Composite
5.8 / 100 percentile
Screener / 295024
A
HARMONY MANOR SKILLED NURSING FACILITY
snfNV
118 EAST HASKELL ST, WINNEMUCCA, NV 89445 · CCN 295024
Peer group
snf n = 14,684
Evidence depth
moderate
Certified beds
42
Model
v1.2
Reads as: riskier than 5.8% 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 model3Components9CHOW radar1Distress radar1Staffing16Penalties0Deficiencies24Licensure0Ownership7Related party0Transactions0Comps12Market rent30
Composite explanation
3| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 42.8 | 31.6 | 0.30 | 0.4286 | 18.34 | in index |
| chow risk | 25.2 | 25.0 | 0.15 | 0.2143 | 5.40 | in index |
| staffing risk | 2.2 | 2.3 | 0.25 | 0.3571 | 0.79 | 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.
Component scores and registry models
9| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| chow risk | 25.0 | B | 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. |
| p adverse action 12m | 0.4 | — | 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 | 0.3 | — | 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 | 31.6 | B | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 2.3 | A | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| regulatory risk | 31.5 | B | 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 | 31.5 | B | 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 | 2.3 | A | 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 | 2.3 | A | 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)
0.3%
model v0.1 · computed 2026-07-29
Percentile among SNFs
45.8
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | -1.24 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| Total nurse staffing (HPRD) | 5.46 | -0.48 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Chain size (log) | 0.00 | -0.40 | |
| Occupancy | 0.82 | -0.35 | |
| 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)
0.4%
model v0.1 · computed 2026-07-29
Percentile among SNFs
71.9
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | +1.62 | |
| Chain size (log) | 0.00 | +1.20 | |
| Total nurse staffing (HPRD) | 5.46 | -0.95 | |
| Deficiencies, last 12 months | 10.00 | -0.43 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Occupancy | 0.82 | -0.29 | |
| Fine amount, 12m (log) | 0.00 | +0.18 | |
| Facility size (log beds) | 3.76 | +0.12 |
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 | NV median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 5.46 | 3.62 | 3.28 | 2.90–3.77 |
| RN | 1.13 | 0.64 | 0.39 | 0.25–0.58 |
| Weekend total | 4.97 | 3.46 | 3.11 | — |
| Weekday total | 5.66 | 3.68 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 34.3 | 5.46 | 1.13 | 0.54 | 3.79 | 4.97 | 7.1% |
| 2025Q3 | 92 | 33.8 | 5.42 | 0.98 | 0.60 | 3.85 | 5.31 | 3.9% |
| 2025Q2 | 91 | 31.9 | 5.25 | 0.87 | 0.70 | 3.68 | 4.71 | 3.0% |
| 2025Q1 | 90 | 32.7 | 5.16 | 1.05 | 0.68 | 3.43 | 4.76 | 8.9% |
| 2024Q4 | 92 | 34.8 | 5.45 | 1.10 | 0.46 | 3.89 | 4.95 | 26.6% |
| 2024Q3 | 92 | 32.3 | 5.03 | 1.23 | 0.51 | 3.30 | 4.42 | 22.6% |
| 2024Q2 | 91 | 34.8 | 5.21 | 1.03 | 0.58 | 3.60 | 4.83 | 12.9% |
| 2024Q1 | 91 | 35.1 | 5.12 | 0.90 | 0.61 | 3.61 | 4.92 | 9.3% |
| 2023Q4 | 92 | 32.1 | 4.53 | 0.91 | 0.63 | 2.99 | 4.21 | 6.9% |
| 2023Q3 | 92 | 31.5 | 5.28 | 1.08 | 0.74 | 3.46 | 4.91 | 12.4% |
| 2023Q2 | 91 | 31.6 | 5.28 | 1.07 | 0.75 | 3.47 | 4.75 | 0.0% |
| 2023Q1 | 90 | 33.0 | 5.32 | 1.17 | 0.72 | 3.43 | 4.91 | 0.0% |
| 2022Q4 | 92 | 32.6 | 5.11 | 1.14 | 0.76 | 3.20 | 4.75 | 0.0% |
| 2022Q3 | 92 | 34.1 | 5.24 | 1.22 | 0.69 | 3.33 | 4.91 | 1.7% |
| 2022Q2 | 91 | 34.1 | 5.50 | 1.04 | 0.72 | 3.74 | 4.99 | 1.0% |
| 2022Q1 | 90 | 29.2 | 6.56 | 1.24 | 1.08 | 4.24 | 6.04 | 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.
