Composite
86.0 / 100 percentile
| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 90.1 | 87.7 | 0.30 | 0.2308 | 20.79 | in index |
| financial risk | 83.6 | 70.3 | 0.30 | 0.2308 | 19.29 | in index |
| staffing risk | 87.7 | 87.7 | 0.25 | 0.1923 | 16.87 | in index |
| chow risk | 60.1 | 58.7 | 0.15 | 0.1154 | 6.93 | in index |
| billing conduct | 0.0 | 0.0 | 0.30 | 0.2308 | 0.00 | in index |
| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 0.0 | A | 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 | 92.3 | F | v0.6 | default · in composite | |
| financial risk | 70.3 | D | v0.5 | default · in composite | R18. |
| p adverse action 12m | 0.6 | — | 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 | 0.0 | — | 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 | 87.7 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 87.7 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 87.7 | F | 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 | 67.7 | D | 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 | 68.9 | D | 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 | 69.7 | D | 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 | 87.6 | 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 | 87.6 | 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 | 87.7 | F | 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 | 87.7 | F | 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 | |
|---|---|---|---|
| Current owner tenure (years) | 1.49 | -1.70 | |
| Never sold on record | 0.00 | -1.62 | |
| Ownership changes, last 5 years | 1.00 | -0.87 | |
| For-profit ownership | 1.00 | +0.69 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Chain size (log) | 0.00 | -0.40 | |
| Deficiencies, last 12 months | 3.00 | -0.10 | |
| Contract staffing share | 0.00 | -0.10 |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Chain size (log) | 0.00 | +1.20 | |
| Deficiencies, last 12 months | 3.00 | +0.87 | |
| For-profit ownership | 1.00 | -0.69 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Never sold on record | 0.00 | -0.28 | |
| Current owner tenure (years) | 1.49 | -0.28 | |
| Staffing trend, last 4 quarters | 0.63 | +0.27 | |
| Total nurse staffing (HPRD) | 2.60 | +0.26 |
| 2025Q4 HPRD | This facility | IA median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 2.60 | 3.15 | 3.28 | 2.90–3.77 |
| RN | 0.49 | 0.46 | 0.39 | 0.25–0.58 |
| Weekend total | 2.38 | 2.96 | 3.11 | — |
| Weekday total | 2.69 | 3.20 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 28.8 | 2.60 | 0.49 | 0.33 | 1.78 | 2.38 | 0.0% |
| 2025Q3 | 92 | 28.4 | 2.38 | 0.50 | 0.37 | 1.50 | 2.11 | 1.2% |
| 2025Q2 | 91 | 27.1 | 2.12 | 0.47 | 0.42 | 1.23 | 1.76 | 0.0% |
| 2025Q1 | 90 | 25.6 | 2.35 | 0.60 | 0.42 | 1.33 | 2.28 | 0.9% |
| 2024Q4 | 92 | 26.5 | 1.97 | 0.63 | 0.31 | 1.03 | 1.94 | 24.5% |
| 2024Q3 | 92 | 27.8 | 1.77 | 0.45 | 0.41 | 0.91 | 1.72 | 27.8% |
| 2024Q2 | 91 | 30.7 | 1.79 | 0.35 | 0.39 | 1.05 | 1.75 | 11.6% |
| 2024Q1 | 91 | 28.7 | 1.83 | 0.41 | 0.36 | 1.06 | 1.78 | 0.3% |
| 2023Q4 | 92 | 29.2 | 1.51 | 0.34 | 0.48 | 0.70 | 1.44 | 0.0% |
| 2023Q3 | 92 | 31.3 | 1.44 | 0.36 | 0.47 | 0.61 | 1.37 | 0.0% |
| 2023Q2 | 91 | 32.4 | 1.83 | 0.32 | 0.49 | 1.02 | 1.75 | 0.0% |
| 2023Q1 | 90 | 30.4 | 1.85 | 0.25 | 0.44 | 1.16 | 1.75 | 0.0% |
| 2022Q4 | 92 | 25.1 | 2.10 | 0.36 | 0.15 | 1.58 | 2.03 | 0.0% |
| 2022Q3 | 92 | 26.3 | 2.61 | 0.36 | 0.14 | 2.11 | 2.65 | 0.0% |
| 2022Q2 | 91 | 23.2 | 2.88 | 0.44 | 0.74 | 1.69 | 2.51 | 0.0% |
| 2022Q1 | 90 | 20.9 | 2.75 | 0.31 | 0.83 | 1.61 | 2.67 | 0.0% |
| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-01-07 | Fine | $48,796 | CMS provider data |
| 2023-08-17 | Fine | $16,881 | CMS provider data |
| 2023-08-17 | Payment Denial | — | CMS provider data |
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-01-08 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2026-01-15 |
| 2026-01-08 | Health | F0851 | Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. | F | 2026-01-15 |
| 2025-11-20 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-08-27 |
| 2025-01-07 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | J | 2025-01-14 |
| 2024-11-07 | 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 | 2024-11-26 |
| 2024-11-07 | 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. | B | 2024-11-26 |
| 2024-11-07 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2024-11-26 |
| 2024-11-07 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-11-26 |
| 2024-11-07 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-11-26 |
| 2024-11-07 | 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 | 2024-11-26 |
| 2024-11-07 | 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 | 2024-11-26 |
| 2024-11-07 | Health · complaint | F0727 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | E | 2024-11-26 |
| 2024-11-07 | 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 | 2024-11-26 |
