Composite
92.5 / 100 percentile
| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| billing conduct | 92.2 | 62.0 | 0.30 | 0.2308 | 21.28 | in index |
| staffing risk | 94.9 | 94.9 | 0.25 | 0.1923 | 18.25 | in index |
| financial risk | 69.7 | 59.0 | 0.30 | 0.2308 | 16.08 | in index |
| regulatory risk | 42.8 | 31.6 | 0.30 | 0.2308 | 9.88 | in index |
| chow risk | 29.1 | 27.9 | 0.15 | 0.1154 | 3.36 | in index |
| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 62.0 | C | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| 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. |
| chow risk | 30.9 | B | v0.6 | default · in composite | |
| financial risk | 59.0 | C | v0.5 | default · in composite | R18. |
| p adverse action 12m | 0.1 | — | 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 | 4.9 | — | 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 | 94.9 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 77.0 | D | v0.1 | superseded | 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. |
| financial risk | 57.0 | C | v0.2 | superseded | 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. |
| financial risk | 57.2 | C | v0.3 | superseded | 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. |
| financial risk | 61.8 | C | v0.4 | superseded | 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. |
| 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 | 94.9 | F | 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 | 94.9 | F | 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. |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 1.00 | +0.69 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| Occupancy | 0.86 | -0.46 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Contract staffing share | 0.21 | +0.22 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Total nurse staffing (HPRD) | 2.29 | +0.15 |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Deficiencies, last 12 months | 2.00 | +1.06 | |
| For-profit ownership | 1.00 | -0.69 | |
| Occupancy | 0.86 | -0.45 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Total nurse staffing (HPRD) | 2.29 | +0.39 | |
| Fine amount, 12m (log) | 0.00 | +0.18 | |
| Contract staffing share | 0.21 | +0.15 | |
| Chain size (log) | 2.30 | -0.14 |
| 2025Q4 HPRD | This facility | IA median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 2.29 | 3.15 | 3.28 | 2.90–3.77 |
| RN | 0.05 | 0.46 | 0.39 | 0.25–0.58 |
| Weekend total | 2.01 | 2.96 | 3.11 | — |
| Weekday total | 2.40 | 3.20 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 54.8 | 2.29 | 0.05 | 0.05 | 2.20 | 2.01 | 20.7% |
| 2025Q3 | 92 | 57.0 | 2.09 | 0.24 | 0.17 | 1.68 | 1.79 | 39.9% |
| 2025Q2 | 91 | 50.1 | 2.30 | 0.23 | 0.34 | 1.73 | 2.03 | 40.1% |
| 2025Q1 | 90 | 47.3 | 2.43 | 0.19 | 0.37 | 1.88 | 2.19 | 40.1% |
| 2024Q4 | 92 | 47.4 | 2.52 | 0.16 | 0.49 | 1.86 | 2.24 | 44.6% |
| 2024Q3 | 92 | 48.5 | 2.25 | 0.14 | 0.35 | 1.75 | 2.05 | 44.1% |
| 2024Q2 | 91 | 49.9 | 2.22 | 0.17 | 0.43 | 1.62 | 2.07 | 41.8% |
| 2024Q1 | 91 | 52.9 | 2.13 | 0.21 | 0.27 | 1.65 | 2.03 | 37.8% |
| 2023Q4 | 92 | 53.5 | 2.16 | 0.14 | 0.42 | 1.60 | 1.81 | 44.6% |
| 2023Q3 | 92 | 51.7 | 1.93 | 0.18 | 0.38 | 1.37 | 1.80 | 29.4% |
| 2023Q2 | 91 | 48.3 | 1.95 | 0.13 | 0.36 | 1.46 | 1.64 | 27.8% |
| 2023Q1 | 90 | 52.2 | 1.61 | 0.03 | 0.19 | 1.38 | 1.35 | 18.9% |
| 2022Q4 | 92 | 53.9 | 1.71 | 0.03 | 0.21 | 1.47 | 1.50 | 18.0% |
| 2022Q3 | 92 | 53.9 | 1.85 | 0.03 | 0.22 | 1.60 | 1.44 | 17.2% |
| 2022Q2 | 91 | 56.6 | 1.72 | 0.03 | 0.23 | 1.47 | 1.34 | 20.9% |
| 2022Q1 | 90 | 56.6 | 1.59 | 0.01 | 0.16 | 1.41 | 1.32 | 16.5% |
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-12-15 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2025-12-22 |
| 2025-10-08 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2025-10-10 |
| 2025-06-26 | 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 | 2025-07-11 |
| 2025-06-26 | Health | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | 2025-07-11 |
