Screener / 445393

SIGNATURE HEALTHCARE OF MONTEAGLE REHAB & WELLNESS

snfTN

26 SECOND STREET, MONTEAGLE, TN 37356 · CCN 445393 · chain WHEATEN LLC

Composite

68.5 / 100 percentile

Peer group

snf n = 14,684

Evidence depth

deep

Certified beds

150

Model

v1.2

Reads as: riskier than 68.5% 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 model5 ML signals1 Components16 CHOW radar1 Distress radar1 Staffing16 Penalties2 Deficiencies21 Licensure0 Ownership15 Related party5 Transactions0 Comps12 Market rent30

Composite explanation

Component	Percentile	Raw	Weight	Weight share	Contribution	Counts
regulatory risk	70.7	65.8	0.30	0.2308	16.32	in index
financial risk	70.5	59.5	0.30	0.2308	16.27	in index
staffing risk	54.7	54.7	0.25	0.1923	10.52	in index
chow risk	54.1	52.3	0.15	0.1154	6.24	in index
billing conduct	26.0	29.6	0.30	0.2308	6.00	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

Kind	Finding	Signal	Subject	First seen
connection	Owner spans multiple chains	6 chains	HARRISON JOHN	71 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

Score type	Score	Grade	Model	Status	Registry model notes
billing conduct	29.6	B	v0.1-pacpuf-snf	default · in composite	R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup.
chow risk	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	79.6	D	v0.6	default · in composite
financial risk	59.5	C	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	14.8	—	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	65.8	D	v0.3	default · in composite	Deficiency-based, SNF population. Runs alongside v0.5-pos.
staffing risk	54.7	C	v0.3	default · in composite	Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS.
financial risk	82.3	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	62.3	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	48.6	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	63.9	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	65.6	D	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	65.6	D	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	54.7	C	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	54.7	C	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)

14.8%

model v0.1 · computed 2026-07-29

Percentile among SNFs

99.4

100 = most likely to sell

Holdout AUC

0.874

evaluated before shipping, never refit

Driver	Value	Pull on odds
For-profit ownership	1.00	+0.69
Occupancy	0.46	+0.69
Never sold on record	1.00	+0.62
Current owner tenure (years)	25.00	+0.57
Chain size (log)	4.29	+0.51
No PBJ staffing report	0.00	+0.42
Ownership changes, last 5 years	0.00	+0.20
Facility size (log beds)	5.02	-0.10

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

27.7

100 = most likely to lose certification

Holdout AUC

0.971

top decile caught 95% of actual exits

Driver	Value	Pull on odds
Chain size (log)	4.29	-1.29
Occupancy	0.46	+1.22
For-profit ownership	1.00	-0.69
Deficiencies, last 12 months	10.00	-0.43
No PBJ staffing report	0.00	+0.39
Fine amount, 12m (log)	0.00	+0.18
Facility size (log beds)	5.02	-0.14
Never sold on record	1.00	+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

2025Q4 HPRD	This facility	TN median	National median	National p25–p75
Total nurse	3.21	3.28	3.28	2.90–3.77
RN	0.14	0.34	0.39	0.25–0.58
Weekend total	3.14	3.10	3.11	—
Weekday total	3.24	3.36	3.35	—

Quarter	Days	Avg census	Total HPRD	RN	LPN	CNA	Weekend	Contract %
2025Q4	92	68.9	3.21	0.14	1.06	2.01	3.14	5.0%
2025Q3	92	68.0	3.10	0.10	0.90	2.10	2.89	0.0%
2025Q2	91	64.4	3.17	0.10	0.99	2.08	3.02	0.0%
2025Q1	90	64.1	3.17	0.23	0.92	2.02	3.15	0.0%
2024Q4	92	63.9	3.39	0.24	0.96	2.19	3.33	20.6%
2024Q3	92	71.5	3.52	0.18	1.00	2.35	3.48	33.0%
2024Q2	91	72.4	2.84	0.15	0.87	1.82	2.82	19.8%
2024Q1	91	77.7	2.85	0.18	0.92	1.75	2.79	10.8%
2023Q4	92	79.2	3.26	0.23	1.17	1.86	2.96	10.2%
2023Q3	92	85.7	3.15	0.17	1.10	1.88	2.89	7.6%
2023Q2	91	84.8	2.87	0.14	1.02	1.70	2.61	2.8%
2023Q1	90	85.9	2.86	0.16	0.94	1.76	2.77	0.6%
2022Q4	92	81.4	2.86	0.09	1.00	1.77	2.58	0.4%
2022Q3	92	84.3	2.98	0.14	0.93	1.91	2.75	1.1%
2022Q2	91	84.7	2.62	0.14	0.77	1.72	2.54	0.0%
2022Q1	90	82.4	2.81	0.10	0.83	1.88	2.83	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

fines by year

Date	Type	Fine	Source
2024-07-31	Fine	$31,902	CMS provider data
2023-08-03	Fine	$7,605	CMS provider data