| 2024-11-07 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2024-11-26 |
| 2024-11-07 | Health | F0835 | Administer the facility in a manner that enables it to use its resources effectively and efficiently. | D | 2024-11-26 |
| 2024-11-07 | Health | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | D | 2024-11-26 |
| 2024-08-27 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | 2024-09-20 |
| 2024-08-01 | 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. | F | 2024-08-31 |
| 2024-08-01 | Health · complaint | 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 | 2024-08-31 |
| 2024-08-01 | Health · complaint | F0803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | F | 2024-08-31 |
| 2024-08-01 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-08-31 |
| 2023-08-17 | 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 | 2023-09-12 |
| 2023-08-17 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | K | 2023-09-12 |
| 2023-08-17 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2023-09-12 |
| 2023-08-17 | 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 | 2023-09-12 |
| 2023-08-17 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2023-09-12 |
| 2023-08-17 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | K | 2023-09-12 |
| 2023-08-17 | Health · complaint | 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 | 2023-09-12 |
| 2023-08-17 | Health · complaint | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2023-09-12 |
| 2023-08-17 | Health · complaint | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | D | 2023-09-12 |
| 2023-08-17 | Health | F0726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | D | 2023-09-12 |
| 2023-08-17 | 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 | 2023-09-12 |
| 2023-08-17 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2023-09-12 |
| 2023-08-17 | Health | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | D | 2023-09-12 |
| 2023-08-17 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2023-10-16 |
| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| DOLE, ISAAC | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-02-01 | current | pecos_ownership |
| ISAAC DOLE | INDIRECT OWNERSHIP INTEREST | 100% | 2025-02-01 | ended 2026-05-18 | pecos_ownership |
| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2025-02-01 | — | OPCO GRUNDY CENTER IA LLC | PREMIER ESTATES 504, LLC | chow |
| 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 Centerthis facility | — | — | — | 40 | OPCO GRUNDY CENTER IA LLC |
| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 19075 | acs median gross | 0 | $625 | 2024-12-31 | CENSUS_ACS5 |
| county 19075 | fmr | 0 | $725 | 2025-10-01 | HUD_USER_FMR |
| county 19075 | acs median gross | 1 | $589 | 2024-12-31 | CENSUS_ACS5 |
| county 19075 | fmr | 1 | $801 | 2025-10-01 | HUD_USER_FMR |
| county 19075 | acs median gross | 2 | $771 | 2024-12-31 | CENSUS_ACS5 |
| county 19075 | fmr | 2 | $1,051 | 2025-10-01 | HUD_USER_FMR |
| county 19075 | acs median gross | 3 | $777 | 2024-12-31 | CENSUS_ACS5 |
| county 19075 | fmr | 3 | $1,357 | 2025-10-01 | HUD_USER_FMR |
| county 19075 | acs median gross | 4 | $1,601 | 2024-12-31 | CENSUS_ACS5 |
| county 19075 | fmr | 4 | $1,763 | 2025-10-01 | HUD_USER_FMR |
| county 19075 | acs median gross | 5 | $947 | 2024-12-31 | CENSUS_ACS5 |
| county 19075 | acs median gross | $774 | 2024-12-31 | CENSUS_ACS5 | |
| county 19075 | acs recent mover gross | $638 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 50638 | acs median gross | 1 | $213 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50638 | acs median gross | 2 | $738 | 2024-12-31 | CENSUS_ACS5 |
| zip 50638 | payment standard 110 | 0 | $693 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | payment standard 90 | 0 | $567 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | safmr | 0 | $630 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | payment standard 110 | 1 | $770 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | payment standard 90 | 1 | $630 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | safmr | 1 | $700 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | payment standard 110 | 2 | $1,012 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | payment standard 90 | 2 | $828 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | safmr | 2 | $920 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | payment standard 110 | 3 | $1,309 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | payment standard 90 | 3 | $1,071 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | safmr | 3 | $1,190 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | payment standard 110 | 4 | $1,694 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | payment standard 90 | 4 | $1,386 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50638 | safmr | 4 | $1,540 | 2025-10-01 | HUD_USER_SAFMR |