Reads as: riskier than 59.2% 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
TN median
National median
National p25–p75
Total nurse
3.50
3.28
3.28
2.90–3.77
RN
0.08
0.34
0.39
0.25–0.58
Weekend total
3.44
3.10
3.11
—
Weekday total
3.52
3.36
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
80.1
3.50
0.08
1.26
2.16
3.44
0.0%
2025Q3
92
77.1
3.50
0.05
1.29
2.15
3.40
0.0%
2025Q2
91
82.0
3.65
0.05
1.33
2.27
3.46
0.0%
2025Q1
90
82.2
3.47
0.07
1.27
2.13
3.24
0.0%
2024Q4
92
76.8
3.63
0.09
1.33
2.21
3.37
0.0%
2024Q3
92
77.0
3.56
0.07
1.32
2.16
3.16
0.0%
2024Q2
91
77.7
3.16
0.10
1.34
1.71
2.83
0.0%
2024Q1
91
77.7
3.31
0.12
1.35
1.84
2.95
0.0%
2023Q4
92
77.2
2.94
0.17
1.14
1.63
2.74
0.0%
2023Q3
92
78.2
3.26
0.25
1.15
1.86
2.98
0.0%
2023Q2
91
78.3
3.15
0.30
0.97
1.88
2.83
0.0%
2023Q1
90
79.6
3.15
0.30
1.10
1.75
2.86
0.0%
2022Q4
92
77.5
3.06
0.30
0.93
1.83
2.76
0.0%
2022Q3
92
74.3
3.05
0.17
0.92
1.97
2.98
0.0%
2022Q2
91
76.0
3.14
0.16
1.04
1.93
2.99
0.0%
2022Q1
90
85.3
2.91
0.21
1.04
1.66
2.90
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.
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2025-01-13
2024-12-04
Health
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
E
2025-01-13
2024-12-04
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
2025-01-13
2024-12-04
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
2025-01-13
2024-12-04
Health
F0814
Dispose of garbage and refuse properly.
E
2025-01-13
2024-12-04
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
E
2025-01-13
2024-12-04
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.
F
2025-01-13
2024-12-04
Health
F0880
Provide and implement an infection prevention and control program.
E
2025-01-13
2024-08-28
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2024-09-20
2024-08-28
Health · complaint
F0602
Protect each resident from the wrongful use of the resident's belongings or money.
D
2024-09-20
2024-08-28
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2024-09-20
2023-12-21
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2024-01-19
2021-11-17
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.
D
2022-01-01
2021-11-17
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2022-01-01
2019-06-19
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2019-07-25
2019-06-19
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2019-07-25
2019-06-19
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2019-07-25
2019-06-19
Health
F0880
Provide and implement an infection prevention and control program.
D
2019-07-25
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
40
Owner
Role
Pct
From
Status
Source
BILBREY, EMILY
MANAGING CONTROL - GOVERNING BODY
—
2024-07-19
current
pecos_ownership
CROSS, CINDY
CORPORATE OFFICER
—
2008-11-01
current
pecos_ownership
CROSSVILLE MEDICAL INVESTORS, LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2009-01-12
current
pecos_ownership
DEVELOPERS INVESTMENT COMPANY II, INC
OPERATIONAL/MANAGERIAL CONTROL
—
2008-06-13
current
pecos_ownership
FLETCHER, TODD
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
current
pecos_ownership
HENRY, TERRY
CORPORATE OFFICER
—
2008-11-01
current
pecos_ownership
HOWE, CATHY
ADP OF THE SNF
—
2025-03-04
current
pecos_ownership
HOWE, CATHY
MANAGING CONTROL - GOVERNING BODY
—
2019-05-13
current
pecos_ownership
LAY, LISA
CORPORATE DIRECTOR
—
2017-04-24
current
pecos_ownership
LAY, LISA
CORPORATE OFFICER
—
2018-02-09
current
pecos_ownership
LIFE CARE CENTERS OF AMERICA, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
2008-11-01
current
pecos_ownership
LIFE CARE CENTERS OF AMERICA, INC.