Penalties
0No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
24B × 1C × 1D × 21E × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-04-23 | Health | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2026-05-13 |
| 2026-04-23 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2026-05-12 |
| 2026-04-23 | 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 | 2026-05-13 |
| 2026-04-23 | Health | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | 2026-06-07 |
| 2026-04-23 | Health | F0730 | Observe each nurse aide's job performance and give regular training. | D | 2026-05-13 |
| 2026-04-23 | 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. | D | 2026-05-13 |
| 2026-04-23 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2026-05-15 |
| 2026-04-23 | Health | F0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | D | 2026-05-15 |
| 2026-04-23 | Health | F0943 | Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. | D | 2026-05-18 |
| 2026-04-23 | Health | F0949 | Provide behavior health training consistent with the requirements and as determined by a facility assessment. | D | 2026-05-04 |
| 2025-02-06 | Health | F0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | B | 2025-02-24 |
| 2025-02-06 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2025-02-25 |
| 2025-02-06 | Health | F0680 | Ensure the activities program is directed by a qualified professional. | D | 2025-02-25 |
| 2025-02-06 | Health | F0732 | Post nurse staffing information every day. | C | 2025-02-25 |
| 2025-02-06 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2025-03-23 |
| 2025-02-06 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2025-03-06 |
| 2024-04-04 | 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 | 2024-04-12 |
| 2024-04-04 | Health | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | 2024-04-17 |
| 2024-04-04 | 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 | 2024-04-19 |
| 2024-04-04 | 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 | 2024-04-15 |
| 2024-04-04 | Health | F0851 | Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. | D | 2024-04-17 |
| 2024-04-04 | Health | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | D | 2024-04-17 |
| 2024-04-04 | Health | F0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | D | 2024-04-15 |
| 2024-04-04 | Health | F0887 | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | D | 2024-04-19 |
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
7| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| HUMBOLDT GENERAL HOSPITAL | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | — | current | pecos_ownership |
| DUNCKHORST, ROBYN | CORPORATE OFFICER | — | 2021-01-08 | current | pecos_ownership |
| PLUMMER, KIMBERLEY | W-2 MANAGING EMPLOYEE | — | 2018-10-01 | current | pecos_ownership |
| POWERS, TIMOTHY | CORPORATE OFFICER | — | 2020-08-17 | current | pecos_ownership |
| KIMBERLEY PLUMMER | W-2 MANAGING EMPLOYEE | — | 2018-10-01 | ended 2026-05-18 | pecos_ownership |
| ROBYN DUNCKHORST | CORPORATE OFFICER | — | 2021-01-08 | ended 2026-05-18 | pecos_ownership |
| TIMOTHY POWERS | W-2 MANAGING EMPLOYEE | — | 2020-08-17 | 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
0No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Comparable trades — NV snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-04-17 | OASIS NURSING & REHAB OF GREEN VALLEY | — | — | — | 242 | HENDERSON DELMAR NV OPCO LLC |
| 2024-08-01 | NORTHERN NEVADA STATE VETERANS HOME | — | — | — | 96 | DIMENSIONS MANAGEMENT OF NORTHERN NEVADA LLC |
| 2024-04-18 | HIGHLAND MANOR OF ELKO REHABILITATION LLC | — | — | — | 146 | HIGHLAND MANOR OF ELKO REHABILITATION LLC |
| 2024-04-18 | HIGHLAND MANOR OF FALLON REHABILITATION LLC | — | — | — | 102 | HIGHLAND MANOR OF FALLON REHABILITATION LLC |
| 2024-04-18 | HIGHLAND MANOR OF MESQUITE REHABILITATION LLC | — | — | — | 112 | HIGHLAND MANOR OF MESQUITE REHABILITATION LLC |
| 2024-01-01 | HEARTHSTONE | — | — | — | 125 | TRUCKEE MEADOWS HEALTHCARE, INC. |
| 2023-09-07 | TLC CARE CENTER | — | — | — | 255 | TLC SNF OPERATIONS LLC |
| 2023-08-31 | PAHRUMP HEALTH AND REHABILITATION CENTER | — | — | — | 120 | PAHRUMP SNF OPERATIONS, LLC |
| 2023-08-31 | MOUNTAIN VIEW HEALTH AND REHABILITATION | — | — | — | 146 | MV SNF OPERATIONS LLC |
| 2023-08-31 | GARDNERVILLE HEALTH & REHABILITATION CENTER | — | — | — | 60 | GARDNERVILLE SNF OPERATIONS LLC |
| 2023-08-31 | ORMSBY POST ACUTE REHABILITATION | — | — | — | 120 | ORMSBY SNF OPERATIONS LLC |
| 2023-06-01 | MOUNTAIN VIEW CARE CENTER | — | — | — | 87 | BOULDER CITY NV OPCO 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
30| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 32013 | fmr | 0 | $993 | 2025-10-01 | HUD_USER_FMR |
| county 32013 | acs median gross | 1 | $490 | 2024-12-31 | CENSUS_ACS5 |
| county 32013 | fmr | 1 | $1,000 | 2025-10-01 | HUD_USER_FMR |
| county 32013 | acs median gross | 2 | $1,046 | 2024-12-31 | CENSUS_ACS5 |
| county 32013 | fmr | 2 | $1,312 | 2025-10-01 | HUD_USER_FMR |
| county 32013 | acs median gross | 3 | $1,239 | 2024-12-31 | CENSUS_ACS5 |
| county 32013 | fmr | 3 | $1,636 | 2025-10-01 | HUD_USER_FMR |
| county 32013 | fmr | 4 | $2,201 | 2025-10-01 | HUD_USER_FMR |
| county 32013 | acs median gross | $994 | 2024-12-31 | CENSUS_ACS5 | |
| county 32013 | acs recent mover gross | $1,331 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 89445 | acs median gross | 1 | $490 | 2024-12-31 | CENSUS_ACS5 |
| zcta 89445 | acs median gross | 2 | $1,061 | 2024-12-31 | CENSUS_ACS5 |
| zcta 89445 | acs median gross | 3 | $1,242 | 2024-12-31 | CENSUS_ACS5 |
| zcta 89445 | acs median gross | $990 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 89445 | acs recent mover gross | $1,331 | 2024-12-31 | CENSUS_ACS5 | |
| zip 89445 | payment standard 110 | 0 | $1,100 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | payment standard 90 | 0 | $900 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | safmr | 0 | $1,000 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | payment standard 110 | 1 | $1,122 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | payment standard 90 | 1 | $918 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | safmr | 1 | $1,020 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | payment standard 110 | 2 | $1,452 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | payment standard 90 | 2 | $1,188 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | safmr | 2 | $1,320 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | payment standard 110 | 3 | $1,815 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | payment standard 90 | 3 | $1,485 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | safmr | 3 | $1,650 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | payment standard 110 | 4 | $2,431 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | payment standard 90 | 4 | $1,989 | 2025-10-01 | HUD_USER_SAFMR |
| zip 89445 | safmr | 4 | $2,210 | 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.