Composite
24.8 / 100 percentile
Screener / 056416
A
MAYERS MEMORIAL HOSPITAL
snfCA
43563 HWY 299 E, FALL RIVER MILLS, CA 96028 · CCN 056416 · chain MAYERS MEMORIAL HOSPITAL DISTRICT
Peer group
snf n = 14,684
Evidence depth
moderate
Certified beds
99
Model
v1.2
Reads as: riskier than 24.8% 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 model3Components9CHOW radar1Distress radar1Staffing14Penalties3Deficiencies36Licensure0Ownership7Related party0Transactions0Comps12Market rent30
Composite explanation
3| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 79.8 | 76.4 | 0.30 | 0.4286 | 34.20 | in index |
| chow risk | 16.4 | 24.5 | 0.15 | 0.2143 | 3.51 | in index |
| staffing risk | 2.0 | 2.1 | 0.25 | 0.3571 | 0.71 | 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.
Component scores and registry models
9| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| chow risk | 24.5 | A | 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. |
| p adverse action 12m | 0.7 | — | 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 | 0.6 | — | 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 | 76.4 | D | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 2.1 | A | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| regulatory risk | 76.3 | D | 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 | 76.3 | D | 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 | 2.1 | A | 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 | 2.1 | A | 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)
0.6%
model v0.1 · computed 2026-07-29
Percentile among SNFs
55.8
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | -1.24 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| Total nurse staffing (HPRD) | 5.62 | -0.51 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Contract staffing share | 0.31 | +0.39 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Chain size (log) | 1.10 | -0.17 |
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)
0.7%
model v0.1 · computed 2026-07-29
Percentile among SNFs
82.3
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | +1.62 | |
| Total nurse staffing (HPRD) | 5.62 | -1.01 | |
| Chain size (log) | 1.10 | +0.56 | |
| Staffing trend, last 4 quarters | 0.93 | +0.41 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Occupancy | 0.68 | +0.28 | |
| Contract staffing share | 0.31 | +0.26 | |
| Deficiencies, last 12 months | 9.00 | -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
14| 2025Q4 HPRD | This facility | CA median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 5.62 | 3.95 | 3.28 | 2.90–3.77 |
| RN | 0.35 | 0.38 | 0.39 | 0.25–0.58 |
| Weekend total | 5.19 | 3.79 | 3.11 | — |
| Weekday total | 5.79 | 4.01 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 67.5 | 5.62 | 0.35 | 1.24 | 4.03 | 5.19 | 31.3% |
| 2025Q3 | 92 | 67.5 | 4.90 | 0.32 | 1.19 | 3.39 | 4.19 | 20.0% |
| 2025Q2 | 91 | 73.8 | 5.45 | 0.50 | 1.33 | 3.63 | 4.92 | 36.2% |
| 2025Q1 | 90 | 76.6 | 4.78 | 0.36 | 1.19 | 3.23 | 4.29 | 34.6% |
| 2024Q4 | 92 | 78.3 | 4.68 | 0.42 | 1.13 | 3.13 | 4.29 | 35.4% |
| 2024Q3 | 92 | 77.7 | 4.64 | 0.39 | 1.14 | 3.11 | 4.00 | 36.8% |
| 2024Q1 | 91 | 77.5 | 4.47 | 0.32 | 1.26 | 2.89 | 4.06 | 36.8% |
| 2023Q4 | 92 | 79.8 | 3.52 | 0.30 | 0.42 | 2.80 | 3.52 | 26.0% |
| 2023Q3 | 92 | 78.3 | 4.45 | 0.35 | 1.24 | 2.85 | 4.10 | 43.2% |
| 2023Q2 | 91 | 77.9 | 4.62 | 0.34 | 1.28 | 2.99 | 4.10 | 37.7% |
| 2023Q1 | 90 | 83.2 | 2.85 | 0.14 | 0.42 | 2.29 | 2.63 | 0.7% |
| 2022Q4 | 92 | 75.6 | 3.88 | 0.21 | 1.10 | 2.56 | 3.44 | 35.9% |
| 2022Q2 | 91 | 74.8 | 4.56 | 0.17 | 1.28 | 3.10 | 4.16 | 29.5% |
| 2022Q1 | 90 | 72.7 | 4.36 | 0.15 | 1.43 | 2.78 | 4.03 | 34.8% |
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
3fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-04-14 | Payment Denial | — | CMS provider data |
| 2023-12-20 | Fine | $62,258 | CMS provider data |
