Reads as: riskier than 84.7% of the 14,684 facilities in the snf peer group. percentile within peer group, 100 = highest risk. Grade bands are fixed percentile cuts (F is the top 5% of peer risk), so a grade is a position, not an absolute level.
weighted_contribution sums to pre_rank_index over rows where counts_toward_index is true. The composite is the facility's percentile position of that index within its peer group, so contributions explain the input, and the rank explains the score.
ML signals — parallel engine
9
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+28.7 vs natl
LINCOLN JUDY
55 facilities
connection
Owner fleet risk far above national
+28.6 vs natl
SYSTEMS LEASING INC
57 facilities
connection
Owner fleet risk far above national
+28.6 vs natl
ERGO MIDWEST INC
57 facilities
connection
Owner fleet risk far above national
+27.5 vs natl
LINCOLN JAMES
56 facilities
connection
Owner fleet risk far above national
+26.3 vs natl
STUTTS CHARLOTTE
18 facilities
connection
Owner fleet risk far above national
+26.3 vs natl
CRANE GARY
18 facilities
connection
Owner fleet risk far above national
+25.9 vs natl
BYSOR BRANDON
13 facilities
connection
Owner fleet risk far above national
+25.2 vs natl
DRAKE TIMOTHY
21 facilities
connection
Owner spans multiple chains
4 chains
ERGO MIDWEST INC
38 facilities
Findings from the always-on scanning layer: anomalies on this facility, connections through its current owners and past buyers. Runs beside the deterministic composite, never inside it. Full board on the ML Lab page.
Change-of-ownership footprint in the CMS Provider of Services file: control-family, legal-name and address deltas across quarterly snapshots, plus certification reset recency and Medicare tenure.
R23/W4-3. Deterministic logistic p(Medicare termination within 12m), SNF only. Label = first POS termination date (any code: voluntary closure, involuntary termination, merger exit); facilities already terminated by the panel date are excluded, not counted as safe. Trained on panels 2024-07/2024-10/2025-01 (n=46,466, 283 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.971, top-decile lift 9.5x, top-decile capture 95.4% of the 65 terminations that followed. Separability is high because closures announce themselves in the data: collapsing occupancy is the strongest signal, and the learned NEGATIVE weight on 12m deficiency counts is the surveys-stop signature of a facility winding down, not a claim that clean inspections are dangerous. Same 15 as-of-date features and anti-leakage chassis as p_chow_12m; SFF entry rejected as a label (only one month of SFF history exists, so as-of transitions cannot be reconstructed). Score = probability x 100; grade NULL. Not in any composite.
R22/W4-2. Deterministic logistic p(CHOW within 12m), SNF only. Trained on panels 2024-07/2024-10/2025-01 (n=50,700, 1,207 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.874, top-decile lift 5.0x (top 10% of predictions captured 49.6% of the CHOWs that actually closed in the next 12 months). Shipped coefficients are the evaluated ones; no post-holdout refit. Caveat: holdout positives (133) run below the training base rate because recent CHOWs surface in public records with a lag, so measured lift is conservative. Features are as-of-date public records: PBJ staffing level/trend/contract share (quarterly history to 2022Q1), deficiency and CMP counts (12m), ownership tenure and churn from CHOW-evidenced transactions, beds, occupancy, ownership type, chain size. Chain membership and ownership type are current-state (history not published). SFF and star ratings deliberately excluded (no as-of history). Notable learned direction: long ownership tenure RAISES sale odds and a recent prior CHOW lowers them. Score = probability x 100; grade is NULL because a probability is not a quality letter. Not in any composite.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Rows with counts_toward_composite false come from models that are addressable or retracted rather than default. They exist and may be informative, but they did not enter the published composite and must not be summed as though they had.
p_adverse_action_12m: probability the facility's Medicare participation terminates within 12 months (any POS termination code; already-terminated facilities are excluded, not scored safe). Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.971, top-decile lift 9.5x. Closures announce themselves: collapsing occupancy dominates, and fewer recent surveys is a winding-down signature. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models. | p_chow_12m: probability of a change of ownership within 12 months. Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.874, top-decile lift 5.0x. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models for full notes.
Probability the facility's Medicare participation ends within 12 months, from public records only. Red bars raise exit odds. A negative pull from deficiencies is the winding-down signature — surveys stop as a facility empties — not evidence that clean inspections are dangerous.
