Composite
97.9 / 100 percentile
Screener / 265331
F
FOUNTAIN CARE AT SUNSET HILLS
snfMO
10954 KENNERLY ROAD, SAINT LOUIS, MO 63128 · CCN 265331
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
166
Model
v1.2
Reads as: riskier than 97.9% 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.
Score model5ML signals1Components16CHOW radar1Distress radar1Staffing16Penalties5Deficiencies78Licensure0Ownership17Related party6Transactions1Comps12Market rent34
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 95.8 | 94.1 | 0.30 | 0.2308 | 22.11 | in index |
| staffing risk | 94.0 | 94.0 | 0.25 | 0.1923 | 18.08 | in index |
| financial risk | 75.9 | 63.6 | 0.30 | 0.2308 | 17.52 | in index |
| billing conduct | 46.7 | 38.1 | 0.30 | 0.2308 | 10.78 | in index |
| chow risk | 69.2 | 47.8 | 0.15 | 0.1154 | 7.98 | in index |
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 | 15 chains | CIBC BANK USA | 155 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.
Component scores and registry models
16| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 38.1 | B | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 45.0 | C | 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 | 50.5 | C | v0.6 | default · in composite | |
| financial risk | 63.6 | C | v0.5 | default · in composite | R18. |
| p adverse action 12m | 0.9 | — | 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 | 0.2 | — | 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 | 94.1 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 94.0 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 82.9 | 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 | 62.9 | C | 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 | 52.8 | C | 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 | 67.3 | 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 | 94.0 | 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 | 94.0 | 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 | 94.0 | 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 | 94.0 | 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. |
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.
CHOW radar — 12-month sale probability
full board →p(CHOW, 12m)
0.2%
model v0.1 · computed 2026-07-29
Percentile among SNFs
36.3
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Never sold on record | 0.00 | -1.62 | |
| Current owner tenure (years) | 6.41 | -1.22 | |
| For-profit ownership | 1.00 | +0.69 | |
| Contract staffing share | 0.48 | +0.64 | |
| Occupancy | 0.53 | +0.48 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Chain size (log) | 0.00 | -0.40 | |
| Ownership changes, last 5 years | 0.00 | +0.20 |
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.
Distress radar — 12-month termination probability
full board →p(termination, 12m)
0.9%
model v0.1 · computed 2026-07-29
Percentile among SNFs
85.1
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Chain size (log) | 0.00 | +1.20 | |
| Occupancy | 0.53 | +0.92 | |
| Deficiencies, last 12 months | 3.00 | +0.87 | |
| For-profit ownership | 1.00 | -0.69 | |
| Contract staffing share | 0.48 | +0.43 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Total nurse staffing (HPRD) | 2.37 | +0.36 | |
| Never sold on record | 0.00 | -0.28 |
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 | MO median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 2.37 | 2.41 | 3.28 | 2.90–3.77 |
| RN | 0.07 | 0.25 | 0.39 | 0.25–0.58 |
| Weekend total | 2.37 | 2.24 | 3.11 | — |
| Weekday total | 2.37 | 2.49 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 88.1 | 2.37 | 0.07 | 0.58 | 1.71 | 2.37 | 47.8% |
| 2025Q3 | 92 | 88.2 | 2.46 | 0.07 | 0.66 | 1.72 | 2.46 | 49.3% |
| 2025Q2 | 91 | 93.7 | 2.54 | 0.09 | 0.65 | 1.80 | 2.56 | 42.4% |
| 2025Q1 | 90 | 94.4 | 2.51 | 0.11 | 0.61 | 1.79 | 2.40 | 44.0% |
| 2024Q4 | 92 | 99.2 | 2.50 | 0.12 | 0.63 | 1.75 | 2.55 | 43.9% |
| 2024Q3 | 92 | 97.0 | 2.45 | 0.10 | 0.65 | 1.70 | 2.29 | 45.0% |
| 2024Q2 | 91 | 92.2 | 2.50 | 0.14 | 0.81 | 1.56 | 2.45 | 58.7% |
| 2024Q1 | 91 | 93.9 | 2.36 | 0.17 | 0.65 | 1.53 | 2.28 | 44.1% |
| 2023Q4 | 92 | 98.7 | 2.35 | 0.14 | 0.60 | 1.61 | 2.29 | 43.1% |
| 2023Q3 | 92 | 95.2 | 2.36 | 0.10 | 0.67 | 1.60 | 2.33 | 37.3% |
| 2023Q2 | 91 | 93.8 | 2.52 | 0.12 | 0.61 | 1.79 | 2.45 | 38.5% |
| 2023Q1 | 90 | 91.9 | 2.36 | 0.12 | 0.44 | 1.80 | 2.29 | 40.7% |
| 2022Q4 | 92 | 93.7 | 1.62 | 0.18 | 0.30 | 1.14 | 1.57 | 49.0% |
| 2022Q3 | 92 | 101.8 | 2.57 | 0.18 | 0.77 | 1.62 | 2.40 | 64.7% |
| 2022Q2 | 91 | 98.4 | 2.37 | 0.05 | 0.68 | 1.63 | 2.15 | 63.3% |
| 2022Q1 | 90 | 100.3 | 2.37 | 0.06 | 0.69 | 1.62 | 2.22 | 56.5% |
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
5fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2024-10-21 | Fine | $57,899 | CMS provider data |
| 2024-10-21 | Payment Denial | — | CMS provider data |
