Reads as: riskier than 38.7% of the 14,684 facilities in the snf peer group. percentile within peer group, 100 = highest risk. Grade bands are fixed percentile cuts (F is the top 5% of peer risk), so a grade is a position, not an absolute level.
weighted_contribution sums to pre_rank_index over rows where counts_toward_index is true. The composite is the facility's percentile position of that index within its peer group, so contributions explain the input, and the rank explains the score.
Change-of-ownership footprint in the CMS Provider of Services file: control-family, legal-name and address deltas across quarterly snapshots, plus certification reset recency and Medicare tenure.
R23/W4-3. Deterministic logistic p(Medicare termination within 12m), SNF only. Label = first POS termination date (any code: voluntary closure, involuntary termination, merger exit); facilities already terminated by the panel date are excluded, not counted as safe. Trained on panels 2024-07/2024-10/2025-01 (n=46,466, 283 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.971, top-decile lift 9.5x, top-decile capture 95.4% of the 65 terminations that followed. Separability is high because closures announce themselves in the data: collapsing occupancy is the strongest signal, and the learned NEGATIVE weight on 12m deficiency counts is the surveys-stop signature of a facility winding down, not a claim that clean inspections are dangerous. Same 15 as-of-date features and anti-leakage chassis as p_chow_12m; SFF entry rejected as a label (only one month of SFF history exists, so as-of transitions cannot be reconstructed). Score = probability x 100; grade NULL. Not in any composite.
R22/W4-2. Deterministic logistic p(CHOW within 12m), SNF only. Trained on panels 2024-07/2024-10/2025-01 (n=50,700, 1,207 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.874, top-decile lift 5.0x (top 10% of predictions captured 49.6% of the CHOWs that actually closed in the next 12 months). Shipped coefficients are the evaluated ones; no post-holdout refit. Caveat: holdout positives (133) run below the training base rate because recent CHOWs surface in public records with a lag, so measured lift is conservative. Features are as-of-date public records: PBJ staffing level/trend/contract share (quarterly history to 2022Q1), deficiency and CMP counts (12m), ownership tenure and churn from CHOW-evidenced transactions, beds, occupancy, ownership type, chain size. Chain membership and ownership type are current-state (history not published). SFF and star ratings deliberately excluded (no as-of history). Notable learned direction: long ownership tenure RAISES sale odds and a recent prior CHOW lowers them. Score = probability x 100; grade is NULL because a probability is not a quality letter. Not in any composite.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Rows with counts_toward_composite false come from models that are addressable or retracted rather than default. They exist and may be informative, but they did not enter the published composite and must not be summed as though they had.
p_adverse_action_12m: probability the facility's Medicare participation terminates within 12 months (any POS termination code; already-terminated facilities are excluded, not scored safe). Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.971, top-decile lift 9.5x. Closures announce themselves: collapsing occupancy dominates, and fewer recent surveys is a winding-down signature. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models. | p_chow_12m: probability of a change of ownership within 12 months. Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.874, top-decile lift 5.0x. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models for full notes.
Probability the facility's Medicare participation ends within 12 months, from public records only. Red bars raise exit odds. A negative pull from deficiencies is the winding-down signature — surveys stop as a facility empties — not evidence that clean inspections are dangerous.
