Reads as: riskier than 66.2% 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
6
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+24.0 vs natl
GATEWAY HEALTHCARE LLC
12 facilities
connection
Owner spans multiple chains
18 chains
ENSIGN SERVICES INC
286 facilities
connection
Owner spans multiple chains
17 chains
BURNAM SOON
335 facilities
connection
Owner spans multiple chains
17 chains
KEETCH CHAD
283 facilities
connection
Owner spans multiple chains
6 chains
GRAPE TREE MEDICAL STAFFING LLC
55 facilities
connection
Owner fleet enforcement cluster
60% fined
KARE TECHNOLOGIES LLC
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.
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
NE median
National median
National p25–p75
Total nurse
2.97
2.88
3.28
2.90–3.77
RN
0.37
0.42
0.39
0.25–0.58
Weekend total
2.88
2.75
3.11
—
Weekday total
3.01
2.96
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
70.4
2.97
0.37
0.66
1.94
2.88
1.1%
2025Q3
92
74.7
2.55
0.14
0.75
1.66
2.49
13.2%
2025Q2
91
70.1
2.58
0.28
0.74
1.56
2.43
12.4%
2025Q1
90
70.5
2.56
0.35
0.70
1.51
2.28
20.9%
2024Q4
92
65.6
2.98
0.45
0.75
1.78
2.67
25.5%
2024Q3
92
68.6
2.48
0.27
0.82
1.39
2.25
15.2%
2024Q2
91
70.1
2.38
0.28
0.73
1.36
2.25
11.8%
2024Q1
91
66.3
2.02
0.20
0.74
1.09
1.87
2.5%
2023Q4
92
68.1
2.06
0.23
0.78
1.04
1.89
3.8%
2023Q3
92
68.4
2.24
0.20
0.73
1.32
2.06
0.8%
2023Q2
91
70.1
2.40
0.29
0.69
1.43
2.24
8.3%
2023Q1
90
71.9
2.41
0.27
0.79
1.34
2.16
14.7%
2022Q4
92
72.9
2.25
0.24
0.77
1.23
2.08
33.6%
2022Q3
92
65.8
2.35
0.35
0.72
1.27
2.16
28.8%
2022Q2
91
69.4
2.10
0.35
0.65
1.10
1.97
19.4%
2022Q1
90
65.2
2.17
0.43
0.54
1.20
2.06
8.6%
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.
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
2025-07-03
2025-05-21
Health
F0791
Provide or obtain dental services for each resident.
D
2025-07-03
2025-05-21
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2025-07-03
2025-05-21
Health · complaint
F0865
Have a plan that describes the process for conducting QAPI and QAA activities.
F
2025-07-03
2025-05-21
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-07-03
2024-10-24
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
2024-10-30
2024-10-24
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2024-10-30
2024-10-10
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-10-11
2024-10-10
Health · complaint
F0757
Ensure each resident’s drug regimen must be free from unnecessary drugs.
J
2024-10-11
2024-10-10
Health · complaint
F0760
Ensure that residents are free from significant medication errors.
J
2024-10-11
2024-07-02
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-08-09
2024-05-02
Health · complaint
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2024-06-14
2024-05-02
Health
F0583
Keep residents' personal and medical records private and confidential.
D
2024-06-14
2024-05-02
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.
E
2024-06-14
2024-05-02
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2024-06-14
2024-05-02
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
2024-06-14
2024-05-02
Health · complaint
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2024-06-14
2024-05-02
Health
F0727
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
F
2024-06-14
2024-05-02
Health · complaint
F0804
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
F
2024-06-14
2024-05-02
Health · complaint
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2024-06-14
2024-05-02
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.
F
2024-06-14
2024-05-02
Health · complaint
F0923
Have enough outside ventilation via a window or mechanical ventilation, or both.
E
2024-06-14
2023-03-09
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
2023-05-03
2023-03-09
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
2023-05-03
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
25
Owner
Role
Pct
From
Status
Source
BURNAM, SOON
CORPORATE OFFICER
—
2014-04-25
current
pecos_ownership
ENSIGN SERVICES INC
ADP OF THE SNF
—
2015-02-01
current
pecos_ownership
FUSION MEDICAL STAFFING LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2015-02-01
current
pecos_ownership
GATEWAY HEALTHCARE LLC
DIRECT OWNERSHIP INTEREST
—
2014-04-24
current
pecos_ownership
GRAPE TREE MEDICAL STAFFING LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2015-02-01
current
pecos_ownership
HELENTHAL, TARA
CORPORATE OFFICER
—
2021-08-01
current
pecos_ownership
JORGENSEN, DAVID
CORPORATE DIRECTOR
—
2024-01-01
current
pecos_ownership
KAKISH, EYAD
ADP OF THE SNF
—
2013-09-13
current
pecos_ownership
