Composite
99.2 / 100 percentile
Screener / 165381
F
Stone Cottage Care Center
snfIA
900 South Stone Street, Sigourney, IA 52591 · CCN 165381 · chain SAMARA FAMILY HOLDINGS LLC
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
41
Model
v1.2
Reads as: riskier than 99.2% 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 model4ML signals18Components15CHOW radar1Distress radar1Staffing16Penalties3Deficiencies64Licensure0Ownership22Related party3Transactions1Comps12Market rent30
Composite explanation
4| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| financial risk | 96.7 | 87.5 | 0.30 | 0.3000 | 29.01 | in index |
| regulatory risk | 85.6 | 82.7 | 0.30 | 0.3000 | 25.68 | in index |
| staffing risk | 69.7 | 69.7 | 0.25 | 0.2500 | 17.43 | in index |
| chow risk | 58.6 | 57.0 | 0.15 | 0.1500 | 8.79 | 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
18| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +47.8 vs natl | IOWA 5784 LLC | 5 facilities |
| connection | Owner fleet risk far above national | +47.2 vs natl | AMARANTHINE HOLDINGS LLC | 5 facilities |
| connection | Owner fleet risk far above national | +47.2 vs natl | JSJ 2020 FAMILY TR | 5 facilities |
| connection | Owner fleet risk far above national | +47.2 vs natl | CARESAGE ADMINISTRATIVE CONSULTING LLC | 5 facilities |
| connection | Owner fleet risk far above national | +41.9 vs natl | SAMARA FAM TR | 6 facilities |
| connection | Owner fleet risk far above national | +40.3 vs natl | CEDAR VIEW HOLDINGS LLC | 9 facilities |
| connection | Owner fleet risk far above national | +31.7 vs natl | JSJ PROPERTY LLC | 7 facilities |
| connection | Owner fleet risk far above national | +21.5 vs natl | GAMZEH DAVID | 15 facilities |
| connection | Owner fleet risk far above national | +20.7 vs natl | MILLER DANIEL | 14 facilities |
| connection | Owner spans multiple chains | 9 chains | MILLER DANIEL | 12 facilities |
| connection | Owner spans multiple chains | 6 chains | SUMMATION FINANCIAL SERVICES LLC | 48 facilities |
| connection | Owner spans multiple chains | 5 chains | CLINICAL CONSULTING SERVICES LLC | 42 facilities |
| connection | Owner spans multiple chains | 5 chains | SEBBAG GABRIEL | 32 facilities |
| connection | Owner fleet enforcement cluster | 44% fined | CEDAR VIEW HOLDINGS LLC | 9 facilities |
| connection | Owner fleet enforcement cluster | 40% fined | JSJ 2020 FAMILY TR | 5 facilities |
| connection | Owner fleet enforcement cluster | 40% fined | AMARANTHINE HOLDINGS LLC | 5 facilities |
| connection | Owner fleet enforcement cluster | 40% fined | CARESAGE ADMINISTRATIVE CONSULTING LLC | 5 facilities |
| connection | Owner fleet enforcement cluster | 40% fined | IOWA 5784 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
15| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| 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 | 88.9 | F | v0.6 | default · in composite | |
| financial risk | 87.5 | F | 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 | 0.0 | — | 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 | 82.7 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 69.7 | D | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 94.8 | F | 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 | 74.8 | D | 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 | 76.1 | 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 | 86.0 | 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 | 82.7 | 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 | 82.7 | 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 | 69.7 | D | 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 | 69.7 | D | 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)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
7.0
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Current owner tenure (years) | 1.57 | -1.69 | |
| Never sold on record | 0.00 | -1.62 | |
| Ownership changes, last 5 years | 1.00 | -0.87 | |
| For-profit ownership | 1.00 | +0.69 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Occupancy | 0.80 | -0.30 | |
| Deficiencies, last 12 months | 14.00 | +0.17 | |
| Facility size (log beds) | 3.74 | +0.09 |
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)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
10.1
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Deficiencies, last 12 months | 14.00 | -1.17 | |
| For-profit ownership | 1.00 | -0.69 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Never sold on record | 0.00 | -0.28 | |
| Current owner tenure (years) | 1.57 | -0.28 | |
| Chain size (log) | 1.61 | +0.26 | |
| Ownership changes, last 5 years | 1.00 | +0.23 | |
| Occupancy | 0.80 | -0.22 |
Probability the facility's Medicare participation ends within 12 months, from public records only. Red bars raise exit odds. A negative pull from deficiencies is the winding-down signature — surveys stop as a facility empties — not evidence that clean inspections are dangerous.
