2023-05-13 |
| 2023-03-29 | Health | F0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | 2023-05-13 |
| 2023-03-29 | 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. | E | 2023-05-13 |
| 2023-03-29 | Health | F0790 | Provide routine and 24-hour emergency dental care for each resident. | D | 2023-05-13 |
| 2023-03-29 | Health | F0803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | E | 2023-05-13 |
| 2023-03-29 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | D | 2023-05-13 |
| 2023-03-29 | Health | F0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | E | 2023-05-13 |
| 2023-03-29 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2023-05-13 |
| 2023-03-29 | Health | F0813 | Have a policy regarding use and storage of foods brought to residents by family and other visitors. | D | 2023-05-13 |
| 2023-03-29 | Health | F0814 | Dispose of garbage and refuse properly. | D | 2023-05-13 |
| 2023-03-29 | Health | F0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | F | 2023-05-13 |
| 2023-03-29 | Health | F0908 | Keep all essential equipment working safely. | F | 2023-05-13 |
| 2023-03-29 | Health | F0926 | Have policies on smoking. | D | 2023-05-13 |
| 2023-03-29 | Health | F0947 | Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | E | 2023-05-13 |
| 2020-03-09 | 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. | E | 2020-04-23 |
| 2020-03-09 | Health | F0604 | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | D | 2020-04-23 |
| 2020-03-09 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2020-04-23 |
| 2020-03-09 | Health | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | 2020-04-23 |
| 2020-03-09 | 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 | 2020-04-23 |
| 2020-03-09 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | G | 2020-04-23 |
| 2020-03-09 | Health | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | 2020-04-23 |
| 2020-03-09 | 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 | 2020-04-23 |
| 2020-03-09 | Health | F0740 | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | D | 2020-04-23 |
| 2020-03-09 | Health | F0742 | Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder. | D | 2020-04-23 |
| 2020-03-09 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2020-04-23 |
| 2020-03-09 | Health | F0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | E | 2020-04-23 |
| 2020-03-09 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2020-04-23 |
| 2020-03-09 | Health | F0908 | Keep all essential equipment working safely. | E | 2020-04-23 |
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
29| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| 810 E WALNUT STREET MO LLC | ADP OF THE SNF | — | 2022-12-12 | current | pecos_ownership |
| CALIBER ADVISORS LLC | INDIRECT OWNERSHIP INTEREST | — | 2022-12-12 | current | pecos_ownership |
| COFFMAN-WILLIAMS, CHARMAINE | ADP OF THE SNF | — | 2022-12-12 | current | pecos_ownership |
| CRESTVIEW TRUST | INDIRECT OWNERSHIP INTEREST | — | 2022-12-12 | current | pecos_ownership |
| EL DORADO NURSING AND REHABILITATION LLC | DIRECT OWNERSHIP INTEREST | — | 2022-12-12 | current | pecos_ownership |
| EMERALD PROPERTY PARTNERS LLC | 5% OR GREATER MORTGAGE INTEREST | — | 2022-12-12 | current | pecos_ownership |
| ESDOV INVESTMENTS LLC | ADP OF THE SNF | — | 2022-12-12 | current | pecos_ownership |
| FIRST SWEETZER HOLDINGS LLC | INDIRECT OWNERSHIP INTEREST | — | 2022-12-12 | current | pecos_ownership |
| GARETZ, DAVID | OPERATIONAL/MANAGERIAL CONTROL | — | 2022-12-12 | current | pecos_ownership |
| GIBRALTAR TRUST | 5% OR GREATER MORTGAGE INTEREST | — | 2022-12-12 | current | pecos_ownership |
| HAGINS, ELIZABETH | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-04-30 | current | pecos_ownership |
| HATTERAS INVESTMENTS LLC | INDIRECT OWNERSHIP INTEREST | — | 2022-12-12 | current | pecos_ownership |
| JUBILEE MASTER HOLDINGS LLC | ADP OF THE SNF | — | 2022-12-12 | current | pecos_ownership |
| KAPLAN, ESTHER | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-04-30 | current | pecos_ownership |
| KAPLAN, MORDECHAI | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-04-30 | current | pecos_ownership |
| KAPLAN, MOSHA | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-04-30 | current | pecos_ownership |
| MONTGOMERY SKY TRUST | ADP OF THE SNF | — | 2022-12-12 | current | pecos_ownership |
| OZARK HEALTHCARE REALTY LLC | 5% OR GREATER MORTGAGE INTEREST | — | 2022-12-12 | current | pecos_ownership |
| RIMPAU HOLDINGS TRUST | INDIRECT OWNERSHIP INTEREST | — | 2022-12-12 | current | pecos_ownership |
| SASEM INVESTMENTS LLC | INDIRECT OWNERSHIP INTEREST | — | 2022-12-12 | current | pecos_ownership |
| STERNSHEIN, JENNIFER | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-04-30 | current | pecos_ownership |
| TADAKAMALLA, SRINATH | ADP OF THE SNF | — | 2022-12-12 | current | pecos_ownership |
