105 SPRUCE STREET, FREDERICKTOWN, MO 63645 · CCN 265514
Composite
99.4 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
90
Model
v1.2
Reads as: riskier than 99.4% 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
2.13
2.41
3.28
2.90–3.77
RN
0.20
0.25
0.39
0.25–0.58
Weekend total
1.97
2.24
3.11
—
Weekday total
2.20
2.49
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
69.4
2.13
0.20
0.32
1.62
1.97
10.2%
2025Q3
92
70.9
2.18
0.16
0.35
1.67
1.99
23.0%
2025Q2
91
71.5
2.31
0.12
0.33
1.86
2.16
41.7%
2025Q1
90
74.1
2.46
0.13
0.32
2.01
2.21
79.0%
2024Q4
92
74.1
2.53
0.13
0.31
2.09
2.50
75.5%
2024Q3
92
72.5
2.59
0.15
0.30
2.14
2.61
69.0%
2024Q2
91
68.7
2.78
0.17
0.32
2.30
2.75
65.6%
2024Q1
91
68.3
2.54
0.13
0.33
2.08
2.50
64.1%
2023Q4
92
68.5
2.18
0.07
0.28
1.82
2.31
79.9%
2023Q3
92
66.6
2.67
0.13
0.32
2.22
2.69
74.8%
2023Q2
91
67.4
2.64
0.13
0.32
2.19
2.80
83.2%
2023Q1
90
65.8
2.61
0.13
0.33
2.16
2.62
79.4%
2022Q4
92
62.6
2.73
0.16
0.34
2.23
2.68
75.1%
2022Q3
92
59.2
2.37
0.14
0.39
1.83
2.27
55.3%
2022Q2
91
59.8
1.96
0.18
0.35
1.43
1.75
40.3%
2022Q1
90
65.2
1.68
0.15
0.31
1.23
1.63
19.4%
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.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2025-04-14
2025-01-17
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
G
2025-03-03
2025-01-17
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
K
2025-03-03
2025-01-17
Health
F0645
PASARR screening for Mental disorders or Intellectual Disabilities
D
2025-03-03
2025-01-17
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2025-03-03
2025-01-17
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.
E
2025-03-03
2025-01-17
Health · complaint
F0742
Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
G
2025-03-03
2025-01-17
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2025-03-03
2025-01-17
Health
F0865
Have a plan that describes the process for conducting QAPI and QAA activities.
F
2025-03-03
2025-01-17
Health
F0867
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
F
2025-03-03
2025-01-17
Health
F0868
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
F
2025-03-03
2025-01-17
Health
F0880
Provide and implement an infection prevention and control program.
F
2025-03-03
2024-10-31
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2024-10-10
2024-05-01
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
2024-06-11
2024-05-01
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
2024-06-11
2024-05-01
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.
D
2024-06-11
2023-10-05
Health
F0623
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
D
2023-12-01
2023-10-05
Health
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
2023-12-01
2023-10-05
Health
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
2023-12-01
2023-10-05
Health
F0921
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
D
2023-12-01
2021-06-11
Health
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
D
2021-07-23
2021-06-11
Health
F0623
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
D
2021-07-23
2021-06-11
Health
F0624
Prepare residents for a safe transfer or discharge from the nursing home.
