2121 Raybrook SE, Grand Rapids, MI 49546 · CCN 235440 · chain CONCEPT REHAB INC
Composite
4.7 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
101
Model
v1.2
Reads as: riskier than 4.7% 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
3
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
18 chains
PLANTE MORAN PLLC
55 facilities
connection
Owner spans multiple chains
6 chains
SMITH DAVID
7 facilities
connection
Owner fleet enforcement cluster
50% fined
JOHNSON MARK
6 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
MI median
National median
National p25–p75
Total nurse
4.38
3.52
3.28
2.90–3.77
RN
0.54
0.47
0.39
0.25–0.58
Weekend total
4.19
3.32
3.11
—
Weekday total
4.45
3.61
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
90.3
4.38
0.54
0.78
3.06
4.19
0.0%
2025Q3
92
88.1
4.42
0.57
0.78
3.07
4.23
0.0%
2025Q2
91
87.5
4.52
0.60
0.80
3.12
4.31
0.0%
2025Q1
90
84.5
4.48
0.65
0.81
3.03
4.27
0.0%
2024Q4
92
85.2
4.74
0.61
0.87
3.27
4.61
0.0%
2024Q3
92
88.7
4.58
0.50
0.92
3.15
4.42
0.0%
2024Q2
91
87.8
4.31
0.52
0.88
2.91
4.11
0.0%
2024Q1
91
83.5
4.53
0.70
0.79
3.04
4.33
0.0%
2023Q4
92
84.6
4.43
0.54
0.84
3.04
4.24
0.0%
2023Q3
92
80.7
4.67
0.53
0.91
3.23
4.45
0.0%
2023Q2
91
81.9
4.39
0.60
0.79
3.00
4.29
0.1%
2023Q1
90
82.0
4.28
0.54
0.83
2.90
4.25
0.0%
2022Q4
92
77.0
4.51
0.61
0.85
3.04
4.36
0.0%
2022Q3
92
76.4
4.52
0.61
0.87
3.05
4.41
0.0%
2022Q2
91
77.3
4.41
0.57
0.85
2.99
4.34
0.0%
2022Q1
90
72.5
4.96
0.67
0.91
3.38
4.94
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.
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2026-01-27
2025-12-23
Health · complaint
F0761
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
D
2026-01-27
2025-02-05
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2025-03-11
2025-02-05
Health
F0583
Keep residents' personal and medical records private and confidential.
F
2025-03-11
2025-02-05
Health
F0585
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
D
2025-03-11
2025-02-05
Health
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2025-03-11
2025-02-05
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
2025-03-11
2025-02-05
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2025-03-11
2025-02-05
Health
F0810
Provide special eating equipment and utensils for residents who need them and appropriate assistance.
D
2025-03-11
2025-02-05
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2025-03-11
2025-02-05
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-03-11
2024-01-26
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2024-01-02
2024-01-26
Health
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
2024-02-27
2024-01-26
Health
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
D
2024-02-27
2024-01-26
Health
F0726
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
B
2024-02-27
2024-01-26
Health
F0761
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
D
2024-02-27
2024-01-26
Health
F0883
Develop and implement policies and procedures for flu and pneumonia vaccinations.
D
2024-02-27
2023-11-29
Health · complaint
F0610
Respond appropriately to all alleged violations.
E
2024-01-02
2023-11-29
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-01-18
2023-11-29
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
E
2024-01-02
2023-01-11
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
E
2023-02-15
2023-01-11
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2023-02-15
2023-01-11
Health
F0813
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
D
2023-02-15
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
58
Owner
Role
Pct
From
Status
Source
CHRISTIAN LIVING SERVICES
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2009-01-01
current
pecos_ownership
AUTHENTICITY MARKETING GROUP
ADP OF THE SNF
—
2014-01-01
current
pecos_ownership
CONCEPT REHAB, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
2025-10-01
current
pecos_ownership
DECKINGA, BRANDYN
ADP OF THE SNF
—
2019-08-08
current
pecos_ownership
DEMAAGD, SCOTT