| UNGER, JEFFREY | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-04-30 | current | pecos_ownership |
| ZIMMERMAN, CAROLINE | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-04-30 | current | pecos_ownership |
| 810 E WALNUT STREET MO LLC | Director, officer, administrator or key person of provider or organization | — | 2020-01-01 | ended 2020-12-31 | hcris_a_8_1 |
| 810 E WALNUT STREET MO LLC | Director, officer, administrator or key person of provider or organization | — | 2021-01-01 | ended 2021-12-28 | hcris_a_8_1 |
| CHARMAINE COFFMAN-WILLIAMS | ADP OF THE SNF | — | 2022-12-12 | ended 2026-05-18 | pecos_ownership |
| DAVID GARETZ | OPERATIONAL/MANAGERIAL CONTROL | — | 2022-12-12 | ended 2026-05-18 | pecos_ownership |
| SRINATH TADAKAMALLA | ADP OF THE SNF | — | 2022-12-12 | 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 |
|---|---|---|---|---|
| 2022-12-12 | — | 810 OPCO LLC | CARMEL HILLS MO CONSULTING LLC | chow |
Comparable trades — MO snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-10-01 | AVENIR AT MAPLE GROVE | — | — | — | 90 | NBH2 MGOPCO LLC |
| 2025-10-01 | AVENIR AT MARK TWAIN | — | — | — | 120 | NBH1 MTOPCO LLC |
| 2025-10-01 | ARBOR HILLS CARE & REHAB CENTER | — | — | — | 150 | ARBOR HILLS HEALTHCARE, LLC |
| 2025-10-01 | ASCEND AT AURORA | — | — | — | 125 | NBH3 SFOPCO LLC |
| 2025-09-01 | HUBBLE CREEK | — | — | — | 105 | HUBBLE CREEK LLC |
| 2025-08-01 | HIDDEN LAKE HEALTH CARE CENTER | — | — | — | 67 | HIDDEN LAKE HEALTH CARE CENTER, LLC |
| 2025-05-01 | PINE GROVE MANOR | — | — | — | 77 | PINE GROVE MANOR LLC |
| 2025-05-01 | MONARCH SPRINGS WELLNESS & REHABILITATION | — | — | — | 119 | MONARCH SPRINGS WELLNESS & REHABILITATION LLC |
| 2025-05-01 | ASPIRE SENIOR LIVING NEW FLORENCE | — | — | — | 87 | ASPIRE SENIOR LIVING NEW FLORENCE LLC |
| 2025-04-01 | SOUTH COUNTY HEALTH CARE CENTER | — | — | — | 153 | SOUTH COUNTY HEALTH CARE CENTER, L.L.C. |
| 2025-02-01 | ARBOR VIEW NURSING AND REHABILITATION | — | — | — | 150 | FORREST OPCO LLC |
| 2025-02-01 | AMBERWOOD ESTATES NURSING AND REHABILITATION | — | — | — | 115 | ISLAND HC 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
35| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 29095 | acs median gross | 0 | $938 | 2024-12-31 | CENSUS_ACS5 |
| county 29095 | fmr | 0 | $1,095 | 2025-10-01 | HUD_USER_FMR |
| county 29095 | acs median gross | 1 | $1,024 | 2024-12-31 | CENSUS_ACS5 |
| county 29095 | fmr | 1 | $1,197 | 2025-10-01 | HUD_USER_FMR |
| county 29095 | acs median gross | 2 | $1,179 | 2024-12-31 | CENSUS_ACS5 |
| county 29095 | fmr | 2 | $1,358 | 2025-10-01 | HUD_USER_FMR |
| county 29095 | acs median gross | 3 | $1,422 | 2024-12-31 | CENSUS_ACS5 |
| county 29095 | fmr | 3 | $1,769 | 2025-10-01 | HUD_USER_FMR |
| county 29095 | acs median gross | 4 | $1,731 | 2024-12-31 | CENSUS_ACS5 |
| county 29095 | fmr | 4 | $2,103 | 2025-10-01 | HUD_USER_FMR |
| county 29095 | acs median gross | 5 | $1,736 | 2024-12-31 | CENSUS_ACS5 |
| county 29095 | acs median gross | $1,197 | 2024-12-31 | CENSUS_ACS5 | |
| county 29095 | acs recent mover gross | $1,373 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 64050 | acs median gross | 0 | $414 | 2024-12-31 | CENSUS_ACS5 |
| zcta 64050 | acs median gross | 1 | $812 | 2024-12-31 | CENSUS_ACS5 |
| zcta 64050 | acs median gross | 2 | $957 | 2024-12-31 | CENSUS_ACS5 |
| zcta 64050 | acs median gross | 3 | $1,238 | 2024-12-31 | CENSUS_ACS5 |
| zcta 64050 | acs median gross | 4 | $1,462 | 2024-12-31 | CENSUS_ACS5 |
| zcta 64050 | acs median gross | $948 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 64050 | acs recent mover gross | $990 | 2024-12-31 | CENSUS_ACS5 | |
| zip 64050 | payment standard 110 | 0 | $935 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | payment standard 90 | 0 | $765 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | safmr | 0 | $850 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | payment standard 110 | 1 | $1,023 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | payment standard 90 | 1 | $837 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | safmr | 1 | $930 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | payment standard 110 | 2 | $1,155 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | payment standard 90 | 2 | $945 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | safmr | 2 | $1,050 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | payment standard 110 | 3 | $1,507 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | payment standard 90 | 3 | $1,233 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | safmr | 3 | $1,370 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | payment standard 110 | 4 | $1,793 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | payment standard 90 | 4 | $1,467 | 2025-10-01 | HUD_USER_SAFMR |
| zip 64050 | safmr | 4 | $1,630 | 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.