Reads as: riskier than 22.6% 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.
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
4.61
3.62
3.28
2.90–3.77
RN
0.74
0.64
0.39
0.25–0.58
Weekend total
4.18
3.46
3.11
—
Weekday total
4.78
3.68
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
38.8
4.61
0.74
0.86
3.01
4.18
0.0%
2025Q3
92
40.6
4.51
0.58
0.97
2.97
4.37
2.3%
2025Q2
91
41.5
4.19
0.58
0.84
2.76
4.00
1.8%
2025Q1
90
41.6
4.32
0.64
0.78
2.90
4.03
0.5%
2024Q4
92
41.7
4.18
0.59
0.80
2.79
3.91
0.4%
2024Q3
92
41.7
4.26
0.75
0.82
2.70
3.89
0.4%
2024Q2
91
41.8
4.35
0.65
0.89
2.81
3.84
0.4%
2024Q1
91
41.7
4.37
0.59
1.09
2.69
4.13
0.0%
2023Q4
92
41.8
4.17
0.70
0.86
2.61
3.62
1.2%
2023Q3
92
41.7
4.52
1.13
0.61
2.78
3.96
0.0%
2023Q2
91
41.6
4.33
0.93
0.69
2.72
3.65
0.0%
2023Q1
90
42.4
4.10
0.73
0.69
2.68
3.64
0.0%
2022Q4
92
41.8
3.37
0.69
0.48
2.19
3.15
5.2%
2022Q3
92
41.6
3.43
0.68
0.61
2.15
3.02
5.6%
2022Q2
91
41.6
3.52
0.62
0.76
2.14
3.24
1.2%
2022Q1
90
41.7
3.92
0.65
0.93
2.34
3.57
2.8%
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
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
18
D × 17E × 1
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2025-11-20
Health
F0655
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
D
2026-01-04
2025-11-20
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
2026-01-04
2025-11-20
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2026-01-04
2025-11-20
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
2026-01-04
2025-11-20
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
2026-01-04
2025-11-20
Health
F0838
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
D
2026-01-04
2025-11-20
Health
F0908
Keep all essential equipment working safely.
D
2026-01-04
2024-10-31
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-12-01
2024-10-31
Health
F0730
Observe each nurse aide's job performance and give regular training.
D
2024-12-01
2024-10-31
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
2024-12-01
2023-11-30
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2024-01-12
2023-11-30
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-01-12
2023-11-30
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
2024-01-12
2023-11-30
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2024-01-12
2023-11-30
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2024-01-12
2023-11-30
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
2024-01-12
2023-11-30
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
2024-01-12
2023-11-30
Health
F0880
Provide and implement an infection prevention and control program.
E
2024-01-12
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
24
Owner
Role
Pct
From
Status
Source
NEW AHC HOLDINGS, LLC
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2021-01-01
current
pecos_ownership
THE GAIL MILLER GST TRUST
5% OR GREATER INDIRECT OWNERSHIP INTEREST
72%
2024-01-01
current
pecos_ownership
HOPKINS, DOUGLAS
ADP OF THE SNF
—
2025-05-01
current
pecos_ownership
HOPKINS, DOUGLAS
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-13
current
pecos_ownership
LHMSH LLC
ADP OF THE SNF
—
2024-01-01
current
pecos_ownership
MAUL, MARY
ADP OF THE SNF
—
2025-05-01
current
pecos_ownership
NEW AHC HOLDINGS, LLC
ADP OF THE SNF
—
2025-05-01
current
pecos_ownership
OXNAM, NATHAN
CORPORATE OFFICER
—
2024-01-01
current
pecos_ownership
RENO RP SNF LLC
Corporation, partnership or other organization has financial interest in provider
—
2024-01-01
current
hcris_a_8_1
RENO RP SNF LLC
Corporation, partnership or other organization has financial interest in provider
—
2023-01-01
current
hcris_a_8_1
THE BRYAN MILLER UTAH DYNASTY TRUST DATED APRIL 22, 2014
INDIRECT OWNERSHIP INTEREST
—
2024-01-01
current
pecos_ownership
THE G&H MILLER UTAH TRUST DATED FEBRUARY 26, 2019
INDIRECT OWNERSHIP INTEREST
—
2024-01-01
current
pecos_ownership
ADVANCED HEALTH CARE - LARRY H MILLER CORPORATION
5% OR GREATER INDIRECT OWNERSHIP INTEREST
100%
2021-01-01
ended 2026-05-18
pecos_ownership
RENO RP SNF LLC
Corporation, partnership or other organization has financial interest in provider
100%
2021-01-01
ended 2021-12-31
hcris_a_8_1
KAREN GAIL MILLER IRREV TR FBO ZANE MILLER
5% OR GREATER INDIRECT OWNERSHIP INTEREST
5%
2024-01-01
ended 2026-05-18
pecos_ownership
THE KAREN GAIL MILLER IRREVOCABLE TRUST FOR THE BENEFIT OF KAREN R. WI
5% OR GREATER INDIRECT OWNERSHIP INTEREST
5%
2024-01-01
ended 2026-05-18
pecos_ownership
THE KAREN GAIL MILLER IRREVOCABLE TRUST FOR THE BENEFIT OF ROGER L. MI
5% OR GREATER INDIRECT OWNERSHIP INTEREST
5%
2024-01-01
ended 2026-05-18
pecos_ownership
THE KAREN GAIL MILLER IRREVOCABLE TRUST FOR THE BENEFIT OF STEPHEN F.
