Composite
61.1 / 100 percentile
| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 84.6 | 81.7 | 0.30 | 0.2308 | 19.52 | in index |
| staffing risk | 72.5 | 72.5 | 0.25 | 0.1923 | 13.94 | in index |
| financial risk | 40.5 | 39.8 | 0.30 | 0.2308 | 9.35 | in index |
| billing conduct | 36.0 | 34.2 | 0.30 | 0.2308 | 8.31 | in index |
| chow risk | 12.6 | 12.5 | 0.15 | 0.1154 | 1.45 | in index |
| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 34.2 | 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 | 0.0 | A | v0.6 | default · in composite | |
| financial risk | 39.8 | B | v0.5 | default · in composite | R18. |
| p adverse action 12m | 2.4 | — | 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 | 0.8 | — | 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 | 81.7 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 72.5 | D | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 63.9 | C | 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 | 43.9 | B | 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 | 32.8 | B | 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 | 43.8 | B | 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 | 81.6 | 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 | 81.6 | 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 | 72.5 | D | 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 | 72.5 | D | 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. |
| 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 | |
| Contract staffing share | 0.41 | +0.53 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Occupancy | 0.81 | -0.33 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Deficiencies, last 12 months | 2.00 | -0.12 |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | +1.62 | |
| Deficiencies, last 12 months | 2.00 | +1.06 | |
| Chain size (log) | 1.39 | +0.39 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Contract staffing share | 0.41 | +0.36 | |
| Occupancy | 0.81 | -0.27 | |
| Fine amount, 12m (log) | 0.00 | +0.18 | |
| Staffing trend, last 4 quarters | -0.31 | -0.17 |
| 2025Q4 HPRD | This facility | IA median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 2.95 | 3.15 | 3.28 | 2.90–3.77 |
| RN | 0.37 | 0.46 | 0.39 | 0.25–0.58 |
| Weekend total | 2.80 | 2.96 | 3.11 | — |
| Weekday total | 3.00 | 3.20 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 69.9 | 2.95 | 0.37 | 0.50 | 2.08 | 2.80 | 40.6% |
| 2025Q3 | 92 | 67.4 | 2.59 | 0.30 | 0.50 | 1.79 | 2.53 | 37.0% |
| 2025Q2 | 91 | 61.1 | 2.73 | 0.33 | 0.61 | 1.78 | 2.71 | 49.4% |
| 2025Q1 | 90 | 57.9 | 2.81 | 0.41 | 0.60 | 1.80 | 2.79 | 51.3% |
| 2024Q4 | 92 | 59.4 | 3.26 | 0.33 | 0.67 | 2.26 | 3.21 | 52.9% |
| 2024Q3 | 92 | 61.5 | 3.13 | 0.26 | 0.64 | 2.22 | 2.94 | 59.7% |
| 2024Q2 | 91 | 61.8 | 2.94 | 0.29 | 0.59 | 2.06 | 2.90 | 60.4% |
| 2024Q1 | 91 | 63.3 | 2.40 | 0.38 | 0.41 | 1.61 | 2.20 | 58.9% |
| 2023Q4 | 92 | 64.0 | 2.75 | 0.39 | 0.47 | 1.89 | 2.64 | 68.2% |
| 2023Q3 | 92 | 61.8 | 2.61 | 0.40 | 0.44 | 1.77 | 2.53 | 59.8% |
| 2023Q2 | 91 | 59.7 | 2.46 | 0.38 | 0.36 | 1.72 | 2.38 | 44.0% |
| 2023Q1 | 90 | 65.2 | 2.80 | 0.25 | 0.64 | 1.91 | 2.44 | 35.0% |
| 2022Q4 | 92 | 59.7 | 3.01 | 0.30 | 0.65 | 2.07 | 2.70 | 46.2% |
| 2022Q3 | 92 | 61.5 | 2.77 | 0.24 | 0.64 | 1.88 | 2.50 | 53.1% |
| 2022Q2 | 91 | 58.3 | 3.00 | 0.31 | 0.61 | 2.08 | 2.91 | 44.7% |
| 2022Q1 | 90 | 61.5 | 2.90 | 0.39 | 0.40 | 2.11 | 2.66 | 26.8% |
| Date | Type | Fine | Source |
|---|---|---|---|
| 2024-12-09 | Fine | $50,211 | CMS provider data |
| 2024-07-25 | Fine | $43,628 | CMS provider data |
| 2024-07-25 | Payment Denial | — | CMS provider data |
| 2023-07-11 | Fine | $59,840 | CMS provider data |
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-09-23 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2025-09-24 |
| 2025-09-23 | Health · complaint | F0923 | Have enough outside ventilation via a window or mechanical ventilation, or both. | E | 2025-09-24 |
| 2025-06-12 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2025-06-26 |
| 2025-06-12 | Health | F0641 | Ensure each resident receives an accurate assessment. | B | 2025-06-26 |
| 2025-06-12 | Health | F0943 | Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. | D | 2025-06-26 |
| 2024-12-09 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | 2024-12-10 |
| 2024-09-25 | Health · complaint | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | 2024-09-26 |
| 2024-09-25 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-09-26 |
| 2024-07-25 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2024-07-26 |
| 2024-07-25 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-07-26 |
| 2024-07-25 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2024-07-26 |
| 2024-07-25 | Health | F0800 | Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. | E | 2024-07-26 |
| 2024-07-25 | 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. | C | 2024-07-26 |
| 2024-07-25 | Health | F0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | E | 2024-07-26 |
