Composite
97.0 / 100 percentile
Screener / 265001
F
ATHENE NURSING AND REHABILITATION
snfMO
13995 CLAYTON ROAD, TOWN AND COUNTRY, MO 63017 · CCN 265001 · chain VHS MO OPCO HOLDINGS LLC
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
282
Model
v1.2
Reads as: riskier than 97.0% 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 model5ML signals5Components16CHOW radar1Distress radar1Staffing16Penalties11Deficiencies116Licensure0Ownership10Related party6Transactions1Comps12Market rent36
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 97.4 | 96.1 | 0.30 | 0.2308 | 22.48 | in index |
| financial risk | 96.0 | 86.3 | 0.30 | 0.2308 | 22.15 | in index |
| staffing risk | 97.5 | 97.5 | 0.25 | 0.1923 | 18.75 | in index |
| chow risk | 55.0 | 61.1 | 0.15 | 0.1154 | 6.35 | in index |
| billing conduct | 20.7 | 25.7 | 0.30 | 0.2308 | 4.78 | 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.
ML signals — parallel engine
5| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +39.7 vs natl | MAYLACK ELIZABETH | 6 facilities |
| connection | Owner fleet risk far above national | +39.0 vs natl | VHS MO OPCO HOLDINGS LLC | 9 facilities |
| connection | Owner fleet risk far above national | +25.0 vs natl | MILLER WILLIAM | 18 facilities |
| connection | Owner fleet enforcement cluster | 50% fined | MAYLACK ELIZABETH | 6 facilities |
| connection | Owner fleet enforcement cluster | 44% fined | VHS MO OPCO HOLDINGS LLC | 9 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.
Component scores and registry models
16| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 25.6 | B | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 23.9 | A | 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 | 98.4 | F | v0.6 | default · in composite | |
| financial risk | 86.3 | F | v0.5 | default · in composite | R18. |
| p adverse action 12m | 0.0 | — | 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 | 0.1 | — | 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 | 96.1 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 97.5 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 95.4 | F | 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 | 75.4 | D | 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 | 69.4 | D | 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 | 85.6 | F | 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 | 96.2 | F | 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 | 96.2 | F | 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 | 97.5 | 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 | 97.5 | 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. |
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)
0.1%
model v0.1 · computed 2026-07-29
Percentile among SNFs
21.2
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Never sold on record | 0.00 | -1.62 | |
| Current owner tenure (years) | 3.16 | -1.54 | |
| Ownership changes, last 5 years | 1.00 | -0.87 | |
| For-profit ownership | 1.00 | +0.69 | |
| Deficiencies, last 12 months | 32.00 | +0.61 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Occupancy | 0.58 | +0.34 | |
| Facility size (log beds) | 5.65 | -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)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
0.0
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Deficiencies, last 12 months | 32.00 | -4.51 | |
| Occupancy | 0.58 | +0.71 | |
| For-profit ownership | 1.00 | -0.69 | |
| Total nurse staffing (HPRD) | 2.06 | +0.48 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Never sold on record | 0.00 | -0.28 | |
| Facility size (log beds) | 5.65 | -0.27 | |
| Current owner tenure (years) | 3.16 | -0.25 |
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 | MO median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 2.06 | 2.41 | 3.28 | 2.90–3.77 |
| RN | 0.20 | 0.25 | 0.39 | 0.25–0.58 |
| Weekend total | 1.87 | 2.24 | 3.11 | — |
| Weekday total | 2.14 | 2.49 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 163.6 | 2.06 | 0.20 | 0.48 | 1.39 | 1.87 | 0.0% |
| 2025Q3 | 92 | 156.5 | 2.23 | 0.22 | 0.63 | 1.38 | 2.04 | 0.0% |
| 2025Q2 | 91 | 157.2 | 1.99 | 0.21 | 0.48 | 1.31 | 1.78 | 0.0% |
| 2025Q1 | 90 | 149.2 | 2.05 | 0.18 | 0.52 | 1.35 | 1.83 | 0.0% |
| 2024Q4 | 92 | 141.7 | 2.38 | 0.21 | 0.58 | 1.60 | 2.23 | 0.0% |
| 2024Q3 | 92 | 141.1 | 2.15 | 0.19 | 0.54 | 1.43 | 2.03 | 0.0% |
| 2024Q2 | 91 | 133.0 | 2.17 | 0.22 | 0.61 | 1.33 | 2.05 | 0.0% |
| 2024Q1 | 91 | 128.7 | 2.37 | 0.25 | 0.71 | 1.41 | 2.15 | 0.8% |