D
2021-07-25
2021-06-11
Health
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
2021-07-23
2021-06-11
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2021-07-23
2021-06-11
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
2021-07-23
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
29
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%
1998-08-01
current
pecos_ownership
LINCOLN, JUDY
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
1998-08-01
current
pecos_ownership
BYSOR, BRANDON
CORPORATE DIRECTOR
—
2022-04-25
current
pecos_ownership
CRANE, GARY
CORPORATE DIRECTOR
—
1998-08-01
current
pecos_ownership
DRAKE, TIMOTHY
CORPORATE OFFICER
—
2022-04-25
current
pecos_ownership
LINCOLN, JAMES
OPERATIONAL/MANAGERIAL CONTROL
—
2016-06-27
current
pecos_ownership
LINCOLN, JUDY
OPERATIONAL/MANAGERIAL CONTROL
—
2016-06-27
current
pecos_ownership
N & R OF FREDERICKTOWN, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
1998-08-01
current
pecos_ownership
STOTLER, DANIELE
W-2 MANAGING EMPLOYEE
—
2022-04-25
current
pecos_ownership
STUTTS, CHARLOTTE
CORPORATE OFFICER
—
1998-08-01
current
pecos_ownership
DANIELE STOTLER
W-2 MANAGING EMPLOYEE
100%
2022-04-25
ended 2026-05-18
pecos_ownership
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
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%
2020-01-01
ended 2020-12-31
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
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
BRANDON BYSOR
CORPORATE DIRECTOR
50%
2022-04-25
ended 2026-05-18
pecos_ownership
CHARLOTTE STUTTS
CORPORATE OFFICER
50%
1998-08-01
ended 2026-05-18
pecos_ownership
GARY CRANE
CORPORATE DIRECTOR
50%
1998-08-01
ended 2026-05-18
pecos_ownership
JAMES LINCOLN
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
1998-08-01
ended 2026-05-18
pecos_ownership
JUDY LINCOLN
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
1998-08-01
ended 2026-05-18
pecos_ownership
TIMOTHY DRAKE
CORPORATE OFFICER
50%
2022-04-25
ended 2026-05-18
pecos_ownership
JAMES LINCOLN
OPERATIONAL/MANAGERIAL CONTROL
—
2016-06-27
ended 2026-05-18
pecos_ownership
JUDY LINCOLN
OPERATIONAL/MANAGERIAL CONTROL
—
2016-06-27
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
$815,167
—
—
$58,220
$144,292
13
propco
2023-12-31
$781,138
—
—
$40,708
$140,235
14
propco
2022-12-31
$671,758
—
—
$33,887
$142,022
13
propco
2021-12-31
$700,117
—
—
$76,065
$154,087
12
propco
2020-12-31
$720,531
—
—
$75,454
$152,825
12
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
29
Geo
Kind
BR
Amount
As of
Source
county 29123
fmr
0
$695
2025-10-01
HUD_USER_FMR
county 29123
acs median gross
1
$526
2024-12-31
CENSUS_ACS5
county 29123
fmr
1
$713
2025-10-01
HUD_USER_FMR
county 29123
acs median gross
2
$818
2024-12-31
CENSUS_ACS5
county 29123
fmr
2
$935
2025-10-01
HUD_USER_FMR
county 29123
acs median gross
3
$1,029
2024-12-31
CENSUS_ACS5
county 29123
fmr
3
$1,133
2025-10-01
HUD_USER_FMR
county 29123
fmr
4
$1,390
2025-10-01
HUD_USER_FMR
county 29123
acs median gross
5
$1,025
2024-12-31
CENSUS_ACS5
county 29123
acs median gross
$808
2024-12-31
CENSUS_ACS5
zcta 63645
acs median gross
1
$531
2024-12-31
CENSUS_ACS5
zcta 63645
acs median gross
2
$816
2024-12-31
CENSUS_ACS5
zcta 63645
acs median gross
3
$1,083
2024-12-31
CENSUS_ACS5
zcta 63645
acs median gross
$811
2024-12-31
CENSUS_ACS5
zip 63645
payment standard 110
0
$770
2025-10-01
HUD_USER_SAFMR
zip 63645
payment standard 90
0
$630
2025-10-01
HUD_USER_SAFMR
zip 63645
safmr
0
$700
2025-10-01
HUD_USER_SAFMR
zip 63645
payment standard 110
1
$792
2025-10-01
HUD_USER_SAFMR
zip 63645
payment standard 90
1
$648
2025-10-01
HUD_USER_SAFMR
zip 63645
safmr
1
$720
2025-10-01
HUD_USER_SAFMR
zip 63645
payment standard 110
2
$1,034
2025-10-01
HUD_USER_SAFMR
zip 63645
payment standard 90
2
$846
2025-10-01
HUD_USER_SAFMR
zip 63645
safmr
2
$940
2025-10-01
HUD_USER_SAFMR
zip 63645
payment standard 110
3
$1,375
2025-10-01
HUD_USER_SAFMR
zip 63645
payment standard 90
3
$1,125
2025-10-01
HUD_USER_SAFMR
zip 63645
safmr
3
$1,250
2025-10-01
HUD_USER_SAFMR
zip 63645
payment standard 110
4
$1,639
2025-10-01
HUD_USER_SAFMR
zip 63645
payment standard 90
4
$1,341
2025-10-01
HUD_USER_SAFMR
zip 63645
safmr
4
$1,490
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.