| 2023-12-20 | Payment Denial | — | CMS provider data |
Total fines on record: $62,258
Deficiencies
36D × 18E × 15F × 2K × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-04-01 | Health · complaint | F0627 | Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. | D | 2026-05-19 |
| 2025-08-07 | Health | F0557 | Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | E | 2025-09-05 |
| 2025-08-07 | 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 | 2025-09-07 |
| 2025-08-07 | Health | F0605 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | E | 2025-09-05 |
| 2025-08-07 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2025-09-05 |
| 2025-08-07 | Health | F0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | E | 2025-09-07 |
| 2025-08-07 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | E | 2025-09-05 |
| 2025-08-07 | 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 | 2025-09-05 |
| 2025-08-07 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2025-09-05 |
| 2025-06-20 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-08-09 |
| 2025-06-20 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2025-08-09 |
| 2025-05-27 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2025-06-30 |
| 2025-05-27 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2025-06-30 |
| 2025-05-27 | Health · complaint | F0641 | Ensure each resident receives an accurate assessment. | D | 2025-06-30 |
| 2025-04-14 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | E | 2025-05-28 |
| 2025-01-30 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2025-03-01 |
| 2024-10-15 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | E | 2024-11-20 |
| 2024-09-13 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | 2024-10-31 |
| 2024-05-09 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2024-05-23 |
| 2024-05-09 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | E | 2024-05-23 |
| 2024-05-09 | 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. | E | 2024-05-23 |
| 2024-05-09 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | 2024-05-23 |
| 2024-05-09 | 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 | 2024-05-23 |
| 2024-05-09 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2024-05-23 |
| 2023-12-20 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | K | 2024-02-02 |
| 2023-11-02 | Health · complaint | F0557 | Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | D | 2023-12-18 |
| 2023-05-05 | Health | F0585 | 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 | 2023-06-05 |
| 2023-05-05 | Health | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2023-06-05 |
| 2023-05-05 | Health | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-06-05 |
| 2023-05-05 | Health | 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 | 2023-06-05 |
| 2023-05-05 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2023-06-05 |
| 2023-05-05 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2023-06-05 |
| 2023-05-05 | Health | 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. | D | 2023-06-05 |
| 2023-05-05 | Health | F0744 | Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. | D | 2023-06-05 |
| 2023-05-05 | Health | F0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | D | 2023-06-05 |
| 2023-05-05 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2023-06-05 |
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
7| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| MAYERS MEMORIAL HOSPITAL DISTRICT | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | — | current | pecos_ownership |
| HARRIS, RYAN | ADP OF THE SNF | — | 2024-01-01 | current | pecos_ownership |
| LAKEY, TRAVIS | ADP OF THE SNF | — | 2009-11-23 | current | pecos_ownership |
| OVERTON, THERESA | ADP OF THE SNF | — | 2022-10-05 | current | pecos_ownership |