| 2023Q4 | 92 | 130.1 | 2.56 | 0.26 | 0.70 | 1.60 | 2.31 | 3.4% |
| 2023Q3 | 92 | 136.5 | 2.37 | 0.24 | 0.54 | 1.59 | 2.13 | 5.7% |
| 2023Q2 | 91 | 156.1 | 1.72 | 0.23 | 0.49 | 0.99 | 1.38 | 3.7% |
| 2023Q1 | 90 | 137.5 | 1.56 | 0.20 | 0.53 | 0.83 | 1.53 | 18.9% |
| 2022Q4 | 92 | 102.9 | 1.76 | 0.21 | 0.55 | 0.99 | 1.63 | 1.1% |
| 2022Q3 | 92 | 94.4 | 1.84 | 0.16 | 0.36 | 1.32 | 1.71 | 0.5% |
| 2022Q2 | 91 | 96.5 | 2.00 | 0.12 | 0.51 | 1.38 | 1.76 | 1.3% |
| 2022Q1 | 90 | 107.7 | 1.66 | 0.24 | 0.38 | 1.03 | 1.61 | 2.6% |
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
11fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2026-01-13 | Payment Denial | — | CMS provider data |
| 2025-06-12 | Fine | $23,741 | CMS provider data |
| 2024-02-02 | Fine | $17,165 | CMS provider data |
| 2023-09-28 | Fine | $63,591 | CMS provider data |
| 2023-09-28 | Payment Denial | — | CMS provider data |
| 2023-09-25 | Fine | $4,587 | CMS provider data |
| 2023-09-05 | Fine | $13,762 | CMS provider data |
| 2023-08-14 | Fine | $4,587 | CMS provider data |
| 2023-08-07 | Fine | $4,587 | CMS provider data |
| 2023-07-17 | Fine | $13,762 | CMS provider data |
| 2023-06-26 | Fine | $4,587 | CMS provider data |
Total fines on record: $150,369
Deficiencies
116C × 2D × 62E × 39F × 9G × 1J × 3
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-03-04 | Health · complaint | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | D | — |
| 2026-01-13 | Health | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2026-02-27 |
| 2026-01-13 | Health · complaint | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | D | 2026-02-27 |
| 2026-01-13 | Health · complaint | F0575 | Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency. | E | 2026-02-27 |
| 2026-01-13 | Health | F0576 | Ensure residents have reasonable access to and privacy in their use of communication methods. | E | 2026-02-27 |
| 2026-01-13 | 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. | E | 2026-02-27 |
| 2026-01-13 | 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. | E | 2026-02-27 |
| 2026-01-13 | Health · complaint | F0628 | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | 2026-02-27 |
| 2026-01-13 | 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 | 2026-02-27 |
| 2026-01-13 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2026-02-27 |
| 2026-01-13 | Health | F0676 | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | 2026-02-27 |
| 2026-01-13 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2026-02-27 |
| 2026-01-13 | Health | F0679 | Provide activities to meet all resident's needs. | E | 2026-02-27 |
| 2026-01-13 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | E | 2026-02-27 |
| 2026-01-13 | Health | F0687 | Provide appropriate foot care. | E | 2026-02-27 |
| 2026-01-13 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2026-02-27 |
| 2026-01-13 | Health · complaint | 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. | E | 2026-02-27 |
| 2026-01-13 | Health | F0693 | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | 2026-02-27 |
| 2026-01-13 | Health | F0740 | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | D | 2026-02-27 |
| 2026-01-13 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | G | 2026-02-27 |
| 2026-01-13 | 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 | 2026-02-27 |
| 2026-01-13 | Health | F0808 | Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. | D | 2026-02-27 |
| 2026-01-13 | Health | F0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | E | 2026-02-27 |
| 2026-01-13 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2026-02-27 |
| 2026-01-13 | Health | F0881 | Implement a program that monitors antibiotic use. | E | 2026-02-27 |
| 2025-11-18 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-12-05 |
| 2025-11-18 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2025-12-02 |
| 2025-11-18 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-12-05 |
| 2025-11-18 | Health · complaint | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2025-12-05 |
| 2025-11-18 | Health · complaint | F0740 | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | D | 2025-12-02 |
| 2025-11-18 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2025-12-05 |
| 2025-07-31 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-07-01 |
| 2025-06-12 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | J | 2025-06-13 |
| 2025-06-12 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2025-06-13 |
