Composite
29.3 / 100 percentile
Screener / 655000
A
GUAM MEMORIAL HOSPITAL AUTHORITY
snfGU
449 N SABANA DR, BARRIGADA, GU 96913 · CCN 655000
Peer group
snf n = 14,684
Evidence depth
moderate
Certified beds
40
Model
v1.2
Reads as: riskier than 29.3% of the 14,684 facilities in the snf peer group. percentile within peer group, 100 = highest risk. Grade bands are fixed percentile cuts (F is the top 5% of peer risk), so a grade is a position, not an absolute level.
Score model3Components9CHOW radar1Distress radar1Staffing13Penalties2Deficiencies52Licensure0Ownership20Related party0Transactions0Market rent5
Composite explanation
3| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 80.4 | 77.2 | 0.30 | 0.4286 | 34.46 | in index |
| chow risk | 25.2 | 25.0 | 0.15 | 0.2143 | 5.40 | in index |
| staffing risk | 1.6 | 1.7 | 0.25 | 0.3571 | 0.57 | in index |
weighted_contribution sums to pre_rank_index over rows where counts_toward_index is true. The composite is the facility's percentile position of that index within its peer group, so contributions explain the input, and the rank explains the score.
Component scores and registry models
9| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| chow risk | 25.0 | B | v0.1-pos | default · in composite | Change-of-ownership footprint in the CMS Provider of Services file: control-family, legal-name and address deltas across quarterly snapshots, plus certification reset recency and Medicare tenure. |
| p adverse action 12m | 0.0 | — | 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 | 0.7 | — | 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 | 77.2 | D | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 1.7 | A | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| regulatory risk | 77.1 | 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 | 77.1 | 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 | 1.7 | A | v0.1 | superseded | Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
| staffing risk | 1.7 | A | v0.2 | superseded | Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
Rows with counts_toward_composite false come from models that are addressable or retracted rather than default. They exist and may be informative, but they did not enter the published composite and must not be summed as though they had.
CHOW radar — 12-month sale probability
full board →p(CHOW, 12m)
0.7%
model v0.1 · computed 2026-07-29
Percentile among SNFs
56.7
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | -1.24 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| Total nurse staffing (HPRD) | 5.80 | -0.55 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Chain size (log) | 0.00 | -0.40 | |
| Deficiencies, last 12 months | 18.00 | +0.27 | |
| Ownership changes, last 5 years | 0.00 | +0.20 |
p_adverse_action_12m: probability the facility's Medicare participation terminates within 12 months (any POS termination code; already-terminated facilities are excluded, not scored safe). Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.971, top-decile lift 9.5x. Closures announce themselves: collapsing occupancy dominates, and fewer recent surveys is a winding-down signature. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models. | p_chow_12m: probability of a change of ownership within 12 months. Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.874, top-decile lift 5.0x. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models for full notes.
Distress radar — 12-month termination probability
full board →p(termination, 12m)
0.0%
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 | |
|---|---|---|---|
| Deficiencies, last 12 months | 18.00 | -1.91 | |
| For-profit ownership | 0.00 | +1.62 | |
| Chain size (log) | 0.00 | +1.20 | |
| Total nurse staffing (HPRD) | 5.80 | -1.09 | |
| Staffing trend, last 4 quarters | -1.63 | -0.79 | |
| Fine amount, 12m (log) | 9.49 | -0.52 | |
| Occupancy | 0.63 | +0.49 | |
| No PBJ staffing report | 0.00 | +0.39 |
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
13| 2025Q4 HPRD | This facility | GU median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 5.80 | 5.80 | 3.28 | 2.90–3.77 |
| RN | 1.82 | 1.82 | 0.39 | 0.25–0.58 |
| Weekend total | 5.50 | 5.50 | 3.11 | — |
| Weekday total | 5.92 | 5.92 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 25.3 | 5.80 | 1.82 | 1.10 | 2.88 | 5.50 | 0.0% |
| 2025Q3 | 92 | 21.5 | 6.96 | 2.33 | 1.20 | 3.42 | 6.59 | 0.0% |