Staffing vs peers
16
2025Q4 HPRD
This facility
WA median
National median
National p25–p75
Total nurse
4.37
3.70
3.28
2.90–3.77
RN
0.82
0.62
0.39
0.25–0.58
Weekend total
3.94
3.51
3.11
—
Weekday total
4.53
3.79
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
95.2
4.37
0.82
1.25
2.30
3.94
0.0%
2025Q3
92
88.5
4.38
0.86
1.22
2.29
3.98
0.0%
2025Q2
91
83.1
4.37
0.81
1.28
2.28
3.96
0.0%
2025Q1
90
82.9
4.31
0.86
1.22
2.23
3.83
0.0%
2024Q4
92
83.8
4.51
0.86
1.27
2.38
3.96
0.0%
2024Q3
92
90.1
4.39
0.77
1.29
2.33
3.88
0.0%
2024Q2
91
88.9
4.30
0.71
1.37
2.21
3.79
3.1%
2024Q1
91
90.7
4.30
0.83
1.27
2.19
3.91
5.8%
2023Q4
92
87.2
4.29
0.83
1.34
2.12
3.84
14.0%
2023Q3
92
83.5
3.69
0.74
1.25
1.70
3.33
17.1%
2023Q2
91
81.4
3.46
0.77
1.18
1.50
3.23
14.8%
2023Q1
90
82.4
3.75
0.80
1.17
1.78
3.52
25.7%
2022Q4
92
82.0
3.65
0.73
1.03
1.88
3.47
39.0%
2022Q3
92
78.7
4.04
0.72
1.24
2.08
3.79
35.0%
2022Q2
91
80.2
4.24
0.69
1.26
2.29
3.86
41.2%
2022Q1
90
67.9
4.45
0.62
1.30
2.53
3.96
37.2%
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 voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
D
2025-12-22
2025-11-21
Health
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2025-12-22
2025-11-21
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
2025-12-22
2025-11-21
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2025-12-22
2025-11-21
Health
F0692
Provide enough food/fluids to maintain a resident's health.
D
2025-12-22
2025-11-21
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2025-12-22
2025-11-21
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
2025-12-22
2025-11-13
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2025-12-08
2024-10-31
Health
F0578
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
D
2024-12-06
2024-10-31
Health
F0623
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
B
2024-12-06
2024-10-31
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.
B
2024-12-06
2024-10-31
Health
F0641
Ensure each resident receives an accurate assessment.
D
2024-12-06
2024-10-31
Health
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
E
2024-12-06
2024-10-31
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
E
2024-12-06
2024-10-31
Health
F0692
Provide enough food/fluids to maintain a resident's health.
E
2024-12-06
2024-10-31
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
2024-12-06
2024-10-31
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2024-12-06
2024-10-31
Health
F0732
Post nurse staffing information every day.
C
2024-12-06
2024-10-31
Health
F0757
Ensure each resident’s drug regimen must be free from unnecessary drugs.
E
2024-12-06
2024-10-31
Health
F0758
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
E
2024-12-06
2024-10-31
Health · complaint
F0760
Ensure that residents are free from significant medication errors.
G
2024-10-25
2024-10-31
Health
F0880
Provide and implement an infection prevention and control program.
E
2024-12-06
2024-10-31
Health
F0881
Implement a program that monitors antibiotic use.
E
2024-12-06
2024-09-16
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2024-10-15
2024-09-16
Health · complaint
F0610
Respond appropriately to all alleged violations.
D
2024-10-15
2024-09-16
Health · complaint
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2024-10-15
2024-09-16
Health · complaint
F0660
Plan the resident's discharge to meet the resident's goals and needs.
D
2024-10-15
2023-10-12
Health
F0698
Provide safe, appropriate dialysis care/services for a resident who requires such services.
D
2023-10-27
2023-10-12
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2023-10-27
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
40
Owner
Role
Pct
From
Status
Source
SOUTH HILL REAL ESTATE INVESTORS
Individual has financial interest in both related organization and provider
100%
2024-01-01
current
hcris_a_8_1
SOUTH HILL REAL ESTATE INVESTORS
Individual has financial interest in both related organization and provider
100%
2023-01-01
current
hcris_a_8_1
BUTNER, NANCY
MANAGING CONTROL - GOVERNING BODY
—
2018-09-16
current
pecos_ownership
CROSS, CINDY
CORPORATE OFFICER
—
2014-12-15
current
pecos_ownership
DEVELOPERS INVESTMENT COMPANY INC
OPERATIONAL/MANAGERIAL CONTROL
—
2014-07-30
current
pecos_ownership
FLETCHER, TODD
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
current
pecos_ownership
HENRY, TERRY
CORPORATE OFFICER
—
1999-08-16
current
pecos_ownership
LAY, LISA
CORPORATE OFFICER
—
2018-02-09
current
pecos_ownership
LIFE CARE CENTERS OF AMERICA, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
2014-12-15
current
pecos_ownership
LIFE CARE CENTERS OF AMERICA, INC.
