Reads as: riskier than 91.5% 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.
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
7
Kind
Finding
Signal
Subject
First seen
anomaly
Top-decile risk vs 4–5 star rating
6.5
this facility
2026-07-29
connection
Owner fleet risk far above national
+28.7 vs natl
LINCOLN JUDY
55 facilities
connection
Owner fleet risk far above national
+28.6 vs natl
ERGO MIDWEST INC
57 facilities
connection
Owner fleet risk far above national
+28.6 vs natl
SYSTEMS LEASING INC
57 facilities
connection
Owner fleet risk far above national
+28.5 vs natl
LTC MANAGEMENT SERVICES LLC
37 facilities
connection
Owner fleet risk far above national
+27.5 vs natl
LINCOLN JAMES
56 facilities
connection
Owner spans multiple chains
4 chains
ERGO MIDWEST INC
38 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.
Change-of-ownership footprint in the CMS Provider of Services file: control-family, legal-name and address deltas across quarterly snapshots, plus certification reset recency and Medicare tenure.
R23/W4-3. Deterministic logistic p(Medicare termination within 12m), SNF only. Label = first POS termination date (any code: voluntary closure, involuntary termination, merger exit); facilities already terminated by the panel date are excluded, not counted as safe. Trained on panels 2024-07/2024-10/2025-01 (n=46,466, 283 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.971, top-decile lift 9.5x, top-decile capture 95.4% of the 65 terminations that followed. Separability is high because closures announce themselves in the data: collapsing occupancy is the strongest signal, and the learned NEGATIVE weight on 12m deficiency counts is the surveys-stop signature of a facility winding down, not a claim that clean inspections are dangerous. Same 15 as-of-date features and anti-leakage chassis as p_chow_12m; SFF entry rejected as a label (only one month of SFF history exists, so as-of transitions cannot be reconstructed). Score = probability x 100; grade NULL. Not in any composite.
R22/W4-2. Deterministic logistic p(CHOW within 12m), SNF only. Trained on panels 2024-07/2024-10/2025-01 (n=50,700, 1,207 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.874, top-decile lift 5.0x (top 10% of predictions captured 49.6% of the CHOWs that actually closed in the next 12 months). Shipped coefficients are the evaluated ones; no post-holdout refit. Caveat: holdout positives (133) run below the training base rate because recent CHOWs surface in public records with a lag, so measured lift is conservative. Features are as-of-date public records: PBJ staffing level/trend/contract share (quarterly history to 2022Q1), deficiency and CMP counts (12m), ownership tenure and churn from CHOW-evidenced transactions, beds, occupancy, ownership type, chain size. Chain membership and ownership type are current-state (history not published). SFF and star ratings deliberately excluded (no as-of history). Notable learned direction: long ownership tenure RAISES sale odds and a recent prior CHOW lowers them. Score = probability x 100; grade is NULL because a probability is not a quality letter. Not in any composite.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Rows with counts_toward_composite false come from models that are addressable or retracted rather than default. They exist and may be informative, but they did not enter the published composite and must not be summed as though they had.
p_adverse_action_12m: probability the facility's Medicare participation terminates within 12 months (any POS termination code; already-terminated facilities are excluded, not scored safe). Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.971, top-decile lift 9.5x. Closures announce themselves: collapsing occupancy dominates, and fewer recent surveys is a winding-down signature. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models. | p_chow_12m: probability of a change of ownership within 12 months. Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.874, top-decile lift 5.0x. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models for full notes.
Probability the facility's Medicare participation ends within 12 months, from public records only. Red bars raise exit odds. A negative pull from deficiencies is the winding-down signature — surveys stop as a facility empties — not evidence that clean inspections are dangerous.
