Reads as: riskier than 13.5% 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
NV median
National median
National p25–p75
Total nurse
3.32
3.62
3.28
2.90–3.77
RN
0.37
0.64
0.39
0.25–0.58
Weekend total
3.05
3.46
3.11
—
Weekday total
3.42
3.68
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
169.1
3.32
0.37
1.01
1.94
3.05
0.0%
2025Q3
92
170.2
3.26
0.35
1.00
1.90
3.13
0.0%
2025Q2
91
167.7
3.16
0.32
1.02
1.82
3.02
0.0%
2025Q1
90
166.2
3.09
0.33
1.01
1.74
2.96
0.0%
2024Q4
92
160.7
3.04
0.34
0.94
1.75
2.96
0.0%
2024Q3
92
165.6
3.17
0.34
0.95
1.87
3.04
0.0%
2024Q2
91
167.3
3.19
0.31
1.00
1.88
3.06
0.0%
2024Q1
91
171.9
3.11
0.30
1.00
1.81
3.00
0.0%
2023Q4
92
162.3
3.18
0.34
1.01
1.83
3.10
0.0%
2023Q3
92
159.7
3.13
0.33
1.05
1.75
3.00
0.0%
2023Q2
91
163.4
3.09
0.36
0.98
1.75
2.92
0.0%
2023Q1
90
161.7
3.06
0.33
0.97
1.77
2.92
0.0%
2022Q4
92
154.8
3.12
0.32
0.98
1.83
2.94
0.0%
2022Q3
92
148.8
3.23
0.34
1.00
1.89
2.94
0.0%
2022Q2
91
157.2
3.11
0.39
0.96
1.76
2.73
0.0%
2022Q1
90
160.7
3.15
0.38
1.04
1.73
2.85
0.0%
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
0
No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
26
D × 25E × 1
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2026-01-09
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
2026-02-23
2026-01-09
Health
F0692
Provide enough food/fluids to maintain a resident's health.
D
2026-02-23
2026-01-09
Health
F0849
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
D
2026-02-23
2024-11-22
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
2024-12-17
2024-11-22
Health
F0646
Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
D
2024-12-17
2024-11-22
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.
D
2024-12-17
2024-11-22
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2024-12-17
2024-11-22
Health
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.
D
2024-12-17
2024-10-08
Health · complaint
F0624
Prepare residents for a safe transfer or discharge from the nursing home.
D
2024-10-28
2024-10-08
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.
D
2024-10-31
2023-12-01
Health
F0604
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
D
2023-12-28
2023-12-01
Health
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
2023-12-28
2023-12-01
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
2023-12-28
2023-12-01
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2023-12-28
2023-12-01
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2023-12-28
2023-12-01
Health
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.
D
2023-12-28
2023-12-01
Health
F0690
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
D
2023-12-28
2023-12-01
Health
F0694
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
D
2023-12-28
2023-12-01
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2023-12-28
2023-12-01
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2023-12-28
2023-12-01
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.
D
2023-12-28
2023-12-01
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2023-12-28
2023-12-01
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
2023-12-28
2023-12-01
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
2023-12-28
2023-12-01
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2023-12-28
2023-12-01
Health
F0880
Provide and implement an infection prevention and control program.
D
2023-12-28
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
49
Owner
Role
Pct
From
Status
Source
BOISE SNF REAL ESTATE LLC
Individual has financial interest in both related organization and provider
100%
2024-01-01
current
hcris_a_8_1
LAS VEGAS MED INV
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
—
1994-04-21
current
pecos_ownership
DEVELOPERS INVESTMENT COMPANY INC
OPERATIONAL/MANAGERIAL CONTROL
—
2025-12-01
current
pecos_ownership
DEVELOPERS INVESTMENT COMPANY INC
DIRECT OWNERSHIP INTEREST
—
1995-05-15
current
pecos_ownership
DEWESE, CLARISSA
ADP OF THE SNF
—
2026-03-05
current
pecos_ownership
DEWESE, CLARISSA
OPERATIONAL/MANAGERIAL CONTROL
—
2006-06-01
current
pecos_ownership
FLETCHER, TODD
OPERATIONAL/MANAGERIAL CONTROL
—
2025-12-01
current
pecos_ownership
HENRY, TERRY
CORPORATE OFFICER
—
1999-08-16
current
pecos_ownership
JANAPATI, PAVAN
ADP OF THE SNF
—
2026-03-05
current
pecos_ownership
JANAPATI, PAVAN
OPERATIONAL/MANAGERIAL CONTROL
—
2019-08-26
current
pecos_ownership
LAS VEGAS OPERATIONS LLC
OPERATIONAL/MANAGERIAL CONTROL
—
1993-02-22
current
pecos_ownership
LAS VEGAS OPERATIONS LLC
ADP OF THE SNF
—
2000-08-31
current
pecos_ownership
LAY, LISA
CORPORATE DIRECTOR
—
2017-04-24
current
pecos_ownership
LAY, LISA
CORPORATE OFFICER
—
2018-02-09
current
pecos_ownership
LIFE CARE CENTERS OF AMERICA, INC.