| 2025-06-12 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | D | 2025-06-13 |
| 2025-04-16 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | D | 2025-05-02 |
| 2025-01-14 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2025-01-14 |
| 2025-01-14 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | D | 2025-01-29 |
| 2025-01-14 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2025-01-29 |
| 2024-08-29 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2024-10-01 |
| 2024-08-02 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | D | 2024-07-31 |
| 2024-07-01 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | E | 2024-06-30 |
| 2024-07-01 | Health · complaint | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2024-08-01 |
| 2024-07-01 | Health · complaint | F0740 | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | D | 2024-08-01 |
| 2024-06-04 | Health · complaint | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | D | 2024-06-03 |
| 2024-02-15 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-03-19 |
| 2024-02-15 | Health · complaint | F0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | 2024-03-19 |
| 2024-02-15 | Health | F0572 | Give residents a notice of rights, rules, services and charges. | E | 2024-03-19 |
| 2024-02-15 | 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 | 2024-03-19 |
| 2024-02-15 | Health | F0604 | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | D | 2024-03-19 |
| 2024-02-15 | Health | F0605 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | D | 2024-03-19 |
| 2024-02-15 | 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 | 2024-03-19 |
| 2024-02-15 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2024-03-19 |
| 2024-02-15 | Health | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | 2024-03-19 |
| 2024-02-15 | 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 | 2024-03-19 |
| 2024-02-15 | 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 | 2024-03-19 |
| 2024-02-15 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2024-04-11 |
| 2024-02-15 | Health | F0679 | Provide activities to meet all resident's needs. | E | 2024-03-19 |
| 2024-02-15 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-03-19 |
| 2024-02-15 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | 2024-03-19 |
| 2024-02-15 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2024-03-19 |
| 2024-02-15 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2024-03-19 |
| 2024-02-15 | Health | F0726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | D | 2024-03-19 |
| 2024-02-15 | 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. | D | 2024-03-19 |
| 2024-02-15 | 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 | 2024-03-19 |
| 2024-02-15 | 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. | E | 2024-03-19 |
| 2024-02-15 | Health | F0777 | Provide or obtain x-rays/tests when ordered and promptly tell the ordering practitioner of the results. | D | 2024-03-19 |
| 2024-02-15 | Health | F0809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | E | 2024-03-19 |
| 2024-02-15 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-03-19 |
| 2024-02-15 | Health · complaint | F0865 | Have a plan that describes the process for conducting QAPI and QAA activities. | F | 2024-03-19 |
| 2024-02-15 | Health · complaint | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | F | 2024-03-19 |
| 2024-02-15 | Health | F0880 | Provide and implement an infection prevention and control program. | F | 2024-04-30 |
| 2024-02-15 | Health | F0881 | Implement a program that monitors antibiotic use. | F | 2024-03-19 |
| 2024-02-15 | Health | F0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | D | 2024-03-19 |
| 2024-02-15 | Health · complaint | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | 2024-03-19 |
| 2024-02-02 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | 2024-01-12 |
| 2023-11-16 | Health · complaint | F0567 | Honor the resident's right to manage his or her financial affairs. | E | 2023-12-08 |
| 2023-11-16 | Health · complaint | F0568 | Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. | E | 2023-12-08 |
| 2023-11-16 | Health · complaint | F0570 | Assure the security of all personal funds of residents deposited with the facility. | E | 2023-12-08 |
| 2023-11-16 | Health · complaint | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | E | 2023-12-08 |
