Composite
97.3 / 100 percentile
Screener / 265118
F
ASPEN POINT HEALTH AND REHABILITATION
snfMO
2840 WEST CLAY ST, SAINT CHARLES, MO 63301 · CCN 265118 · chain VHS MO OPCO HOLDINGS LLC
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
180
Model
v1.2
Reads as: riskier than 97.3% 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 model5ML signals10Components16CHOW radar1Distress radar1Staffing16Penalties12Deficiencies74Licensure0Ownership16Related party5Transactions1Comps12Market rent35
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 99.9 | 99.8 | 0.30 | 0.2308 | 23.05 | in index |
| financial risk | 99.3 | 95.1 | 0.30 | 0.2308 | 22.92 | in index |
| staffing risk | 90.9 | 90.9 | 0.25 | 0.1923 | 17.48 | in index |
| chow risk | 61.5 | 60.4 | 0.15 | 0.1154 | 7.10 | in index |
| billing conduct | 20.0 | 25.0 | 0.30 | 0.2308 | 4.62 | 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
10| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +39.7 vs natl | MAYLACK ELIZABETH | 6 facilities |
| connection | Owner fleet risk far above national | +39.0 vs natl | VHS MO OPCO HOLDINGS LLC | 9 facilities |
| connection | Owner fleet risk far above national | +36.7 vs natl | VERTICAL HEALTH SERVICES LLC | 6 facilities |
| connection | Owner fleet risk far above national | +36.4 vs natl | VHS ULTIMATE PARENT LLC | 5 facilities |
| connection | Owner fleet risk far above national | +36.4 vs natl | VHS HOLDCO LLC | 5 facilities |
| connection | Owner fleet risk far above national | +25.0 vs natl | MILLER WILLIAM | 18 facilities |
| connection | Owner fleet enforcement cluster | 50% fined | MAYLACK ELIZABETH | 6 facilities |
| connection | Owner fleet enforcement cluster | 44% fined | VHS MO OPCO HOLDINGS LLC | 9 facilities |
| connection | Owner fleet enforcement cluster | 40% fined | VHS HOLDCO LLC | 5 facilities |
| connection | Owner fleet enforcement cluster | 40% fined | VHS ULTIMATE PARENT LLC | 5 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
16| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 24.9 | A | 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 | 95.8 | F | v0.6 | default · in composite | |
| financial risk | 95.1 | F | v0.5 | default · in composite | R18. |
| p adverse action 12m | 0.4 | — | 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 | 0.1 | — | 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 | 99.8 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 90.9 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 58.4 | C | 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 | 38.4 | B | 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 | 76.2 | D | 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 | 93.5 | F | 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 | 99.8 | F | 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 | 99.8 | F | 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 | 90.9 | 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 | 90.9 | 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. |
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)
0.1%
model v0.1 · computed 2026-07-29
Percentile among SNFs
21.2
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Never sold on record | 0.00 | -1.62 | |
| Current owner tenure (years) | 3.16 | -1.54 | |
| Occupancy | 0.30 | +1.14 | |
| Ownership changes, last 5 years | 1.00 | -0.87 | |
| For-profit ownership | 1.00 | +0.69 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Facility size (log beds) | 5.20 | -0.13 | |
| Chain size (log) | 2.48 | +0.13 |
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)
0.4%
model v0.1 · computed 2026-07-29
Percentile among SNFs
70.7
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Occupancy | 0.30 | +1.87 | |
| For-profit ownership | 1.00 | -0.69 | |
| Deficiencies, last 12 months | 5.00 | +0.50 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Total nurse staffing (HPRD) | 2.50 | +0.30 | |
| Never sold on record | 0.00 | -0.28 | |
| Current owner tenure (years) | 3.16 | -0.25 | |
| Chain size (log) | 2.48 | -0.24 |
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 | 2.50 | 2.41 | 3.28 | 2.90–3.77 |
| RN | 0.57 | 0.25 | 0.39 | 0.25–0.58 |
| Weekend total | 2.31 | 2.24 | 3.11 | — |
| Weekday total | 2.58 | 2.49 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 54.8 | 2.50 | 0.57 | 0.72 | 1.21 | 2.31 | 0.0% |
| 2025Q3 | 92 | 54.6 | 2.50 | 0.44 | 0.85 | 1.21 | 2.19 | 0.0% |
| 2025Q2 | 91 | 53.6 | 2.16 | 0.60 | 0.61 | 0.95 | 2.01 | 0.0% |
| 2025Q1 | 90 | 54.0 | 1.90 | 0.49 | 0.61 | 0.80 | 1.75 | 0.0% |
| 2024Q4 | 92 | 53.1 | 2.17 | 0.49 | 0.54 | 1.14 | 2.06 | 0.0% |
| 2024Q3 | 92 | 54.6 | 2.47 | 0.49 | 0.63 | 1.35 | 2.19 | 0.0% |
| 2024Q2 | 91 | 62.4 | 2.30 | 0.36 | 0.49 | 1.45 | 2.13 | 0.0% |
| 2024Q1 | 91 | 63.6 | 1.97 | 0.23 | 0.78 | 0.96 | 1.74 | 0.2% |
| 2023Q4 | 92 | 68.3 | 2.37 | 0.17 | 0.99 | 1.21 | 1.97 | 0.0% |
| 2023Q3 | 92 | 74.2 | 2.10 | 0.27 | 0.53 | 1.30 | 2.04 | 0.2% |
| 2023Q2 | 91 | 73.1 | 2.20 | 0.17 | 0.65 | 1.38 | 1.97 | 0.7% |