Total fines on record: $39,507

Deficiencies

D × 16F × 3G × 2

deficiencies by survey year

Survey	Type	Tag	Deficiency	Scope	Corrected
2025-09-17	Health	F0569	Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.	D	2025-10-15
2025-09-17	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	2025-10-15
2025-09-17	Health	F0636	Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.	D	2025-10-15
2025-09-17	Health	F0640	Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.	D	2025-10-15
2025-09-17	Health	F0641	Ensure each resident receives an accurate assessment.	D	2025-10-15
2025-09-17	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	2025-10-15
2025-09-17	Health	F0686	Provide appropriate pressure ulcer care and prevent new ulcers from developing.	D	2025-10-15
2025-09-17	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.	F	2025-10-15
2025-09-17	Health	F0814	Dispose of garbage and refuse properly.	D	2025-10-15
2025-09-17	Health	F0880	Provide and implement an infection prevention and control program.	D	2025-10-15
2024-07-31	Health	F0558	Reasonably accommodate the needs and preferences of each resident.	D	2024-08-22
2024-07-31	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.	D	2024-08-22
2024-07-31	Health · complaint	F0600	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	G	2024-08-22
2024-07-31	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	2024-08-22
2024-07-31	Health	F0684	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	2024-08-22
2024-07-31	Health	F0732	Post nurse staffing information every day.	F	2024-08-22
2024-07-31	Health	F0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	F	2024-08-22
2024-07-31	Health	F0880	Provide and implement an infection prevention and control program.	D	2024-08-22
2023-08-03	Health · complaint	F0600	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	G	2023-08-23
2021-08-04	Health	F0658	Ensure services provided by the nursing facility meet professional standards of quality.	D	2021-09-06
2021-08-04	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.	D	2021-09-06

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

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

Owner	Role	Pct	From	Status	Source
LP CR HOLDINGS LLC	5% OR GREATER DIRECT OWNERSHIP INTEREST	100%	2007-11-01	current	pecos_ownership
SHC LP HOLDINGS II LLC	Corporation, partnership or other organization has financial interest in provider	100%	2024-01-01	current	hcris_a_8_1
SHC LP HOLDINGS III LLC	Corporation, partnership or other organization has financial interest in provider	100%	2024-01-01	current	hcris_a_8_1
AGEMO HOLDINGS LLC	5% OR GREATER INDIRECT OWNERSHIP INTEREST	—	2016-10-01	current	pecos_ownership
HARRISON, JOHN	CORPORATE OFFICER	—	2007-11-01	current	pecos_ownership
JJLA LLC	5% OR GREATER INDIRECT OWNERSHIP INTEREST	—	2007-11-01	current	pecos_ownership
LEVIEUX, AMANDA	W-2 MANAGING EMPLOYEE	—	2022-10-10	current	pecos_ownership
LPSNF II LLC	5% OR GREATER INDIRECT OWNERSHIP INTEREST	—	2016-10-01	current	pecos_ownership
STEIER III, ELMER	5% OR GREATER INDIRECT OWNERSHIP INTEREST	—	2007-11-01	current	pecos_ownership
WHEATEN LLC	5% OR GREATER INDIRECT OWNERSHIP INTEREST	—	2007-11-01	current	pecos_ownership
ELMER STEIER III	5% OR GREATER INDIRECT OWNERSHIP INTEREST	20%	2007-11-01	ended 2026-05-18	pecos_ownership
IRA SMEDRA	5% OR GREATER INDIRECT OWNERSHIP INTEREST	12%	2007-11-01	ended 2026-05-18	pecos_ownership
JOHN HARRISON	CORPORATE OFFICER	0%	2007-11-01	ended 2026-05-18	pecos_ownership
SIGNATURE HEALTHCARE LLC	OTHER	0%	2007-11-01	ended 2026-05-18	pecos_ownership
AMANDA LEVIEUX	W-2 MANAGING EMPLOYEE	—	2022-10-10	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

FY end	Total allowable	Rent	Home office	Therapy	Staffing	Counterparties	PropCo
2024-12-31	$1,337,707	—	$524,467	$433,215	$299,005	33	propco
2023-12-31	$1,062,264	—	$498,664	$455,064	$4,355	24	—
2022-12-31	$1,058,490	—	$449,157	$528,800	$12,869	24	—
2021-12-31	$985,354	—	$407,225	$507,112	$11,133	22	—
2020-12-31	$905,205	—	$416,124	$431,532	$9,752	19	—

Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.

