2571 Guthrie Avenue, Des Moines, IA 50317 · CCN 165507 · chain CASSIA
Composite
49.0 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
79
Model
v1.2
Reads as: riskier than 49.0% 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.
weighted_contribution sums to pre_rank_index over rows where counts_toward_index is true. The composite is the facility's percentile position of that index within its peer group, so contributions explain the input, and the rank explains the score.
Change-of-ownership footprint in the CMS Provider of Services file: control-family, legal-name and address deltas across quarterly snapshots, plus certification reset recency and Medicare tenure.
R23/W4-3. Deterministic logistic p(Medicare termination within 12m), SNF only. Label = first POS termination date (any code: voluntary closure, involuntary termination, merger exit); facilities already terminated by the panel date are excluded, not counted as safe. Trained on panels 2024-07/2024-10/2025-01 (n=46,466, 283 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.971, top-decile lift 9.5x, top-decile capture 95.4% of the 65 terminations that followed. Separability is high because closures announce themselves in the data: collapsing occupancy is the strongest signal, and the learned NEGATIVE weight on 12m deficiency counts is the surveys-stop signature of a facility winding down, not a claim that clean inspections are dangerous. Same 15 as-of-date features and anti-leakage chassis as p_chow_12m; SFF entry rejected as a label (only one month of SFF history exists, so as-of transitions cannot be reconstructed). Score = probability x 100; grade NULL. Not in any composite.
R22/W4-2. Deterministic logistic p(CHOW within 12m), SNF only. Trained on panels 2024-07/2024-10/2025-01 (n=50,700, 1,207 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.874, top-decile lift 5.0x (top 10% of predictions captured 49.6% of the CHOWs that actually closed in the next 12 months). Shipped coefficients are the evaluated ones; no post-holdout refit. Caveat: holdout positives (133) run below the training base rate because recent CHOWs surface in public records with a lag, so measured lift is conservative. Features are as-of-date public records: PBJ staffing level/trend/contract share (quarterly history to 2022Q1), deficiency and CMP counts (12m), ownership tenure and churn from CHOW-evidenced transactions, beds, occupancy, ownership type, chain size. Chain membership and ownership type are current-state (history not published). SFF and star ratings deliberately excluded (no as-of history). Notable learned direction: long ownership tenure RAISES sale odds and a recent prior CHOW lowers them. Score = probability x 100; grade is NULL because a probability is not a quality letter. Not in any composite.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Rows with counts_toward_composite false come from models that are addressable or retracted rather than default. They exist and may be informative, but they did not enter the published composite and must not be summed as though they had.
p_adverse_action_12m: probability the facility's Medicare participation terminates within 12 months (any POS termination code; already-terminated facilities are excluded, not scored safe). Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.971, top-decile lift 9.5x. Closures announce themselves: collapsing occupancy dominates, and fewer recent surveys is a winding-down signature. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models. | p_chow_12m: probability of a change of ownership within 12 months. Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.874, top-decile lift 5.0x. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models for full notes.
Probability the facility's Medicare participation ends within 12 months, from public records only. Red bars raise exit odds. A negative pull from deficiencies is the winding-down signature — surveys stop as a facility empties — not evidence that clean inspections are dangerous.