Staffing vs peers
16
2025Q4 HPRD
This facility
MO median
National median
National p25–p75
Total nurse
2.32
2.41
3.28
2.90–3.77
RN
0.06
0.25
0.39
0.25–0.58
Weekend total
2.07
2.24
3.11
—
Weekday total
2.42
2.49
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
31.8
2.32
0.06
0.75
1.51
2.07
5.7%
2025Q3
92
35.4
2.19
0.10
0.68
1.42
2.21
4.8%
2025Q2
91
37.5
2.49
0.14
0.72
1.62
2.29
9.2%
2025Q1
90
36.5
2.48
0.17
0.74
1.57
2.19
10.5%
2024Q4
92
34.5
0.80
0.06
0.21
0.52
0.74
9.7%
2024Q3
92
36.5
2.26
0.16
0.59
1.51
2.15
8.4%
2024Q2
91
36.5
2.06
0.17
0.56
1.32
1.79
11.7%
2024Q1
91
33.3
2.22
0.21
0.79
1.22
1.88
13.3%
2023Q4
92
39.4
1.91
0.01
0.62
1.28
1.55
23.9%
2023Q3
92
44.9
2.04
0.02
0.48
1.53
1.81
32.2%
2023Q2
91
44.0
2.16
0.01
0.48
1.67
2.02
20.7%
2023Q1
90
38.4
2.61
0.00
0.67
1.95
2.12
7.1%
2022Q4
92
36.0
2.91
0.04
0.68
2.19
2.58
7.0%
2022Q3
92
37.0
3.20
0.12
0.60
2.48
3.00
31.4%
2022Q2
91
36.2
3.48
0.14
0.67
2.68
3.26
32.2%
2022Q1
90
37.7
3.19
0.10
0.71
2.39
2.91
24.9%
HPRD is census-weighted: total hours over the quarter divided by total resident-days, not an average of daily ratios. Source is CMS Payroll-Based Journal daily records; only SNFs report PBJ, so other settings legitimately return zero rows.
Penalties
0
No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
23
C × 2D × 8E × 10F × 3
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2025-06-25
Health
F0567
Honor the resident's right to manage his or her financial affairs.
E
2025-08-05
2025-06-25
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
2025-08-05
2025-06-25
Health
F0628
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
C
2025-08-05
2025-06-25
Health
F0641
Ensure each resident receives an accurate assessment.
D
2025-08-05
2025-06-25
Health
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
E
2025-08-05
2025-06-25
Health
F0680
Ensure the activities program is directed by a qualified professional.
C
2025-08-05
2025-06-25
Health
F0732
Post nurse staffing information every day.
D
2025-08-05
2025-06-25
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
2025-08-05
2025-06-25
Health
F0883
Develop and implement policies and procedures for flu and pneumonia vaccinations.
E
2025-08-05
2024-07-29
Health · complaint
F0610
Respond appropriately to all alleged violations.
D
2024-09-09
2024-07-29
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-09-09
2024-07-29
Health · complaint
F0728
Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training.
E
2024-09-09
2024-07-29
Health · complaint
F0925
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
F
2024-09-09
2023-12-14
Health
F0582
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
E
2024-01-26
2023-12-14
Health
F0692
Provide enough food/fluids to maintain a resident's health.
D
2024-01-26
2023-12-14
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
2024-01-26
2023-12-14
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2024-01-26
2023-12-14
Health
F0880
Provide and implement an infection prevention and control program.
E
2024-01-26
2023-09-06
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2023-10-16
2021-05-21
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
E
2021-07-02
2021-05-21
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2021-07-02
2021-05-21
Health
F0700
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
E
2021-07-02
2021-05-21
Health
F0760
Ensure that residents are free from significant medication errors.
D
2021-07-02
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
25
Owner
Role
Pct
From
Status
Source
ERGO MIDWEST INC
Individual has financial interest in both related organization and provider
100%
2023-01-01
current
hcris_a_8_1
ERGO MIDWEST INC
Individual has financial interest in both related organization and provider
100%
2024-01-01
current
hcris_a_8_1
SYSTEMS LEASING INC
Individual has financial interest in both related organization and provider
100%
2024-01-01
current
hcris_a_8_1
SYSTEMS LEASING INC
Individual has financial interest in both related organization and provider
100%
2023-01-01
current
hcris_a_8_1
LINCOLN, JAMES
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
2003-03-01
current
pecos_ownership
LINCOLN, JUDY
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
2003-03-01
current
pecos_ownership
BYSOR, BRANDON
CORPORATE DIRECTOR
—
2023-03-15
current
pecos_ownership
CRANE, GARY
CORPORATE DIRECTOR
—
2003-03-01
current
pecos_ownership
DRAKE, TIMOTHY
CORPORATE OFFICER
—
2023-03-15
current
