1977 Albia Road, Ottumwa, IA 52501 · CCN 165223 · chain CARE INITIATIVES
Composite
28.8 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
60
Model
v1.2
Reads as: riskier than 28.8% 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.
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
IA median
National median
National p25–p75
Total nurse
2.96
3.15
3.28
2.90–3.77
RN
0.55
0.46
0.39
0.25–0.58
Weekend total
3.05
2.96
3.11
—
Weekday total
2.93
3.20
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
55.1
2.96
0.55
0.49
1.93
3.05
0.0%
2025Q3
92
53.8
2.47
0.50
0.41
1.56
2.38
0.0%
2025Q2
91
53.5
2.38
0.53
0.48
1.37
2.41
0.0%
2025Q1
90
50.5
2.65
0.53
0.56
1.56
2.63
0.0%
2024Q4
92
55.2
2.55
0.39
0.61
1.56
2.48
0.0%
2024Q3
92
55.5
2.24
0.27
0.58
1.40
2.01
0.0%
2024Q2
91
56.7
2.14
0.25
0.63
1.27
1.78
0.0%
2024Q1
91
53.8
2.02
0.30
0.59
1.13
1.85
0.0%
2023Q4
92
54.7
2.10
0.37
0.51
1.22
1.85
0.0%
2023Q3
92
54.3
2.08
0.34
0.43
1.31
1.90
0.0%
2023Q2
91
53.7
2.13
0.37
0.39
1.37
1.95
0.3%
2023Q1
90
56.3
2.13
0.40
0.33
1.41
1.96
8.3%
2022Q4
92
56.2
2.26
0.44
0.31
1.50
1.87
8.3%
2022Q3
92
53.2
2.07
0.44
0.33
1.29
1.64
9.4%
2022Q2
91
50.6
2.06
0.49
0.31
1.26
1.86
7.6%
2022Q1
90
52.6
2.00
0.64
0.27
1.09
1.76
8.8%
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.
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
D
2025-12-30
2025-12-22
Health
F0865
Have a plan that describes the process for conducting QAPI and QAA activities.
D
2025-12-30
2025-12-22
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-12-30
2024-10-31
Health · complaint
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2024-11-01
2024-10-31
Health
F0558
Reasonably accommodate the needs and preferences of each resident.
D
2024-11-01
2024-10-31
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
2024-11-01
2024-10-31
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
2024-11-01
2024-10-31
Health · complaint
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2024-11-01
2024-10-31
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-11-01
2024-10-31
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-11-01
2024-10-31
Health
F0803
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
E
2024-11-01
2024-10-31
Health
F0805
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
J
2024-11-01
2024-10-31
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2024-11-01
2024-04-11
Health · complaint
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
2024-04-24
2024-04-11
Health · complaint
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2024-04-24
2024-02-15
Health · complaint
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2024-03-04
2023-10-05
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
2023-10-16
2023-10-05
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
2023-10-16
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