| 2025Q2 | 91 | 19.9 | 7.28 | 2.64 | 1.06 | 3.58 | 6.94 | 0.0% |
| 2025Q1 | 90 | 22.2 | 6.78 | 2.18 | 1.10 | 3.50 | 6.44 | 0.0% |
| 2024Q4 | 92 | 20.6 | 7.44 | 2.36 | 1.19 | 3.90 | 6.99 | 0.0% |
| 2024Q3 | 92 | 17.8 | 8.71 | 2.83 | 1.39 | 4.48 | 8.14 | 0.0% |
| 2023Q4 | 92 | 20.7 | 7.48 | 2.47 | 1.19 | 3.82 | 7.04 | 0.0% |
| 2023Q3 | 92 | 26.0 | 5.74 | 2.00 | 0.81 | 2.93 | 5.59 | 0.0% |
| 2023Q1 | 90 | 16.5 | 9.35 | 3.15 | 1.61 | 4.59 | 8.97 | 0.0% |
| 2022Q4 | 92 | 15.5 | 9.46 | 3.40 | 1.46 | 4.60 | 9.21 | 0.0% |
| 2022Q3 | 92 | 15.2 | 9.09 | 3.53 | 1.37 | 4.19 | 9.04 | 0.0% |
| 2022Q2 | 91 | 16.3 | 9.69 | 3.69 | 1.32 | 4.68 | 9.68 | 0.0% |
| 2022Q1 | 90 | 17.8 | 9.52 | 3.78 | 1.40 | 4.34 | 9.39 | 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
2| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-08-22 | Fine | $13,247 | CMS provider data |
| 2025-08-22 | Payment Denial | — | CMS provider data |
Total fines on record: $13,247
Deficiencies
52C × 3D × 24E × 15F × 9G × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-08-22 | Health | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2025-10-06 |
| 2025-08-22 | Health | F0561 | Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | G | 2025-10-06 |
| 2025-08-22 | 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 | 2025-10-06 |
| 2025-08-22 | 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 | 2025-10-06 |
| 2025-08-22 | Health | F0605 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | D | 2025-10-06 |
| 2025-08-22 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2025-10-06 |
| 2025-08-22 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-10-06 |
| 2025-08-22 | Health | F0691 | Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services. | D | 2025-10-06 |
| 2025-08-22 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2025-10-06 |
| 2025-08-22 | 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 | 2025-10-06 |
| 2025-08-22 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2025-10-06 |
| 2025-08-22 | Health | F0837 | Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. | F | 2025-09-19 |
| 2025-08-22 | Health | F0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | F | 2025-10-06 |
| 2025-08-22 | Health | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | F | 2025-10-06 |
| 2025-08-22 | Health | F0880 | Provide and implement an infection prevention and control program. | F | 2025-10-06 |
| 2025-08-22 | Health | F0882 | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | F | 2025-10-06 |
| 2025-08-22 | Health | F0887 | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | E | 2025-10-06 |
| 2025-08-22 | Health | F0945 | Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program. | E | 2025-10-06 |
| 2024-08-09 | Health | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | 2024-08-29 |
| 2024-08-09 | 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 | 2024-08-29 |
| 2024-08-09 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2024-08-28 |
| 2024-08-09 | Health | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | F | 2024-08-30 |
| 2024-08-09 | Health | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | 2024-08-29 |
| 2024-08-09 | 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 | 2024-08-29 |
| 2024-08-09 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2024-08-29 |
| 2024-08-09 | Health | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | E | 2024-08-29 |
| 2024-08-09 | Health | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | 2024-08-29 |
| 2024-08-09 | Health | F0732 | Post nurse staffing information every day. | C | 2024-08-28 |
| 2024-08-09 | 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. | E | 2024-09-04 |
| 2024-08-09 | Health | F0790 | Provide routine and 24-hour emergency dental care for each resident. | D | 2024-08-29 |
| 2024-08-09 | Health | F0837 | Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. | C | 2024-08-29 |
| 2024-08-09 | Health | F0838 | Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies. | D | 2024-08-28 |
| 2024-08-09 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2024-09-04 |
| 2024-08-09 | Health | F0865 | Have a plan that describes the process for conducting QAPI and QAA activities. | D | 2024-08-30 |
| 2024-08-09 | Health | F0880 | Provide and implement an infection prevention and control program. | C | 2024-08-30 |