| 2025-06-26 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2025-07-11 |
| 2025-06-26 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2025-07-11 |
| 2025-06-26 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-07-11 |
| 2025-06-26 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2025-07-11 |
| 2025-06-26 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2025-07-11 |
| 2024-10-22 | Health · complaint | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | D | 2024-11-01 |
| 2024-10-22 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | E | 2024-11-01 |
| 2024-08-11 | Health | F0625 | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. | D | 2024-09-05 |
| 2024-08-11 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2024-09-05 |
| 2024-08-11 | 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 | 2024-09-05 |
| 2024-08-11 | 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 | 2024-09-05 |
| 2024-08-11 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-09-05 |
| 2024-08-11 | 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 | 2024-09-05 |
| 2024-08-11 | Health | F0803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | E | 2024-09-05 |
| 2024-08-11 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-09-05 |
| 2024-08-11 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | E | 2024-09-05 |
| 2024-08-11 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2024-09-05 |
| 2024-05-15 | Health · complaint | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | D | 2024-05-31 |
| 2024-05-15 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2024-05-31 |
| 2023-06-06 | Health | F0578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | 2023-06-26 |
| 2023-06-06 | Health | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | 2023-06-26 |
| 2023-06-06 | Health · complaint | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | D | 2023-06-26 |
| 2023-06-06 | Health | F0610 | Respond appropriately to all alleged violations. | D | 2023-06-26 |
| 2023-06-06 | 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 | 2023-06-26 |
| 2023-06-06 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2023-06-26 |
| 2023-06-06 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | G | 2023-06-26 |
| 2023-06-06 | Health | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | 2023-06-26 |
| 2023-06-06 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2023-06-26 |
| 2023-06-06 | Health | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | 2023-06-26 |
| 2023-06-06 | Health | F0727 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | E | 2023-06-26 |
| 2023-06-06 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2023-06-26 |
| 2023-06-06 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2023-06-26 |
| 2023-06-06 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2023-06-26 |
| 2023-06-06 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2023-06-26 |
| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| AMERICAN LUTHERAN CHURCH | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2003-02-14 | current | pecos_ownership |
| BLAKESTAD, ALAN | CORPORATE OFFICER | — | 2020-03-01 | current | pecos_ownership |
| GUDE, PAUL | CORPORATE OFFICER | — | 2021-03-01 | current | pecos_ownership |
| NIELSEN, PHIL | CORPORATE OFFICER | — | 2016-03-06 | current | pecos_ownership |
| NORBY, NICKLOS | OPERATIONAL/MANAGERIAL CONTROL | — | 2020-02-14 | current | pecos_ownership |
| SCHECHINGER, TAMI | CORPORATE OFFICER | — | 2021-03-01 | current | pecos_ownership |
| SHELL, STEPHEN | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-08-01 | current | pecos_ownership |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | OPERATIONAL/MANAGERIAL CONTROL | — | 2007-11-20 | current | pecos_ownership |
| ALAN BLAKESTAD | CORPORATE OFFICER | — | 2020-03-01 | ended 2026-05-18 | pecos_ownership |
| NICKLOS NORBY | OPERATIONAL/MANAGERIAL CONTROL | — | 2020-02-14 | ended 2026-05-18 | pecos_ownership |