| RYAN HARRIS | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-01-01 | ended 2026-05-18 | pecos_ownership |
| THERESA OVERTON | ADP OF THE SNF | — | 2022-10-05 | ended 2026-05-18 | pecos_ownership |
| TRAVIS LAKEY | OPERATIONAL/MANAGERIAL CONTROL | — | 2009-11-23 | 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 — CA snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-08-01 | Turlock Nursing & Rehabilitation Center | — | — | — | 144 | TRACY RIDGE HEALTHCARE, INC. |
| 2025-04-01 | ALAMITOS WEST HEALTH & REHABILITATION | — | — | — | 150 | MALCOLM HEALTHCARE, INC. |
| 2025-04-01 | PACIFIC HAVEN SUBACUTE AND HEALTHCARE CENTER | — | — | — | 99 | STRAWBERRY POND HEALTHCARE LLC |
| 2025-01-16 | GOLDEN HARBOR HEALTHCARE CENTER | — | — | — | 99 | CEYLON HOLDINGS LLC |
| 2024-12-30 | GRASS VALLEY HEALTHCARE CENTER | — | — | — | 86 | HEISMAN LLC |
| 2024-10-01 | REDWOOD GROVE POST ACUTE | — | — | — | 144 | SOQUEL CARE LLC |
| 2024-09-01 | OAK GROVE POST ACUTE | — | — | — | 119 | 4545 SHELLEY COURT OPCO, LLC |
| 2024-08-01 | WE CARE SKILLED NURSING - FREMONT | — | — | — | 99 | WE CARE SKILLED NURSING-FREMONT, LLC |
| 2024-05-01 | MAJESTIC MOUNTAIN CARE CENTER | — | — | — | 66 | OAKHURST SKILLED CARE LLC |
| 2024-04-01 | THE BRADLEY GARDENS | — | — | — | 44 | GHC OF SAN JACINTO LLC |
| 2024-04-01 | SANTA FE POST-ACUTE | — | — | — | 187 | SKILLED BOBIER LLC |
| 2024-04-01 | BAYSHIRE SAN DIMAS POST-ACUTE | — | — | — | 45 | SKILLED SAN DIMAS 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
30| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 06089 | acs median gross | 0 | $987 | 2024-12-31 | CENSUS_ACS5 |
| county 06089 | fmr | 0 | $1,172 | 2025-10-01 | HUD_USER_FMR |
| county 06089 | acs median gross | 1 | $917 | 2024-12-31 | CENSUS_ACS5 |
| county 06089 | fmr | 1 | $1,212 | 2025-10-01 | HUD_USER_FMR |
| county 06089 | acs median gross | 2 | $1,270 | 2024-12-31 | CENSUS_ACS5 |
| county 06089 | fmr | 2 | $1,590 | 2025-10-01 | HUD_USER_FMR |
| county 06089 | acs median gross | 3 | $1,755 | 2024-12-31 | CENSUS_ACS5 |
| county 06089 | fmr | 3 | $2,211 | 2025-10-01 | HUD_USER_FMR |
| county 06089 | acs median gross | 4 | $2,224 | 2024-12-31 | CENSUS_ACS5 |
| county 06089 | fmr | 4 | $2,667 | 2025-10-01 | HUD_USER_FMR |
| county 06089 | acs median gross | 5 | $1,585 | 2024-12-31 | CENSUS_ACS5 |
| county 06089 | acs median gross | $1,317 | 2024-12-31 | CENSUS_ACS5 | |
| county 06089 | acs recent mover gross | $1,620 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 96028 | acs median gross | 2 | $956 | 2024-12-31 | CENSUS_ACS5 |
| zcta 96028 | acs median gross | $984 | 2024-12-31 | CENSUS_ACS5 | |
| zip 96028 | payment standard 110 | 0 | $1,287 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | payment standard 90 | 0 | $1,053 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | safmr | 0 | $1,170 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | payment standard 110 | 1 | $1,331 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | payment standard 90 | 1 | $1,089 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | safmr | 1 | $1,210 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | payment standard 110 | 2 | $1,749 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | payment standard 90 | 2 | $1,431 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | safmr | 2 | $1,590 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | payment standard 110 | 3 | $2,431 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | payment standard 90 | 3 | $1,989 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | safmr | 3 | $2,210 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | payment standard 110 | 4 | $2,937 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | payment standard 90 | 4 | $2,403 | 2025-10-01 | HUD_USER_SAFMR |
| zip 96028 | safmr | 4 | $2,670 | 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.