Composite
81.6 / 100 percentile
Screener / 265460
C
CASSVILLE HEALTH CARE CENTER
snfMOSFF: SFF Candidate
1300 COUNTY FARM ROAD, CASSVILLE, MO 65625 · CCN 265460 · chain DKDP MISSOURI LLC
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
60
Model
v1.2
Reads as: riskier than 81.6% 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 signals8Components16CHOW radar1Distress radar1Staffing16Penalties2Deficiencies82Licensure0Ownership23Related party5Transactions1Comps12Market rent32
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 94.8 | 92.9 | 0.30 | 0.2308 | 21.88 | in index |
| staffing risk | 93.4 | 93.4 | 0.25 | 0.1923 | 17.96 | in index |
| financial risk | 60.4 | 52.6 | 0.30 | 0.2308 | 13.94 | in index |
| chow risk | 35.0 | 33.5 | 0.15 | 0.1154 | 4.04 | in index |
| billing conduct | 15.3 | 20.0 | 0.30 | 0.2308 | 3.53 | 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
8| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +22.6 vs natl | RICHARD J DESTEFANE REVOCABLE LIVING TRUST | 23 facilities |
| connection | Owner fleet risk far above national | +20.4 vs natl | RELIANT CARE MANAGEMENT COMPANY LLC | 32 facilities |
| connection | Owner fleet enforcement cluster | 61% fined | RELIANT CARE GROUP LLC | 18 facilities |
| connection | Owner fleet enforcement cluster | 59% fined | DESTEFANE RICHARD | 32 facilities |
| connection | Owner fleet enforcement cluster | 59% fined | RELIANT CARE MANAGEMENT COMPANY LLC | 32 facilities |
| connection | Owner fleet enforcement cluster | 56% fined | RICHARD J DESTEFANE REVOCABLE LIVING TRUST | 23 facilities |
| connection | Owner fleet enforcement cluster | 55% fined | RCG INC | 20 facilities |
| connection | Owner fleet enforcement cluster | 54% fined | ARSHAD ABDULLAH | 24 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 | 20.0 | A | 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 | 42.1 | B | v0.6 | default · in composite | |
| financial risk | 52.6 | 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 | 0.1 | — | 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 | 92.9 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 93.4 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 81.0 | 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 | 61.0 | 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 | 53.4 | 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 | 56.2 | 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 | 92.8 | 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 | 92.8 | 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 | 93.4 | 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 | 93.4 | 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)
0.1%
model v0.1 · computed 2026-07-29
Percentile among SNFs
25.3
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) | 4.91 | -1.37 | |
| Ownership changes, last 5 years | 1.00 | -0.87 | |
| For-profit ownership | 1.00 | +0.69 | |
| Deficiencies, last 12 months | 31.00 | +0.58 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| High-severity deficiencies, 12m | 4.00 | +0.20 | |
| Total nurse staffing (HPRD) | 2.41 | +0.13 |
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
0.0
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 | 31.00 | -4.32 | |
| For-profit ownership | 1.00 | -0.69 | |
| Fine amount, 12m (log) | 11.73 | -0.68 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Total nurse staffing (HPRD) | 2.41 | +0.34 | |
| Never sold on record | 0.00 | -0.28 | |
| High-severity deficiencies, 12m | 4.00 | -0.28 | |
| Chain size (log) | 2.48 | -0.24 |
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 | 2.41 | 2.41 | 3.28 | 2.90–3.77 |
| RN | 0.10 | 0.25 | 0.39 | 0.25–0.58 |
| Weekend total | 2.30 | 2.24 | 3.11 | — |
| Weekday total | 2.45 | 2.49 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 42.9 | 2.41 | 0.10 | 0.55 | 1.76 | 2.30 | 0.0% |
| 2025Q3 | 92 | 44.7 | 2.45 | 0.21 | 0.47 | 1.77 | 2.56 | 1.1% |
| 2025Q2 | 91 | 49.3 | 2.53 | 0.31 | 0.47 | 1.74 | 2.37 | 10.2% |
| 2025Q1 | 90 | 47.9 | 2.77 | 0.34 | 0.55 | 1.88 | 2.64 | 8.1% |
| 2024Q4 | 92 | 43.8 | 2.85 | 0.38 | 0.59 | 1.89 | 2.75 | 4.0% |
| 2024Q3 | 92 | 46.2 | 3.08 | 0.31 | 0.65 | 2.12 | 2.91 | 4.5% |
| 2024Q2 | 91 | 46.6 | 2.68 | 0.28 | 0.47 | 1.93 | 2.19 | 8.9% |
| 2024Q1 | 91 | 43.8 | 2.98 | 0.27 | 0.70 | 2.01 | 2.52 | 16.0% |
| 2023Q4 | 92 | 46.5 | 2.56 | 0.21 | 0.75 | 1.60 | 2.25 | 22.7% |
| 2023Q3 | 92 | 43.3 | 3.19 | 0.29 | 0.89 | 2.01 | 2.86 | 48.9% |
| 2023Q2 | 91 | 47.2 | 2.53 | 0.36 | 0.71 | 1.46 | 1.97 | 21.6% |
| 2023Q1 | 90 | 47.9 | 2.87 | 0.24 | 0.74 | 1.89 | 2.71 | 5.9% |
| 2022Q4 | 92 | 60.9 | 2.20 | 0.28 | 0.46 | 1.46 | 1.72 | 0.0% |
