Reads as: riskier than 57.1% 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
2
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet enforcement cluster
80% fined
WEST NC HOLDINGS LLC
5 facilities
connection
Owner fleet enforcement cluster
50% fined
ALTER TZVI
22 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
16
2025Q4 HPRD
This facility
NC median
National median
National p25–p75
Total nurse
3.10
3.08
3.28
2.90–3.77
RN
0.16
0.30
0.39
0.25–0.58
Weekend total
2.99
2.93
3.11
—
Weekday total
3.14
3.14
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
78.3
3.10
0.16
0.95
1.99
2.99
0.1%
2025Q3
92
81.6
3.10
0.14
0.94
2.02
2.98
2.1%
2025Q2
91
82.5
3.08
0.11
0.96
2.00
2.91
8.4%
2025Q1
90
84.5
2.88
0.16
0.88
1.85
2.67
9.1%
2024Q4
92
78.6
3.04
0.26
0.89
1.90
2.75
14.0%
2024Q3
92
74.2
3.22
0.24
0.94
2.04
2.84
10.5%
2024Q2
91
80.0
2.69
0.16
0.78
1.75
2.32
7.4%
2024Q1
91
78.8
2.80
0.16
0.90
1.75
2.58
3.6%
2023Q4
92
75.5
2.83
0.05
1.04
1.74
2.68
17.3%
2023Q3
92
76.1
2.77
0.04
0.89
1.84
2.86
28.6%
2023Q2
91
80.2
2.53
0.06
0.89
1.57
2.30
37.1%
2023Q1
90
79.0
2.54
0.07
0.92
1.55
2.49
31.2%
2022Q4
92
75.8
2.66
0.08
0.99
1.60
2.73
44.0%
2022Q3
92
76.5
2.46
0.10
0.79
1.57
2.40
45.1%
2022Q2
91
77.6
2.27
0.16
0.62
1.49
2.03
32.1%
2022Q1
90
79.1
1.72
0.11
0.54
1.07
1.40
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.
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
G
2025-02-26
2025-08-01
Health
F0641
Ensure each resident receives an accurate assessment.
B
2025-08-16
2025-08-01
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
G
2025-08-16
2024-05-17
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
J
2024-06-05
2024-05-17
Health · complaint
F0602
Protect each resident from the wrongful use of the resident's belongings or money.
E
2024-03-02
2024-05-17
Health · complaint
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
J
2024-06-05
2024-05-17
Health · complaint
F0623
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
B
2024-06-05
2024-05-17
Health
F0640
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
B
2024-06-05
2024-05-17
Health
F0641
Ensure each resident receives an accurate assessment.
B
2024-06-05
2024-05-17
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
2024-06-05
2024-05-17
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.
B
2024-06-05
2024-05-17
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-06-05
2024-05-17
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2024-06-05
2024-05-17
Health
F0867
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
D
2024-06-05
2023-02-23
Health
F0554
Allow residents to self-administer drugs if determined clinically appropriate.
D
2023-03-23
2023-02-23
Health
F0565
Honor the resident's right to organize and participate in resident/family groups in the facility.
E
2023-03-23
2023-02-23
Health
F0637
Assess the resident when there is a significant change in condition
D
2023-03-23
2023-02-23
Health
F0640
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
B
2023-03-23
2023-02-23
Health
F0641
Ensure each resident receives an accurate assessment.
D
2023-03-23
2023-02-23
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.
E
2023-03-23
2023-02-23
Health
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2023-03-23
2023-02-23
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
E
2023-03-23
2023-02-23
Health
F0679
Provide activities to meet all resident's needs.
E
2023-03-23
2023-02-23
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2023-03-23
2023-02-23
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
2023-03-23
2023-02-23
Health
F0730
Observe each nurse aide's job performance and give regular training.
B
2023-03-23
2023-02-23
Health
F0732
Post nurse staffing information every day.