Transactions

No 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 — TN snf

Close	Facility	Price	$/bed	Cap rate	Beds	Buyer
2025-05-01	WEXFORD HOUSE	—	—	—	174	WEXFORD OPERATING GROUP LLC
2025-05-01	LAUGHLIN HEALTH CARE CENTER	—	—	—	90	LAUGHLIN OPERATING GROUP LLC
2025-02-01	EATON CREEK POST ACUTE	—	—	—	124	NASHVILLE SNF HEALTHCARE LLC
2025-01-01	APPLINGWOOD POST ACUTE	—	—	—	78	DOHENY BEACH HOLDINGS LLC
2025-01-01	Meadowbrook Healthcare and Rehabilitation Center	—	—	—	83	BIG CREEK HEALTHCARE, INC.
2025-01-01	Westwood Nursing and Rehabilitation	—	—	—	90	BLACK WOLF HEALTHCARE LLC
2025-01-01	SHELBY OAKS POST ACUTE	—	—	—	77	EAGLE LAKE HOLDINGS LLC
2025-01-01	Stone River Post Acute	—	—	—	68	MURFREESBORO SNF HEALTHCARE LLC
2025-01-01	UNION CITY HEALTH AND REHABILITATION	—	—	—	115	TURNER HEALTHCARE INC
2025-01-01	Decatur County Healthcare	—	—	—	125	BEAR CREEK HEALTHCARE LLC
2025-01-01	COVINGTON POST ACUTE	—	—	—	98	FLORIDA BAY HOLDINGS LLC
2025-01-01	CYPRESS GROVE POST ACUTE	—	—	—	170	GOODHOPE BAY HOLDINGS 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

Geo	Kind	BR	Amount	As of	Source
county 47061	fmr	0	$724	2025-10-01	HUD_USER_FMR
county 47061	acs median gross	1	$387	2024-12-31	CENSUS_ACS5
county 47061	fmr	1	$844	2025-10-01	HUD_USER_FMR
county 47061	acs median gross	2	$645	2024-12-31	CENSUS_ACS5
county 47061	fmr	2	$925	2025-10-01	HUD_USER_FMR
county 47061	acs median gross	3	$768	2024-12-31	CENSUS_ACS5
county 47061	fmr	3	$1,162	2025-10-01	HUD_USER_FMR
county 47061	fmr	4	$1,289	2025-10-01	HUD_USER_FMR
county 47061	acs median gross		$636	2024-12-31	CENSUS_ACS5
county 47061	acs recent mover gross		$597	2024-12-31	CENSUS_ACS5
zcta 37356	acs median gross	1	$700	2024-12-31	CENSUS_ACS5
zcta 37356	acs median gross	2	$754	2024-12-31	CENSUS_ACS5
zcta 37356	acs median gross	3	$910	2024-12-31	CENSUS_ACS5
zcta 37356	acs median gross		$752	2024-12-31	CENSUS_ACS5
zcta 37356	acs recent mover gross		$584	2024-12-31	CENSUS_ACS5
zip 37356	payment standard 110	0	$869	2025-10-01	HUD_USER_SAFMR
zip 37356	payment standard 90	0	$711	2025-10-01	HUD_USER_SAFMR
zip 37356	safmr	0	$790	2025-10-01	HUD_USER_SAFMR
zip 37356	payment standard 110	1	$979	2025-10-01	HUD_USER_SAFMR
zip 37356	payment standard 90	1	$801	2025-10-01	HUD_USER_SAFMR
zip 37356	safmr	1	$890	2025-10-01	HUD_USER_SAFMR
zip 37356	payment standard 110	2	$1,067	2025-10-01	HUD_USER_SAFMR
zip 37356	payment standard 90	2	$873	2025-10-01	HUD_USER_SAFMR
zip 37356	safmr	2	$970	2025-10-01	HUD_USER_SAFMR
zip 37356	payment standard 110	3	$1,342	2025-10-01	HUD_USER_SAFMR
zip 37356	payment standard 90	3	$1,098	2025-10-01	HUD_USER_SAFMR
zip 37356	safmr	3	$1,220	2025-10-01	HUD_USER_SAFMR
zip 37356	payment standard 110	4	$1,463	2025-10-01	HUD_USER_SAFMR
zip 37356	payment standard 90	4	$1,197	2025-10-01	HUD_USER_SAFMR
zip 37356	safmr	4	$1,330	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.