200 DR MARTIN LUTHER KING JR DRIVE, CLEVELAND, MS 38732 · CCN 255228 · chain NEXION HEALTH INC
Composite
45.4 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
75
Model
v1.2
Reads as: riskier than 45.4% 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
18
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+27.5 vs natl
RINER MEERA
46 facilities
connection
Owner fleet risk far above national
+26.4 vs natl
LEE BRIAN
46 facilities
connection
Owner fleet risk far above national
+25.4 vs natl
NEXION HEALTH INC
33 facilities
connection
Owner fleet risk far above national
+24.8 vs natl
NEXION HEALTH LEASING INC
33 facilities
connection
Owner fleet risk far above national
+24.6 vs natl
HERDRICH WILLIAM
33 facilities
connection
Owner fleet risk far above national
+23.7 vs natl
NEXION HEALTH OF OHI INC
31 facilities
connection
Owner fleet risk far above national
+23.5 vs natl
BOLT BRETTON
30 facilities
connection
Owner fleet risk far above national
+23.4 vs natl
KIRLEY FRANCIS
50 facilities
connection
Owner spans multiple chains
10 chains
KIRLEY FRANCIS
49 facilities
connection
Owner spans multiple chains
8 chains
RINER MEERA
46 facilities
connection
Owner spans multiple chains
7 chains
LEE BRIAN
46 facilities
connection
Owner fleet enforcement cluster
46% fined
RINER MEERA
46 facilities
connection
Owner fleet enforcement cluster
44% fined
KIRLEY FRANCIS
50 facilities
connection
Owner fleet enforcement cluster
44% fined
LEE BRIAN
46 facilities
connection
Owner fleet enforcement cluster
42% fined
NEXION HEALTH INC
33 facilities
connection
Owner fleet enforcement cluster
42% fined
NEXION HEALTH LEASING INC
33 facilities
connection
Owner fleet enforcement cluster
42% fined
NEXION HEALTH OF OHI INC
31 facilities
connection
Owner fleet enforcement cluster
40% fined
BOLT BRETTON
30 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
MS median
National median
National p25–p75
Total nurse
2.79
3.68
3.28
2.90–3.77
RN
0.19
0.34
0.39
0.25–0.58
Weekend total
2.85
3.30
3.11
—
Weekday total
2.76
3.82
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
69.1
2.79
0.19
0.60
1.99
2.85
0.0%
2025Q3
92
67.9
2.63
0.33
0.41
1.90
2.73
0.0%
2025Q2
91
67.8
2.70
0.21
0.51
1.98
2.66
0.0%
2025Q1
90
67.1
2.67
0.14
0.56
1.97
2.75
0.0%
2024Q4
92
67.4
2.71
0.12
0.60
1.99
2.77
0.0%
2024Q3
92
66.4
2.76
0.19
0.55
2.02
2.83
0.0%
2024Q2
91
66.6
2.78
0.18
0.60
2.00
2.81
0.0%
2024Q1
91
67.4
2.65
0.17
0.62
1.87
2.66
0.0%
2023Q4
92
67.1
2.70
0.16
0.63
1.92
2.66
0.0%
2023Q3
92
63.6
2.76
0.11
0.66
1.99
2.68
0.0%
2023Q2
91
66.2
2.63
0.04
0.70
1.88
2.58
0.0%
2023Q1
90
66.4
2.42
0.02
0.69
1.71
2.40
0.4%
2022Q4
92
63.7
2.57
0.09
0.68
1.80
2.50
11.0%
2022Q3
92
64.0
2.57
0.18
0.58
1.81
2.56
8.3%
2022Q2
91
61.5
2.65
0.20
0.60
1.84
2.56
6.5%
2022Q1
90
59.3
2.86
0.23
0.68
1.95
2.83
3.0%
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
0
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
14
D × 13F × 1
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2025-07-31
Health
F0640
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
D
2025-09-09
2025-07-31
Health
F0641
Ensure each resident receives an accurate assessment.
D
2025-09-09
2025-07-31
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
2025-09-09
2025-07-31
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2025-09-09
2025-07-31
Health
F0761
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
D
2025-09-09
2025-07-31
Health
F0810
Provide special eating equipment and utensils for residents who need them and appropriate assistance.
D
2025-09-09
2025-07-31
Health
F0851
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
F
2025-09-09
2025-02-12
Health · complaint
F0760
Ensure that residents are free from significant medication errors.
D
2024-11-15
2023-11-16
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2023-12-08
2023-09-13
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
2023-10-13
2023-09-13
Health · complaint
F0584
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
D
2023-10-13
2023-09-13
Health · complaint
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2023-10-13
2022-10-28
Health
F0584
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
D
2022-11-22
2022-10-28
Health
F0919
Make sure that a working call system is available in each resident's bathroom and bathing area.