| 2023-09-28 | Health · complaint | F0572 | Give residents a notice of rights, rules, services and charges. | D | 2023-11-08 |
| 2023-09-28 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | 2023-11-08 |
| 2023-07-25 | 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. | E | 2023-08-18 |
| 2023-07-25 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2023-08-18 |
| 2023-07-25 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2023-08-18 |
| 2023-06-08 | 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. | E | 2023-08-18 |
| 2023-06-08 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2023-08-18 |
| 2023-06-08 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2023-08-18 |
| 2023-06-08 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2023-08-18 |
| 2023-06-08 | Health · complaint | F0835 | Administer the facility in a manner that enables it to use its resources effectively and efficiently. | F | 2023-06-10 |
| 2021-08-31 | Health | F0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | 2021-10-15 |
| 2021-08-31 | Health | F0570 | Assure the security of all personal funds of residents deposited with the facility. | E | 2021-10-15 |
| 2021-08-31 | Health | F0577 | Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. | C | 2021-10-15 |
| 2021-08-31 | 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. | E | 2021-10-15 |
| 2021-08-31 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2021-10-15 |
| 2021-08-31 | 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. | E | 2021-10-15 |
| 2021-08-31 | Health | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2021-10-15 |
| 2021-08-31 | Health | F0622 | Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | D | 2021-10-15 |
| 2021-08-31 | 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 | 2021-10-15 |
| 2021-08-31 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2021-10-15 |
| 2021-08-31 | Health | F0679 | Provide activities to meet all resident's needs. | F | 2021-10-15 |
| 2021-08-31 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2021-10-15 |
| 2021-08-31 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2021-10-15 |
| 2021-08-31 | 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 | 2021-10-15 |
| 2021-08-31 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2021-10-15 |
| 2021-08-31 | Health | F0700 | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | D | 2021-10-15 |
| 2021-08-31 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2021-10-15 |
| 2021-08-31 | 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. | E | 2021-10-15 |
| 2021-08-31 | Health | F0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | F | 2021-10-15 |
| 2021-08-31 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | F | 2021-10-15 |
| 2021-08-31 | Health | F0809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | E | 2021-10-15 |
| 2021-08-31 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | C | 2021-10-15 |
| 2021-08-31 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2021-10-15 |
| 2021-08-31 | Health | F0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | E | 2021-10-15 |
| 2021-08-31 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2021-10-15 |
| 2021-08-31 | Health | F0909 | Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame. | E | 2021-10-15 |
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
10| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| CLAYTON ROAD CONSULTING LLC | ADP OF THE SNF | — | 2025-03-24 | current | pecos_ownership |
| CLAYTON ROAD CONSULTING LLC | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-06-01 | current | pecos_ownership |
| MAYLACK, ELIZABETH | ADP OF THE SNF | — | 2025-03-24 | current | pecos_ownership |
| MILLER, WILLIAM | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-06-01 | current | pecos_ownership |
| MITCHELL, RYAN | ADP OF THE SNF | — | 2025-03-24 | current | pecos_ownership |
| VHS MO OPCO HOLDINGS LLC | DIRECT OWNERSHIP INTEREST | — | 2023-06-01 | current | pecos_ownership |
| WILLIAM MILLER | INDIRECT OWNERSHIP INTEREST | 100% | 2023-06-01 | ended 2026-05-18 | pecos_ownership |
| ELIZABETH MAYLACK | ADP OF THE SNF | — | 2025-03-24 | ended 2026-05-18 | pecos_ownership |
| RYAN MITCHELL | ADP OF THE SNF | — | 2025-03-24 | ended 2026-05-18 | pecos_ownership |
| T&C PROPERTIES MISSOURI LLC | Corporation, partnership or other organization has financial interest in provider | — | 2021-01-01 | ended 2021-12-31 | hcris_a_8_1 |
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.