| 2023Q1 | 90 | 85.7 | 2.05 | 0.26 | 0.59 | 1.21 | 1.70 | 3.3% |
| 2022Q4 | 92 | 99.9 | 2.29 | 0.17 | 0.68 | 1.43 | 1.96 | 0.0% |
| 2022Q3 | 92 | 103.0 | 3.14 | 0.17 | 1.00 | 1.96 | 2.75 | 0.1% |
| 2022Q2 | 91 | 93.9 | 2.33 | 0.12 | 0.83 | 1.38 | 1.94 | 9.5% |
| 2022Q1 | 90 | 76.7 | 2.86 | 0.25 | 1.03 | 1.58 | 2.35 | 21.5% |
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
12fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-02-27 | Fine | $44,298 | CMS provider data |
| 2024-12-09 | Fine | $12,012 | CMS provider data |
| 2024-08-29 | Fine | $150,799 | CMS provider data |
| 2024-02-23 | Fine | $110,638 | CMS provider data |
| 2024-02-23 | Payment Denial | — | CMS provider data |
| 2023-10-02 | Fine | $4,587 | CMS provider data |
| 2023-09-25 | Fine | $4,587 | CMS provider data |
| 2023-09-05 | Fine | $13,762 | CMS provider data |
| 2023-08-15 | Fine | $110,189 | CMS provider data |
| 2023-08-15 | Payment Denial | — | CMS provider data |
| 2023-07-31 | Fine | $13,762 | CMS provider data |
| 2023-06-26 | Fine | $4,587 | CMS provider data |
Total fines on record: $469,221
Deficiencies
74D × 15E × 26F × 13G × 13J × 4K × 3
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-02-11 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2026-02-26 |
| 2026-02-11 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2026-02-26 |
| 2026-02-11 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2026-02-26 |
| 2025-08-14 | 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 | 2025-09-10 |
| 2025-08-14 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2025-09-10 |
| 2025-02-27 | Health | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2025-03-25 |
| 2025-02-27 | Health | F0583 | Keep residents' personal and medical records private and confidential. | G | 2025-03-25 |
| 2025-02-27 | Health | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | 2025-03-25 |
| 2025-02-27 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | E | 2025-03-25 |
| 2025-02-27 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2025-03-25 |
| 2025-02-27 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | G | 2025-03-25 |
| 2025-02-27 | Health | F0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | E | 2025-03-25 |
| 2024-12-09 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | G | 2024-12-12 |
| 2024-12-09 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | 2024-12-12 |
| 2024-08-29 | Health · complaint | 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 | 2024-10-12 |
| 2024-08-29 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-10-12 |
| 2024-08-29 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2024-10-12 |
| 2024-08-29 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | 2024-10-12 |
| 2024-08-29 | Health · complaint | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | J | 2024-10-12 |
| 2024-08-29 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2024-10-12 |
| 2024-08-29 | Health · complaint | F0835 | Administer the facility in a manner that enables it to use its resources effectively and efficiently. | F | 2024-10-12 |
| 2024-08-29 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | F | 2024-10-12 |
| 2024-08-29 | Health · complaint | F0908 | Keep all essential equipment working safely. | E | 2024-10-12 |
| 2024-08-29 | Health · complaint | F0947 | Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | F | 2024-10-12 |
| 2024-06-05 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2024-07-30 |
| 2024-05-02 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | G | 2024-05-14 |
| 2024-04-17 | Health · complaint | 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 | 2024-05-14 |
| 2024-04-17 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | E | 2024-07-30 |
| 2024-04-17 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2024-07-30 |
| 2024-04-17 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | 2024-07-30 |
| 2024-04-17 | Health · complaint | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | F | 2024-05-14 |
| 2024-04-17 | Health · complaint | 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. | E | 2024-05-14 |
| 2024-02-23 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2024-03-25 |
| 2024-02-23 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | E | 2024-07-30 |
| 2024-02-23 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2024-07-30 |
| 2024-02-23 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | 2024-07-30 |
| 2024-02-23 | Health · complaint | F0692 | Provide enough food/fluids to maintain a resident's health. | E | 2024-03-25 |
| 2024-02-23 | Health · complaint | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | F | 2024-05-14 |
| 2024-02-23 | Health · complaint | 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. | E | 2024-05-14 |
| 2024-02-23 | Health · complaint | F0809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | E | 2024-05-14 |
| 2024-02-23 | Health · complaint | F0865 | Have a plan that describes the process for conducting QAPI and QAA activities. | F | 2024-03-25 |