ADP OF THE SNF
—
2026-03-05
current
pecos_ownership
LIFE CARE CENTERS OF AMERICA, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
1992-02-20
current
pecos_ownership
MORENO, REBECCA
MANAGING CONTROL - GOVERNING BODY
—
2019-07-14
current
pecos_ownership
PRESTON, AUBREY
OPERATIONAL/MANAGERIAL CONTROL
—
2025-12-01
current
pecos_ownership
PRESTON, FORREST
DIRECT OWNERSHIP INTEREST
—
1992-01-10
current
pecos_ownership
PRESTON, FORREST
ADP OF THE SNF
—
2000-08-31
current
pecos_ownership
PRESTON, FORREST
INDIRECT OWNERSHIP INTEREST
—
1995-05-15
current
pecos_ownership
SWANKER, RICHARD
CORPORATE OFFICER
—
2011-04-01
current
pecos_ownership
SWANKER, RICHARD
CORPORATE DIRECTOR
—
2022-01-01
current
pecos_ownership
THURMOND, JOAN
CORPORATE OFFICER
—
2000-09-22
current
pecos_ownership
ZIEGLER, JAMES
OPERATIONAL/MANAGERIAL CONTROL
—
2025-12-01
current
pecos_ownership
LAS VEGAS MED INV
Individual has financial interest in both related organization and provider
100%
2022-01-01
ended 2022-12-31
hcris_a_8_1
LAS VEGAS MED. INV.
Individual has financial interest in both related organization and provider
100%
2021-01-01
ended 2021-12-31
hcris_a_8_1
LAS VEGAS MED. INV.
Individual has financial interest in both related organization and provider
100%
2020-01-01
ended 2020-12-31
hcris_a_8_1
FORREST PRESTON
DIRECT OWNERSHIP INTEREST
99%
1992-01-10
ended 2026-05-18
pecos_ownership
FORREST PRESTON
INDIRECT OWNERSHIP INTEREST
1%
1995-05-15
ended 2026-05-18
pecos_ownership
AUBREY PRESTON
OPERATIONAL/MANAGERIAL CONTROL
—
2025-12-01
ended 2026-05-18
pecos_ownership
CINDY CROSS
CORPORATE OFFICER
—
1994-04-21
ended 2026-05-18
pecos_ownership
CLARISSA DEWESE
MANAGING CONTROL - GOVERNING BODY
—
2006-06-01
ended 2026-05-18
pecos_ownership
CLARISSA DEWESE
ADP OF THE SNF
—
2026-03-05
ended 2026-05-18
pecos_ownership
FORREST PRESTON
ADP OF THE SNF
—
2000-08-31
ended 2026-05-18
pecos_ownership
JAMES ZIEGLER
OPERATIONAL/MANAGERIAL CONTROL
—
2025-12-01
ended 2026-05-18
pecos_ownership
JOAN THURMOND
CORPORATE OFFICER
—
2000-09-22
ended 2026-05-18
pecos_ownership
LISA LAY
CORPORATE OFFICER
—
2018-02-09
ended 2026-05-18
pecos_ownership
LISA LAY
CORPORATE DIRECTOR
—
2017-04-24
ended 2026-05-18
pecos_ownership
NANCY BUTNER
MANAGING CONTROL - GOVERNING BODY
—
2018-09-16
ended 2026-05-18
pecos_ownership
PAVAN JANAPATI
OPERATIONAL/MANAGERIAL CONTROL
—
2019-08-26
ended 2026-05-18
pecos_ownership
PAVAN JANAPATI
ADP OF THE SNF
—
2026-03-05
ended 2026-05-18
pecos_ownership
REBECCA MORENO
OPERATIONAL/MANAGERIAL CONTROL
—
2019-07-14
ended 2026-05-18
pecos_ownership
RICHARD SWANKER
CORPORATE OFFICER
—
2011-04-01
ended 2026-05-18
pecos_ownership
RICHARD SWANKER
CORPORATE DIRECTOR
—
2022-01-01
ended 2026-05-18
pecos_ownership
TERRY HENRY
CORPORATE OFFICER
—
1999-08-16
ended 2026-05-18
pecos_ownership
TODD FLETCHER
OPERATIONAL/MANAGERIAL CONTROL
—
2025-12-01
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.