| 2024-07-23 | Fine | $33,248 | CMS provider data |
| 2023-12-22 | Fine | $14,518 | CMS provider data |
| 2023-08-10 | Fine | $13,923 | CMS provider data |
Total fines on record: $119,588
Deficiencies
78C × 3D × 38E × 23F × 8G × 3J × 3
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-01-27 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2026-02-26 |
| 2026-01-27 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2026-02-26 |
| 2026-01-27 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | 2026-02-26 |
| 2025-04-24 | Health | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | D | 2025-06-08 |
| 2025-04-24 | Health | F0577 | Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. | C | 2025-06-08 |
| 2025-04-24 | Health · complaint | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | 2025-06-08 |
| 2025-04-24 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-06-08 |
| 2025-04-24 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2025-06-08 |
| 2025-04-24 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2025-06-08 |
| 2025-04-24 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2025-06-08 |
| 2025-04-24 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | D | 2025-06-08 |
| 2025-04-24 | Health | F0809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | D | 2025-06-08 |
| 2025-04-24 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2025-06-05 |
| 2025-04-24 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2025-06-08 |
| 2025-04-24 | Health | F0919 | Make sure that a working call system is available in each resident's bathroom and bathing area. | D | 2025-06-08 |
| 2025-01-17 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | 2025-02-26 |
| 2024-12-03 | Health · complaint | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | 2024-12-09 |
| 2024-12-03 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-12-09 |
| 2024-10-21 | Health · complaint | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | 2024-12-09 |
| 2024-10-21 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-12-09 |
| 2024-10-21 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | 2025-02-26 |
| 2024-10-21 | Health · complaint | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2024-12-03 |
| 2024-07-23 | Health · complaint | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | D | 2024-07-10 |
| 2024-07-23 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | 2024-08-19 |
| 2024-02-20 | Health · complaint | F0622 | Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | D | 2024-03-19 |
| 2024-01-04 | Health · complaint | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | 2024-02-17 |
| 2024-01-04 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-02-17 |
| 2023-12-22 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | 2023-12-17 |
| 2023-11-27 | Health · complaint | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | D | 2023-12-01 |
| 2023-11-27 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-12-01 |
| 2023-10-13 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2023-11-24 |
| 2023-10-13 | Health · complaint | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | 2023-11-24 |
| 2023-10-13 | Health · complaint | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | D | 2023-12-01 |
| 2023-10-13 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-12-01 |
| 2023-10-13 | Health | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | C | 2023-11-24 |
| 2023-10-13 | 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. | C | 2023-11-24 |
| 2023-10-13 | Health | F0637 | Assess the resident when there is a significant change in condition | D | 2023-11-24 |
| 2023-10-13 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2023-11-24 |
| 2023-10-13 | 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 | 2023-11-24 |
| 2023-10-13 | Health | F0661 | Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | D | 2023-11-24 |
| 2023-10-13 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2023-11-24 |
| 2023-10-13 | Health | 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. | F | 2023-11-24 |
| 2023-10-13 | 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. | F | 2023-11-24 |
| 2023-10-13 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2023-11-24 |
| 2023-10-13 | Health · complaint | F0814 | Dispose of garbage and refuse properly. | F | 2023-11-24 |
| 2023-10-13 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2023-11-24 |
| 2023-10-13 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2023-12-01 |
| 2023-08-10 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | 2023-08-16 |
| 2023-08-10 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-08-16 |
| 2023-08-10 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2023-08-16 |
| 2023-08-10 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | G | 2023-08-16 |
