Composite
93.4 / 100 percentile
Screener / 165273
D
Accura Healthcare of South Des Moines
snfIA
4911 SW 19th Street, Des Moines, IA 50315 · CCN 165273 · chain AMERICAN HEALTHCARE MANAGEMENT SERVICES LLC
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
89
Model
v1.2
Reads as: riskier than 93.4% 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.
Score model5ML signals1Components16CHOW radar1Distress radar1Staffing16Penalties4Deficiencies71Licensure0Ownership21Related party5Transactions0Comps12Market rent35
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 93.2 | 90.9 | 0.30 | 0.2308 | 21.51 | in index |
| staffing risk | 89.2 | 89.2 | 0.25 | 0.1923 | 17.15 | in index |
| billing conduct | 55.9 | 41.9 | 0.30 | 0.2308 | 12.90 | in index |
| financial risk | 53.3 | 47.6 | 0.30 | 0.2308 | 12.30 | in index |
| chow risk | 50.0 | 48.1 | 0.15 | 0.1154 | 5.77 | 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
1| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner spans multiple chains | 7 chains | BRIGHTON CONSULTING GROUP LLC | 17 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 | 41.9 | B | 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 | 71.2 | D | v0.6 | default · in composite | |
| financial risk | 47.6 | C | v0.5 | default · in composite | R18. |
| p adverse action 12m | 0.0 | — | 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 | 3.0 | — | 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 | 90.9 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 89.2 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 82.0 | F | 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 | 62.0 | 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 | 54.7 | C | 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 | 51.0 | 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 | 90.9 | F | 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 | 90.9 | F | 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 | 89.2 | 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 | 89.2 | 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)
3.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
77.5
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Occupancy | 0.96 | -0.77 | |
| For-profit ownership | 1.00 | +0.69 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Chain size (log) | 3.43 | +0.33 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Deficiencies, last 12 months | 1.00 | -0.15 |
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)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
33.6
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 | |
| Occupancy | 0.96 | -0.91 | |
| Chain size (log) | 3.43 | -0.80 | |
| For-profit ownership | 1.00 | -0.69 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Total nurse staffing (HPRD) | 2.56 | +0.27 | |
| Fine amount, 12m (log) | 0.00 | +0.18 | |
| Never sold on record | 1.00 | +0.12 |
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 | 2.56 | 3.15 | 3.28 | 2.90–3.77 |
| RN | 0.39 | 0.46 | 0.39 | 0.25–0.58 |
| Weekend total | 2.38 | 2.96 | 3.11 | — |
| Weekday total | 2.64 | 3.20 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 85.8 | 2.56 | 0.39 | 0.33 | 1.85 | 2.38 | 0.6% |
| 2025Q3 | 92 | 79.6 | 2.71 | 0.38 | 0.35 | 1.98 | 2.47 | 1.2% |
| 2025Q2 | 91 | 73.0 | 2.70 | 0.38 | 0.28 | 2.04 | 2.43 | 1.6% |
| 2025Q1 | 90 | 75.7 | 2.79 | 0.34 | 0.44 | 2.01 | 2.59 | 3.8% |
| 2024Q4 | 92 | 78.3 | 2.71 | 0.40 | 0.32 | 1.99 | 2.51 | 10.3% |
| 2024Q3 | 92 | 72.9 | 2.97 | 0.42 | 0.37 | 2.18 | 2.82 | 14.0% |
| 2024Q2 | 91 | 75.1 | 2.88 | 0.34 | 0.51 | 2.03 | 2.60 | 9.3% |
| 2024Q1 | 91 | 76.1 | 2.91 | 0.34 | 0.40 | 2.17 | 3.07 | 5.7% |
| 2023Q4 | 92 | 80.4 | 2.85 | 0.27 | 0.38 | 2.20 | 2.76 | 0.0% |
| 2023Q3 | 92 | 88.8 | 2.51 | 0.20 | 0.34 | 1.97 | 2.32 | 0.0% |
| 2023Q2 | 91 | 83.9 | 2.86 | 0.25 | 0.39 | 2.22 | 2.65 | 0.0% |
| 2023Q1 | 90 | 69.8 | 2.87 | 0.34 | 0.44 | 2.09 | 3.20 | 0.0% |
| 2022Q4 | 92 | 68.5 | 2.97 | 0.37 | 0.54 | 2.06 | 2.93 | 0.0% |
| 2022Q3 | 92 | 58.9 | 3.51 | 0.34 | 0.36 | 2.81 | 3.20 | 0.0% |
| 2022Q2 | 91 | 61.0 | 2.80 | 0.28 | 0.35 | 2.17 | 2.15 | 0.4% |
| 2022Q1 | 90 | 58.3 | 2.46 | 0.23 | 0.26 | 1.96 | 2.19 | 1.7% |
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
4fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2024-04-25 | Fine | $30,675 | CMS provider data |
| 2024-04-25 | Payment Denial | — | CMS provider data |
| 2023-11-02 | Fine | $21,957 | CMS provider data |
| 2023-11-02 | Payment Denial | — | CMS provider data |