Staffing vs peers
16
2025Q4 HPRD
This facility
MO median
National median
National p25–p75
Total nurse
1.59
2.41
3.28
2.90–3.77
RN
0.10
0.25
0.39
0.25–0.58
Weekend total
1.37
2.24
3.11
—
Weekday total
1.67
2.49
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
88.5
1.59
0.10
0.41
1.08
1.37
25.0%
2025Q3
92
86.8
1.49
0.08
0.41
1.00
1.28
24.7%
2025Q2
91
76.9
1.83
0.15
0.39
1.28
1.51
32.4%
2025Q1
90
78.9
2.34
0.14
0.51
1.68
2.07
56.0%
2024Q4
92
78.5
2.24
0.14
0.52
1.58
1.99
60.9%
2024Q3
92
78.8
2.14
0.13
0.51
1.50
2.00
61.2%
2024Q2
91
74.1
2.32
0.13
0.54
1.66
1.96
66.5%
2024Q1
91
71.2
2.56
0.20
0.46
1.89
2.23
60.1%
2023Q4
92
72.3
2.37
0.16
0.53
1.68
2.15
55.9%
2023Q3
92
72.3
2.39
0.19
0.49
1.71
2.19
54.2%
2023Q2
91
72.1
1.51
0.18
0.28
1.05
1.19
12.7%
2023Q1
90
73.7
1.69
0.24
0.22
1.23
1.41
4.0%
2022Q4
92
76.8
1.70
0.14
0.34
1.23
1.44
2.0%
2022Q3
92
78.3
1.87
0.13
0.43
1.32
1.68
0.1%
2022Q2
91
76.9
2.08
0.15
0.43
1.49
1.77
0.0%
2022Q1
90
78.6
2.17
0.16
0.38
1.64
1.83
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
0
No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
21
D × 18F × 3
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2026-04-02
Health · complaint
F0580
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
D
2026-04-30
2026-02-23
Health · complaint
F0697
Provide safe, appropriate pain management for a resident who requires such services.
D
2026-04-30
2025-11-17
Health · complaint
F0580
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
D
2025-11-27
2025-11-17
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2025-11-27
2025-06-13
Health
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.
D
2025-07-11
2025-06-13
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
2025-07-11
2025-06-13
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
2025-07-11
2025-06-13
Health
F0732
Post nurse staffing information every day.
D
2025-07-11
2025-06-13
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
2025-07-11
2025-06-13
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2025-07-11
2025-06-13
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.
D
2025-07-11
2024-11-26
Health · complaint
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2024-11-29
2024-06-13
Health
F0583
Keep residents' personal and medical records private and confidential.
D
2024-07-28
2024-06-13
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
2024-07-28
2024-06-13
Health
F0699
Provide care or services that was trauma informed and/or culturally competent.
D
2024-07-28
2024-06-13
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2024-07-28
2024-06-13
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
2024-07-28
2023-01-12
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
2023-02-26
2023-01-12
Health
F0688
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
D
2023-02-26
2023-01-12
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2023-02-26
2023-01-12
Health
F0814
Dispose of garbage and refuse properly.
F
2023-02-26
scope_severity uses the CMS letter grid: A is least serious, L most. J, K and L are immediate jeopardy. Rows are the surveyor's findings of record, not the model's opinion.
Licensure actions
0
No licensure actions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Ownership
17
Owner
Role
Pct
From
Status
Source
ERGO MIDWEST INC
Individual has financial interest in both related organization and provider
100%
2024-01-01
current
hcris_a_8_1
ERGO MIDWEST INC
Individual has financial interest in both related organization and provider
100%
2023-01-01
current
hcris_a_8_1
SYSTEMS LEASING INC
Individual has financial interest in both related organization and provider
100%
2024-01-01
current
hcris_a_8_1
SYSTEMS LEASING INC
Individual has financial interest in both related organization and provider
100%
2023-01-01
current
hcris_a_8_1
LINCOLN, JUDY
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
2008-10-01
current
pecos_ownership
LINCOLN, JAMES
5% OR GREATER DIRECT OWNERSHIP INTEREST
—
2008-10-01
current
pecos_ownership
LTC MANAGEMENT SERVICES LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2008-10-01
current
pecos_ownership
SIMPSON, JENNIFER
W-2 MANAGING EMPLOYEE
—
2022-04-25
current
pecos_ownership
ERGO MIDWEST INC
Individual has financial interest in both related organization and provider
100%
2021-01-01
ended 2021-12-31
hcris_a_8_1
ERGO MIDWEST INC
Individual has financial interest in both related organization and provider
100%
2022-01-01
ended 2022-12-31
hcris_a_8_1
ERGO MIDWEST INC
Individual has financial interest in both related organization and provider
100%
2020-01-01
ended 2020-12-31
hcris_a_8_1
JENNIFER SIMPSON
W-2 MANAGING EMPLOYEE
100%
2022-04-25
ended 2026-05-18
pecos_ownership
SYSTEMS LEASING INC
Individual has financial interest in both related organization and provider
100%
2021-01-01
ended 2021-12-31
hcris_a_8_1
SYSTEMS LEASING INC
Individual has financial interest in both related organization and provider
100%
2020-01-01
ended 2020-12-31
hcris_a_8_1
SYSTEMS LEASING INC
Individual has financial interest in both related organization and provider
100%
2022-01-01
ended 2022-12-31
hcris_a_8_1
JUDY LINCOLN
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
2008-10-01
ended 2026-05-18
pecos_ownership
JAMES LINCOLN
5% OR GREATER DIRECT OWNERSHIP INTEREST
—
2008-10-01
ended 2026-05-18
pecos_ownership
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.