| 2020-09-28 | Health | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2020-11-06 |
| 2020-09-28 | Health | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | D | 2020-12-17 |
| 2020-09-28 | Health | F0568 | Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. | E | 2020-11-06 |
| 2020-09-28 | Health | F0569 | Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. | E | 2020-11-06 |
| 2020-09-28 | 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. | E | 2020-11-06 |
| 2020-09-28 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | E | 2020-11-06 |
| 2020-09-28 | Health | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | 2020-12-17 |
| 2020-09-28 | Health | F0620 | Not require residents to give up Medicare or Medicaid benefits, or pay privately as a condition of admission; and must tell residents what care they do not provide. | E | 2020-11-06 |
| 2020-09-28 | Health | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | E | 2020-11-06 |
| 2020-09-28 | Health | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | 2020-11-06 |
| 2020-09-28 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | E | 2020-11-06 |
| 2020-09-28 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | 2020-12-17 |
| 2020-09-28 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2020-11-06 |
| 2020-09-28 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2020-12-17 |
| 2020-09-28 | Health | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | E | 2020-12-17 |
| 2020-09-28 | 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. | F | 2020-11-06 |
| 2020-09-28 | Health | F0730 | Observe each nurse aide's job performance and give regular training. | F | 2020-11-06 |
| 2020-09-28 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2020-11-06 |
| 2020-09-28 | Health | F0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | E | 2020-11-06 |
| 2020-09-28 | 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. | E | 2020-12-17 |
| 2020-09-28 | 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 | 2020-12-17 |
| 2020-09-28 | Health | F0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | 2020-11-06 |
| 2020-09-28 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2020-12-17 |
| 2020-09-28 | 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. | F | 2020-11-06 |
| 2020-09-28 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2020-11-06 |
| 2020-09-28 | 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 | 2020-11-06 |
| 2020-09-28 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2020-12-17 |
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
0No 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
17| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| CHESTNUT HOLDINGS GROUP LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2020-03-01 | current | pecos_ownership |
| CHESTNUT REALTY LLC | Individual has financial interest in both related organization and provider | 100% | 2024-01-01 | current | hcris_a_8_1 |
| CHESTNUT REALTY LLC | Individual has financial interest in both related organization and provider | 100% | 2023-01-01 | current | hcris_a_8_1 |
| BRECHER, MENDEL | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 65% | 2020-03-01 | current | pecos_ownership |
| ANDERSON, DENNIS | W-2 MANAGING EMPLOYEE | — | 2020-03-01 | current | pecos_ownership |
| CIBC BANK USA | 5% OR GREATER SECURITY INTEREST | — | 2020-03-01 | current | pecos_ownership |
| LICHTMAN, CHANA | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2020-03-01 | current | pecos_ownership |
| SCHUETTLER, MELISSA | W-2 MANAGING EMPLOYEE | — | 2020-03-01 | current | pecos_ownership |
| ZIMMERMAN, JACOB | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2020-03-01 | current | pecos_ownership |
| CHESTNUT REALTY LLC | Individual has financial interest in both related organization and provider | 100% | 2022-01-01 | ended 2022-12-31 | hcris_a_8_1 |
| MENDEL BRECHER | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 65% | 2020-03-01 | ended 2026-05-18 | pecos_ownership |
| BLUE CIRCLE REALTY LLC | Director, officer, administrator or key person of provider or organization | — | 2020-03-01 | ended 2020-12-31 | hcris_a_8_1 |
| CHANA LICHTMAN | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2020-03-01 | ended 2026-05-18 | pecos_ownership |
| CHESTNUT REALTY LLC | Director, officer, administrator or key person of provider or organization | — | 2021-01-01 | ended 2021-12-31 | hcris_a_8_1 |
| DENNIS ANDERSON | W-2 MANAGING EMPLOYEE | — | 2020-03-01 | ended 2026-05-18 | pecos_ownership |
| JACOB ZIMMERMAN | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2020-03-01 | ended 2026-05-18 | pecos_ownership |
| MELISSA SCHUETTLER | W-2 MANAGING EMPLOYEE | — | 2020-03-01 | 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.
