Reads as: riskier than 39.6% 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
1
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
47 chains
FORVIS MAZARS LLP
251 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
13
2025Q4 HPRD
This facility
MO median
National median
National p25–p75
Total nurse
1.52
2.41
3.28
2.90–3.77
RN
0.20
0.25
0.39
0.25–0.58
Weekend total
1.47
2.24
3.11
—
Weekday total
1.54
2.49
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
41.2
1.52
0.20
0.77
0.55
1.47
7.5%
2025Q3
92
40.9
1.45
0.23
0.67
0.55
1.36
6.7%
2025Q2
91
36.9
1.71
0.34
0.68
0.69
1.49
3.5%
2025Q1
90
37.9
1.88
0.35
0.67
0.86
1.63
0.0%
2024Q4
92
39.1
2.01
0.25
0.71
1.04
1.91
0.0%
2024Q3
92
39.9
1.73
0.28
0.55
0.90
1.61
0.0%
2024Q2
91
40.3
2.04
0.21
0.81
1.01
1.94
0.0%
2024Q1
91
38.3
1.99
0.10
0.80
1.09
1.94
0.0%
2023Q3
92
42.2
1.76
0.17
0.68
0.92
1.72
0.0%
2023Q2
91
41.7
1.95
0.16
0.65
1.14
1.90
0.0%
2023Q1
90
39.8
2.37
0.18
0.53
1.66
2.38
0.0%
2022Q4
92
38.9
2.46
0.28
0.42
1.76
2.51
0.0%
2022Q3
92
37.2
2.19
0.32
0.59
1.28
2.06
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
20
C × 1D × 16E × 1F × 2
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2025-05-30
Health
F0570
Assure the security of all personal funds of residents deposited with the facility.
E
2025-07-11
2025-05-30
Health
F0605
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
D
2025-07-11
2025-05-30
Health
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
D
2025-07-11
2025-05-30
Health
F0610
Respond appropriately to all alleged violations.
D
2025-07-11
2025-05-30
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
2025-07-11
2025-05-30
Health
F0729
Verify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining.
D
2025-07-11
2025-05-30
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-07-11
2025-05-30
Health
F0947
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
D
2025-07-11
2024-05-16
Health
F0623
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
D
2024-06-28
2024-05-16
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.
D
2024-06-28
2024-05-16
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
2024-06-28
2024-05-16
Health
F0851
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
F
2024-06-28
2024-05-16
Health
F0909
Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.
D
2024-06-28
2023-03-23
Health
F0565
Honor the resident's right to organize and participate in resident/family groups in the facility.
C
2023-05-05
2023-03-23
Health
F0655
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
D
2023-05-05
2023-03-23
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
2023-05-05
2023-03-23
Health
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2023-05-05
2023-03-23
Health
F0730
Observe each nurse aide's job performance and give regular training.
D
2023-05-05
2023-03-23
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2023-05-05
2023-03-23
Health
F0947
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
D
2023-05-05
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
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
18
Owner
Role
Pct
From
Status
Source
RATLIFF, EMMAGENE
5% OR GREATER INDIRECT OWNERSHIP INTEREST
100%
2019-02-13
current
pecos_ownership
CHOICE REHABILITATION LLC
ADP OF THE SNF
—
2025-02-24
current
pecos_ownership
FORVIS MAZARS LLP
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-14
current
pecos_ownership
PALEN, JAMES
ADP OF THE SNF
—
2025-01-14
current
pecos_ownership
RATLIFF ENTERPRISES LLC