Related-party costs
5
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$1,114,578
—
—
$23,121
$166,152
13
propco
2023-12-31
$1,107,013
—
—
$12,448
$217,276
13
propco
2022-12-31
$990,614
—
—
$12,406
$221,860
13
propco
2021-12-31
$988,089
—
—
$28,234
$218,225
12
propco
2020-12-31
$988,402
—
—
$51,779
$186,303
12
propco
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
Transactions
0
No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Most recent same-state, same-setting trades. Most CHOW-derived trades carry no disclosed consideration, so price, $/bed, and cap rate show only where a sale price was resolved from a deed or filing — blanks are honest, not missing data.
Market rent context
35
Geo
Kind
BR
Amount
As of
Source
county 29187
acs median gross
0
$720
2024-12-31
CENSUS_ACS5
county 29187
fmr
0
$684
2025-10-01
HUD_USER_FMR
county 29187
acs median gross
1
$582
2024-12-31
CENSUS_ACS5
county 29187
fmr
1
$689
2025-10-01
HUD_USER_FMR
county 29187
acs median gross
2
$834
2024-12-31
CENSUS_ACS5
county 29187
fmr
2
$904
2025-10-01
HUD_USER_FMR
county 29187
acs median gross
3
$883
2024-12-31
CENSUS_ACS5
county 29187
fmr
3
$1,169
2025-10-01
HUD_USER_FMR
county 29187
acs median gross
4
$973
2024-12-31
CENSUS_ACS5
county 29187
fmr
4
$1,197
2025-10-01
HUD_USER_FMR
county 29187
acs median gross
$794
2024-12-31
CENSUS_ACS5
county 29187
acs recent mover gross
$862
2024-12-31
CENSUS_ACS5
zcta 63640
acs median gross
0
$724
2024-12-31
CENSUS_ACS5
zcta 63640
acs median gross
1
$729
2024-12-31
CENSUS_ACS5
zcta 63640
acs median gross
2
$888
2024-12-31
CENSUS_ACS5
zcta 63640
acs median gross
3
$864
2024-12-31
CENSUS_ACS5
zcta 63640
acs median gross
4
$1,264
2024-12-31
CENSUS_ACS5
zcta 63640
acs median gross
5
$868
2024-12-31
CENSUS_ACS5
zcta 63640
acs median gross
$857
2024-12-31
CENSUS_ACS5
zcta 63640
acs recent mover gross
$890
2024-12-31
CENSUS_ACS5
zip 63640
payment standard 110
0
$803
2025-10-01
HUD_USER_SAFMR
zip 63640
payment standard 90
0
$657
2025-10-01
HUD_USER_SAFMR
zip 63640
safmr
0
$730
2025-10-01
HUD_USER_SAFMR
zip 63640
payment standard 110
1
$814
2025-10-01
HUD_USER_SAFMR
zip 63640
payment standard 90
1
$666
2025-10-01
HUD_USER_SAFMR
zip 63640
safmr
1
$740
2025-10-01
HUD_USER_SAFMR
zip 63640
payment standard 110
2
$1,067
2025-10-01
HUD_USER_SAFMR
zip 63640
payment standard 90
2
$873
2025-10-01
HUD_USER_SAFMR
zip 63640
safmr
2
$970
2025-10-01
HUD_USER_SAFMR
zip 63640
payment standard 110
3
$1,375
2025-10-01
HUD_USER_SAFMR
zip 63640
payment standard 90
3
$1,125
2025-10-01
HUD_USER_SAFMR
zip 63640
safmr
3
$1,250
2025-10-01
HUD_USER_SAFMR
zip 63640
payment standard 110
4
$1,463
2025-10-01
HUD_USER_SAFMR
zip 63640
payment standard 90
4
$1,197
2025-10-01
HUD_USER_SAFMR
zip 63640
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.