401 PROMISE WAY LANE, MEDINA, TN 38355 · CCN 445539
Composite
95.7 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
66
Model
v1.2
Reads as: riskier than 95.7% 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 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
11
2025Q4 HPRD
This facility
TN median
National median
National p25–p75
Total nurse
2.99
3.28
3.28
2.90–3.77
RN
0.19
0.34
0.39
0.25–0.58
Weekend total
2.82
3.10
3.11
—
Weekday total
3.06
3.36
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
61.7
2.99
0.19
0.92
1.88
2.82
0.0%
2025Q3
92
59.9
3.15
0.21
0.94
2.00
3.04
0.0%
2025Q2
91
63.3
2.96
0.15
0.89
1.92
2.92
0.0%
2025Q1
90
63.3
2.88
0.15
0.89
1.84
2.92
2.4%
2024Q4
92
62.5
2.94
0.20
0.85
1.90
2.98
2.6%
2024Q3
92
61.3
2.98
0.28
0.82
1.88
3.13
17.3%
2024Q2
91
54.2
3.19
0.19
0.94
2.06
3.24
14.8%
2024Q1
91
52.8
3.03
0.17
0.93
1.93
3.13
7.7%
2023Q4
92
56.3
3.05
0.16
0.93
1.96
3.04
9.1%
2023Q3
92
59.7
2.84
0.17
0.81
1.85
2.87
17.8%
2023Q2
91
34.8
4.67
0.33
1.28
3.06
5.00
29.8%
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.
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
2026-02-12
2026-01-14
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2026-02-12
2025-03-12
Health
F0655
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
D
2025-04-22
2025-03-12
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2025-04-22
2025-03-12
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2025-04-22
2025-03-12
Health · complaint
F0757
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
2025-04-22
2025-03-12
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
2025-04-22
2025-03-12
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2025-04-22
2025-03-12
Health
F0760
Ensure that residents are free from significant medication errors.
D
2025-04-22
2025-03-12
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
2025-04-22
2025-03-12
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-04-22
2024-01-02
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2024-01-30
2024-01-02
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
2024-01-30
2024-01-02
Health · complaint
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
2024-01-30
2024-01-02
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
J
2024-01-30
2024-01-02
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
J
2024-01-30
2024-01-02
Health · complaint
F0610
Respond appropriately to all alleged violations.
J
2024-01-30
2024-01-02
Health · complaint
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
E
2024-01-30
2024-01-02
Health · complaint
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
2024-01-30
2024-01-02
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
E
2024-01-30
2024-01-02
Health · complaint
F0740
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
D
2024-01-30
2024-01-02
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2024-01-30
2024-01-02
Health · complaint
F0760
Ensure that residents are free from significant medication errors.
D
2024-01-30
2024-01-02
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
2024-01-30
2024-01-02
Health · complaint
F0835
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
J
2024-01-30
2024-01-02
Health · complaint
F0841
Designate a physician to serve as medical director responsible for implementation of resident care policies and coordination of medical care in the facility.
D
2024-01-30
2024-01-02
Health · complaint
F0867
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
D
2024-01-30
2024-01-02
Health
F0880
Provide and implement an infection prevention and control program.
E
2024-01-30
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
24
Owner
Role
Pct
From
Status
Source
GIBSON COUNTY REAL ESTATE INVESTORS
Director, officer, administrator or key person of provider or organization
—
2023-01-01
current
hcris_a_8_1
GIBSON COUNTY REAL ESTATE INVESTORS
Director, officer, administrator or key person of provider or organization
—
2024-01-01
current
hcris_a_8_1
CARE CENTERS MANAGEMENT CONSULTING, INC.