| 2023-09-29 | Health | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2023-11-01 |
| 2023-09-29 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | E | 2023-10-01 |
| 2023-09-29 | Health | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2023-11-03 |
| 2023-09-29 | Health | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | 2023-11-03 |
| 2023-09-29 | Health | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-11-03 |
| 2023-09-29 | Health | F0610 | Respond appropriately to all alleged violations. | D | 2023-11-03 |
| 2023-09-29 | Health | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | E | 2023-11-01 |
| 2023-09-29 | Health | F0660 | Plan the resident's discharge to meet the resident's goals and needs. | D | 2023-12-06 |
| 2023-09-29 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2023-12-05 |
| 2023-09-29 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2023-11-03 |
| 2023-09-29 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2023-11-03 |
| 2023-09-29 | Health | F0835 | Administer the facility in a manner that enables it to use its resources effectively and efficiently. | F | 2023-12-05 |
| 2023-09-29 | Health | F0837 | Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. | F | 2023-11-30 |
| 2023-09-29 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | E | 2023-11-03 |
| 2023-09-29 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2023-11-13 |
| 2023-09-29 | Health | F0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | E | 2023-11-13 |
| 2023-09-29 | Health | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | 2023-11-06 |
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
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
20| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| GUAM MEMORIAL HOSPITAL | OPERATIONAL/MANAGERIAL CONTROL | — | 1999-12-01 | current | pecos_ownership |
| GUAM MEMORIAL HOSPITAL | DIRECT OWNERSHIP INTEREST | — | — | current | pecos_ownership |
| HECHANOVA, YUKARI | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-01-06 | current | pecos_ownership |
| HECHANOVA, YUKARI | INDIRECT OWNERSHIP INTEREST | — | 2022-04-19 | current | pecos_ownership |
| HECHANOVA, YUKARI | CORPORATE OFFICER | — | 2019-04-22 | current | pecos_ownership |
| LIZAMA, FLORENCIO | INDIRECT OWNERSHIP INTEREST | — | 2019-01-19 | current | pecos_ownership |
| LIZAMA, FLORENCIO | ADP OF THE SNF | — | 2025-01-13 | current | pecos_ownership |
| LIZAMA, FLORENCIO | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-12-30 | current | pecos_ownership |
| PEREZ-POSADAS, LILLIAN | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-01-06 | current | pecos_ownership |
| PEREZ-POSADAS, LILLIAN | CORPORATE OFFICER | — | 2019-01-28 | current | pecos_ownership |
| PEREZ-POSADAS, LILLIAN | ADP OF THE SNF | — | 2025-01-13 | current | pecos_ownership |
| LILLIAN PEREZ-POSADAS | CORPORATE OFFICER | 50% | 2019-01-28 | ended 2026-05-18 | pecos_ownership |
| YUKARI HECHANOVA | W-2 MANAGING EMPLOYEE | 5% | 2019-04-22 | ended 2026-05-18 | pecos_ownership |
| YUKARI HECHANOVA | INDIRECT OWNERSHIP INTEREST | 5% | 2022-04-19 | ended 2026-05-18 | pecos_ownership |
| FLORENCIO LIZAMA | INDIRECT OWNERSHIP INTEREST | 0% | 2019-01-19 | ended 2026-05-18 | pecos_ownership |
| FLORENCIO LIZAMA | ADP OF THE SNF | — | 2025-01-13 | ended 2026-05-18 | pecos_ownership |
| FLORENCIO LIZAMA | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-12-30 | ended 2026-05-18 | pecos_ownership |
| LILLIAN PEREZ-POSADAS | ADP OF THE SNF | — | 2025-01-13 | ended 2026-05-18 | pecos_ownership |
| LILLIAN PEREZ-POSADAS | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-01-06 | ended 2026-05-18 | pecos_ownership |
| YUKARI HECHANOVA | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-01-06 | ended 2026-05-18 | pecos_ownership |
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.
Transactions
0No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Market rent context
5| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 66010 | fmr | 0 | $1,100 | 2025-10-01 | HUD_USER_FMR |
| county 66010 | fmr | 1 | $1,211 | 2025-10-01 | HUD_USER_FMR |
| county 66010 | fmr | 2 | $1,589 | 2025-10-01 | HUD_USER_FMR |
| county 66010 | fmr | 3 | $2,226 | 2025-10-01 | HUD_USER_FMR |
| county 66010 | fmr | 4 | $2,668 | 2025-10-01 | HUD_USER_FMR |
ACS median gross rents and HUD FMR/SAFMR for the facility's county and ZIP. Context for underwriting, not facility pricing.