Composite
45.1 / 100 percentile
| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| staffing risk | 83.5 | 83.5 | 0.25 | 0.1923 | 16.06 | in index |
| regulatory risk | 54.0 | 43.7 | 0.30 | 0.2308 | 12.46 | in index |
| financial risk | 29.0 | 33.2 | 0.30 | 0.2308 | 6.69 | in index |
| chow risk | 51.6 | 49.8 | 0.15 | 0.1154 | 5.95 | in index |
| billing conduct | 24.0 | 28.3 | 0.30 | 0.2308 | 5.54 | in index |
| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 28.3 | 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 | 74.5 | D | v0.6 | default · in composite | |
| financial risk | 33.2 | B | 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 | 5.2 | — | 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 | 43.7 | B | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 83.5 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 65.0 | D | 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 | 45.0 | 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 | 51.9 | 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 | 37.1 | B | 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 | 43.6 | B | 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 | 43.6 | B | 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 | 83.5 | 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 | 83.5 | 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. |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Occupancy | 0.96 | -0.76 | |
| Chain size (log) | 5.46 | +0.76 | |
| For-profit ownership | 1.00 | +0.69 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Contract staffing share | 0.00 | -0.10 |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Chain size (log) | 5.46 | -1.98 | |
| Occupancy | 0.96 | -0.89 | |
| For-profit ownership | 1.00 | -0.69 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Total nurse staffing (HPRD) | 2.73 | +0.21 | |
| Fine amount, 12m (log) | 0.00 | +0.18 | |
| Deficiencies, last 12 months | 7.00 | +0.13 | |
| Never sold on record | 1.00 | +0.12 |
| 2025Q4 HPRD | This facility | IA median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 2.73 | 3.15 | 3.28 | 2.90–3.77 |
| RN | 0.24 | 0.46 | 0.39 | 0.25–0.58 |
| Weekend total | 2.51 | 2.96 | 3.11 | — |
| Weekday total | 2.81 | 3.20 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 71.1 | 2.73 | 0.24 | 0.49 | 2.00 | 2.51 | 0.0% |
| 2025Q3 | 92 | 71.5 | 2.71 | 0.31 | 0.48 | 1.92 | 2.62 | 0.0% |
| 2025Q2 | 91 | 70.4 | 2.87 | 0.28 | 0.54 | 2.05 | 2.73 | 0.0% |
| 2025Q1 | 90 | 70.4 | 2.75 | 0.27 | 0.50 | 1.98 | 2.48 | 0.0% |
| 2024Q4 | 92 | 69.4 | 2.77 | 0.39 | 0.51 | 1.88 | 2.47 | 1.0% |
| 2024Q3 | 92 | 68.5 | 2.70 | 0.35 | 0.53 | 1.83 | 2.33 | 2.7% |
| 2024Q2 | 91 | 67.0 | 2.69 | 0.41 | 0.56 | 1.72 | 2.43 | 2.8% |
| 2024Q1 | 91 | 66.6 | 2.72 | 0.30 | 0.69 | 1.74 | 2.54 | 2.6% |
| 2023Q4 | 92 | 67.7 | 2.75 | 0.30 | 0.63 | 1.81 | 2.51 | 1.1% |
| 2023Q3 | 92 | 70.6 | 2.50 | 0.34 | 0.58 | 1.58 | 2.35 | 4.2% |
| 2023Q2 | 91 | 69.3 | 2.54 | 0.30 | 0.64 | 1.60 | 2.50 | 7.2% |
| 2023Q1 | 90 | 68.3 | 2.50 | 0.34 | 0.66 | 1.51 | 2.35 | 23.2% |
| 2022Q4 | 92 | 66.0 | 2.41 | 0.42 | 0.52 | 1.47 | 2.07 | 6.7% |
| 2022Q3 | 92 | 66.8 | 2.33 | 0.40 | 0.48 | 1.45 | 1.97 | 5.9% |
| 2022Q2 | 91 | 66.4 | 2.37 | 0.33 | 0.49 | 1.55 | 2.12 | 16.1% |
| 2022Q1 | 90 | 65.4 | 2.86 | 0.32 | 0.56 | 1.98 | 2.60 | 20.3% |
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-09-16 | Health | F0641 | Ensure each resident receives an accurate assessment. | E | 2025-10-15 |
| 2025-09-16 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-10-15 |
| 2025-09-16 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2025-10-15 |
| 2025-09-16 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2025-10-15 |
| 2025-09-16 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2025-10-15 |
| 2025-09-16 | Health | F0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | E | 2025-10-15 |
| 2025-09-16 | 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 | 2025-10-15 |