Staffing vs peers
16| 2025Q4 HPRD | This facility | IA median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 2.98 | 3.15 | 3.28 | 2.90–3.77 |
| RN | 0.25 | 0.46 | 0.39 | 0.25–0.58 |
| Weekend total | 2.96 | 2.96 | 3.11 | — |
| Weekday total | 2.98 | 3.20 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 32.8 | 2.98 | 0.25 | 0.60 | 2.13 | 2.96 | 0.7% |
| 2025Q3 | 92 | 28.6 | 2.79 | 0.13 | 0.76 | 1.91 | 2.59 | 0.4% |
| 2025Q2 | 91 | 24.9 | 2.92 | 0.09 | 0.92 | 1.91 | 2.84 | 0.1% |
| 2025Q1 | 90 | 26.7 | 2.85 | 0.15 | 0.82 | 1.87 | 2.87 | 1.5% |
| 2024Q4 | 92 | 25.3 | 2.86 | 0.15 | 0.83 | 1.89 | 2.95 | 0.9% |
| 2024Q3 | 92 | 22.9 | 3.42 | 0.44 | 0.73 | 2.25 | 3.61 | 1.2% |
| 2024Q2 | 91 | 24.4 | 3.21 | 0.37 | 0.64 | 2.20 | 3.36 | 4.5% |
| 2024Q1 | 91 | 26.3 | 3.05 | 0.47 | 0.47 | 2.11 | 3.29 | 17.2% |
| 2023Q4 | 92 | 27.4 | 2.79 | 0.15 | 0.76 | 1.88 | 2.81 | 9.2% |
| 2023Q3 | 92 | 25.6 | 2.97 | 0.17 | 0.86 | 1.94 | 3.00 | 19.5% |
| 2023Q2 | 91 | 24.3 | 3.12 | 0.20 | 0.86 | 2.06 | 3.17 | 13.0% |
| 2023Q1 | 90 | 24.0 | 3.08 | 0.29 | 0.62 | 2.17 | 2.96 | 28.4% |
| 2022Q4 | 92 | 23.6 | 2.92 | 0.26 | 0.70 | 1.97 | 2.61 | 38.5% |
| 2022Q3 | 92 | 25.4 | 2.53 | 0.41 | 0.32 | 1.81 | 2.42 | 14.0% |
| 2022Q2 | 91 | 27.6 | 2.34 | 0.10 | 0.70 | 1.54 | 2.46 | 3.9% |
| 2022Q1 | 90 | 19.5 | 3.88 | 0.34 | 1.33 | 2.21 | 3.54 | 0.0% |
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
3fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-11-05 | Payment Denial | — | CMS provider data |
| 2023-09-25 | Fine | $18,682 | CMS provider data |
| 2023-09-25 | Payment Denial | — | CMS provider data |
Total fines on record: $18,682
Deficiencies
64C × 1D × 41E × 11F × 8G × 2J × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-12-23 | Health · complaint | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2026-01-03 |
| 2025-12-23 | 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. | D | 2026-01-03 |
| 2025-11-05 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2025-11-30 |
| 2025-09-04 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2025-09-26 |
| 2025-09-04 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-09-26 |
| 2025-09-04 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-09-26 |
| 2025-09-04 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-09-26 |
| 2025-09-04 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2025-09-26 |
| 2025-09-04 | Health | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | E | 2025-09-26 |
| 2025-09-04 | Health · complaint | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2025-09-26 |
| 2025-09-04 | Health | F0760 | Ensure that residents are free from significant medication errors. | D | 2025-09-26 |
| 2025-09-04 | 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. | F | 2025-09-26 |
| 2025-09-04 | Health | F0865 | Have a plan that describes the process for conducting QAPI and QAA activities. | F | 2025-09-26 |
| 2025-09-04 | 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. | D | 2025-09-26 |
| 2025-03-24 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2025-04-02 |
| 2024-12-31 | Health · complaint | F0622 | Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | D | 2025-01-13 |
| 2024-12-31 | 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 | 2025-01-13 |
| 2024-09-26 | Health · complaint | F0606 | Not hire anyone with a finding of abuse, neglect, exploitation, or theft. | D | 2024-10-18 |
| 2024-09-26 | 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 | 2024-10-18 |
| 2024-09-26 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-10-18 |
| 2024-09-26 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2024-10-18 |
| 2024-09-26 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2024-10-18 |
| 2024-09-26 | Health | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | D | 2024-10-18 |
| 2024-09-26 | 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. | F | 2024-10-18 |
| 2024-09-26 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-10-18 |
| 2024-09-26 | Health | F0865 | Have a plan that describes the process for conducting QAPI and QAA activities. | C | 2024-10-18 |