Transactions
1| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2020-03-01 | — | CHESTNUT REHAB AND NURSING LLC | THI OF MISSOURI AT GRAVOIS, LLC | chow |
Comparable trades — MO snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-10-01 | AVENIR AT MAPLE GROVE | — | — | — | 90 | NBH2 MGOPCO LLC |
| 2025-10-01 | AVENIR AT MARK TWAIN | — | — | — | 120 | NBH1 MTOPCO LLC |
| 2025-10-01 | ARBOR HILLS CARE & REHAB CENTER | — | — | — | 150 | ARBOR HILLS HEALTHCARE, LLC |
| 2025-10-01 | ASCEND AT AURORA | — | — | — | 125 | NBH3 SFOPCO LLC |
| 2025-09-01 | HUBBLE CREEK | — | — | — | 105 | HUBBLE CREEK LLC |
| 2025-08-01 | HIDDEN LAKE HEALTH CARE CENTER | — | — | — | 67 | HIDDEN LAKE HEALTH CARE CENTER, LLC |
| 2025-05-01 | PINE GROVE MANOR | — | — | — | 77 | PINE GROVE MANOR LLC |
| 2025-05-01 | MONARCH SPRINGS WELLNESS & REHABILITATION | — | — | — | 119 | MONARCH SPRINGS WELLNESS & REHABILITATION LLC |
| 2025-05-01 | ASPIRE SENIOR LIVING NEW FLORENCE | — | — | — | 87 | ASPIRE SENIOR LIVING NEW FLORENCE LLC |
| 2025-04-01 | SOUTH COUNTY HEALTH CARE CENTER | — | — | — | 153 | SOUTH COUNTY HEALTH CARE CENTER, L.L.C. |
| 2025-02-01 | ARBOR VIEW NURSING AND REHABILITATION | — | — | — | 150 | FORREST OPCO LLC |
| 2025-02-01 | AMBERWOOD ESTATES NURSING AND REHABILITATION | — | — | — | 115 | ISLAND HC OPERATIONS LLC |
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
34| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 29189 | acs median gross | 0 | $1,067 | 2024-12-31 | CENSUS_ACS5 |
| county 29189 | fmr | 0 | $955 | 2025-10-01 | HUD_USER_FMR |
| county 29189 | acs median gross | 1 | $995 | 2024-12-31 | CENSUS_ACS5 |
| county 29189 | fmr | 1 | $995 | 2025-10-01 | HUD_USER_FMR |
| county 29189 | acs median gross | 2 | $1,216 | 2024-12-31 | CENSUS_ACS5 |
| county 29189 | fmr | 2 | $1,218 | 2025-10-01 | HUD_USER_FMR |
| county 29189 | acs median gross | 3 | $1,446 | 2024-12-31 | CENSUS_ACS5 |
| county 29189 | fmr | 3 | $1,568 | 2025-10-01 | HUD_USER_FMR |
| county 29189 | acs median gross | 4 | $1,742 | 2024-12-31 | CENSUS_ACS5 |
| county 29189 | fmr | 4 | $1,812 | 2025-10-01 | HUD_USER_FMR |
| county 29189 | acs median gross | 5 | $1,850 | 2024-12-31 | CENSUS_ACS5 |
| county 29189 | acs median gross | $1,209 | 2024-12-31 | CENSUS_ACS5 | |
| county 29189 | acs recent mover gross | $1,369 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 63128 | acs median gross | 0 | $1,106 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63128 | acs median gross | 1 | $1,118 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63128 | acs median gross | 2 | $1,207 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63128 | acs median gross | 4 | $2,464 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63128 | acs median gross | $1,193 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 63128 | acs recent mover gross | $1,463 | 2024-12-31 | CENSUS_ACS5 | |
| zip 63128 | payment standard 110 | 0 | $1,056 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | payment standard 90 | 0 | $864 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | safmr | 0 | $960 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | payment standard 110 | 1 | $1,100 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | payment standard 90 | 1 | $900 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | safmr | 1 | $1,000 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | payment standard 110 | 2 | $1,342 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | payment standard 90 | 2 | $1,098 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | safmr | 2 | $1,220 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | payment standard 110 | 3 | $1,727 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | payment standard 90 | 3 | $1,413 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | safmr | 3 | $1,570 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | payment standard 110 | 4 | $1,991 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | payment standard 90 | 4 | $1,629 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63128 | safmr | 4 | $1,810 | 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.