ADP OF THE SNF
—
2025-03-04
current
pecos_ownership
PRESTON, AUBREY
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
current
pecos_ownership
PRESTON, FORREST
ADP OF THE SNF
—
2009-01-12
current
pecos_ownership
PRESTON, FORREST
DIRECT OWNERSHIP INTEREST
—
2008-06-13
current
pecos_ownership
SOLOMON, JENNIFER
MANAGING CONTROL - GOVERNING BODY
—
2019-05-01
current
pecos_ownership
SWANKER, RICHARD
CORPORATE DIRECTOR
—
2022-01-01
current
pecos_ownership
SWANKER, RICHARD
CORPORATE OFFICER
—
2011-04-01
current
pecos_ownership
THURMOND, JOAN
CORPORATE OFFICER
—
2008-11-01
current
pecos_ownership
WILLETT, DWIGHT
ADP OF THE SNF
—
2025-03-04
current
pecos_ownership
WILLETT, DWIGHT
OPERATIONAL/MANAGERIAL CONTROL
—
2010-10-01
current
pecos_ownership
ZIEGLER, JAMES
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
current
pecos_ownership
FORREST PRESTON
5% OR GREATER DIRECT OWNERSHIP INTEREST
99%
2008-06-13
ended 2026-05-18
pecos_ownership
AUBREY PRESTON
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
ended 2026-05-18
pecos_ownership
CATHY HOWE
ADP OF THE SNF
—
2025-03-04
ended 2026-05-18
pecos_ownership
CATHY HOWE
MANAGING CONTROL - GOVERNING BODY
—
2019-05-13
ended 2026-05-18
pecos_ownership
CINDY CROSS
CORPORATE OFFICER
—
2008-11-01
ended 2026-05-18
pecos_ownership
DWIGHT WILLETT
ADP OF THE SNF
—
2025-03-04
ended 2026-05-18
pecos_ownership
DWIGHT WILLETT
OPERATIONAL/MANAGERIAL CONTROL
—
2010-10-01
ended 2026-05-18
pecos_ownership
EMILY BILBREY
OPERATIONAL/MANAGERIAL CONTROL
—
2024-07-19
ended 2026-05-18
pecos_ownership
FORREST PRESTON
ADP OF THE SNF
—
2009-01-12
ended 2026-05-18
pecos_ownership
JAMES ZIEGLER
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
ended 2026-05-18
pecos_ownership
JENNIFER SOLOMON
MANAGING CONTROL - GOVERNING BODY
—
2019-05-01
ended 2026-05-18
pecos_ownership
JOAN THURMOND
CORPORATE OFFICER
—
2008-11-01
ended 2026-05-18
pecos_ownership
LISA LAY
CORPORATE DIRECTOR
—
2017-04-24
ended 2026-05-18
pecos_ownership
LISA LAY
CORPORATE OFFICER
—
2018-02-09
ended 2026-05-18
pecos_ownership
RICHARD SWANKER
CORPORATE OFFICER
—
2011-04-01
ended 2026-05-18
pecos_ownership
RICHARD SWANKER
CORPORATE DIRECTOR
—
2022-01-01
ended 2026-05-18
pecos_ownership
TERRY HENRY
CORPORATE OFFICER
—
2008-11-01
ended 2026-05-18
pecos_ownership
TODD FLETCHER
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-13
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
5
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$1,107,729
$17,064
—
—
—
5
—
2023-12-31
$987,621
$22,851
—
—
—
5
—
2022-12-31
$1,139,460
$30,619
—
—
$659,787
5
—
2021-12-31
$1,265,162
$42,047
—
—
$715,108
5
—
2020-12-31
$1,294,681
—
—
—
$743,747
5
—
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 47035
acs median gross
0
$340
2024-12-31
CENSUS_ACS5
county 47035
fmr
0
$719
2025-10-01
HUD_USER_FMR
county 47035
acs median gross
1
$524
2024-12-31
CENSUS_ACS5
county 47035
fmr
1
$723
2025-10-01
HUD_USER_FMR
county 47035
acs median gross
2
$850
2024-12-31
CENSUS_ACS5
county 47035
fmr
2
$942
2025-10-01
HUD_USER_FMR
county 47035
acs median gross
3
$1,006
2024-12-31
CENSUS_ACS5
county 47035
fmr
3
$1,304
2025-10-01
HUD_USER_FMR
county 47035
acs median gross
4
$398
2024-12-31
CENSUS_ACS5
county 47035
fmr
4
$1,354
2025-10-01
HUD_USER_FMR
county 47035
acs median gross
5
$1,028
2024-12-31
CENSUS_ACS5
county 47035
acs median gross
$839
2024-12-31
CENSUS_ACS5
county 47035
acs recent mover gross
$1,087
2024-12-31
CENSUS_ACS5
zcta 38555
acs median gross
0
$328
2024-12-31
CENSUS_ACS5
zcta 38555
acs median gross
1
$495
2024-12-31
CENSUS_ACS5
zcta 38555
acs median gross
2
$888
2024-12-31
CENSUS_ACS5
zcta 38555
acs median gross
3
$878
2024-12-31
CENSUS_ACS5
zcta 38555
acs median gross
4
$396
2024-12-31
CENSUS_ACS5
zcta 38555
acs median gross
$804
2024-12-31
CENSUS_ACS5
zcta 38555
acs recent mover gross
$1,047
2024-12-31
CENSUS_ACS5
zip 38555
payment standard 110
0
$781
2025-10-01
HUD_USER_SAFMR
zip 38555
payment standard 90
0
$639
2025-10-01
HUD_USER_SAFMR
zip 38555
safmr
0
$710
2025-10-01
HUD_USER_SAFMR
zip 38555
payment standard 110
1
$781
2025-10-01
HUD_USER_SAFMR
zip 38555
payment standard 90
1
$639
2025-10-01
HUD_USER_SAFMR
zip 38555
safmr
1
$710
2025-10-01
HUD_USER_SAFMR
zip 38555
payment standard 110
2
$1,023
2025-10-01
HUD_USER_SAFMR
zip 38555
payment standard 90
2
$837
2025-10-01
HUD_USER_SAFMR
zip 38555
safmr
2
$930
2025-10-01
HUD_USER_SAFMR
zip 38555
payment standard 110
3
$1,408
2025-10-01
HUD_USER_SAFMR
zip 38555
payment standard 90
3
$1,152
2025-10-01
HUD_USER_SAFMR
zip 38555
safmr
3
$1,280
2025-10-01
HUD_USER_SAFMR
zip 38555
payment standard 110
4
$1,496
2025-10-01
HUD_USER_SAFMR
zip 38555
payment standard 90
4
$1,224
2025-10-01
HUD_USER_SAFMR
zip 38555
safmr
4
$1,360
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.