Composite
35.0 / 100 percentile
| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 80.9 | 77.7 | 0.30 | 0.2308 | 18.67 | in index |
| staffing risk | 92.0 | 92.0 | 0.25 | 0.1923 | 17.69 | in index |
| chow risk | 40.9 | 39.2 | 0.15 | 0.1154 | 4.72 | in index |
| financial risk | 7.4 | 16.4 | 0.30 | 0.2308 | 1.71 | in index |
| billing conduct | 0.0 | 0.0 | 0.30 | 0.2308 | 0.00 | in index |
| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 0.0 | 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 | 53.4 | C | v0.6 | default · in composite | |
| financial risk | 16.4 | A | 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 | 6.0 | — | 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 | 77.7 | D | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 92.0 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 64.2 | 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 | 44.2 | 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 | 38.5 | B | 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 | 22.2 | A | 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 | 77.6 | 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 | 77.6 | 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 | 92.0 | 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 | 92.0 | 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 | |
|---|---|---|---|
| For-profit ownership | 1.00 | +0.69 | |
| Occupancy | 0.92 | -0.64 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Chain size (log) | 3.43 | +0.33 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Contract staffing share | 0.15 | +0.14 |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Deficiencies, last 12 months | 12.00 | -0.80 | |
| Chain size (log) | 3.43 | -0.80 | |
| Occupancy | 0.92 | -0.71 | |
| For-profit ownership | 1.00 | -0.69 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Total nurse staffing (HPRD) | 2.46 | +0.32 | |
| Fine amount, 12m (log) | 0.00 | +0.18 | |
| Never sold on record | 1.00 | +0.12 |
| 2025Q4 HPRD | This facility | IA median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 2.46 | 3.15 | 3.28 | 2.90–3.77 |
| RN | 0.25 | 0.46 | 0.39 | 0.25–0.58 |
| Weekend total | 2.11 | 2.96 | 3.11 | — |
| Weekday total | 2.60 | 3.20 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 49.6 | 2.46 | 0.25 | 0.48 | 1.74 | 2.11 | 15.5% |
| 2025Q3 | 92 | 53.7 | 2.44 | 0.24 | 0.45 | 1.75 | 1.96 | 5.5% |
| 2025Q2 | 91 | 53.4 | 2.36 | 0.32 | 0.37 | 1.67 | 1.96 | 0.0% |
| 2025Q1 | 90 | 49.3 | 2.52 | 0.28 | 0.42 | 1.81 | 2.23 | 0.0% |
| 2024Q4 | 92 | 51.3 | 2.43 | 0.24 | 0.45 | 1.74 | 2.47 | 0.0% |
| 2024Q3 | 92 | 51.0 | 2.41 | 0.20 | 0.36 | 1.85 | 2.23 | 0.0% |
| 2024Q2 | 91 | 50.8 | 2.41 | 0.21 | 0.46 | 1.74 | 2.44 | 0.0% |
| 2024Q1 | 91 | 50.8 | 2.35 | 0.14 | 0.44 | 1.77 | 2.40 | 0.0% |
| 2023Q4 | 92 | 52.6 | 2.27 | 0.18 | 0.54 | 1.56 | 2.21 | 0.0% |
| 2023Q3 | 92 | 52.2 | 2.50 | 0.15 | 0.50 | 1.86 | 2.47 | 0.0% |
| 2023Q2 | 91 | 51.0 | 2.39 | 0.24 | 0.43 | 1.72 | 2.19 | 0.0% |
| 2023Q1 | 90 | 51.0 | 2.58 | 0.32 | 0.29 | 1.97 | 2.37 | 0.0% |
| 2022Q4 | 92 | 52.7 | 2.49 | 0.36 | 0.23 | 1.90 | 2.31 | 0.2% |
| 2022Q3 | 92 | 50.9 | 2.44 | 0.26 | 0.33 | 1.85 | 2.25 | 0.0% |
| 2022Q2 | 91 | 39.9 | 2.58 | 0.37 | 0.38 | 1.82 | 2.45 | 3.9% |
| 2022Q1 | 90 | 45.8 | 2.37 | 0.36 | 0.36 | 1.66 | 2.18 | 9.1% |
| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-02-19 | Fine | $19,744 | CMS provider data |
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-02-18 | Health | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | 2026-03-13 |
| 2026-02-18 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2026-03-13 |
| 2026-02-18 | 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 | 2026-03-13 |
| 2026-02-18 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2026-03-13 |
| 2026-02-18 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2026-03-13 |
| 2026-02-18 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2026-03-13 |
| 2026-02-18 | 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. | F | 2026-03-13 |
| 2026-02-18 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2026-03-13 |
| 2026-02-18 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2026-03-13 |
| 2025-08-07 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2025-08-26 |
| 2025-08-07 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2025-08-21 |
| 2025-08-07 | 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 | 2025-08-22 |
| 2025-02-19 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-03-14 |
| 2025-02-19 | 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 | 2025-03-14 |
| 2025-02-19 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | 2025-03-14 |
| 2025-02-19 | Health | F0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | 2025-03-14 |
| 2025-02-19 | Health | F0801 | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | E | 2025-03-14 |
| 2025-02-19 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2025-03-14 |
| 2025-02-19 | Health | F0805 | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | E | 2025-03-14 |
| 2025-02-19 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2025-03-14 |
| 2025-02-19 | Health | F0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | D | 2025-03-14 |
| 2025-02-19 | Health | F0908 | Keep all essential equipment working safely. | E | 2025-03-14 |
| 2025-02-19 | Health | F0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | E | 2025-03-14 |