ADP OF THE SNF
—
2025-04-01
current
pecos_ownership
MEDINA, ALEXANDER
ADP OF THE SNF
—
2025-04-01
current
pecos_ownership
MEDINA, ALEXANDER
OPERATIONAL/MANAGERIAL CONTROL
—
2022-04-04
current
pecos_ownership
PRESTON, AUBREY
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
current
pecos_ownership
PRESTON, FORREST
INDIRECT OWNERSHIP INTEREST
—
2014-07-30
current
pecos_ownership
PRESTON, FORREST
ADP OF THE SNF
—
2011-06-10
current
pecos_ownership
SCHMITZ, BRADLEY
OPERATIONAL/MANAGERIAL CONTROL
—
2021-11-15
current
pecos_ownership
SCHMITZ, BRADLEY
ADP OF THE SNF
—
2025-04-01
current
pecos_ownership
SUWANEH, ALHAJI
OPERATIONAL/MANAGERIAL CONTROL
—
2023-11-18
current
pecos_ownership
SWANKER, RICHARD
CORPORATE OFFICER
—
2011-04-01
current
pecos_ownership
THURMOND, JOAN
CORPORATE OFFICER
—
2014-07-30
current
pecos_ownership
ZIEGLER, JAMES
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
current
pecos_ownership
SOUTH HILL REAL ESTATE INVESTORS
Individual has financial interest in both related organization and provider
100%
2022-01-01
ended 2022-12-31
hcris_a_8_1
SOUTH HILL REAL ESTATE INVESTORS
Individual has financial interest in both related organization and provider
100%
2021-01-01
ended 2021-12-31
hcris_a_8_1
SOUTH HILL REAL ESTATE INVESTORS
Individual has financial interest in both related organization and provider
100%
2020-01-01
ended 2020-12-31
hcris_a_8_1
FORREST PRESTON
5% OR GREATER DIRECT OWNERSHIP INTEREST
99%
2014-07-30
ended 2026-05-18
pecos_ownership
ALEXANDER MEDINA
ADP OF THE SNF
—
2025-04-01
ended 2026-05-18
pecos_ownership
ALEXANDER MEDINA
MANAGING CONTROL - GOVERNING BODY
—
2022-04-04
ended 2026-05-18
pecos_ownership
ALHAJI SUWANEH
OPERATIONAL/MANAGERIAL CONTROL
—
2023-11-18
ended 2026-05-18
pecos_ownership
AUBREY PRESTON
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
ended 2026-05-18
pecos_ownership
BRADLEY SCHMITZ
ADP OF THE SNF
—
2025-04-01
ended 2026-05-18
pecos_ownership
BRADLEY SCHMITZ
OPERATIONAL/MANAGERIAL CONTROL
—
2021-11-15
ended 2026-05-18
pecos_ownership
CINDY CROSS
CORPORATE OFFICER
—
2014-12-15
ended 2026-05-18
pecos_ownership
FORREST PRESTON
ADP OF THE SNF
—
2011-06-10
ended 2026-05-18
pecos_ownership
JAMES ZIEGLER
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
ended 2026-05-18
pecos_ownership
JOAN THURMOND
CORPORATE OFFICER
—
2014-07-30
ended 2026-05-18
pecos_ownership
LISA LAY
CORPORATE OFFICER
—
2018-02-09
ended 2026-05-18
pecos_ownership
NANCY BUTNER
OPERATIONAL/MANAGERIAL CONTROL
—
2018-09-16
ended 2026-05-18
pecos_ownership
RICHARD SWANKER
CORPORATE OFFICER
—
2011-04-01
ended 2026-05-18
pecos_ownership
TERRY HENRY
CORPORATE OFFICER
—
1999-08-16
ended 2026-05-18
