Reads as: riskier than 75.6% 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
9
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+29.3 vs natl
TUTERA JOSEPH
22 facilities
connection
Owner fleet risk far above national
+27.2 vs natl
WALNUT CREEK MANAGEMENT COMPANY LLC
22 facilities
connection
Owner fleet risk far above national
+26.8 vs natl
BROOKS KILEY
29 facilities
connection
Owner fleet risk far above national
+25.0 vs natl
BLOOM RANDALL
15 facilities
connection
Owner fleet risk far above national
+22.5 vs natl
TUTERA GROUP INC
5 facilities
connection
Owner fleet enforcement cluster
59% fined
TUTERA JOSEPH
22 facilities
connection
Owner fleet enforcement cluster
53% fined
BLOOM RANDALL
15 facilities
connection
Owner fleet enforcement cluster
48% fined
BROOKS KILEY
29 facilities
connection
Owner fleet enforcement cluster
46% fined
WALNUT CREEK MANAGEMENT COMPANY LLC
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
15
2025Q4 HPRD
This facility
IA median
National median
National p25–p75
Total nurse
3.88
3.15
3.28
2.90–3.77
RN
1.00
0.46
0.39
0.25–0.58
Weekend total
3.55
2.96
3.11
—
Weekday total
4.01
3.20
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
30.0
3.88
1.00
0.48
2.40
3.55
0.0%
2025Q3
92
30.3
5.67
1.30
0.78
3.59
5.18
8.7%
2025Q2
91
28.6
4.46
0.93
0.54
2.99
4.01
0.0%
2025Q1
90
28.4
4.45
1.06
0.39
3.00
4.34
0.8%
2024Q3
92
31.5
3.04
1.19
0.33
1.53
3.03
0.0%
2024Q2
91
32.8
3.29
0.96
0.37
1.96
3.18
5.7%
2024Q1
91
33.0
3.20
0.96
0.37
1.87
3.14
14.2%
2023Q4
92
32.0
3.06
0.85
0.31
1.89
2.86
7.0%
2023Q3
92
30.0
2.97
0.79
0.33
1.85
2.85
0.0%
2023Q2
91
29.5
3.27
0.89
0.32
2.06
3.21
0.0%
2023Q1
90
30.9
3.46
0.88
0.33
2.26
3.34
3.6%
2022Q4
92
28.5
3.60
0.90
0.53
2.17
3.67
0.0%
2022Q3
92
30.4
3.33
1.01
0.43
1.89
3.36
0.0%
2022Q2
91
31.5
3.44
1.18
0.39
1.87
3.47
0.0%
2022Q1
90
32.1
3.38
1.26
0.23
1.89
3.58
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.
E
2026-04-16
2026-03-26
Health · complaint
F0580
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
D
2026-04-16
2026-03-26
Health
F0582
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
D
2026-04-15
2026-03-26
Health
F0605
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
D
2026-04-16
2026-03-26
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2026-04-16
2026-03-26
Health
F0880
Provide and implement an infection prevention and control program.
D
2026-04-16
2026-03-26
Health
F0883
Develop and implement policies and procedures for flu and pneumonia vaccinations.
D
2026-04-15
2025-06-13
Health · complaint
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2025-06-25
2025-03-06
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
2025-03-20
2025-03-06
Health
F0699
Provide care or services that was trauma informed and/or culturally competent.
D
2025-03-20
2025-03-06
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
2025-03-20
2025-03-06
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2025-03-20
2024-04-23
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2024-04-24
2024-04-23
Health · complaint
F0610
Respond appropriately to all alleged violations.
D
2024-04-24
2024-04-23
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2024-04-24
2024-04-23
Health · complaint
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2024-04-24
2024-04-23
Health
F0814
Dispose of garbage and refuse properly.
E
2024-04-24
2024-04-23
Health · complaint
F0865
Have a plan that describes the process for conducting QAPI and QAA activities.