Total fines on record: $52,632
Deficiencies
71B × 3C × 1D × 39E × 22F × 2G × 2J × 1K × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-09-18 | Health · complaint | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2025-10-10 |
| 2025-07-24 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-08-15 |
| 2025-07-24 | 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 | 2025-08-15 |
| 2025-07-24 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2025-08-15 |
| 2025-02-17 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | E | 2025-02-21 |
| 2025-02-17 | Health · complaint | 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 | 2025-02-21 |
| 2025-02-17 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-02-21 |
| 2025-02-17 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2025-02-21 |
| 2024-08-22 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2024-09-16 |
| 2024-08-22 | 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 | 2024-09-16 |
| 2024-08-22 | 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 | 2024-09-16 |
| 2024-08-22 | Health | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | 2024-09-16 |
| 2024-08-22 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-09-16 |
| 2024-08-22 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2024-09-16 |
| 2024-08-22 | Health · complaint | 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 | 2024-09-16 |
| 2024-08-22 | Health · complaint | F0726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | E | 2024-09-16 |
| 2024-08-22 | Health · complaint | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2024-09-16 |
| 2024-08-22 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | D | 2024-09-16 |
| 2024-08-22 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2024-09-16 |
| 2024-06-13 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | 2024-06-23 |
| 2024-06-13 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2024-06-23 |
| 2024-04-25 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | J | 2024-06-23 |
| 2024-04-25 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-05-10 |
| 2024-04-25 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2024-05-10 |
| 2024-04-25 | Health · complaint | F0712 | Ensure that the resident and his/her doctor meet face-to-face at all required visits. | D | 2024-05-10 |
| 2024-04-25 | 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. | D | 2024-05-10 |
| 2024-02-29 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-03-12 |
| 2024-02-29 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-03-12 |
| 2024-02-29 | 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 | 2024-03-12 |
| 2024-01-25 | Health · complaint | F0568 | Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. | D | 2024-02-16 |
| 2024-01-25 | Health · complaint | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | 2024-02-16 |
| 2024-01-25 | 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 | 2024-02-16 |
| 2024-01-25 | Health · complaint | 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 | 2024-02-16 |
| 2024-01-25 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2024-02-16 |
| 2024-01-25 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-02-16 |
| 2024-01-25 | 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 | 2024-02-16 |
| 2024-01-25 | Health · complaint | F0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | E | 2024-02-16 |
| 2023-12-21 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | K | 2024-01-09 |
| 2023-12-21 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | 2024-01-09 |
| 2023-12-21 | 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 | 2024-02-16 |
| 2023-11-02 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2023-12-04 |
| 2023-11-02 | Health | F0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | 2023-12-04 |
| 2023-11-02 | Health · complaint | F0567 | Honor the resident's right to manage his or her financial affairs. | D | 2023-12-04 |
| 2023-11-02 | Health · complaint | F0568 | Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. | D | 2024-02-16 |
| 2023-11-02 | Health | F0576 | Ensure residents have reasonable access to and privacy in their use of communication methods. | E | 2023-12-04 |
| 2023-11-02 | 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 | 2023-12-04 |
| 2023-11-02 | Health | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | E | 2024-02-16 |
| 2023-11-02 | Health · complaint | 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. | B | 2023-12-04 |