| 2024-12-11 | 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 | 2025-01-11 |
| 2024-12-11 | Health · complaint | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | 2025-01-11 |
| 2024-03-19 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2024-04-07 |
| 2024-03-19 | Health · complaint | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2024-04-07 |
| 2024-03-19 | 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 | 2024-04-07 |
| 2024-03-19 | 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 | 2024-04-07 |
| 2024-03-19 | 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 | 2024-04-07 |
| 2024-03-19 | Health · complaint | 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 | 2024-04-07 |
| 2024-03-19 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2024-04-07 |
| 2024-03-19 | 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 | 2024-04-07 |
| 2024-03-19 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-03-19 |
| 2024-03-19 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2024-04-07 |
| 2024-03-19 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2024-04-07 |
| 2023-11-02 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-11-03 |
| 2023-11-02 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2023-11-03 |
| 2023-11-02 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2023-11-03 |
| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| AMERICAN HEALTHCARE MANAGEMENT SERVICES LLC | OPERATIONAL/MANAGERIAL CONTROL | — | 2003-01-01 | current | pecos_ownership |
| CONNER, ROBERT | W-2 MANAGING EMPLOYEE | — | 2024-01-01 | current | pecos_ownership |
| ELLIOTT, COREY | W-2 MANAGING EMPLOYEE | — | 2023-01-01 | current | pecos_ownership |
| LENEAVE, TED | CORPORATE OFFICER | — | 2016-01-01 | current | pecos_ownership |
| LENEAVE, THOMAS | CORPORATE OFFICER | — | 2016-01-01 | current | pecos_ownership |
| TOTI, LISA | CORPORATE DIRECTOR | — | 2019-01-01 | current | pecos_ownership |
| AMERICAN HEALTHCARE ASSOCIATES INC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2016-01-01 | ended 2026-05-18 | pecos_ownership |
| TED LENEAVE | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 70% | 2016-01-01 | ended 2026-05-18 | pecos_ownership |
| THOMAS LENEAVE | CORPORATE OFFICER | 30% | 2016-01-01 | ended 2026-05-18 | pecos_ownership |
| ACCURA HEALTHCARE | Corporation, partnership or other organization has financial interest in provider | — | 2020-01-01 | ended 2020-12-31 | hcris_a_8_1 |
| COREY ELLIOTT | W-2 MANAGING EMPLOYEE | — | 2023-01-01 | ended 2026-05-18 | pecos_ownership |
| LISA TOTI | W-2 MANAGING EMPLOYEE | — | 2019-01-01 | ended 2026-05-18 | pecos_ownership |
| ROBERT CONNER | W-2 MANAGING EMPLOYEE | — | 2024-01-01 | 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 19099 | acs median gross | 0 | $674 | 2024-12-31 | CENSUS_ACS5 |
| county 19099 | fmr | 0 | $784 | 2025-10-01 | HUD_USER_FMR |
| county 19099 | acs median gross | 1 | $666 | 2024-12-31 | CENSUS_ACS5 |
| county 19099 | fmr | 1 | $789 | 2025-10-01 | HUD_USER_FMR |
| county 19099 | acs median gross | 2 | $839 | 2024-12-31 | CENSUS_ACS5 |
| county 19099 | fmr | 2 | $1,008 | 2025-10-01 | HUD_USER_FMR |
| county 19099 | acs median gross | 3 | $1,100 | 2024-12-31 | CENSUS_ACS5 |
| county 19099 | fmr | 3 | $1,348 | 2025-10-01 | HUD_USER_FMR |
| county 19099 | acs median gross | 4 | $1,179 | 2024-12-31 | CENSUS_ACS5 |
| county 19099 | fmr | 4 | $1,372 | 2025-10-01 | HUD_USER_FMR |
| county 19099 | acs median gross | 5 | $1,153 | 2024-12-31 | CENSUS_ACS5 |
| county 19099 | acs median gross | $836 | 2024-12-31 | CENSUS_ACS5 | |
| county 19099 | acs recent mover gross | $862 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 50208 | acs median gross | 1 | $673 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50208 | acs median gross | 2 | $836 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50208 | acs median gross | 3 | $1,100 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50208 | acs median gross | 4 | $1,308 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50208 | acs median gross | 5 | $1,154 | 2024-12-31 | CENSUS_ACS5 |
| zcta 50208 | acs median gross | $833 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 50208 | acs recent mover gross | $827 | 2024-12-31 | CENSUS_ACS5 | |
| zip 50208 | payment standard 110 | 0 | $869 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | payment standard 90 | 0 | $711 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | safmr | 0 | $790 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | payment standard 110 | 1 | $869 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | payment standard 90 | 1 | $711 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | safmr | 1 | $790 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | payment standard 110 | 2 | $1,111 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | payment standard 90 | 2 | $909 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | safmr | 2 | $1,010 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | payment standard 110 | 3 | $1,485 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | payment standard 90 | 3 | $1,215 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | safmr | 3 | $1,350 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | payment standard 110 | 4 | $1,507 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | payment standard 90 | 4 | $1,233 | 2025-10-01 | HUD_USER_SAFMR |
| zip 50208 | safmr | 4 | $1,370 | 2025-10-01 | HUD_USER_SAFMR |