Transactions
1| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2023-06-01 | — | CLAYTON ROAD HEALTHCARE LLC | TANDC OP LLC | chow |
Comparable trades — MO snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-10-01 | AVENIR AT MAPLE GROVE | — | — | — | 90 | NBH2 MGOPCO LLC |
| 2025-10-01 | AVENIR AT MARK TWAIN | — | — | — | 120 | NBH1 MTOPCO LLC |
| 2025-10-01 | ARBOR HILLS CARE & REHAB CENTER | — | — | — | 150 | ARBOR HILLS HEALTHCARE, LLC |
| 2025-10-01 | ASCEND AT AURORA | — | — | — | 125 | NBH3 SFOPCO LLC |
| 2025-09-01 | HUBBLE CREEK | — | — | — | 105 | HUBBLE CREEK LLC |
| 2025-08-01 | HIDDEN LAKE HEALTH CARE CENTER | — | — | — | 67 | HIDDEN LAKE HEALTH CARE CENTER, LLC |
| 2025-05-01 | PINE GROVE MANOR | — | — | — | 77 | PINE GROVE MANOR LLC |
| 2025-05-01 | MONARCH SPRINGS WELLNESS & REHABILITATION | — | — | — | 119 | MONARCH SPRINGS WELLNESS & REHABILITATION LLC |
| 2025-05-01 | ASPIRE SENIOR LIVING NEW FLORENCE | — | — | — | 87 | ASPIRE SENIOR LIVING NEW FLORENCE LLC |
| 2025-04-01 | SOUTH COUNTY HEALTH CARE CENTER | — | — | — | 153 | SOUTH COUNTY HEALTH CARE CENTER, L.L.C. |
| 2025-02-01 | ARBOR VIEW NURSING AND REHABILITATION | — | — | — | 150 | FORREST OPCO LLC |
| 2025-02-01 | AMBERWOOD ESTATES NURSING AND REHABILITATION | — | — | — | 115 | ISLAND HC OPERATIONS 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
36| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 29189 | acs median gross | 0 | $1,067 | 2024-12-31 | CENSUS_ACS5 |
| county 29189 | fmr | 0 | $955 | 2025-10-01 | HUD_USER_FMR |
| county 29189 | acs median gross | 1 | $995 | 2024-12-31 | CENSUS_ACS5 |
| county 29189 | fmr | 1 | $995 | 2025-10-01 | HUD_USER_FMR |
| county 29189 | acs median gross | 2 | $1,216 | 2024-12-31 | CENSUS_ACS5 |
| county 29189 | fmr | 2 | $1,218 | 2025-10-01 | HUD_USER_FMR |
| county 29189 | acs median gross | 3 | $1,446 | 2024-12-31 | CENSUS_ACS5 |
| county 29189 | fmr | 3 | $1,568 | 2025-10-01 | HUD_USER_FMR |
| county 29189 | acs median gross | 4 | $1,742 | 2024-12-31 | CENSUS_ACS5 |
| county 29189 | fmr | 4 | $1,812 | 2025-10-01 | HUD_USER_FMR |
| county 29189 | acs median gross | 5 | $1,850 | 2024-12-31 | CENSUS_ACS5 |
| county 29189 | acs median gross | $1,209 | 2024-12-31 | CENSUS_ACS5 | |
| county 29189 | acs recent mover gross | $1,369 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 63017 | acs median gross | 0 | $1,759 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63017 | acs median gross | 1 | $1,458 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63017 | acs median gross | 2 | $1,770 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63017 | acs median gross | 3 | $1,912 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63017 | acs median gross | 4 | $2,250 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63017 | acs median gross | 5 | $1,114 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63017 | acs median gross | $1,709 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 63017 | acs recent mover gross | $1,691 | 2024-12-31 | CENSUS_ACS5 | |
| zip 63017 | payment standard 110 | 0 | $1,474 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | payment standard 90 | 0 | $1,206 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | safmr | 0 | $1,340 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | payment standard 110 | 1 | $1,540 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | payment standard 90 | 1 | $1,260 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | safmr | 1 | $1,400 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | payment standard 110 | 2 | $1,881 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | payment standard 90 | 2 | $1,539 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | safmr | 2 | $1,710 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | payment standard 110 | 3 | $2,420 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | payment standard 90 | 3 | $1,980 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | safmr | 3 | $2,200 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | payment standard 110 | 4 | $2,794 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | payment standard 90 | 4 | $2,286 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63017 | safmr | 4 | $2,540 | 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.