Staffing vs peers
16
2025Q4 HPRD
This facility
IA median
National median
National p25–p75
Total nurse
3.46
3.15
3.28
2.90–3.77
RN
1.15
0.46
0.39
0.25–0.58
Weekend total
3.48
2.96
3.11
—
Weekday total
3.46
3.20
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
74.8
3.46
1.15
0.00
2.31
3.48
4.1%
2025Q3
92
74.3
3.55
1.25
0.03
2.27
3.51
0.0%
2025Q2
91
71.1
4.21
1.26
0.14
2.81
4.08
0.0%
2025Q1
90
78.9
3.61
1.10
0.07
2.44
3.74
0.0%
2024Q4
92
74.5
3.86
1.12
0.13
2.60
3.81
0.0%
2024Q3
92
73.5
3.80
1.06
0.20
2.55
3.83
0.0%
2024Q2
91
74.1
3.89
1.12
0.22
2.56
3.88
0.0%
2024Q1
91
72.0
3.66
1.16
0.21
2.29
3.61
0.0%
2023Q4
92
72.9
3.59
1.18
0.21
2.20
3.45
0.0%
2023Q3
92
73.3
3.68
1.02
0.34
2.32
3.58
2.3%
2023Q2
91
71.9
3.81
0.90
0.46
2.45
3.66
4.9%
2023Q1
90
72.8
3.61
0.88
0.40
2.33
3.47
13.2%
2022Q4
92
71.0
3.71
0.95
0.28
2.48
3.67
30.2%
2022Q3
92
72.2
3.44
0.85
0.31
2.28
3.31
13.3%
2022Q2
91
73.6
3.59
0.61
0.48
2.49
3.54
24.6%
2022Q1
90
71.8
3.44
0.61
0.64
2.19
3.27
20.6%
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.
PASARR screening for Mental disorders or Intellectual Disabilities
D
—
2026-04-30
Health · complaint
F0675
Honor each resident's preferences, choices, values and beliefs.
D
—
2026-04-30
Health · complaint
F0725
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
E
—
2025-11-24
Health · complaint
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
2025-12-25
2025-05-08
Health
F0640
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
D
2025-06-07
2025-05-08
Health
F0641
Ensure each resident receives an accurate assessment.
D
2025-06-07
2025-05-08
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
2025-06-07
2025-05-08
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-06-07
2025-03-05
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2025-03-21
2024-05-30
Health
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2024-06-30
2024-05-30
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2024-06-30
2024-05-30
Health · complaint
F0741
Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.
G
2024-06-30
2024-05-30
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
2024-06-30
2024-05-30
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2024-06-30
2024-05-30
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2024-06-30
2024-05-30
Health · complaint
F0880
Provide and implement an infection prevention and control program.
E
2024-08-08
2023-12-28
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-01-28
2023-08-24
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2023-09-24
2023-03-02
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2023-04-07
2023-03-02
Health
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2023-04-07
2023-03-02
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2023-04-07
2023-03-02
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
2023-04-07
2023-03-02
Health
F0880
Provide and implement an infection prevention and control program.
D
2023-04-07
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
18
Owner
Role
Pct
From
Status
Source
ELIM CARE INC
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2007-02-19
current
pecos_ownership
CASSIA
OPERATIONAL/MANAGERIAL CONTROL
—
2020-01-01
current
pecos_ownership
DAHL, ROBERT
CORPORATE OFFICER
—
2007-02-19
current
pecos_ownership
KERN, MATTHEW
CORPORATE OFFICER
—
2019-02-28
current
pecos_ownership
LEFF, WILLIAM
CORPORATE DIRECTOR
—
2007-02-19
current
pecos_ownership
NYE, GERALD
CORPORATE DIRECTOR
—
2019-06-13
current
pecos_ownership
PETERSON, ROLAND
CORPORATE DIRECTOR
—
2007-02-19
current
pecos_ownership
PROPER, STEPHANIE
W-2 MANAGING EMPLOYEE
—
2017-01-03
current
pecos_ownership
TANGEDAHL, GUY
CORPORATE DIRECTOR
—
2007-02-19
current
pecos_ownership
YOUNGQUIST, KATHRYN
CORPORATE OFFICER
—
2007-02-19
current
pecos_ownership
GERALD NYE
CORPORATE DIRECTOR
—
2019-06-13
ended 2026-05-18
pecos_ownership
GUY TANGEDAHL
CORPORATE DIRECTOR
—
2007-02-19
ended 2026-05-18
pecos_ownership
KATHRYN YOUNGQUIST
CORPORATE OFFICER
—
2007-02-19
ended 2026-05-18
pecos_ownership
MATTHEW KERN
CORPORATE OFFICER
—
2019-02-28
ended 2026-05-18
pecos_ownership
ROBERT DAHL
CORPORATE OFFICER
—
2007-02-19
ended 2026-05-18
pecos_ownership
ROLAND PETERSON
CORPORATE DIRECTOR
—
2007-02-19
ended 2026-05-18
pecos_ownership
STEPHANIE PROPER
W-2 MANAGING EMPLOYEE
—
2017-01-03
ended 2026-05-18
pecos_ownership
WILLIAM LEFF
CORPORATE DIRECTOR
—
2007-02-19
ended 2026-05-18
pecos_ownership
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.