| 2024-01-18 | Health · complaint | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | G | 2024-02-01 |
| 2023-12-14 | 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 | 2024-01-10 |
| 2023-12-14 | Health · complaint | 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 | 2024-01-10 |
| 2023-12-14 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | G | 2024-01-10 |
| 2023-12-14 | Health · complaint | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | 2024-01-10 |
| 2023-12-04 | Health · complaint | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | D | 2023-11-10 |
| 2023-11-09 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | G | 2023-12-08 |
| 2023-11-09 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2023-12-08 |
| 2023-11-09 | Health · complaint | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | F | 2023-12-08 |
| 2023-11-09 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | K | 2023-12-08 |
| 2023-10-12 | Health · complaint | F0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | 2023-10-30 |
| 2023-10-12 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | E | 2023-10-30 |
| 2023-10-12 | Health · complaint | F0678 | Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives. | K | 2023-10-30 |
| 2023-10-12 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | J | 2023-10-30 |
| 2023-10-12 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | 2023-12-08 |
| 2023-10-12 | Health · complaint | F0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | F | 2023-10-30 |
| 2023-10-12 | Health · complaint | 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. | F | 2023-10-16 |
| 2023-10-12 | Health · complaint | 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 | 2023-10-30 |
| 2023-10-12 | Health · complaint | F0809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | E | 2023-10-30 |
| 2023-10-12 | Health · complaint | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | F | 2023-10-30 |
| 2023-10-12 | Health · complaint | F0881 | Implement a program that monitors antibiotic use. | F | 2023-10-30 |
| 2023-10-12 | Health · complaint | F0882 | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | F | 2023-10-30 |
| 2023-08-15 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | G | 2023-12-08 |
| 2023-08-15 | Health · complaint | F0605 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | D | 2023-09-19 |
| 2023-08-15 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-09-19 |
| 2023-08-15 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | E | 2023-09-19 |
| 2023-08-15 | Health · complaint | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | 2023-09-19 |
| 2023-08-15 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2023-09-19 |
| 2023-08-15 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2023-12-08 |
| 2023-08-15 | Health · complaint | F0692 | Provide enough food/fluids to maintain a resident's health. | G | 2023-09-19 |
| 2023-08-15 | Health · complaint | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | G | 2024-02-01 |
| 2023-08-15 | Health · complaint | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | F | 2023-12-08 |
| 2023-08-15 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | K | 2023-12-08 |
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
16| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| CLAY STREET CONSULTING LLC | ADP OF THE SNF | — | 2025-03-17 | current | pecos_ownership |
| CLAY STREET CONSULTING LLC | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-06-01 | current | pecos_ownership |
| KEENER, LYNDSI | ADP OF THE SNF | — | 2025-04-04 | current | pecos_ownership |
| KEENER, LYNDSI | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-04-29 | current | pecos_ownership |
| MAYLACK, ELIZABETH | ADP OF THE SNF | — | 2025-04-04 | current | pecos_ownership |
| MAYLACK, ELIZABETH | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-06-01 | current | pecos_ownership |
| MILLER, WILLIAM | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-06-01 | current | pecos_ownership |
| VERTICAL HEALTH SERVICES LLC | INDIRECT OWNERSHIP INTEREST | — | 2023-06-01 | current | pecos_ownership |
| VHS HOLDCO LLC | INDIRECT OWNERSHIP INTEREST | — | 2023-06-01 | current | pecos_ownership |
| VHS MO OPCO HOLDINGS LLC | DIRECT OWNERSHIP INTEREST | — | 2023-06-01 | current | pecos_ownership |
| VHS ULTIMATE PARENT LLC | INDIRECT OWNERSHIP INTEREST | — | 2023-06-01 | current | pecos_ownership |
| ELIZABETH MAYLACK | ADP OF THE SNF | — | 2025-04-04 | ended 2026-05-18 | pecos_ownership |
| ELIZABETH MAYLACK | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-06-01 | ended 2026-05-18 | pecos_ownership |
| LYNDSI KEENER | ADP OF THE SNF | — | 2025-04-04 | ended 2026-05-18 | pecos_ownership |
| LYNDSI KEENER | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-04-29 | ended 2026-05-18 | pecos_ownership |
| WILLIAM MILLER | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-06-01 | 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.