C
2023-03-23
2023-02-23
Health
F0867
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
E
2023-03-23
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
12
Owner
Role
Pct
From
Status
Source
RAMSEUR HOLDINGS I LLC
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2024-06-01
current
pecos_ownership
ALTER, TZVI
5% OR GREATER INDIRECT OWNERSHIP INTEREST
—
2024-06-01
current
pecos_ownership
CARTER, ALYSSA
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
current
pecos_ownership
CARTER, ALYSSA
ADP OF THE SNF
—
2025-03-27
current
pecos_ownership
SHETH, ANOOP
ADP OF THE SNF
—
2025-03-27
current
pecos_ownership
SHETH, ANOOP
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
current
pecos_ownership
WEST NC HOLDINGS LLC
5% OR GREATER INDIRECT OWNERSHIP INTEREST
—
2024-06-01
current
pecos_ownership
TZVI ALTER
5% OR GREATER INDIRECT OWNERSHIP INTEREST
100%
2024-06-01
ended 2026-05-18
pecos_ownership
ALYSSA CARTER
ADP OF THE SNF
—
2025-03-27
ended 2026-05-18
pecos_ownership
ALYSSA CARTER
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
ended 2026-05-18
pecos_ownership
ANOOP SHETH
ADP OF THE SNF
—
2025-03-27
ended 2026-05-18
pecos_ownership
ANOOP SHETH
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
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
6
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-09-30
$126,129
—
$126,129
—
—
1
—
2024-05-31
$905,000
—
$381,723
$2,841
$7,705
30
—
2023-12-31
$1,456,791
—
—
$7,542
$125,696
25
—
2022-12-31
$1,213,840
—
—
$6,311
$321,298
25
—
2021-12-31
$1,122,716
—
$327,657
$11,649
$14,587
30
—
2020-12-31
$1,119,307
—
$358,692
$5,427
$14,413
24
—
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
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
33
Geo
Kind
BR
Amount
As of
Source
county 37151
acs median gross
0
$827
2024-12-31
CENSUS_ACS5
county 37151
fmr
0
$1,159
2025-10-01
HUD_USER_FMR
county 37151
acs median gross
1
$642
2024-12-31
CENSUS_ACS5
county 37151
fmr
1
$1,213
2025-10-01
HUD_USER_FMR
county 37151
acs median gross
2
$856
2024-12-31
CENSUS_ACS5
county 37151
fmr
2
$1,330
2025-10-01
HUD_USER_FMR
county 37151
acs median gross
3
$1,044
2024-12-31
CENSUS_ACS5
county 37151
fmr
3
$1,703
2025-10-01
HUD_USER_FMR
county 37151
acs median gross
4
$1,403
2024-12-31
CENSUS_ACS5
county 37151
fmr
4
$1,960
2025-10-01
HUD_USER_FMR
county 37151
acs median gross
5
$1,189
2024-12-31
CENSUS_ACS5
county 37151
acs median gross
$887
2024-12-31
CENSUS_ACS5
county 37151
acs recent mover gross
$960
2024-12-31
CENSUS_ACS5
zcta 27316
acs median gross
1
$420
2024-12-31
CENSUS_ACS5
zcta 27316
acs median gross
2
$683
2024-12-31
CENSUS_ACS5
zcta 27316
acs median gross
3
$1,083
2024-12-31
CENSUS_ACS5
zcta 27316
acs median gross
$777
2024-12-31
CENSUS_ACS5
zcta 27316
acs recent mover gross
$752
2024-12-31
CENSUS_ACS5
zip 27316
payment standard 110
0
$1,001
2025-10-01
HUD_USER_SAFMR
zip 27316
payment standard 90
0
$819
2025-10-01
HUD_USER_SAFMR
zip 27316
safmr
0
$910
2025-10-01
HUD_USER_SAFMR
zip 27316
payment standard 110
1
$1,045
2025-10-01
HUD_USER_SAFMR
zip 27316
payment standard 90
1
$855
2025-10-01
HUD_USER_SAFMR
zip 27316
safmr
1
$950
2025-10-01
HUD_USER_SAFMR
zip 27316
payment standard 110
2
$1,144
2025-10-01
HUD_USER_SAFMR
zip 27316
payment standard 90
2
$936
2025-10-01
HUD_USER_SAFMR
zip 27316
safmr
2
$1,040
2025-10-01
HUD_USER_SAFMR
zip 27316
payment standard 110
3
$1,463
2025-10-01
HUD_USER_SAFMR
zip 27316
payment standard 90
3
$1,197
2025-10-01
HUD_USER_SAFMR
zip 27316
safmr
3
$1,330
2025-10-01
HUD_USER_SAFMR
zip 27316
payment standard 110
4
$1,683
2025-10-01
HUD_USER_SAFMR
zip 27316
payment standard 90
4
$1,377
2025-10-01
HUD_USER_SAFMR
zip 27316
safmr
4
$1,530
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.