Related-party costs
5
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$1,344,172
—
—
$608,104
$65,676
6
—
2023-12-31
$1,181,709
—
—
$515,715
$58,554
6
—
2022-12-31
$1,123,974
—
$55,353
$482,242
—
7
—
2021-12-31
$1,132,803
—
$51,501
$511,854
—
6
—
2020-12-31
$1,068,330
—
—
$507,158
$41,148
6
—
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
34
Geo
Kind
BR
Amount
As of
Source
county 19153
acs median gross
0
$926
2024-12-31
CENSUS_ACS5
county 19153
fmr
0
$1,063
2025-10-01
HUD_USER_FMR
county 19153
acs median gross
1
$963
2024-12-31
CENSUS_ACS5
county 19153
fmr
1
$1,109
2025-10-01
HUD_USER_FMR
county 19153
acs median gross
2
$1,169
2024-12-31
CENSUS_ACS5
county 19153
fmr
2
$1,318
2025-10-01
HUD_USER_FMR
county 19153
acs median gross
3
$1,497
2024-12-31
CENSUS_ACS5
county 19153
fmr
3
$1,794
2025-10-01
HUD_USER_FMR
county 19153
acs median gross
4
$1,605
2024-12-31
CENSUS_ACS5
county 19153
fmr
4
$1,841
2025-10-01
HUD_USER_FMR
county 19153
acs median gross
5
$1,834
2024-12-31
CENSUS_ACS5
county 19153
acs median gross
$1,149
2024-12-31
CENSUS_ACS5
county 19153
acs recent mover gross
$1,235
2024-12-31
CENSUS_ACS5
zcta 50317
acs median gross
1
$831
2024-12-31
CENSUS_ACS5
zcta 50317
acs median gross
2
$996
2024-12-31
CENSUS_ACS5
zcta 50317
acs median gross
3
$1,444
2024-12-31
CENSUS_ACS5
zcta 50317
acs median gross
4
$1,634
2024-12-31
CENSUS_ACS5
zcta 50317
acs median gross
$1,102
2024-12-31
CENSUS_ACS5
zcta 50317
acs recent mover gross
$1,151
2024-12-31
CENSUS_ACS5
zip 50317
payment standard 110
0
$1,067
2025-10-01
HUD_USER_SAFMR
zip 50317
payment standard 90
0
$873
2025-10-01
HUD_USER_SAFMR
zip 50317
safmr
0
$970
2025-10-01
HUD_USER_SAFMR
zip 50317
payment standard 110
1
$1,111
2025-10-01
HUD_USER_SAFMR
zip 50317
payment standard 90
1
$909
2025-10-01
HUD_USER_SAFMR
zip 50317
safmr
1
$1,010
2025-10-01
HUD_USER_SAFMR
zip 50317
payment standard 110
2
$1,320
2025-10-01
HUD_USER_SAFMR
zip 50317
payment standard 90
2
$1,080
2025-10-01
HUD_USER_SAFMR
zip 50317
safmr
2
$1,200
2025-10-01
HUD_USER_SAFMR
zip 50317
payment standard 110
3
$1,793
2025-10-01
HUD_USER_SAFMR
zip 50317
payment standard 90
3
$1,467
2025-10-01
HUD_USER_SAFMR
zip 50317
safmr
3
$1,630
2025-10-01
HUD_USER_SAFMR
zip 50317
payment standard 110
4
$1,848
2025-10-01
HUD_USER_SAFMR
zip 50317
payment standard 90
4
$1,512
2025-10-01
HUD_USER_SAFMR
zip 50317
safmr
4
$1,680
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.