43
Owner
Role
Pct
From
Status
Source
CARE INITIATIVES
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2010-11-12
current
pecos_ownership
BEAL, MICHAEL
CORPORATE DIRECTOR
—
2020-06-01
current
pecos_ownership
BOWEN, LANE
CORPORATE DIRECTOR
—
2021-01-01
current
pecos_ownership
CAROTHERS, MARY JANE
CORPORATE DIRECTOR
—
2023-01-01
current
pecos_ownership
CHILDS, KEVIN
CORPORATE DIRECTOR
—
2023-04-01
current
pecos_ownership
COMPUTERSHARE CORPORATE TRUST COMPANY, NA
ADP OF THE SNF
—
2025-08-05
current
pecos_ownership
COMPUTERSHARE CORPORATE TRUST COMPANY, NA
5% OR GREATER MORTGAGE INTEREST
—
2025-01-01
current
pecos_ownership
CORLESS, PETER
CORPORATE DIRECTOR
—
2025-01-01
current
pecos_ownership
DIXON, DAVID
CORPORATE OFFICER
—
2016-06-01
current
pecos_ownership
DRAKE, EMILY
CORPORATE OFFICER
—
2023-01-04
current
pecos_ownership
GILYARD, TANYA
CORPORATE OFFICER
—
2025-05-23
current
pecos_ownership
GORMAN, VALERIA
ADP OF THE SNF
—
2025-08-05
current
pecos_ownership
GORMAN, VALERIA
OPERATIONAL/MANAGERIAL CONTROL
—
2025-03-14
current
pecos_ownership
KREIN, KEITH
CORPORATE DIRECTOR
—
2022-06-29
current
pecos_ownership
KUHN, JERAMY
CORPORATE OFFICER
—
2008-06-25
current
pecos_ownership
MAHLER, CARLA
OPERATIONAL/MANAGERIAL CONTROL
—
2024-01-01
current
pecos_ownership
MCDYER, JESSICA
CORPORATE OFFICER
—
2023-02-22
current
pecos_ownership
RUST, ELIZABETH
CORPORATE DIRECTOR
—
2023-01-01
current
pecos_ownership
STURM, DENISE
CORPORATE DIRECTOR
—
2021-01-01
current
pecos_ownership
UPMEYER, LINDA
CORPORATE DIRECTOR
—
2022-06-29
current
pecos_ownership
VOLM, JOHANNA
CORPORATE OFFICER
—
2021-01-01
current
pecos_ownership
WHYMS, BRIAN
ADP OF THE SNF
—
2025-08-05
current
pecos_ownership
WHYMS, BRIAN
OPERATIONAL/MANAGERIAL CONTROL
—
2024-01-01
current
pecos_ownership
ELIZABETH RUST
CORPORATE DIRECTOR
0%
2023-01-01
ended 2026-05-18
pecos_ownership
EMILY DRAKE
CORPORATE OFFICER
0%
2023-01-04
ended 2026-05-18
pecos_ownership
JERAMY KUHN
CORPORATE OFFICER
0%
2008-06-25
ended 2026-05-18
pecos_ownership
JESSICA MCDYER
CORPORATE OFFICER
0%
2023-02-22
ended 2026-05-18
pecos_ownership
JOHANNA VOLM
CORPORATE OFFICER
0%
2021-01-01
ended 2026-05-18
pecos_ownership
KEITH KREIN
CORPORATE DIRECTOR
0%
2022-06-29
ended 2026-05-18
pecos_ownership
KEVIN CHILDS
CORPORATE DIRECTOR
0%
2023-04-01
ended 2026-05-18
pecos_ownership
MARY JANE CAROTHERS
CORPORATE DIRECTOR
0%
2023-01-01
ended 2026-05-18
pecos_ownership
PETER CORLESS
CORPORATE DIRECTOR
0%
2025-01-01
ended 2026-05-18
pecos_ownership
TANYA GILYARD
CORPORATE OFFICER
0%
2025-05-23
ended 2026-05-18
pecos_ownership
BRIAN WHYMS
OPERATIONAL/MANAGERIAL CONTROL
—
2024-01-01
ended 2026-05-18
pecos_ownership
BRIAN WHYMS
ADP OF THE SNF
—
2025-08-05
ended 2026-05-18
pecos_ownership
CARLA MAHLER
OPERATIONAL/MANAGERIAL CONTROL
—
2024-01-01
ended 2026-05-18