D
2024-04-24
2023-09-14
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2023-10-02
2023-09-14
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2023-10-02
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
21
Owner
Role
Pct
From
Status
Source
BLOOM, RANDALL
ADP OF THE SNF
—
2024-10-01
current
pecos_ownership
BROOKS, KILEY
ADP OF THE SNF
—
2024-10-01
current
pecos_ownership
CONSTACE MARIE MENDOLIA 2009 IRRV TR
INDIRECT OWNERSHIP INTEREST
—
2024-10-01
current
pecos_ownership
DOMINIC FRANK TUTERA 2016 IRRV TR
INDIRECT OWNERSHIP INTEREST
—
2024-10-01
current
pecos_ownership
GRAND MEADOWS SENIOR LIVING & HEALTH CARE PROPERTY LLC
ADP OF THE SNF
—
2024-09-30
current
pecos_ownership
HANNAH MARIE TUTERA 2016 IRRV TR
INDIRECT OWNERSHIP INTEREST
—
2024-10-01
current
pecos_ownership
JEWELL, SUSAN
ADP OF THE SNF
—
2025-05-01
current
pecos_ownership
JOSEPH CHARLES TUTERA JR 2016 IRRV TR
INDIRECT OWNERSHIP INTEREST
—
2024-10-01
current
pecos_ownership
LAURA CIRESE TUTERA 2016 IRRV TR
INDIRECT OWNERSHIP INTEREST
—
2024-10-01
current
pecos_ownership
MARY MARGARET CUNNINGHAM 2009 IRRV TR
ADP OF THE SNF
—
2024-10-01
current
pecos_ownership
SEITERA LP LLC
DIRECT OWNERSHIP INTEREST
—
2024-10-01
current
pecos_ownership
TUTERA GROUP, INC
ADP OF THE SNF
—
2024-09-30
current
pecos_ownership
TUTERA, JOSEPH
ADP OF THE SNF
—
2024-10-01
current
pecos_ownership
WALNUT CREEK MANAGEMENT COMPANY LLC
ADP OF THE SNF
—
2025-05-07
current
pecos_ownership
WALNUT CREEK MANAGEMENT COMPANY LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-10-01
current
pecos_ownership
WARREN, JANET
ADP OF THE SNF
—
2024-10-01
current
pecos_ownership
JANET WARREN
OPERATIONAL/MANAGERIAL CONTROL
—
2024-10-01
ended 2026-05-18
pecos_ownership
JOSEPH TUTERA
OPERATIONAL/MANAGERIAL CONTROL
—
2024-10-01
ended 2026-05-18
pecos_ownership
KILEY BROOKS
OPERATIONAL/MANAGERIAL CONTROL
—
2024-10-01
ended 2026-05-18
pecos_ownership
RANDALL BLOOM
OPERATIONAL/MANAGERIAL CONTROL
—
2024-10-01
ended 2026-05-18
pecos_ownership
SUSAN JEWELL
ADP OF THE SNF
—
2025-05-01
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
1
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$281,948
—
$76,341
—
—
2
—
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 19061
acs median gross
0
$620
2024-12-31
CENSUS_ACS5
county 19061
fmr
0
$774
2025-10-01
HUD_USER_FMR
county 19061
acs median gross
1
$754
2024-12-31
CENSUS_ACS5
county 19061
fmr
1
$841
2025-10-01
HUD_USER_FMR
county 19061
acs median gross
2
$994
2024-12-31
CENSUS_ACS5
county 19061
fmr
2
$1,077
2025-10-01
HUD_USER_FMR
county 19061
acs median gross
3
$1,233
2024-12-31
CENSUS_ACS5
county 19061
fmr
3
$1,450
2025-10-01
HUD_USER_FMR
county 19061
acs median gross
4
$1,330
2024-12-31
CENSUS_ACS5
county 19061
fmr
4
$1,807
2025-10-01
HUD_USER_FMR
county 19061
acs median gross
5
$1,250
2024-12-31
CENSUS_ACS5
county 19061
acs median gross
$959
2024-12-31
CENSUS_ACS5
county 19061
acs recent mover gross
$1,002
2024-12-31
CENSUS_ACS5
zcta 52002
acs median gross
1
$840
2024-12-31
CENSUS_ACS5
zcta 52002
acs median gross
2
$1,205
2024-12-31
CENSUS_ACS5
zcta 52002
acs median gross
3
$1,365
2024-12-31
CENSUS_ACS5
zcta 52002
acs median gross
$1,080
2024-12-31
CENSUS_ACS5
zcta 52002
acs recent mover gross
$983
2024-12-31
CENSUS_ACS5
zip 52002
payment standard 110
0
$924
2025-10-01
HUD_USER_SAFMR
zip 52002
payment standard 90
0
$756
2025-10-01
HUD_USER_SAFMR
zip 52002
safmr
0
$840
2025-10-01
HUD_USER_SAFMR
zip 52002
payment standard 110
1
$1,001
2025-10-01
HUD_USER_SAFMR
zip 52002
payment standard 90
1
$819
2025-10-01
HUD_USER_SAFMR
zip 52002
safmr
1
$910
2025-10-01
HUD_USER_SAFMR
zip 52002
payment standard 110
2
$1,287
2025-10-01
HUD_USER_SAFMR
zip 52002
payment standard 90
2
$1,053
2025-10-01
HUD_USER_SAFMR
zip 52002
safmr
2
$1,170
2025-10-01
HUD_USER_SAFMR
zip 52002
payment standard 110
3
$1,727
2025-10-01
HUD_USER_SAFMR
zip 52002
payment standard 90
3
$1,413
2025-10-01
HUD_USER_SAFMR
zip 52002
safmr
3
$1,570
2025-10-01
HUD_USER_SAFMR
zip 52002
payment standard 110
4
$2,156
2025-10-01
HUD_USER_SAFMR
zip 52002
payment standard 90
4
$1,764
2025-10-01
HUD_USER_SAFMR
zip 52002
safmr
4
$1,960
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.