| 2024-07-25 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2024-07-26 |
| 2024-02-07 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-02-08 |
| 2024-02-07 | 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. | D | 2024-02-08 |
| 2024-02-07 | Health · complaint | F0641 | Ensure each resident receives an accurate assessment. | D | 2024-02-08 |
| 2024-02-07 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-02-08 |
| 2024-02-07 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2024-02-08 |
| 2024-02-07 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2024-02-08 |
| 2023-09-18 | Health | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2023-09-29 |
| 2023-09-18 | 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 | 2023-09-29 |
| 2023-09-18 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | B | 2023-09-29 |
| 2023-09-18 | 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 | 2023-09-29 |
| 2023-09-18 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2023-09-29 |
| 2023-09-18 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2023-09-29 |
| 2023-07-11 | Health · complaint | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | 2023-07-26 |
| 2023-07-11 | 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 | 2023-07-26 |
| 2023-07-11 | 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 | 2023-07-26 |
| 2023-07-11 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2023-07-26 |
| 2023-07-11 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | 2023-07-26 |
| 2023-07-11 | 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 | 2023-07-26 |
| 2023-07-11 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2023-07-26 |
| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| BJELLAND, SUSAN | W-2 MANAGING EMPLOYEE | — | 2010-02-22 | current | pecos_ownership |
| CONTINUUM HEALTH CARE SERVICES LLC | OPERATIONAL/MANAGERIAL CONTROL | — | 2013-01-17 | current | pecos_ownership |
| ELSBERND, NANCY | W-2 MANAGING EMPLOYEE | — | 2010-02-22 | current | pecos_ownership |
| SCHMIDT, JEFFREY | CORPORATE DIRECTOR | — | 2013-05-20 | current | pecos_ownership |
| JEFFREY SCHMIDT | CORPORATE DIRECTOR | 100% | 2013-05-20 | ended 2026-05-18 | pecos_ownership |
| NANCY ELSBERND | W-2 MANAGING EMPLOYEE | — | 2010-02-22 | ended 2026-05-18 | pecos_ownership |
| SUSAN BJELLAND | W-2 MANAGING EMPLOYEE | — | 2010-02-22 | ended 2026-05-18 | pecos_ownership |
| 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 |
| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 19191 | fmr | 0 | $682 | 2025-10-01 | HUD_USER_FMR |
| county 19191 | acs median gross | 1 | $635 | 2024-12-31 | CENSUS_ACS5 |
| county 19191 | fmr | 1 | $700 | 2025-10-01 | HUD_USER_FMR |
| county 19191 | acs median gross | 2 | $827 | 2024-12-31 | CENSUS_ACS5 |
| county 19191 | fmr | 2 | $919 | 2025-10-01 | HUD_USER_FMR |
| county 19191 | acs median gross | 3 | $1,153 | 2024-12-31 | CENSUS_ACS5 |
| county 19191 | fmr | 3 | $1,212 | 2025-10-01 | HUD_USER_FMR |
| county 19191 | acs median gross | 4 | $867 | 2024-12-31 | CENSUS_ACS5 |
| county 19191 | fmr | 4 | $1,217 | 2025-10-01 | HUD_USER_FMR |
| county 19191 | acs median gross | $861 | 2024-12-31 | CENSUS_ACS5 | |
| county 19191 | acs recent mover gross | $1,043 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 52101 | acs median gross | 1 | $645 | 2024-12-31 | CENSUS_ACS5 |
| zcta 52101 | acs median gross | 2 | $841 | 2024-12-31 | CENSUS_ACS5 |
| zcta 52101 | acs median gross | 3 | $1,282 | 2024-12-31 | CENSUS_ACS5 |
| zcta 52101 | acs median gross | 4 | $826 | 2024-12-31 | CENSUS_ACS5 |
| zcta 52101 | acs median gross | $883 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 52101 | acs recent mover gross | $1,064 | 2024-12-31 | CENSUS_ACS5 | |
| zip 52101 | payment standard 110 | 0 | $770 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | payment standard 90 | 0 | $630 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | safmr | 0 | $700 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | payment standard 110 | 1 | $792 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | payment standard 90 | 1 | $648 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | safmr | 1 | $720 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | payment standard 110 | 2 | $1,034 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | payment standard 90 | 2 | $846 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | safmr | 2 | $940 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | payment standard 110 | 3 | $1,364 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | payment standard 90 | 3 | $1,116 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | safmr | 3 | $1,240 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | payment standard 110 | 4 | $1,375 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | payment standard 90 | 4 | $1,125 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52101 | safmr | 4 | $1,250 | 2025-10-01 | HUD_USER_SAFMR |