pecos_ownership
TODD FLETCHER
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
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
$3,919,586
$2,192,753
—
—
$981,668
7
propco
2023-12-31
$3,506,160
$2,162,063
—
—
$699,765
7
propco
2022-12-31
$3,485,762
$2,245,211
—
—
$589,739
7
propco
2021-12-31
$3,705,807
$2,247,222
—
—
$698,961
7
propco
2020-12-31
$4,006,952
$2,351,723
—
—
$899,898
7
propco
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
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 53053
acs median gross
0
$1,289
2024-12-31
CENSUS_ACS5
county 53053
fmr
0
$1,428
2025-10-01
HUD_USER_FMR
county 53053
acs median gross
1
$1,465
2024-12-31
CENSUS_ACS5
county 53053
fmr
1
$1,605
2025-10-01
HUD_USER_FMR
county 53053
acs median gross
2
$1,794
2024-12-31
CENSUS_ACS5
county 53053
fmr
2
$1,971
2025-10-01
HUD_USER_FMR
county 53053
acs median gross
3
$2,233
2024-12-31
CENSUS_ACS5
county 53053
fmr
3
$2,733
2025-10-01
HUD_USER_FMR
county 53053
acs median gross
4
$2,564
2024-12-31
CENSUS_ACS5
county 53053
fmr
4
$3,102
2025-10-01
HUD_USER_FMR
county 53053
acs median gross
5
$2,810
2024-12-31
CENSUS_ACS5
county 53053
acs median gross
$1,806
2024-12-31
CENSUS_ACS5
county 53053
acs recent mover gross
$1,963
2024-12-31
CENSUS_ACS5
zcta 98374
acs median gross
0
$2,120
2024-12-31
CENSUS_ACS5
zcta 98374
acs median gross
1
$1,562
2024-12-31
CENSUS_ACS5
zcta 98374
acs median gross
2
$2,033
2024-12-31
CENSUS_ACS5
zcta 98374
acs median gross
3
$2,208
2024-12-31
CENSUS_ACS5
zcta 98374
acs median gross
4
$2,899
2024-12-31
CENSUS_ACS5
zcta 98374
acs median gross
5
$3,117
2024-12-31
CENSUS_ACS5
zcta 98374
acs median gross
$2,061
2024-12-31
CENSUS_ACS5
zcta 98374
acs recent mover gross
$2,280
2024-12-31
CENSUS_ACS5
zip 98374
payment standard 110
0
$1,782
2025-10-01
HUD_USER_SAFMR
zip 98374
payment standard 90
0
$1,458
2025-10-01
HUD_USER_SAFMR
zip 98374
safmr
0
$1,620
2025-10-01
HUD_USER_SAFMR
zip 98374
payment standard 110
1
$2,002
2025-10-01
HUD_USER_SAFMR
zip 98374
payment standard 90
1
$1,638
2025-10-01
HUD_USER_SAFMR
zip 98374
safmr
1
$1,820
2025-10-01
HUD_USER_SAFMR
zip 98374
payment standard 110
2
$2,453
2025-10-01
HUD_USER_SAFMR
zip 98374
payment standard 90
2
$2,007
2025-10-01
HUD_USER_SAFMR
zip 98374
safmr
2
$2,230
2025-10-01
HUD_USER_SAFMR
zip 98374
payment standard 110
3
$3,399
2025-10-01
HUD_USER_SAFMR
zip 98374
payment standard 90
3
$2,781
2025-10-01
HUD_USER_SAFMR
zip 98374
safmr
3
$3,090
2025-10-01
HUD_USER_SAFMR
zip 98374
payment standard 110
4
$3,861
2025-10-01
HUD_USER_SAFMR
zip 98374
payment standard 90
4
$3,159
2025-10-01
HUD_USER_SAFMR
zip 98374
safmr
4
$3,510
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.