| 2023-11-02 | Health | F0636 | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | B | 2023-12-04 |
| 2023-11-02 | Health | F0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | B | 2023-12-04 |
| 2023-11-02 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2023-12-04 |
| 2023-11-02 | Health | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | 2024-02-16 |
| 2023-11-02 | Health · complaint | 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 | 2024-02-16 |
| 2023-11-02 | Health · complaint | F0660 | Plan the resident's discharge to meet the resident's goals and needs. | D | 2023-12-04 |
| 2023-11-02 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2024-02-16 |
| 2023-11-02 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-02-16 |
| 2023-11-02 | Health · complaint | 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 | 2023-12-04 |
| 2023-11-02 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2023-12-04 |
| 2023-11-02 | 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. | F | 2024-02-16 |
| 2023-11-02 | Health · complaint | 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 | 2023-12-04 |
| 2023-11-02 | Health | F0732 | Post nurse staffing information every day. | C | 2023-12-04 |
| 2023-11-02 | Health · complaint | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2023-12-04 |
| 2023-11-02 | Health | F0760 | Ensure that residents are free from significant medication errors. | D | 2023-12-04 |
| 2023-11-02 | 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 | 2023-12-04 |
| 2023-11-02 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2023-12-04 |
| 2023-11-02 | Health | F0917 | Make sure each resident has 1) at least one window to the outside in a room; 2) a room at or above ground level; 3) adequate bedding; 4) furniture that meets the resident's needs; or 5) adequate closet space. | E | 2023-12-04 |
| 2023-11-02 | Health | F0919 | Make sure that a working call system is available in each resident's bathroom and bathing area. | E | 2023-12-04 |
| 2023-06-16 | 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 | 2023-07-13 |
| 2023-06-16 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2023-07-13 |
| 2023-06-16 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2023-07-13 |
| 2023-06-16 | 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. | D | 2023-07-13 |
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
21| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| BABB, KEVIN | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 49% | 2015-12-02 | current | pecos_ownership |
| AMERICAN HEALTHCARE MANAGEMENT SERVICES LLC | ADP OF THE SNF | — | 2025-12-26 | current | pecos_ownership |
| AMERICAN HEALTHCARE MANAGEMENT SERVICES LLC | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-01-01 | current | pecos_ownership |
| BABB, KEVIN | ADP OF THE SNF | — | 2017-04-12 | current | pecos_ownership |
| BRIGHTON CONSULTING GROUP LLC | ADP OF THE SNF | — | 2002-01-01 | current | pecos_ownership |
| CONNER, JENNIFER | CORPORATE OFFICER | — | 2015-12-02 | current | pecos_ownership |
| CONNER, ROBERT | ADP OF THE SNF | — | 2001-01-01 | current | pecos_ownership |
| CONNER, ROBERT | CORPORATE DIRECTOR | — | 2015-12-02 | current | pecos_ownership |
| FIRST INTERSTATE BANK | 5% OR GREATER MORTGAGE INTEREST | — | 2002-06-01 | current | pecos_ownership |
| HERST, JOSEPH | ADP OF THE SNF | — | 2025-03-17 | current | pecos_ownership |
| LENEAVE, TED | ADP OF THE SNF | — | 2024-01-01 | current | pecos_ownership |
| MARTENS & COMPANY CPA, LLP | ADP OF THE SNF | — | 2017-01-01 | current | pecos_ownership |
| TOTI, LISA | ADP OF THE SNF | — | 2024-01-01 | current | pecos_ownership |
| KEVIN BABB | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 49% | 2015-12-02 | ended 2026-05-18 | pecos_ownership |
| ROBERT CONNER | CORPORATE DIRECTOR | 49% | 2015-12-02 | ended 2026-05-18 | pecos_ownership |
| JENNIFER CONNER | CORPORATE OFFICER | 1% | 2015-12-02 | ended 2026-05-18 | pecos_ownership |
| JOSEPH HERST | ADP OF THE SNF | — | 2025-03-17 | ended 2026-05-18 | pecos_ownership |
| KEVIN BABB | ADP OF THE SNF | — | 2017-04-12 | ended 2026-05-18 | pecos_ownership |
| LISA TOTI | ADP OF THE SNF | — | 2024-01-01 | ended 2026-05-18 | pecos_ownership |
| ROBERT CONNER | OPERATIONAL/MANAGERIAL CONTROL | — | 2001-01-01 | ended 2026-05-18 | pecos_ownership |
| TED LENEAVE | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-01-01 | 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.