5% OR GREATER INDIRECT OWNERSHIP INTEREST
5%
2024-01-01
ended 2026-05-18
pecos_ownership
DOUGLAS HOPKINS
ADP OF THE SNF
—
2025-05-01
ended 2026-05-18
pecos_ownership
DOUGLAS HOPKINS
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-13
ended 2026-05-18
pecos_ownership
MARY MAUL
ADP OF THE SNF
—
2025-05-01
ended 2026-05-18
pecos_ownership
NATHAN OXNAM
CORPORATE OFFICER
—
2024-01-01
ended 2026-05-18
pecos_ownership
RENO RP SNF LLC
Corporation, partnership or other organization has financial interest in provider
—
2022-01-01
ended 2022-12-31
hcris_a_8_1
RENO RP SNF LLC
Corporation, partnership or other organization has financial interest in provider
—
2020-01-01
ended 2020-12-31
hcris_a_8_1
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
$1,056,922
—
$257
—
—
2
propco
2023-12-31
$1,029,023
$516,654
$232
—
—
2
propco
2022-12-31
$1,095,108
$524,645
$-4,115
—
—
2
propco
2021-12-31
$1,170,710
—
$-17,643
—
—
2
propco
2020-12-31
$1,690,168
—
$7,197
—
—
2
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
35
Geo
Kind
BR
Amount
As of
Source
county 32031
acs median gross
0
$1,083
2024-12-31
CENSUS_ACS5
county 32031
fmr
0
$1,289
2025-10-01
HUD_USER_FMR
county 32031
acs median gross
1
$1,335
2024-12-31
CENSUS_ACS5
county 32031
fmr
1
$1,489
2025-10-01
HUD_USER_FMR
county 32031
acs median gross
2
$1,661
2024-12-31
CENSUS_ACS5
county 32031
fmr
2
$1,870
2025-10-01
HUD_USER_FMR
county 32031
acs median gross
3
$2,013
2024-12-31
CENSUS_ACS5
county 32031
fmr
3
$2,539
2025-10-01
HUD_USER_FMR
county 32031
acs median gross
4
$2,347
2024-12-31
CENSUS_ACS5
county 32031
fmr
4
$2,949
2025-10-01
HUD_USER_FMR
county 32031
acs median gross
5
$2,485
2024-12-31
CENSUS_ACS5
county 32031
acs median gross
$1,608
2024-12-31
CENSUS_ACS5
county 32031
acs recent mover gross
$1,704
2024-12-31
CENSUS_ACS5
zcta 89502
acs median gross
0
$1,150
2024-12-31
CENSUS_ACS5
zcta 89502
acs median gross
1
$1,242
2024-12-31
CENSUS_ACS5
zcta 89502
acs median gross
2
$1,467
2024-12-31
CENSUS_ACS5
zcta 89502
acs median gross
3
$1,719
2024-12-31
CENSUS_ACS5
zcta 89502
acs median gross
4
$1,994
2024-12-31
CENSUS_ACS5
zcta 89502
acs median gross
$1,361
2024-12-31
CENSUS_ACS5
zcta 89502
acs recent mover gross
$1,568
2024-12-31
CENSUS_ACS5
zip 89502
payment standard 110
0
$1,232
2025-10-01
HUD_USER_SAFMR
zip 89502
payment standard 90
0
$1,008
2025-10-01
HUD_USER_SAFMR
zip 89502
safmr
0
$1,120
2025-10-01
HUD_USER_SAFMR
zip 89502
payment standard 110
1
$1,419
2025-10-01
HUD_USER_SAFMR
zip 89502
payment standard 90
1
$1,161
2025-10-01
HUD_USER_SAFMR
zip 89502
safmr
1
$1,290
2025-10-01
HUD_USER_SAFMR
zip 89502
payment standard 110
2
$1,782
2025-10-01
HUD_USER_SAFMR
zip 89502
payment standard 90
2
$1,458
2025-10-01
HUD_USER_SAFMR
zip 89502
safmr
2
$1,620
2025-10-01
HUD_USER_SAFMR
zip 89502
payment standard 110
3
$2,420
2025-10-01
HUD_USER_SAFMR
zip 89502
payment standard 90
3
$1,980
2025-10-01
HUD_USER_SAFMR
zip 89502
safmr
3
$2,200
2025-10-01
HUD_USER_SAFMR
zip 89502
payment standard 110
4
$2,816
2025-10-01
HUD_USER_SAFMR
zip 89502
payment standard 90
4
$2,304
2025-10-01
HUD_USER_SAFMR
zip 89502
safmr
4
$2,560
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.