| 2025-05-07 | Health · complaint | F0557 | Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | D | 2025-05-24 |
| 2025-05-07 | Health · complaint | 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. | D | 2025-05-24 |
| 2025-05-07 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-05-24 |
| 2024-10-17 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-11-17 |
| 2024-10-17 | 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 | 2024-11-17 |
| 2024-10-17 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-11-17 |
| 2024-10-17 | Health · complaint | F0685 | Assist a resident in gaining access to vision and hearing services. | D | 2024-11-17 |
| 2024-10-17 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2024-11-17 |
| 2024-10-17 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2024-11-17 |
| 2024-06-06 | Health · complaint | 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. | D | 2024-06-28 |
| 2024-06-06 | 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 | 2024-06-28 |
| 2024-06-06 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-06-28 |
| 2024-06-06 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2024-06-28 |
| 2024-06-06 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2024-06-28 |
| 2023-10-05 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2023-11-05 |
| 2023-10-05 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-11-05 |
| 2023-10-05 | Health | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | B | 2023-11-05 |
| 2023-10-05 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2023-11-05 |
| 2023-10-05 | 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 | 2023-11-05 |
| 2023-10-05 | 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 | 2023-11-05 |
| 2023-10-05 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2023-11-05 |
| 2023-10-05 | 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 | 2023-11-05 |
| 2023-10-05 | Health · complaint | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | D | 2023-11-05 |
| 2023-10-05 | Health | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | 2023-11-05 |
| 2023-10-05 | Health · complaint | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2023-11-05 |
| 2023-10-05 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2023-11-05 |
| 2023-10-05 | Health · complaint | F0919 | Make sure that a working call system is available in each resident's bathroom and bathing area. | D | 2023-11-05 |
| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| BURNAM, SOON | CORPORATE OFFICER | — | 2017-03-27 | current | pecos_ownership |
| ENSIGN SERVICES INC | ADP OF THE SNF | — | 2016-08-30 | current | pecos_ownership |
| GATEWAY HEALTHCARE LLC | DIRECT OWNERSHIP INTEREST | — | 2017-03-27 | current | pecos_ownership |
| HAYDEN, ELIZABETH | OPERATIONAL/MANAGERIAL CONTROL | — | 2017-04-01 | current | pecos_ownership |
| JORGENSEN, DAVID | CORPORATE DIRECTOR | — | 2024-01-01 | current | pecos_ownership |
| KEETCH, CHAD | CORPORATE OFFICER | — | 2011-03-01 | current | pecos_ownership |
| KOENIG, DEBRA | CORPORATE OFFICER | — | 2020-01-01 | current | pecos_ownership |
| PORT, BARRY | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-08-08 | current | pecos_ownership |
| SATO, AMI | CORPORATE OFFICER | — | 2024-09-09 | current | pecos_ownership |
| THE ENSIGN GROUP INC | INDIRECT OWNERSHIP INTEREST | — | 2017-03-27 | current | pecos_ownership |
| WEI, SHIPENG | MANAGING CONTROL - GOVERNING BODY | — | 2023-05-19 | current | pecos_ownership |
| ELIZABETH HAYDEN | OPERATIONAL/MANAGERIAL CONTROL | 0% | 2017-04-01 | ended 2026-05-18 | pecos_ownership |
| SOON BURNAM | CORPORATE OFFICER | 0% | 2017-03-27 | ended 2026-05-18 | pecos_ownership |
| AMI SATO | CORPORATE OFFICER | — | 2024-09-09 | ended 2026-05-18 | pecos_ownership |
| CHAD KEETCH | CORPORATE OFFICER | — | 2011-03-01 | ended 2026-05-18 | pecos_ownership |
| DAVID JORGENSEN | CORPORATE DIRECTOR | — | 2024-01-01 | ended 2026-05-18 | pecos_ownership |
| DEBRA KOENIG | CORPORATE OFFICER | — | 2020-01-01 | ended 2026-05-18 | pecos_ownership |