Transactions
0No 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 — IA snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-09-01 | St Luke's Regional Medical Center SNF | — | — | — | 20 | NORTHWEST IOWA HOSPITAL CORPORATION |
| 2025-08-01 | Crystal Heights Care Center | — | — | — | 72 | CANFIELD RIVER HEALTHCARE LLC |
| 2025-06-01 | AMS Memorial-Greene | — | — | — | 31 | AMS MEMORIAL-GREENE LLC |
| 2025-02-05 | Chapters Living of Council Bluffs | — | — | — | 102 | CHAPTERS COUNCIL BLUFFS OPCO LLC |
| 2025-02-01 | Osage Rehab and Health Care Center | — | — | — | 46 | OPCO OSAGE IA LLC |
| 2025-02-01 | Iowa City Rehab & Health Care | — | — | — | 89 | OPCO IOWA CITY IA LLC |
| 2025-02-01 | Accura Healthcare of Creston | — | — | — | 31 | ACCURA HEALTHCARE OF CRESTON LLC |
| 2025-02-01 | Casa De Paz Health Care Center | — | — | — | 71 | OPCO 19TH ST SIOUX CITY IA LLC |
| 2025-02-01 | Pleasant Acres Care Center | — | — | — | 46 | OPCO HULL IA LLC |
| 2025-02-01 | Cedar Falls Health Care Center | — | — | — | 70 | OPCO CEDAR FALLS IA LLC |
| 2025-02-01 | Accura Healthcare of Onawa | — | — | — | 46 | ACCURA HEALTHCARE OF ONAWA LLC |
| 2025-02-01 | Grundy Care Center | — | — | — | 40 | OPCO GRUNDY CENTER IA 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 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 50315 | acs median gross | 0 | $968 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50315 | acs median gross | 1 | $820 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50315 | acs median gross | 2 | $1,095 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50315 | acs median gross | 3 | $1,326 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50315 | acs median gross | 4 | $1,396 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50315 | acs median gross | $1,001 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 50315 | acs recent mover gross | $1,068 | 2024-12-31 | CENSUS_ACS5 | |
| zip 50315 | payment standard 110 | 0 | $1,089 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | payment standard 90 | 0 | $891 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | safmr | 0 | $990 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | payment standard 110 | 1 | $1,133 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | payment standard 90 | 1 | $927 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | safmr | 1 | $1,030 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | payment standard 110 | 2 | $1,353 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | payment standard 90 | 2 | $1,107 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | safmr | 2 | $1,230 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | payment standard 110 | 3 | $1,837 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | payment standard 90 | 3 | $1,503 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | safmr | 3 | $1,670 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | payment standard 110 | 4 | $1,892 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | payment standard 90 | 4 | $1,548 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50315 | safmr | 4 | $1,720 | 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.