Reads as: riskier than 31.0% 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.
ML signals — parallel engine
4
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
8 chains
HERZKA YISROEL
70 facilities
connection
Owner fleet enforcement cluster
67% fined
PACIFIC NORTHWEST SNF OPERATIONS HOLDINGS SD LLC
6 facilities
connection
Owner fleet enforcement cluster
67% fined
SOUTH DAKOTA SNF CONSULTING LLC
6 facilities
connection
Owner fleet enforcement cluster
50% fined
LOWE LEONOR
6 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.
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
SD median
National median
National p25–p75
Total nurse
2.40
2.96
3.28
2.90–3.77
RN
0.40
0.52
0.39
0.25–0.58
Weekend total
2.19
2.75
3.11
—
Weekday total
2.48
3.06
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
44.0
2.40
0.40
0.23
1.76
2.19
2.5%
2025Q3
92
44.5
2.04
0.38
0.25
1.40
1.86
1.2%
2025Q2
91
40.2
2.19
0.43
0.27
1.49
1.95
5.6%
2025Q1
90
38.7
2.34
0.43
0.28
1.63
2.13
0.6%
2024Q4
92
40.3
2.29
0.43
0.24
1.62
2.00
2.2%
2024Q3
92
43.7
2.29
0.46
0.23
1.60
2.09
3.3%
2024Q2
91
44.1
2.29
0.46
0.22
1.62
2.08
0.7%
2024Q1
91
41.8
2.25
0.44
0.28
1.53
2.09
0.8%
2023Q4
92
40.1
2.36
0.39
0.38
1.59
2.14
0.0%
2023Q3
92
39.5
2.15
0.48
0.29
1.38
1.91
0.0%
2023Q2
91
37.7
2.13
0.49
0.30
1.34
1.87
9.0%
2023Q1
90
35.5
2.41
0.50
0.34
1.57
2.11
12.9%
2022Q4
92
33.6
2.40
0.48
0.34
1.58
2.27
26.7%
2022Q3
92
34.1
2.56
0.43
0.44
1.70
2.37
25.1%
2022Q2
91
35.1
2.45
0.43
0.38
1.64
2.19
11.2%
2022Q1
90
37.4
2.24
0.42
0.29
1.53
2.11
6.2%
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.
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
G
2025-12-06
2025-12-04
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.
D
2025-12-06
2025-12-04
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2025-12-06
2025-12-04
Health
F0880
Provide and implement an infection prevention and control program.
E
2025-12-06
2025-06-18
Health · complaint
F0688
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
E
2025-07-11
2024-10-30
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2024-10-22
2024-07-10
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
E
2024-08-26
2024-07-10
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
G
2024-08-26
2024-07-10
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.
E
2024-08-26
2024-07-10
Health
F0806
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
E
2024-08-26
2024-07-10
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
2024-08-26
2024-03-28
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.
E
2024-05-14
2023-10-17
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2023-12-04
2023-07-19
Health
F0761
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
E
2023-08-15
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.
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
28
Geo
Kind
BR
Amount
As of
Source
county 46091
fmr
0
$641
2025-10-01
HUD_USER_FMR
county 46091
acs median gross
1
$475
2024-12-31
CENSUS_ACS5
county 46091
fmr
1
$708
2025-10-01
HUD_USER_FMR
county 46091
acs median gross
2
$771
2024-12-31
CENSUS_ACS5
county 46091
fmr
2
$929
2025-10-01
HUD_USER_FMR
county 46091
acs median gross
3
$925
2024-12-31
CENSUS_ACS5
county 46091
fmr
3
$1,281
2025-10-01
HUD_USER_FMR
county 46091
fmr
4
$1,438
2025-10-01
HUD_USER_FMR
county 46091
acs median gross
$752
2024-12-31
CENSUS_ACS5
county 46091
acs recent mover gross
$763
2024-12-31
CENSUS_ACS5
zcta 57430
acs median gross
2
$811
2024-12-31
CENSUS_ACS5
zcta 57430
acs median gross
$820
2024-12-31
CENSUS_ACS5
zcta 57430
acs recent mover gross
$776
2024-12-31
CENSUS_ACS5
zip 57430
payment standard 110
0
$704
2025-10-01
HUD_USER_SAFMR
zip 57430
payment standard 90
0
$576
2025-10-01
HUD_USER_SAFMR
zip 57430
safmr
0
$640
2025-10-01
HUD_USER_SAFMR
zip 57430
payment standard 110
1
$781
2025-10-01
HUD_USER_SAFMR
zip 57430
payment standard 90
1
$639
2025-10-01
HUD_USER_SAFMR
zip 57430
safmr
1
$710
2025-10-01
HUD_USER_SAFMR
zip 57430
payment standard 110
2
$1,023
2025-10-01
HUD_USER_SAFMR
zip 57430
payment standard 90
2
$837
2025-10-01
HUD_USER_SAFMR
zip 57430
safmr
2
$930
2025-10-01
HUD_USER_SAFMR
zip 57430
payment standard 110
3
$1,408
2025-10-01
HUD_USER_SAFMR
zip 57430
payment standard 90
3
$1,152
2025-10-01
HUD_USER_SAFMR
zip 57430
safmr
3
$1,280
2025-10-01
HUD_USER_SAFMR
zip 57430
payment standard 110
4
$1,584
2025-10-01
HUD_USER_SAFMR
zip 57430
payment standard 90
4
$1,296
2025-10-01
HUD_USER_SAFMR
zip 57430
safmr
4
$1,440
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.