| SHIPENG WEI | MANAGING CONTROL - GOVERNING BODY | — | 2023-05-19 | ended 2026-05-18 | pecos_ownership |
| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-09-01 | St Luke's Regional Medical Center SNF | — | — | — | 20 | NORTHWEST IOWA HOSPITAL CORPORATION |
| 2025-08-01 | Crystal Heights Care Center | — | — | — | 72 | CANFIELD RIVER HEALTHCARE LLC |
| 2025-06-01 | AMS Memorial-Greene | — | — | — | 31 | AMS MEMORIAL-GREENE LLC |
| 2025-02-05 | Chapters Living of Council Bluffs | — | — | — | 102 | CHAPTERS COUNCIL BLUFFS OPCO LLC |
| 2025-02-01 | Osage Rehab and Health Care Center | — | — | — | 46 | OPCO OSAGE IA LLC |
| 2025-02-01 | Iowa City Rehab & Health Care | — | — | — | 89 | OPCO IOWA CITY IA LLC |
| 2025-02-01 | Accura Healthcare of Creston | — | — | — | 31 | ACCURA HEALTHCARE OF CRESTON LLC |
| 2025-02-01 | Casa De Paz Health Care Center | — | — | — | 71 | OPCO 19TH ST SIOUX CITY IA LLC |
| 2025-02-01 | Pleasant Acres Care Center | — | — | — | 46 | OPCO HULL IA LLC |
| 2025-02-01 | Cedar Falls Health Care Center | — | — | — | 70 | OPCO CEDAR FALLS IA LLC |
| 2025-02-01 | Accura Healthcare of Onawa | — | — | — | 46 | ACCURA HEALTHCARE OF ONAWA LLC |
| 2025-02-01 | Grundy Care Center | — | — | — | 40 | OPCO GRUNDY CENTER IA LLC |
| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 19153 | acs median gross | 0 | $926 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 0 | $1,063 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 1 | $963 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 1 | $1,109 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 2 | $1,169 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 2 | $1,318 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 3 | $1,497 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 3 | $1,794 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 4 | $1,605 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | fmr | 4 | $1,841 | 2025-10-01 | HUD_USER_FMR |
| county 19153 | acs median gross | 5 | $1,834 | 2024-12-31 | CENSUS_ACS5 |
| county 19153 | acs median gross | $1,149 | 2024-12-31 | CENSUS_ACS5 | |
| county 19153 | acs recent mover gross | $1,235 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 50316 | acs median gross | 0 | $635 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50316 | acs median gross | 1 | $828 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50316 | acs median gross | 2 | $993 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50316 | acs median gross | 3 | $1,348 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50316 | acs median gross | 4 | $1,713 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50316 | acs median gross | $952 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 50316 | acs recent mover gross | $793 | 2024-12-31 | CENSUS_ACS5 | |
| zip 50316 | payment standard 110 | 0 | $1,034 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | payment standard 90 | 0 | $846 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | safmr | 0 | $940 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | payment standard 110 | 1 | $1,078 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | payment standard 90 | 1 | $882 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | safmr | 1 | $980 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | payment standard 110 | 2 | $1,276 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | payment standard 90 | 2 | $1,044 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | safmr | 2 | $1,160 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | payment standard 110 | 3 | $1,738 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | payment standard 90 | 3 | $1,422 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | safmr | 3 | $1,580 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | payment standard 110 | 4 | $1,782 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | payment standard 90 | 4 | $1,458 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50316 | safmr | 4 | $1,620 | 2025-10-01 | HUD_USER_SAFMR |