| 2024-09-26 | Health | F0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | D | 2024-10-18 |
| 2024-09-26 | 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. | D | 2024-10-18 |
| 2024-05-22 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-06-15 |
| 2024-05-22 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2024-06-15 |
| 2024-05-22 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-06-15 |
| 2024-05-22 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2024-06-15 |
| 2024-05-22 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2024-06-15 |
| 2024-05-22 | Health · complaint | F0741 | Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents. | D | 2024-06-15 |
| 2024-05-22 | Health · complaint | F0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | D | 2024-06-15 |
| 2024-01-25 | Health · complaint | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | 2024-02-16 |
| 2024-01-25 | Health · complaint | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | 2024-02-16 |
| 2024-01-25 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-02-16 |
| 2024-01-25 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2024-02-16 |
| 2024-01-25 | 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 | 2024-02-20 |
| 2024-01-25 | 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. | F | 2024-02-20 |
| 2024-01-10 | Health · complaint | F0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | 2024-02-20 |
| 2024-01-10 | Health · complaint | F0567 | Honor the resident's right to manage his or her financial affairs. | E | 2024-02-20 |
| 2024-01-10 | 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 | 2024-02-20 |
| 2024-01-10 | 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. | D | 2024-02-20 |
| 2024-01-10 | 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. | F | 2024-02-20 |
| 2024-01-10 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-02-20 |
| 2024-01-10 | Health · complaint | F0926 | Have policies on smoking. | D | 2024-02-20 |
| 2023-11-30 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2023-12-06 |
| 2023-11-30 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | J | 2024-02-20 |
| 2023-11-30 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2024-02-16 |
| 2023-09-25 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2024-02-16 |
| 2023-06-29 | Health | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2023-07-30 |
| 2023-06-29 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2023-07-30 |
| 2023-06-29 | Health | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | E | 2023-07-30 |
| 2023-06-29 | Health | F0610 | Respond appropriately to all alleged violations. | E | 2023-07-30 |
| 2023-06-29 | 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 | 2023-07-30 |
| 2023-06-29 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2023-07-30 |
| 2023-06-29 | Health | F0732 | Post nurse staffing information every day. | D | 2023-07-30 |
| 2023-06-29 | Health | F0758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | 2023-07-30 |
| 2023-06-29 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2023-07-30 |
| 2023-06-29 | Health | F0836 | Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards. | E | 2023-07-30 |
| 2023-06-29 | Health | F0865 | Have a plan that describes the process for conducting QAPI and QAA activities. | E | 2023-07-30 |
| 2023-06-29 | Health | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | E | 2023-07-30 |
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
22| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| AMARANTHINE HOLDINGS LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2025-01-01 | current | pecos_ownership |
| 900 S STONE STREET PROPCO LLC | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| CARESAGE ADMINISTRATIVE CONSULTING, LLC | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| CASE, JANELLE | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| CEDAR VIEW HOLDINGS LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2025-01-01 | current | pecos_ownership |
| CEDAR VIEW HOLDINGS LLC | ADP OF THE SNF | — | 2025-03-20 | current | pecos_ownership |