| 2022Q3 | 92 | 56.2 | 3.15 | 0.37 | 0.51 | 2.27 | 2.39 | 0.0% |
| 2022Q2 | 91 | 44.6 | 4.05 | 0.56 | 0.87 | 2.62 | 3.24 | 0.0% |
| 2022Q1 | 90 | 40.3 | 2.71 | 0.42 | 0.76 | 1.53 | 2.33 | 0.9% |
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
2| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-09-10 | Fine | $123,925 | CMS provider data |
| 2025-09-10 | Payment Denial | — | CMS provider data |
Total fines on record: $123,925
Deficiencies
82C × 1D × 25E × 34F × 18G × 2J × 1K × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-02-02 | 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 | 2026-02-23 |
| 2026-02-02 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2026-02-23 |
| 2025-11-25 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2026-01-09 |
| 2025-11-25 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | D | 2026-01-09 |
| 2025-11-25 | Health · complaint | F0919 | Make sure that a working call system is available in each resident's bathroom and bathing area. | F | 2026-01-09 |
| 2025-11-25 | Health · complaint | F0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | E | 2026-01-09 |
| 2025-09-24 | Health · complaint | F0561 | Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | E | 2025-10-24 |
| 2025-09-24 | 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 | 2025-10-24 |
| 2025-09-24 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2026-01-09 |
| 2025-09-24 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2025-10-24 |
| 2025-09-24 | Health · complaint | F0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | F | 2026-01-09 |
| 2025-09-10 | 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 | 2026-02-23 |
| 2025-09-10 | Health · complaint | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | E | 2025-10-21 |
| 2025-09-10 | Health · complaint | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | F | 2025-10-21 |
| 2025-09-10 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2026-02-23 |
| 2025-09-10 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | J | 2026-02-23 |
| 2025-09-10 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2026-01-09 |
| 2025-09-10 | Health · complaint | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | G | 2025-10-21 |
| 2025-09-10 | 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. | G | 2025-10-21 |
| 2025-09-10 | Health · complaint | F0732 | Post nurse staffing information every day. | F | 2025-10-21 |
| 2025-09-10 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2026-01-09 |
| 2025-09-10 | Health · complaint | F0757 | Ensure each resident’s drug regimen must be free from unnecessary drugs. | E | 2026-02-23 |
| 2025-09-10 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | E | 2026-01-09 |
| 2025-09-10 | Health · complaint | F0773 | Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results. | E | 2026-02-23 |
| 2025-09-10 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2026-02-23 |
| 2025-09-10 | Health · complaint | F0835 | Administer the facility in a manner that enables it to use its resources effectively and efficiently. | K | 2025-10-21 |
| 2025-09-10 | Health · complaint | F0836 | Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards. | E | 2025-10-21 |
| 2025-09-10 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | F | 2025-10-21 |
| 2025-09-10 | Health · complaint | F0881 | Implement a program that monitors antibiotic use. | E | 2026-02-23 |
| 2025-09-10 | Health · complaint | F0919 | Make sure that a working call system is available in each resident's bathroom and bathing area. | F | 2026-01-09 |
| 2025-09-10 | Health · complaint | F0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | E | 2026-01-09 |
| 2025-06-17 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-07-11 |
| 2025-06-17 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2025-07-11 |
| 2025-04-29 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2025-06-12 |
| 2025-04-29 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-07-11 |
| 2025-04-29 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2025-07-11 |
| 2025-04-01 | Health · complaint | F0557 | Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | D | 2025-04-21 |
| 2025-04-01 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2025-04-21 |
| 2024-10-01 | Health | F0557 | Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | D | 2024-11-15 |
| 2024-10-01 | Health | F0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | 2024-11-15 |
| 2024-10-01 | 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 | 2024-11-15 |
| 2024-10-01 | Health | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | E | 2024-11-15 |
