Reads as: riskier than 22.5% 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
16 chains
BAKER TILLY ADVISORY GROUP LP
77 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
15
2025Q4 HPRD
This facility
WV median
National median
National p25–p75
Total nurse
3.72
3.14
3.28
2.90–3.77
RN
0.30
0.37
0.39
0.25–0.58
Weekend total
3.64
2.97
3.11
—
Weekday total
3.75
3.20
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
59.5
3.72
0.30
0.92
2.49
3.64
0.0%
2025Q3
92
56.1
3.69
0.30
1.01
2.38
3.54
0.0%
2025Q2
91
54.8
3.62
0.17
1.06
2.39
3.49
2.1%
2024Q4
92
52.1
3.52
0.23
1.27
2.02
3.25
0.2%
2024Q3
92
45.2
4.44
0.33
1.55
2.56
4.16
5.0%
2024Q2
91
45.2
3.26
0.35
0.79
2.13
2.80
2.2%
2024Q1
91
47.4
2.71
0.41
0.94
1.36
2.46
0.0%
2023Q4
92
49.6
3.15
0.66
1.02
1.48
2.78
0.0%
2023Q3
92
50.2
3.15
0.71
0.85
1.59
2.83
0.0%
2023Q2
91
55.5
2.70
0.68
0.68
1.34
2.46
0.0%
2023Q1
90
55.9
2.86
0.65
0.81
1.41
2.72
0.0%
2022Q4
92
55.0
3.06
0.79
0.76
1.51
2.88
0.0%
2022Q3
92
47.7
3.47
0.90
0.82
1.75
3.22
0.0%
2022Q2
91
47.9
3.11
0.68
0.87
1.56
2.91
0.0%
2022Q1
90
50.8
2.98
0.64
0.83
1.51
2.87
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.
D
2026-05-04
2026-03-18
Health
F0637
Assess the resident when there is a significant change in condition
D
2026-05-04
2026-03-18
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
2026-05-04
2026-03-18
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
2026-05-04
2026-03-18
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2026-05-04
2026-03-18
Health
F0692
Provide enough food/fluids to maintain a resident's health.
D
2026-05-04
2026-03-18
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.
E
2026-05-04
2026-03-18
Health
F0732
Post nurse staffing information every day.
D
2026-05-04
2026-03-18
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.
E
2026-05-04
2026-03-18
Health
F0880
Provide and implement an infection prevention and control program.
F
2026-05-04
2026-03-18
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.
E
2026-05-04
2024-08-28
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.
D
2024-10-08
2024-08-28
Health
F0645
PASARR screening for Mental disorders or Intellectual Disabilities
D
2024-10-08
2024-08-28
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-10-08
2024-08-28
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-10-08
2024-08-28
Health
F0692
Provide enough food/fluids to maintain a resident's health.
D
2024-10-08
2024-08-28
Health
F0730
Observe each nurse aide's job performance and give regular training.
E
2024-10-08
2024-08-28
Health
F0757
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
2024-10-08
2024-08-28
Health · complaint
F0760
Ensure that residents are free from significant medication errors.
J
2024-10-10
2024-08-28
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
2024-10-08
2024-08-28
Health
F0919
Make sure that a working call system is available in each resident's bathroom and bathing area.
D
2024-10-08
2024-08-28
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
2024-10-10
2023-01-05
Health
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2023-02-13
2023-01-05
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2023-02-13
2023-01-05
Health
F0688
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
D
2023-02-13
2023-01-05
Health
F0697
Provide safe, appropriate pain management for a resident who requires such services.
D
2023-02-13
2023-01-05
Health
F0710
Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care.
D
2023-02-13
2023-01-05
Health
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.