KARE TECHNOLOGIES LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2015-02-01
current
pecos_ownership
KEETCH, CHAD
CORPORATE OFFICER
—
2011-03-01
current
pecos_ownership
LEIMER, SANDRA
ADP OF THE SNF
—
2015-02-01
current
pecos_ownership
MENOMONEE HEALTH HOLDINGS LLC
ADP OF THE SNF
—
2015-02-01
current
pecos_ownership
MENOMONEE HEALTH HOLIDING
Corporation, partnership or other organization has financial interest in provider
—
2024-01-01
current
hcris_a_8_1
MENOMONEE HEALTH HOLIDING
Corporation, partnership or other organization has financial interest in provider
—
2023-01-01
current
hcris_a_8_1
PORT, BARRY
INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
—
2025-07-30
current
pecos_ownership
SATO, AMI
CORPORATE OFFICER
—
2024-09-09
current
pecos_ownership
RON ROSS
OTHER
100%
2014-06-02
ended 2026-05-18
pecos_ownership
THE ENSIGN GROUP INC
5% OR GREATER INDIRECT OWNERSHIP INTEREST
100%
2011-05-23
ended 2026-05-18
pecos_ownership
CRAIG FITCH
CORPORATE OFFICER
0%
2019-01-01
ended 2026-05-18
pecos_ownership
SANDRA LEIMER
W-2 MANAGING EMPLOYEE
0%
2015-02-01
ended 2026-05-18
pecos_ownership
SOON BURNAM
CORPORATE OFFICER
0%
2014-04-25
ended 2026-05-18
pecos_ownership
TARA HELENTHAL
CORPORATE OFFICER
0%
2021-08-01
ended 2026-05-18
pecos_ownership
MENOMONEE HEALTH HOLIDING
Corporation, partnership or other organization has financial interest in provider
—
2020-01-01
ended 2020-12-31
hcris_a_8_1
MENOMONEE HEALTH HOLIDING
Corporation, partnership or other organization has financial interest in provider
—
2021-01-01
ended 2021-12-31
hcris_a_8_1
MENOMONEE HEALTH HOLIDING
Corporation, partnership or other organization has financial interest in provider
—
2022-01-01
ended 2022-12-31
hcris_a_8_1
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
$1,618,900
—
$808,303
—
—
4
propco
2023-12-31
$1,351,644
—
$647,050
—
—
4
propco
2022-12-31
$1,462,444
—
$733,637
—
—
4
propco
2021-12-31
$1,371,265
—
$574,885
—
—
4
propco
2020-12-31
$1,229,366
—
$487,236
—
$1,526
4
propco
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
Transactions
0
No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Most recent same-state, same-setting trades. Most CHOW-derived trades carry no disclosed consideration, so price, $/bed, and cap rate show only where a sale price was resolved from a deed or filing — blanks are honest, not missing data.
Market rent context
36
Geo
Kind
BR
Amount
As of
Source
county 31055
acs median gross
0
$954
2024-12-31
CENSUS_ACS5
county 31055
fmr
0
$1,090
2025-10-01
HUD_USER_FMR
county 31055
acs median gross
1
$1,041
2024-12-31
CENSUS_ACS5
county 31055
fmr
1
$1,148
2025-10-01
HUD_USER_FMR
county 31055
acs median gross
2
$1,249
2024-12-31
CENSUS_ACS5
county 31055
fmr
2
$1,368
2025-10-01
HUD_USER_FMR
county 31055
acs median gross
3
$1,532
2024-12-31
CENSUS_ACS5
county 31055
fmr
3
$1,813
2025-10-01
HUD_USER_FMR
county 31055
acs median gross
4
$1,714
2024-12-31
CENSUS_ACS5
county 31055
fmr
4
$2,046
2025-10-01
HUD_USER_FMR
county 31055
acs median gross
5
$1,461
2024-12-31
CENSUS_ACS5
county 31055
acs median gross
$1,201
2024-12-31
CENSUS_ACS5
county 31055
acs recent mover gross
$1,337
2024-12-31
CENSUS_ACS5
zcta 68134
acs median gross
0
$916
2024-12-31
CENSUS_ACS5
zcta 68134
acs median gross
1
$942
2024-12-31
CENSUS_ACS5
zcta 68134
acs median gross
2
$1,135
2024-12-31
CENSUS_ACS5
zcta 68134
acs median gross
3
$1,634
2024-12-31
CENSUS_ACS5
zcta 68134
acs median gross
4
$1,769
2024-12-31
CENSUS_ACS5
zcta 68134
acs median gross
5
$1,167
2024-12-31
CENSUS_ACS5
zcta 68134
acs median gross
$1,080
2024-12-31
CENSUS_ACS5
zcta 68134
acs recent mover gross
$1,185
2024-12-31
CENSUS_ACS5
zip 68134
payment standard 110
0
$1,155
2025-10-01
HUD_USER_SAFMR
zip 68134
payment standard 90
0
$945
2025-10-01
HUD_USER_SAFMR
zip 68134
safmr
0
$1,050
2025-10-01
HUD_USER_SAFMR
zip 68134
payment standard 110
1
$1,221
2025-10-01
HUD_USER_SAFMR
zip 68134
payment standard 90
1
$999
2025-10-01
HUD_USER_SAFMR
zip 68134
safmr
1
$1,110
2025-10-01
HUD_USER_SAFMR
zip 68134
payment standard 110
2
$1,452
2025-10-01
HUD_USER_SAFMR
zip 68134
payment standard 90
2
$1,188
2025-10-01
HUD_USER_SAFMR
zip 68134
safmr
2
$1,320
2025-10-01
HUD_USER_SAFMR
zip 68134
payment standard 110
3
$1,925
2025-10-01
HUD_USER_SAFMR
zip 68134
payment standard 90
3
$1,575
2025-10-01
HUD_USER_SAFMR
zip 68134
safmr
3
$1,750
2025-10-01
HUD_USER_SAFMR
zip 68134
payment standard 110
4
$2,167
2025-10-01
HUD_USER_SAFMR
zip 68134
payment standard 90
4
$1,773
2025-10-01
HUD_USER_SAFMR
zip 68134
safmr
4
$1,970
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.