| 2024-10-01 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2024-12-30 |
| 2024-10-01 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-11-15 |
| 2024-10-01 | Health | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | 2024-11-15 |
| 2024-10-01 | Health | F0740 | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | D | 2024-12-30 |
| 2024-10-01 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2024-11-15 |
| 2024-10-01 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2024-11-15 |
| 2024-10-01 | Health | F0760 | Ensure that residents are free from significant medication errors. | D | 2024-12-30 |
| 2024-10-01 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-11-15 |
| 2024-10-01 | Health · complaint | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | 2024-11-15 |
| 2022-12-07 | Health | F0561 | Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | E | 2023-02-01 |
| 2022-12-07 | Health | F0583 | Keep residents' personal and medical records private and confidential. | D | 2023-02-01 |
| 2022-12-07 | Health | F0636 | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | E | 2023-02-01 |
| 2022-12-07 | Health | F0637 | Assess the resident when there is a significant change in condition | D | 2023-02-01 |
| 2022-12-07 | Health | F0638 | Assure that each resident’s assessment is updated at least once every 3 months. | E | 2023-02-01 |
| 2022-12-07 | Health | F0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | E | 2023-02-01 |
| 2022-12-07 | 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 | 2023-02-01 |
| 2022-12-07 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2023-02-01 |
| 2022-12-07 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2023-02-01 |
| 2022-12-07 | Health | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | E | 2023-02-01 |
| 2022-12-07 | Health | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | 2023-02-01 |
| 2022-12-07 | Health | F0700 | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | E | 2023-02-01 |
| 2022-12-07 | 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 | 2023-02-01 |
| 2022-12-07 | 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 | 2023-02-01 |
| 2022-12-07 | Health | F0800 | Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. | E | 2023-02-01 |
| 2022-12-07 | Health | F0801 | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | F | 2023-02-01 |
| 2022-12-07 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2023-02-01 |
| 2022-12-07 | Health | F0880 | Provide and implement an infection prevention and control program. | F | 2023-02-01 |
| 2022-12-07 | Health | F0881 | Implement a program that monitors antibiotic use. | F | 2023-02-01 |
| 2022-12-07 | Health | F0882 | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | F | 2023-02-01 |
| 2022-12-07 | Health | F0888 | Ensure staff are vaccinated for COVID-19 | C | 2023-02-01 |
| 2022-12-07 | Health | F0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | F | 2023-02-01 |
| 2020-10-02 | Health | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | E | 2020-11-16 |
| 2020-10-02 | Health | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2020-11-16 |
| 2020-10-02 | Health | F0610 | Respond appropriately to all alleged violations. | E | 2020-11-16 |
| 2020-10-02 | Health | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | 2020-11-16 |
| 2020-10-02 | Health | F0700 | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | E | 2020-11-16 |
| 2020-10-02 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2020-11-16 |
| 2020-10-02 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2020-11-16 |
| 2020-10-02 | Health | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | 2020-11-16 |
| 2020-10-02 | Health | F0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | F | 2020-11-16 |
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
23| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| CASSVILLE REALTY LLC | Individual has financial interest in both related organization and provider | 67% | 2023-01-01 | current | hcris_a_8_1 |
| 1300 COUNTY FARM ROAD, L.L.C. | ADP OF THE SNF | — | 2025-07-01 | current | pecos_ownership |
| ARSHAD, ABDULLAH | ADP OF THE SNF | — | 2025-07-01 | current | pecos_ownership |
| BRIM, ROBERT | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-07-01 | current | pecos_ownership |
| DESTEFANE, RICHARD | CORPORATE OFFICER | — | 2025-07-01 | current | pecos_ownership |
| RCG INC | INDIRECT OWNERSHIP INTEREST | — | 2025-07-01 | current | pecos_ownership |
| RELIANT CARE GROUP LLC | DIRECT OWNERSHIP INTEREST | — | 2025-07-01 | current | pecos_ownership |
| RELIANT CARE MANAGEMENT COMPANY LLC | ADP OF THE SNF | — | 2025-07-22 | current | pecos_ownership |