D
2022-11-22
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
15
Owner
Role
Pct
From
Status
Source
NEXION HEALTH OF OHI INC
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2018-03-29
current
pecos_ownership
BOLT, BRETTON
5% OR GREATER INDIRECT OWNERSHIP INTEREST
—
2018-03-29
current
pecos_ownership
HERDRICH, WILLIAM
CORPORATE DIRECTOR
—
2018-03-29
current
pecos_ownership
KIRLEY, FRANCIS
CORPORATE OFFICER
—
2018-03-29
current
pecos_ownership
LEE, BRIAN
CORPORATE OFFICER
—
2018-03-29
current
pecos_ownership
MATTHEWS, WANDA
W-2 MANAGING EMPLOYEE
—
2018-07-01
current
pecos_ownership
NEXION HEALTH LEASING, INC.
5% OR GREATER INDIRECT OWNERSHIP INTEREST
—
2018-03-29
current
pecos_ownership
NEXION HEALTH, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
2018-03-29
current
pecos_ownership
RINER, MEERA
CORPORATE DIRECTOR
—
2018-03-29
current
pecos_ownership
WANDA MATTHEWS
W-2 MANAGING EMPLOYEE
100%
2018-07-01
ended 2026-05-18
pecos_ownership
FRANCIS KIRLEY
5% OR GREATER INDIRECT OWNERSHIP INTEREST
61%
2018-03-29
ended 2026-05-18
pecos_ownership
BRETTON BOLT
5% OR GREATER INDIRECT OWNERSHIP INTEREST
35%
2018-03-29
ended 2026-05-18
pecos_ownership
BRIAN LEE
CORPORATE OFFICER
—
2018-03-29
ended 2026-05-18
pecos_ownership
MEERA RINER
CORPORATE OFFICER
—
2018-03-29
ended 2026-05-18
pecos_ownership
WILLIAM HERDRICH
CORPORATE DIRECTOR
—
2018-03-29
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
$385,061
—
—
—
$70,829
0
—
2023-12-31
$351,632
—
—
—
$65,610
0
—
2022-12-31
$385,277
—
—
—
$64,685
0
—
2021-12-31
$340,349
—
—
—
$52,501
0
—
2020-12-31
$423,635
—
—
—
$67,316
0
—
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
33
Geo
Kind
BR
Amount
As of
Source
county 28011
acs median gross
0
$337
2024-12-31
CENSUS_ACS5
county 28011
fmr
0
$638
2025-10-01
HUD_USER_FMR
county 28011
acs median gross
1
$517
2024-12-31
CENSUS_ACS5
county 28011
fmr
1
$642
2025-10-01
HUD_USER_FMR
county 28011
acs median gross
2
$734
2024-12-31
CENSUS_ACS5
county 28011
fmr
2
$842
2025-10-01
HUD_USER_FMR
county 28011
acs median gross
3
$859
2024-12-31
CENSUS_ACS5
county 28011
fmr
3
$1,096
2025-10-01
HUD_USER_FMR
county 28011
acs median gross
4
$846
2024-12-31
CENSUS_ACS5
county 28011
fmr
4
$1,115
2025-10-01
HUD_USER_FMR
county 28011
acs median gross
$685
2024-12-31
CENSUS_ACS5
county 28011
acs recent mover gross
$1,046
2024-12-31
CENSUS_ACS5
zcta 38732
acs median gross
1
$560
2024-12-31
CENSUS_ACS5
zcta 38732
acs median gross
2
$838
2024-12-31
CENSUS_ACS5
zcta 38732
acs median gross
3
$1,125
2024-12-31
CENSUS_ACS5
zcta 38732
acs median gross
4
$995
2024-12-31
CENSUS_ACS5
zcta 38732
acs median gross
$810
2024-12-31
CENSUS_ACS5
zcta 38732
acs recent mover gross
$1,095
2024-12-31
CENSUS_ACS5
zip 38732
payment standard 110
0
$737
2025-10-01
HUD_USER_SAFMR
zip 38732
payment standard 90
0
$603
2025-10-01
HUD_USER_SAFMR
zip 38732
safmr
0
$670
2025-10-01
HUD_USER_SAFMR
zip 38732
payment standard 110
1
$748
2025-10-01
HUD_USER_SAFMR
zip 38732
payment standard 90
1
$612
2025-10-01
HUD_USER_SAFMR
zip 38732
safmr
1
$680
2025-10-01
HUD_USER_SAFMR
zip 38732
payment standard 110
2
$979
2025-10-01
HUD_USER_SAFMR
zip 38732
payment standard 90
2
$801
2025-10-01
HUD_USER_SAFMR
zip 38732
safmr
2
$890
2025-10-01
HUD_USER_SAFMR
zip 38732
payment standard 110
3
$1,276
2025-10-01
HUD_USER_SAFMR
zip 38732
payment standard 90
3
$1,044
2025-10-01
HUD_USER_SAFMR
zip 38732
safmr
3
$1,160
2025-10-01
HUD_USER_SAFMR
zip 38732
payment standard 110
4
$1,386
2025-10-01
HUD_USER_SAFMR
zip 38732
payment standard 90
4
$1,134
2025-10-01
HUD_USER_SAFMR
zip 38732
safmr
4
$1,260
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.