| PAUL GUDE | CORPORATE OFFICER | — | 2021-03-01 | ended 2026-05-18 | pecos_ownership |
| PHIL NIELSEN | CORPORATE OFFICER | — | 2016-03-06 | ended 2026-05-18 | pecos_ownership |
| TAMI SCHECHINGER | CORPORATE OFFICER | — | 2021-03-01 | ended 2026-05-18 | pecos_ownership |
| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-09-01 | St Luke's Regional Medical Center SNF | — | — | — | 20 | NORTHWEST IOWA HOSPITAL CORPORATION |
| 2025-08-01 | Crystal Heights Care Center | — | — | — | 72 | CANFIELD RIVER HEALTHCARE LLC |
| 2025-06-01 | AMS Memorial-Greene | — | — | — | 31 | AMS MEMORIAL-GREENE LLC |
| 2025-02-05 | Chapters Living of Council Bluffs | — | — | — | 102 | CHAPTERS COUNCIL BLUFFS OPCO LLC |
| 2025-02-01 | Osage Rehab and Health Care Center | — | — | — | 46 | OPCO OSAGE IA LLC |
| 2025-02-01 | Iowa City Rehab & Health Care | — | — | — | 89 | OPCO IOWA CITY IA LLC |
| 2025-02-01 | Accura Healthcare of Creston | — | — | — | 31 | ACCURA HEALTHCARE OF CRESTON LLC |
| 2025-02-01 | Casa De Paz Health Care Center | — | — | — | 71 | OPCO 19TH ST SIOUX CITY IA LLC |
| 2025-02-01 | Pleasant Acres Care Center | — | — | — | 46 | OPCO HULL IA LLC |
| 2025-02-01 | Cedar Falls Health Care Center | — | — | — | 70 | OPCO CEDAR FALLS IA LLC |
| 2025-02-01 | Accura Healthcare of Onawa | — | — | — | 46 | ACCURA HEALTHCARE OF ONAWA LLC |
| 2025-02-01 | Grundy Care Center | — | — | — | 40 | OPCO GRUNDY CENTER IA LLC |
| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 19165 | fmr | 0 | $682 | 2025-10-01 | HUD_USER_FMR |
| county 19165 | acs median gross | 1 | $563 | 2024-12-31 | CENSUS_ACS5 |
| county 19165 | fmr | 1 | $838 | 2025-10-01 | HUD_USER_FMR |
| county 19165 | acs median gross | 2 | $781 | 2024-12-31 | CENSUS_ACS5 |
| county 19165 | fmr | 2 | $919 | 2025-10-01 | HUD_USER_FMR |
| county 19165 | acs median gross | 3 | $933 | 2024-12-31 | CENSUS_ACS5 |
| county 19165 | fmr | 3 | $1,278 | 2025-10-01 | HUD_USER_FMR |
| county 19165 | acs median gross | 4 | $875 | 2024-12-31 | CENSUS_ACS5 |
| county 19165 | fmr | 4 | $1,309 | 2025-10-01 | HUD_USER_FMR |
| county 19165 | acs median gross | 5 | $1,397 | 2024-12-31 | CENSUS_ACS5 |
| county 19165 | acs median gross | $783 | 2024-12-31 | CENSUS_ACS5 | |
| county 19165 | acs recent mover gross | $584 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 51531 | acs median gross | 1 | $670 | 2024-12-31 | CENSUS_ACS5 |
| zcta 51531 | acs median gross | 2 | $533 | 2024-12-31 | CENSUS_ACS5 |
| zcta 51531 | acs median gross | 3 | $922 | 2024-12-31 | CENSUS_ACS5 |
| zcta 51531 | acs median gross | $668 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 51531 | acs recent mover gross | $922 | 2024-12-31 | CENSUS_ACS5 | |
| zip 51531 | payment standard 110 | 0 | $748 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | payment standard 90 | 0 | $612 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | safmr | 0 | $680 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | payment standard 110 | 1 | $924 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | payment standard 90 | 1 | $756 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | safmr | 1 | $840 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | payment standard 110 | 2 | $1,012 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | payment standard 90 | 2 | $828 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | safmr | 2 | $920 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | payment standard 110 | 3 | $1,375 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | payment standard 90 | 3 | $1,125 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | safmr | 3 | $1,250 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | payment standard 110 | 4 | $1,463 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | payment standard 90 | 4 | $1,197 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51531 | safmr | 4 | $1,330 | 2025-10-01 | HUD_USER_SAFMR |