5% OR GREATER DIRECT OWNERSHIP INTEREST
—
1999-12-31
current
pecos_ownership
RATLIFF ENTERPRISES LLC
ADP OF THE SNF
—
2025-01-14
current
pecos_ownership
RATLIFF REVOCABLE TRUST
ADP OF THE SNF
—
2019-02-13
current
pecos_ownership
RATLIFF REVOCABLE TRUST
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-14
current
pecos_ownership
RATLIFF, EMMAGENE
ADP OF THE SNF
—
2024-03-19
current
pecos_ownership
RATLIFF, MICHAEL
ADP OF THE SNF
—
2025-01-14
current
pecos_ownership
STRICKLAND, CHERYL
OPERATIONAL/MANAGERIAL CONTROL
—
2025-02-24
current
pecos_ownership
SWINDLE, AFTAN
ADP OF THE SNF
—
2025-01-14
current
pecos_ownership
EMMAGENE RATLIFF
5% OR GREATER INDIRECT OWNERSHIP INTEREST
100%
2019-02-13
ended 2026-05-18
pecos_ownership
AFTAN SWINDLE
ADP OF THE SNF
—
2025-01-14
ended 2026-05-18
pecos_ownership
CHERYL STRICKLAND
ADP OF THE SNF
—
2025-02-24
ended 2026-05-18
pecos_ownership
EMMAGENE RATLIFF
ADP OF THE SNF
—
2024-03-19
ended 2026-05-18
pecos_ownership
JAMES PALEN
ADP OF THE SNF
—
2025-01-14
ended 2026-05-18
pecos_ownership
MICHAEL RATLIFF
ADP OF THE SNF
—
2025-01-14
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
$321,811
$98,516
—
—
$223,295
4
—
2023-12-31
$120,708
$120,708
—
—
—
1
—
2022-12-31
$130,858
$114,077
—
—
—
2
—
2021-12-31
$126,040
$96,319
—
—
—
3
—
2020-12-31
$119,087
$87,138
—
—
—
2
—
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 29031
acs median gross
0
$702
2024-12-31
CENSUS_ACS5
county 29031
fmr
0
$763
2025-10-01
HUD_USER_FMR
county 29031
acs median gross
1
$694
2024-12-31
CENSUS_ACS5
county 29031
fmr
1
$807
2025-10-01
HUD_USER_FMR
county 29031
acs median gross
2
$873
2024-12-31
CENSUS_ACS5
county 29031
fmr
2
$992
2025-10-01
HUD_USER_FMR
county 29031
acs median gross
3
$1,197
2024-12-31
CENSUS_ACS5
county 29031
fmr
3
$1,380
2025-10-01
HUD_USER_FMR
county 29031
acs median gross
4
$1,384
2024-12-31
CENSUS_ACS5
county 29031
fmr
4
$1,664
2025-10-01
HUD_USER_FMR
county 29031
acs median gross
5
$1,770
2024-12-31
CENSUS_ACS5
county 29031
acs median gross
$881
2024-12-31
CENSUS_ACS5
county 29031
acs recent mover gross
$978
2024-12-31
CENSUS_ACS5
zcta 63701
acs median gross
0
$714
2024-12-31
CENSUS_ACS5
zcta 63701
acs median gross
1
$713
2024-12-31
CENSUS_ACS5
zcta 63701
acs median gross
2
$836
2024-12-31
CENSUS_ACS5
zcta 63701
acs median gross
3
$1,227
2024-12-31
CENSUS_ACS5
zcta 63701
acs median gross
4
$1,444
2024-12-31
CENSUS_ACS5
zcta 63701
acs median gross
5
$2,098
2024-12-31
CENSUS_ACS5
zcta 63701
acs median gross
$859
2024-12-31
CENSUS_ACS5
zcta 63701
acs recent mover gross
$894
2024-12-31
CENSUS_ACS5
zip 63701
payment standard 110
0
$858
2025-10-01
HUD_USER_SAFMR
zip 63701
payment standard 90
0
$702
2025-10-01
HUD_USER_SAFMR
zip 63701
safmr
0
$780
2025-10-01
HUD_USER_SAFMR
zip 63701
payment standard 110
1
$902
2025-10-01
HUD_USER_SAFMR
zip 63701
payment standard 90
1
$738
2025-10-01
HUD_USER_SAFMR
zip 63701
safmr
1
$820
2025-10-01
HUD_USER_SAFMR
zip 63701
payment standard 110
2
$1,111
2025-10-01
HUD_USER_SAFMR
zip 63701
payment standard 90
2
$909
2025-10-01
HUD_USER_SAFMR
zip 63701
safmr
2
$1,010
2025-10-01
HUD_USER_SAFMR
zip 63701
payment standard 110
3
$1,540
2025-10-01
HUD_USER_SAFMR
zip 63701
payment standard 90
3
$1,260
2025-10-01
HUD_USER_SAFMR
zip 63701
safmr
3
$1,400
2025-10-01
HUD_USER_SAFMR
zip 63701
payment standard 110
4
$1,859
2025-10-01
HUD_USER_SAFMR
zip 63701
payment standard 90
4
$1,521
2025-10-01
HUD_USER_SAFMR
zip 63701
safmr
4
$1,690
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.