pecos_ownership
DAVID DIXON
CORPORATE OFFICER
—
2016-06-01
ended 2026-05-18
pecos_ownership
DENISE STURM
CORPORATE DIRECTOR
—
2021-01-01
ended 2026-05-18
pecos_ownership
LANE BOWEN
CORPORATE DIRECTOR
—
2021-01-01
ended 2026-05-18
pecos_ownership
LINDA UPMEYER
CORPORATE DIRECTOR
—
2022-06-29
ended 2026-05-18
pecos_ownership
MICHAEL BEAL
CORPORATE OFFICER
—
2020-06-01
ended 2026-05-18
pecos_ownership
VALERIA GORMAN
ADP OF THE SNF
—
2025-08-05
ended 2026-05-18
pecos_ownership
VALERIA GORMAN
OPERATIONAL/MANAGERIAL CONTROL
—
2025-03-14
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
$449,821
—
—
—
—
2
—
2023-12-31
$401,822
—
$344,033
—
—
2
—
2022-12-31
$284,404
—
—
—
—
1
—
2021-12-31
$238,840
—
—
—
—
1
—
2020-12-31
$170,878
—
—
—
—
1
—
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
34
Geo
Kind
BR
Amount
As of
Source
county 19179
acs median gross
0
$590
2024-12-31
CENSUS_ACS5
county 19179
fmr
0
$793
2025-10-01
HUD_USER_FMR
county 19179
acs median gross
1
$675
2024-12-31
CENSUS_ACS5
county 19179
fmr
1
$814
2025-10-01
HUD_USER_FMR
county 19179
acs median gross
2
$941
2024-12-31
CENSUS_ACS5
county 19179
fmr
2
$1,068
2025-10-01
HUD_USER_FMR
county 19179
acs median gross
3
$1,262
2024-12-31
CENSUS_ACS5
county 19179
fmr
3
$1,354
2025-10-01
HUD_USER_FMR
county 19179
acs median gross
4
$946
2024-12-31
CENSUS_ACS5
county 19179
fmr
4
$1,468
2025-10-01
HUD_USER_FMR
county 19179
acs median gross
$920
2024-12-31
CENSUS_ACS5
county 19179
acs recent mover gross
$800
2024-12-31
CENSUS_ACS5
zcta 52501
acs median gross
0
$596
2024-12-31
CENSUS_ACS5
zcta 52501
acs median gross
1
$701
2024-12-31
CENSUS_ACS5
zcta 52501
acs median gross
2
$941
2024-12-31
CENSUS_ACS5
zcta 52501
acs median gross
3
$1,273
2024-12-31
CENSUS_ACS5
zcta 52501
acs median gross
4
$961
2024-12-31
CENSUS_ACS5
zcta 52501
acs median gross
$926
2024-12-31
CENSUS_ACS5
zcta 52501
acs recent mover gross
$786
2024-12-31
CENSUS_ACS5
zip 52501
payment standard 110
0
$869
2025-10-01
HUD_USER_SAFMR
zip 52501
payment standard 90
0
$711
2025-10-01
HUD_USER_SAFMR
zip 52501
safmr
0
$790
2025-10-01
HUD_USER_SAFMR
zip 52501
payment standard 110
1
$902
2025-10-01
HUD_USER_SAFMR
zip 52501
payment standard 90
1
$738
2025-10-01
HUD_USER_SAFMR
zip 52501
safmr
1
$820
2025-10-01
HUD_USER_SAFMR
zip 52501
payment standard 110
2
$1,177
2025-10-01
HUD_USER_SAFMR
zip 52501
payment standard 90
2
$963
2025-10-01
HUD_USER_SAFMR
zip 52501
safmr
2
$1,070
2025-10-01
HUD_USER_SAFMR
zip 52501
payment standard 110
3
$1,496
2025-10-01
HUD_USER_SAFMR
zip 52501
payment standard 90
3
$1,224
2025-10-01
HUD_USER_SAFMR
zip 52501
safmr
3
$1,360
2025-10-01
HUD_USER_SAFMR
zip 52501
payment standard 110
4
$1,617
2025-10-01
HUD_USER_SAFMR
zip 52501
payment standard 90
4
$1,323
2025-10-01
HUD_USER_SAFMR
zip 52501
safmr
4
$1,470
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.