Related-party costs
5
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$2,475,131
$1,280,056
—
—
$299,105
6
propco
2023-12-31
$2,380,638
$1,214,266
—
—
$178,341
8
propco
2022-12-31
$2,585,640
$1,381,752
$661,641
—
$226,281
8
propco
2021-12-31
$2,609,479
$1,489,206
—
—
$232,471
7
propco
2020-12-31
$2,824,814
$1,490,610
—
—
$478,050
7
propco
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
Transactions
0
No transactions 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
36
Geo
Kind
BR
Amount
As of
Source
county 32003
acs median gross
0
$1,218
2024-12-31
CENSUS_ACS5
county 32003
fmr
0
$1,333
2025-10-01
HUD_USER_FMR
county 32003
acs median gross
1
$1,308
2024-12-31
CENSUS_ACS5
county 32003
fmr
1
$1,478
2025-10-01
HUD_USER_FMR
county 32003
acs median gross
2
$1,553
2024-12-31
CENSUS_ACS5
county 32003
fmr
2
$1,735
2025-10-01
HUD_USER_FMR
county 32003
acs median gross
3
$1,908
2024-12-31
CENSUS_ACS5
county 32003
fmr
3
$2,413
2025-10-01
HUD_USER_FMR
county 32003
acs median gross
4
$2,227
2024-12-31
CENSUS_ACS5
county 32003
fmr
4
$2,764
2025-10-01
HUD_USER_FMR
county 32003
acs median gross
5
$2,581
2024-12-31
CENSUS_ACS5
county 32003
acs median gross
$1,626
2024-12-31
CENSUS_ACS5
county 32003
acs recent mover gross
$1,755
2024-12-31
CENSUS_ACS5
zcta 89108
acs median gross
0
$1,167
2024-12-31
CENSUS_ACS5
zcta 89108
acs median gross
1
$1,288
2024-12-31
CENSUS_ACS5
zcta 89108
acs median gross
2
$1,559
2024-12-31
CENSUS_ACS5
zcta 89108
acs median gross
3
$1,763
2024-12-31
CENSUS_ACS5
zcta 89108
acs median gross
4
$1,714
2024-12-31
CENSUS_ACS5
zcta 89108
acs median gross
5
$2,008
2024-12-31
CENSUS_ACS5
zcta 89108
acs median gross
$1,554
2024-12-31
CENSUS_ACS5
zcta 89108
acs recent mover gross
$1,627
2024-12-31
CENSUS_ACS5
zip 89108
payment standard 110
0
$1,430
2025-10-01
HUD_USER_SAFMR
zip 89108
payment standard 90
0
$1,170
2025-10-01
HUD_USER_SAFMR
zip 89108
safmr
0
$1,300
2025-10-01
HUD_USER_SAFMR
zip 89108
payment standard 110
1
$1,584
2025-10-01
HUD_USER_SAFMR
zip 89108
payment standard 90
1
$1,296
2025-10-01
HUD_USER_SAFMR
zip 89108
safmr
1
$1,440
2025-10-01
HUD_USER_SAFMR
zip 89108
payment standard 110
2
$1,859
2025-10-01
HUD_USER_SAFMR
zip 89108
payment standard 90
2
$1,521
2025-10-01
HUD_USER_SAFMR
zip 89108
safmr
2
$1,690
2025-10-01
HUD_USER_SAFMR
zip 89108
payment standard 110
3
$2,585
2025-10-01
HUD_USER_SAFMR
zip 89108
payment standard 90
3
$2,115
2025-10-01
HUD_USER_SAFMR
zip 89108
safmr
3
$2,350
2025-10-01
HUD_USER_SAFMR
zip 89108
payment standard 110
4
$2,959
2025-10-01
HUD_USER_SAFMR
zip 89108
payment standard 90
4
$2,421
2025-10-01
HUD_USER_SAFMR
zip 89108
safmr
4
$2,690
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.