| RELIANT CARE MANAGEMENT COMPANY LLC | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-07-01 | current | pecos_ownership |
| RICHARD J. DESTEFANE REVOCABLE LIVING TRUST | INDIRECT OWNERSHIP INTEREST | — | 2025-07-01 | current | pecos_ownership |
| CASSVILLE REALTY LLC | Individual has financial interest in both related organization and provider | 67% | 2021-08-31 | ended 2021-12-31 | hcris_a_8_1 |
| CASSVILLE REALTY LLC | Individual has financial interest in both related organization and provider | 67% | 2022-01-01 | ended 2022-12-31 | hcris_a_8_1 |
| BLUE SKY BASIN LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 67% | 2021-08-31 | ended 2026-05-18 | pecos_ownership |
| SLOANS LAKE TRUST | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 63% | 2021-08-31 | ended 2026-05-18 | pecos_ownership |
| MISSOURI SNF HOLDINGS LLC | Individual has financial interest in both related organization and provider | 58% | 2020-01-01 | ended 2020-12-31 | hcris_a_8_1 |
| MISSOURI SNF HOLDINGS LLC | Individual has financial interest in both related organization and provider | 58% | 2021-01-01 | ended 2021-08-30 | hcris_a_8_1 |
| BERNARD PERLOW | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 23% | 2021-08-31 | ended 2026-05-18 | pecos_ownership |
| DKDP MISSOURI LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 23% | 2021-08-31 | ended 2026-05-18 | pecos_ownership |
| DKYH MISSOURI LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 10% | 2021-08-31 | ended 2026-05-18 | pecos_ownership |
| DOVID KLEINER | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 10% | 2021-08-31 | ended 2026-05-18 | pecos_ownership |
| ELIOT BERGER | OTHER | — | 2021-08-31 | ended 2026-05-18 | pecos_ownership |
| KENNA MORRIS | W-2 MANAGING EMPLOYEE | — | 2021-08-31 | ended 2026-05-18 | pecos_ownership |
| SAMUEL STERN | CORPORATE OFFICER | — | 2023-01-01 | 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
1| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2021-08-31 | — | CASSVILLE HEALTHCARE LLC | CASSVILLE OPCO 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
32| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 29009 | fmr | 0 | $672 | 2025-10-01 | HUD_USER_FMR |
| county 29009 | acs median gross | 1 | $554 | 2024-12-31 | CENSUS_ACS5 |
| county 29009 | fmr | 1 | $677 | 2025-10-01 | HUD_USER_FMR |
| county 29009 | acs median gross | 2 | $757 | 2024-12-31 | CENSUS_ACS5 |
| county 29009 | fmr | 2 | $888 | 2025-10-01 | HUD_USER_FMR |
| county 29009 | acs median gross | 3 | $1,005 | 2024-12-31 | CENSUS_ACS5 |
| county 29009 | fmr | 3 | $1,235 | 2025-10-01 | HUD_USER_FMR |
| county 29009 | acs median gross | 4 | $1,031 | 2024-12-31 | CENSUS_ACS5 |
| county 29009 | fmr | 4 | $1,311 | 2025-10-01 | HUD_USER_FMR |
| county 29009 | acs median gross | 5 | $778 | 2024-12-31 | CENSUS_ACS5 |
| county 29009 | acs median gross | $766 | 2024-12-31 | CENSUS_ACS5 | |
| county 29009 | acs recent mover gross | $804 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 65625 | acs median gross | 2 | $633 | 2024-12-31 | CENSUS_ACS5 |
| zcta 65625 | acs median gross | 3 | $839 | 2024-12-31 | CENSUS_ACS5 |
| zcta 65625 | acs median gross | 4 | $1,523 | 2024-12-31 | CENSUS_ACS5 |
| zcta 65625 | acs median gross | $636 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 65625 | acs recent mover gross | $585 | 2024-12-31 | CENSUS_ACS5 | |
| zip 65625 | payment standard 110 | 0 | $737 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | payment standard 90 | 0 | $603 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | safmr | 0 | $670 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | payment standard 110 | 1 | $748 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | payment standard 90 | 1 | $612 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | safmr | 1 | $680 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | payment standard 110 | 2 | $979 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | payment standard 90 | 2 | $801 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | safmr | 2 | $890 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | payment standard 110 | 3 | $1,353 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | payment standard 90 | 3 | $1,107 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | safmr | 3 | $1,230 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | payment standard 110 | 4 | $1,441 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | payment standard 90 | 4 | $1,179 | 2025-10-01 | HUD_USER_SAFMR |
| zip 65625 | safmr | 4 | $1,310 | 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.