E
2023-02-13
2023-01-05
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2023-02-13
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
14
Owner
Role
Pct
From
Status
Source
BAKER TILLY ADVISORY GROUP, LP
ADP OF THE SNF
—
2024-09-13
current
pecos_ownership
CAMDEN CLARK HEALTH SERVICES INC
DIRECT OWNERSHIP INTEREST
—
2023-07-01
current
pecos_ownership
KARLAPUDI, MOUNISH
ADP OF THE SNF
—
2023-07-01
current
pecos_ownership
LACY, CARLIE
CORPORATE DIRECTOR
—
2023-07-01
current
pecos_ownership
MCBEE, CHRISTOPHER
ADP OF THE SNF
—
2024-03-18
current
pecos_ownership
PIERSON, KYLE
CORPORATE DIRECTOR
—
2023-07-01
current
pecos_ownership
SMITH, SEAN
CORPORATE OFFICER
—
2024-09-01
current
pecos_ownership
WEST VIRGINIA UNITED HEALTH SYSTEM, INC
ADP OF THE SNF
—
2025-10-24
current
pecos_ownership
WEST VIRGINIA UNITED HEALTH SYSTEM, INC
5% OR GREATER INDIRECT OWNERSHIP INTEREST
100%
2023-07-01
ended 2026-05-18
pecos_ownership
MOUNISH KARLAPUDI
CORPORATE DIRECTOR
0%
2023-07-01
ended 2026-05-18
pecos_ownership
CARLIE LACY
CORPORATE DIRECTOR
—
2023-07-01
ended 2026-05-18
pecos_ownership
CHRISTOPHER MCBEE
OPERATIONAL/MANAGERIAL CONTROL
—
2024-03-18
ended 2026-05-18
pecos_ownership
KYLE PIERSON
CORPORATE DIRECTOR
—
2023-07-01
ended 2026-05-18
pecos_ownership
SEAN SMITH
CORPORATE DIRECTOR
—
2024-09-01
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
0
No related-party cost years on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
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
34
Geo
Kind
BR
Amount
As of
Source
county 54107
acs median gross
0
$698
2024-12-31
CENSUS_ACS5
county 54107
fmr
0
$741
2025-10-01
HUD_USER_FMR
county 54107
acs median gross
1
$610
2024-12-31
CENSUS_ACS5
county 54107
fmr
1
$745
2025-10-01
HUD_USER_FMR
county 54107
acs median gross
2
$849
2024-12-31
CENSUS_ACS5
county 54107
fmr
2
$928
2025-10-01
HUD_USER_FMR
county 54107
acs median gross
3
$930
2024-12-31
CENSUS_ACS5
county 54107
fmr
3
$1,194
2025-10-01
HUD_USER_FMR
county 54107
acs median gross
4
$931
2024-12-31
CENSUS_ACS5
county 54107
fmr
4
$1,253
2025-10-01
HUD_USER_FMR
county 54107
acs median gross
5
$1,445
2024-12-31
CENSUS_ACS5
county 54107
acs median gross
$822
2024-12-31
CENSUS_ACS5
county 54107
acs recent mover gross
$861
2024-12-31
CENSUS_ACS5
zcta 26104
acs median gross
1
$436
2024-12-31
CENSUS_ACS5
zcta 26104
acs median gross
2
$854
2024-12-31
CENSUS_ACS5
zcta 26104
acs median gross
3
$981
2024-12-31
CENSUS_ACS5
zcta 26104
acs median gross
4
$1,051
2024-12-31
CENSUS_ACS5
zcta 26104
acs median gross
$828
2024-12-31
CENSUS_ACS5
zcta 26104
acs recent mover gross
$1,068
2024-12-31
CENSUS_ACS5
zip 26104
payment standard 110
0
$770
2025-10-01
HUD_USER_SAFMR
zip 26104
payment standard 90
0
$630
2025-10-01
HUD_USER_SAFMR
zip 26104
safmr
0
$700
2025-10-01
HUD_USER_SAFMR
zip 26104
payment standard 110
1
$770
2025-10-01
HUD_USER_SAFMR
zip 26104
payment standard 90
1
$630
2025-10-01
HUD_USER_SAFMR
zip 26104
safmr
1
$700
2025-10-01
HUD_USER_SAFMR
zip 26104
payment standard 110
2
$957
2025-10-01
HUD_USER_SAFMR
zip 26104
payment standard 90
2
$783
2025-10-01
HUD_USER_SAFMR
zip 26104
safmr
2
$870
2025-10-01
HUD_USER_SAFMR
zip 26104
payment standard 110
3
$1,243
2025-10-01
HUD_USER_SAFMR
zip 26104
payment standard 90
3
$1,017
2025-10-01
HUD_USER_SAFMR
zip 26104
safmr
3
$1,130
2025-10-01
HUD_USER_SAFMR
zip 26104
payment standard 110
4
$1,298
2025-10-01
HUD_USER_SAFMR
zip 26104
payment standard 90
4
$1,062
2025-10-01
HUD_USER_SAFMR
zip 26104
safmr
4
$1,180
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.