pecos_ownership
MERRILL, CLARA
W-2 MANAGING EMPLOYEE
—
2015-08-17
current
pecos_ownership
STUTTS, CHARLOTTE
CORPORATE OFFICER
—
2003-03-01
current
pecos_ownership
TRUMAN VALLEY HEALTH CARE, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
2003-03-01
current
pecos_ownership
CLARA MERRILL
W-2 MANAGING EMPLOYEE
100%
2015-08-17
ended 2026-05-18
pecos_ownership
ERGO MIDWEST INC
Individual has financial interest in both related organization and provider
100%
2020-01-01
ended 2020-12-31
hcris_a_8_1
ERGO MIDWEST INC
Individual has financial interest in both related organization and provider
100%
2021-01-01
ended 2021-12-31
hcris_a_8_1
ERGO MIDWEST INC
Individual has financial interest in both related organization and provider
100%
2022-01-01
ended 2022-12-31
hcris_a_8_1
SYSTEMS LEASING INC
Individual has financial interest in both related organization and provider
100%
2021-01-01
ended 2021-12-31
hcris_a_8_1
SYSTEMS LEASING INC
Individual has financial interest in both related organization and provider
100%
2022-01-01
ended 2022-12-31
hcris_a_8_1
SYSTEMS LEASING INC
Individual has financial interest in both related organization and provider
100%
2020-01-01
ended 2020-12-31
hcris_a_8_1
BRANDON BYSOR
CORPORATE DIRECTOR
50%
2023-03-15
ended 2026-05-18
pecos_ownership
CHARLOTTE STUTTS
CORPORATE OFFICER
50%
2003-03-01
ended 2026-05-18
pecos_ownership
GARY CRANE
CORPORATE DIRECTOR
50%
2003-03-01
ended 2026-05-18
pecos_ownership
JAMES LINCOLN
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
2003-03-01
ended 2026-05-18
pecos_ownership
JUDY LINCOLN
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
2003-03-01
ended 2026-05-18
pecos_ownership
TIMOTHY DRAKE
CORPORATE OFFICER
50%
2023-03-15
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
$578,530
—
—
$85,607
$199,987
13
propco
2023-12-31
$858,262
—
—
$147,659
$249,962
13
propco
2022-12-31
$959,092
—
—
$174,368
$139,620
12
propco
2021-12-31
$939,570
—
—
$195,727
$135,173
11
propco
2020-12-31
$889,482
—
—
$194,534
$110,970
11
propco
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
Transactions
0
No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Most recent same-state, same-setting trades. Most CHOW-derived trades carry no disclosed consideration, so price, $/bed, and cap rate show only where a sale price was resolved from a deed or filing — blanks are honest, not missing data.
Market rent context
33
Geo
Kind
BR
Amount
As of
Source
county 29083
acs median gross
0
$434
2024-12-31
CENSUS_ACS5
county 29083
fmr
0
$652
2025-10-01
HUD_USER_FMR
county 29083
acs median gross
1
$466
2024-12-31
CENSUS_ACS5
county 29083
fmr
1
$677
2025-10-01
HUD_USER_FMR
county 29083
acs median gross
2
$757
2024-12-31
CENSUS_ACS5
county 29083
fmr
2
$888
2025-10-01
HUD_USER_FMR
county 29083
acs median gross
3
$1,025
2024-12-31
CENSUS_ACS5
county 29083
fmr
3
$1,171
2025-10-01
HUD_USER_FMR
county 29083
acs median gross
4
$1,138
2024-12-31
CENSUS_ACS5
county 29083
fmr
4
$1,176
2025-10-01
HUD_USER_FMR
county 29083
acs median gross
5
$879
2024-12-31
CENSUS_ACS5
county 29083
acs median gross
$768
2024-12-31
CENSUS_ACS5
county 29083
acs recent mover gross
$1,050
2024-12-31
CENSUS_ACS5
zcta 65360
acs median gross
2
$818
2024-12-31
CENSUS_ACS5
zcta 65360
acs median gross
3
$975
2024-12-31
CENSUS_ACS5
zcta 65360
acs median gross
4
$789
2024-12-31
CENSUS_ACS5
zcta 65360
acs median gross
$825
2024-12-31
CENSUS_ACS5
zcta 65360
acs recent mover gross
$960
2024-12-31
CENSUS_ACS5
zip 65360
payment standard 110
0
$759
2025-10-01
HUD_USER_SAFMR
zip 65360
payment standard 90
0
$621
2025-10-01
HUD_USER_SAFMR
zip 65360
safmr
0
$690
2025-10-01
HUD_USER_SAFMR
zip 65360
payment standard 110
1
$759
2025-10-01
HUD_USER_SAFMR
zip 65360
payment standard 90
1
$621
2025-10-01
HUD_USER_SAFMR
zip 65360
safmr
1
$690
2025-10-01
HUD_USER_SAFMR
zip 65360
payment standard 110
2
$990
2025-10-01
HUD_USER_SAFMR
zip 65360
payment standard 90
2
$810
2025-10-01
HUD_USER_SAFMR
zip 65360
safmr
2
$900
2025-10-01
HUD_USER_SAFMR
zip 65360
payment standard 110
3
$1,309
2025-10-01
HUD_USER_SAFMR
zip 65360
payment standard 90
3
$1,071
2025-10-01
HUD_USER_SAFMR
zip 65360
safmr
3
$1,190
2025-10-01
HUD_USER_SAFMR
zip 65360
payment standard 110
4
$1,463
2025-10-01
HUD_USER_SAFMR
zip 65360
payment standard 90
4
$1,197
2025-10-01
HUD_USER_SAFMR
zip 65360
safmr
4
$1,330
2025-10-01
HUD_USER_SAFMR
ACS median gross rents and HUD FMR/SAFMR for the facility's county and ZIP. Context for underwriting, not facility pricing.