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2017-07-06
ended 2026-05-18
pecos_ownership
JIMMY LEWIS
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2017-07-06
ended 2026-05-18
pecos_ownership
ANITA WEST
CORPORATE OFFICER
—
2017-07-06
ended 2026-05-18
pecos_ownership
ANITA WEST
OPERATIONAL/MANAGERIAL CONTROL
—
2017-07-20
ended 2026-05-18
pecos_ownership
BRAD ROGERS
OPERATIONAL/MANAGERIAL CONTROL
—
2021-07-30
ended 2026-05-18
pecos_ownership
BROAD RIVER REHABILITATION
LIMITED PARTNERSHIP INTEREST
—
2022-01-01
ended 2026-05-18
pecos_ownership
CATRINA QUENON
ADP OF THE SNF
—
2023-09-27
ended 2026-05-18
pecos_ownership
DONNA SCOTT
INDIRECT OWNERSHIP INTEREST
—
2025-04-01
ended 2026-05-18
pecos_ownership
GEORGE DEAKINS
ADP OF THE SNF
—
2017-07-06
ended 2026-05-18
pecos_ownership
GIBSON COUNTY REAL ESTATE INVESTORS
Director, officer, administrator or key person of provider or organization
—
2022-06-29
ended 2022-12-31
hcris_a_8_1
JACKSON CLINIC PA
ADP OF THE SNF
—
2022-03-01
ended 2026-05-18
pecos_ownership
JACQUELINE COBB
ADP OF THE SNF
—
2022-03-07
ended 2026-05-18
pecos_ownership
JENNIFER BRADFIELD
ADP OF THE SNF
—
2024-05-02
ended 2026-05-18
pecos_ownership
JENNIFER WILLIAMS
ADP OF THE SNF
—
2024-02-06
ended 2026-05-18
pecos_ownership
JERE HAMMOND
ADP OF THE SNF
—
2022-03-01
ended 2026-05-18
pecos_ownership
JIMMY LEWIS
OPERATIONAL/MANAGERIAL CONTROL
—
2017-07-20
ended 2026-05-18
pecos_ownership
JONAH HAYES
ADP OF THE SNF
—
2022-03-29
ended 2026-05-18
pecos_ownership
LEANNE POLASEK
ADP OF THE SNF
—
2022-05-17
ended 2026-05-18
pecos_ownership
LISA CAWOOD-GRAY
CORPORATE OFFICER
—
2017-07-06
ended 2026-05-18
pecos_ownership
LISA CAWOOD-GRAY
OPERATIONAL/MANAGERIAL CONTROL
—
2017-07-16
ended 2026-05-18
pecos_ownership
SANDI RAY
ADP OF THE SNF
—
2022-03-01
ended 2026-05-18
pecos_ownership
TABITHA BAILEY
ADP OF THE SNF
—
2025-04-01
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
3
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$790,064
$392,092
$14,874
—
—
3
propco
2023-12-31
$786,668
$399,653
$16,247
—
—
3
propco
2022-12-31
$109,740
—
$4,971
—
—
3
propco
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
30
Geo
Kind
BR
Amount
As of
Source
county 47113
acs median gross
0
$661
2024-12-31
CENSUS_ACS5
county 47113
fmr
0
$869
2025-10-01
HUD_USER_FMR
county 47113
acs median gross
1
$826
2024-12-31
CENSUS_ACS5
county 47113
fmr
1
$960
2025-10-01
HUD_USER_FMR
county 47113
acs median gross
2
$1,134
2024-12-31
CENSUS_ACS5
county 47113
fmr
2
$1,260
2025-10-01
HUD_USER_FMR
county 47113
acs median gross
3
$1,203
2024-12-31
CENSUS_ACS5
county 47113
fmr
3
$1,677
2025-10-01
HUD_USER_FMR
county 47113
acs median gross
4
$1,402
2024-12-31
CENSUS_ACS5
county 47113
fmr
4
$1,758
2025-10-01
HUD_USER_FMR
county 47113
acs median gross
5
$929
2024-12-31
CENSUS_ACS5
county 47113
acs median gross
$1,123
2024-12-31
CENSUS_ACS5
county 47113
acs recent mover gross
$1,361
2024-12-31
CENSUS_ACS5
zcta 38355
acs median gross
3
$1,268
2024-12-31
CENSUS_ACS5
zcta 38355
acs median gross
$1,248
2024-12-31
CENSUS_ACS5
zip 38355
payment standard 110
0
$935
2025-10-01
HUD_USER_SAFMR
zip 38355
payment standard 90
0
$765
2025-10-01
HUD_USER_SAFMR
zip 38355
safmr
0
$850
2025-10-01
HUD_USER_SAFMR
zip 38355
payment standard 110
1
$1,034
2025-10-01
HUD_USER_SAFMR
zip 38355
payment standard 90
1
$846
2025-10-01
HUD_USER_SAFMR
zip 38355
safmr
1
$940
2025-10-01
HUD_USER_SAFMR
zip 38355
payment standard 110
2
$1,353
2025-10-01
HUD_USER_SAFMR
zip 38355
payment standard 90
2
$1,107
2025-10-01
HUD_USER_SAFMR
zip 38355
safmr
2
$1,230
2025-10-01
HUD_USER_SAFMR
zip 38355
payment standard 110
3
$1,870
2025-10-01
HUD_USER_SAFMR
zip 38355
payment standard 90
3
$1,530
2025-10-01
HUD_USER_SAFMR
zip 38355
safmr
3
$1,700
2025-10-01
HUD_USER_SAFMR
zip 38355
payment standard 110
4
$2,222
2025-10-01
HUD_USER_SAFMR
zip 38355
payment standard 90
4
$1,818
2025-10-01
HUD_USER_SAFMR
zip 38355
safmr
4
$2,020
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.