| CLINICAL CONSULTING SERVICES LLC | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| GAMZEH, DAVID | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-04-07 | current | pecos_ownership |
| GREATOREX, TINA | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-03-20 | current | pecos_ownership |
| IOWA 5784 LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2025-01-01 | current | pecos_ownership |
| JSJ 2020 FAMILY TR | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| JSJ PROPERTY LLC | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| MILLER, DANIEL | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-01-01 | current | pecos_ownership |
| SAMARA FAM TR | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| SAMARA FAMILY HOLDINGS LLC | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| SCHIOWITZ, MARC | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-03-20 | current | pecos_ownership |
| SEBBAG, GABRIEL | MANAGING CONTROL - GOVERNING BODY | — | 2025-01-01 | current | pecos_ownership |
| SUMMATION FINANCIAL SERVICES LLC | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| THE BRYN MAWR TRUST COMPANY OF DELAWARE | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| GABRIEL SEBBAG | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 52% | 2025-01-01 | ended 2026-05-18 | pecos_ownership |
| DANIEL MILLER | ADP OF THE SNF | — | 2025-01-01 | ended 2026-05-18 | pecos_ownership |
| JANELLE CASE | ADP OF THE SNF | — | 2025-01-01 | 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 |
|---|---|---|---|---|
| 2025-01-01 | — | STONE COTTAGE CARE CENTER LLC | OPCO SIGOURNEY IA LLC | chow |
Comparable trades — IA snf
12| 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 |
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
30| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 19107 | fmr | 0 | $682 | 2025-10-01 | HUD_USER_FMR |
| county 19107 | acs median gross | 1 | $627 | 2024-12-31 | CENSUS_ACS5 |
| county 19107 | fmr | 1 | $764 | 2025-10-01 | HUD_USER_FMR |
| county 19107 | acs median gross | 2 | $826 | 2024-12-31 | CENSUS_ACS5 |
| county 19107 | fmr | 2 | $919 | 2025-10-01 | HUD_USER_FMR |
| county 19107 | acs median gross | 3 | $915 | 2024-12-31 | CENSUS_ACS5 |
| county 19107 | fmr | 3 | $1,178 | 2025-10-01 | HUD_USER_FMR |
| county 19107 | acs median gross | 4 | $940 | 2024-12-31 | CENSUS_ACS5 |
| county 19107 | fmr | 4 | $1,227 | 2025-10-01 | HUD_USER_FMR |
| county 19107 | acs median gross | $828 | 2024-12-31 | CENSUS_ACS5 | |
| county 19107 | acs recent mover gross | $842 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 52591 | acs median gross | 1 | $924 | 2024-12-31 | CENSUS_ACS5 |
| zcta 52591 | acs median gross | 2 | $698 | 2024-12-31 | CENSUS_ACS5 |
| zcta 52591 | acs median gross | 3 | $962 | 2024-12-31 | CENSUS_ACS5 |
| zcta 52591 | acs median gross | $912 | 2024-12-31 | CENSUS_ACS5 | |
| zip 52591 | payment standard 110 | 0 | $792 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | payment standard 90 | 0 | $648 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | safmr | 0 | $720 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | payment standard 110 | 1 | $891 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | payment standard 90 | 1 | $729 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | safmr | 1 | $810 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | payment standard 110 | 2 | $1,067 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | payment standard 90 | 2 | $873 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | safmr | 2 | $970 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | payment standard 110 | 3 | $1,364 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | payment standard 90 | 3 | $1,116 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | safmr | 3 | $1,240 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | payment standard 110 | 4 | $1,419 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | payment standard 90 | 4 | $1,161 | 2025-10-01 | HUD_USER_SAFMR |
| zip 52591 | safmr | 4 | $1,290 | 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.