Transactions
1| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2023-06-01 | — | CLAY STREET HEALTHCARE LLC | SRZ OP FRONTIER LLC | chow |
Comparable trades — MO snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-10-01 | AVENIR AT MAPLE GROVE | — | — | — | 90 | NBH2 MGOPCO LLC |
| 2025-10-01 | AVENIR AT MARK TWAIN | — | — | — | 120 | NBH1 MTOPCO LLC |
| 2025-10-01 | ARBOR HILLS CARE & REHAB CENTER | — | — | — | 150 | ARBOR HILLS HEALTHCARE, LLC |
| 2025-10-01 | ASCEND AT AURORA | — | — | — | 125 | NBH3 SFOPCO LLC |
| 2025-09-01 | HUBBLE CREEK | — | — | — | 105 | HUBBLE CREEK LLC |
| 2025-08-01 | HIDDEN LAKE HEALTH CARE CENTER | — | — | — | 67 | HIDDEN LAKE HEALTH CARE CENTER, LLC |
| 2025-05-01 | PINE GROVE MANOR | — | — | — | 77 | PINE GROVE MANOR LLC |
| 2025-05-01 | MONARCH SPRINGS WELLNESS & REHABILITATION | — | — | — | 119 | MONARCH SPRINGS WELLNESS & REHABILITATION LLC |
| 2025-05-01 | ASPIRE SENIOR LIVING NEW FLORENCE | — | — | — | 87 | ASPIRE SENIOR LIVING NEW FLORENCE LLC |
| 2025-04-01 | SOUTH COUNTY HEALTH CARE CENTER | — | — | — | 153 | SOUTH COUNTY HEALTH CARE CENTER, L.L.C. |
| 2025-02-01 | ARBOR VIEW NURSING AND REHABILITATION | — | — | — | 150 | FORREST OPCO LLC |
| 2025-02-01 | AMBERWOOD ESTATES NURSING AND REHABILITATION | — | — | — | 115 | ISLAND HC OPERATIONS 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
35| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 29183 | acs median gross | 0 | $1,204 | 2024-12-31 | CENSUS_ACS5 |
| county 29183 | fmr | 0 | $955 | 2025-10-01 | HUD_USER_FMR |
| county 29183 | acs median gross | 1 | $1,223 | 2024-12-31 | CENSUS_ACS5 |
| county 29183 | fmr | 1 | $995 | 2025-10-01 | HUD_USER_FMR |
| county 29183 | acs median gross | 2 | $1,328 | 2024-12-31 | CENSUS_ACS5 |
| county 29183 | fmr | 2 | $1,218 | 2025-10-01 | HUD_USER_FMR |
| county 29183 | acs median gross | 3 | $1,640 | 2024-12-31 | CENSUS_ACS5 |
| county 29183 | fmr | 3 | $1,568 | 2025-10-01 | HUD_USER_FMR |
| county 29183 | acs median gross | 4 | $2,080 | 2024-12-31 | CENSUS_ACS5 |
| county 29183 | fmr | 4 | $1,812 | 2025-10-01 | HUD_USER_FMR |
| county 29183 | acs median gross | 5 | $2,337 | 2024-12-31 | CENSUS_ACS5 |
| county 29183 | acs median gross | $1,370 | 2024-12-31 | CENSUS_ACS5 | |
| county 29183 | acs recent mover gross | $1,652 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 63301 | acs median gross | 0 | $970 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63301 | acs median gross | 1 | $886 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63301 | acs median gross | 2 | $1,197 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63301 | acs median gross | 3 | $1,443 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63301 | acs median gross | 4 | $2,209 | 2024-12-31 | CENSUS_ACS5 |
| zcta 63301 | acs median gross | $1,154 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 63301 | acs recent mover gross | $1,534 | 2024-12-31 | CENSUS_ACS5 | |
| zip 63301 | payment standard 110 | 0 | $1,056 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | payment standard 90 | 0 | $864 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | safmr | 0 | $960 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | payment standard 110 | 1 | $1,100 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | payment standard 90 | 1 | $900 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | safmr | 1 | $1,000 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | payment standard 110 | 2 | $1,342 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | payment standard 90 | 2 | $1,098 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | safmr | 2 | $1,220 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | payment standard 110 | 3 | $1,727 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | payment standard 90 | 3 | $1,413 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | safmr | 3 | $1,570 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | payment standard 110 | 4 | $1,991 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | payment standard 90 | 4 | $1,629 | 2025-10-01 | HUD_USER_SAFMR |
| zip 63301 | safmr | 4 | $1,810 | 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.