CORPORATE DIRECTOR
—
2025-07-01
current
pecos_ownership
DUEMLER, RONALD
ADP OF THE SNF
—
2000-06-26
current
pecos_ownership
HIDALGO, CARLOS
CORPORATE DIRECTOR
—
2022-07-01
current
pecos_ownership
HIMMELEIN, DOUGLAS
ADP OF THE SNF
—
2021-11-01
current
pecos_ownership
HUNTINGTON
ADP OF THE SNF
—
2009-01-01
current
pecos_ownership
JOHNSON, MARK
CORPORATE DIRECTOR
—
2021-07-21
current
pecos_ownership
JOHNSON, MARK
CORPORATE OFFICER
—
2025-07-01
current
pecos_ownership
KINDER, ADAM
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-04
current
pecos_ownership
KNIBBE, DAVID
CORPORATE DIRECTOR
—
2016-12-01
current
pecos_ownership
MALBURG, GARY
CORPORATE DIRECTOR
—
2012-07-01
current
pecos_ownership
MATRO, PHILIP
ADP OF THE SNF
—
2021-04-14
current
pecos_ownership
MYERS, TIMOTHY
ADP OF THE SNF
—
2016-06-30
current
pecos_ownership
NAGELKERK, JEAN
CORPORATE DIRECTOR
—
2015-07-01
current
pecos_ownership
PLANTE & MORAN PLLC
ADP OF THE SNF
—
2003-01-01
current
pecos_ownership
RAYMOND JAMES
ADP OF THE SNF
—
2011-01-01
current
pecos_ownership
SAINT MARY'S HEALTH SERVICES
ADP OF THE SNF
—
2000-01-01
current
pecos_ownership
SANCHEZ, NELSON
CORPORATE OFFICER
—
2025-07-01
current
pecos_ownership
SANCHEZ, NELSON
CORPORATE DIRECTOR
—
2017-07-01
current
pecos_ownership
SCHAAB, SCOTT
OPERATIONAL/MANAGERIAL CONTROL
—
2006-01-01
current
pecos_ownership
SEGOVIA, GILBERT
CORPORATE DIRECTOR
—
2022-07-01
current
pecos_ownership
SMITH, DAVID
CORPORATE DIRECTOR
—
2022-07-01
current
pecos_ownership
TATREAU, ANNE
OPERATIONAL/MANAGERIAL CONTROL
—
2011-09-06
current
pecos_ownership
THOLE, NICK
CORPORATE DIRECTOR
—
2016-12-01
current
pecos_ownership
URSUL, MARY
CORPORATE DIRECTOR
—
2012-07-01
current
pecos_ownership
VANDERKOOI, MARIE
CORPORATE DIRECTOR
—
2025-07-01
current
pecos_ownership
VOGEL-VANDERSON, SUSAN
CORPORATE DIRECTOR
—
2011-07-01
current
pecos_ownership
VUGTEVEEN, TROY
CORPORATE DIRECTOR
—
2022-01-01
current
pecos_ownership
WATSON, SAM
CORPORATE DIRECTOR
—
2017-07-01
current
pecos_ownership
DAVID KNIBBE
CORPORATE DIRECTOR
0%
2016-12-01
ended 2026-05-18
pecos_ownership
MARK JOHNSON
CORPORATE OFFICER
0%
2025-07-01
ended 2026-05-18
pecos_ownership
ADAM KINDER
CORPORATE OFFICER
—
2021-04-04
ended 2026-05-18
pecos_ownership
ANNE TATREAU
ADP OF THE SNF
—
2011-09-06
ended 2026-05-18
pecos_ownership
BRANDYN DECKINGA
ADP OF THE SNF
—
2019-08-08
ended 2026-05-18
pecos_ownership
CARLOS HIDALGO
CORPORATE DIRECTOR
—
2022-07-01
ended 2026-05-18
pecos_ownership
DAVID SMITH
CORPORATE DIRECTOR
—
2022-07-01
ended 2026-05-18
pecos_ownership
DOUGLAS HIMMELEIN
OPERATIONAL/MANAGERIAL CONTROL
—
2021-11-01
ended 2026-05-18
pecos_ownership
GARY MALBURG
CORPORATE OFFICER
—
2012-07-01
ended 2026-05-18
pecos_ownership
GILBERT SEGOVIA
CORPORATE DIRECTOR
—
2022-07-01
ended 2026-05-18
pecos_ownership
JEAN NAGELKERK
CORPORATE DIRECTOR
—
2015-07-01
ended 2026-05-18
pecos_ownership
MARIE VANDERKOOI
CORPORATE DIRECTOR
—
2025-07-01
ended 2026-05-18
pecos_ownership
MARK JOHNSON
CORPORATE DIRECTOR
—
2021-07-21
ended 2026-05-18
pecos_ownership
MARY URSUL
CORPORATE DIRECTOR
—
2012-07-01
ended 2026-05-18
pecos_ownership
NELSON SANCHEZ
CORPORATE DIRECTOR
—
2017-07-01
ended 2026-05-18
pecos_ownership
NELSON SANCHEZ
CORPORATE OFFICER
—
2025-07-01
ended 2026-05-18
pecos_ownership
NICK THOLE
CORPORATE DIRECTOR
—
2016-12-01
ended 2026-05-18
pecos_ownership
PHILIP MATRO
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-14
ended 2026-05-18
pecos_ownership
RONALD DUEMLER
ADP OF THE SNF
—
2000-06-26
ended 2026-05-18
pecos_ownership
SAM WATSON
CORPORATE DIRECTOR
—
2017-07-01
ended 2026-05-18
pecos_ownership
SCOTT DEMAAGD
CORPORATE DIRECTOR
—
2025-07-01
ended 2026-05-18
pecos_ownership
SCOTT SCHAAB
ADP OF THE SNF
—
2006-01-01
ended 2026-05-18
pecos_ownership
SUSAN VOGEL-VANDERSON
CORPORATE DIRECTOR
—
2011-07-01
ended 2026-05-18
pecos_ownership
TIMOTHY MYERS
ADP OF THE SNF
—
2016-06-30
ended 2026-05-18
pecos_ownership
TRINITY HEALTH
ADP OF THE SNF
—
2000-01-01
ended 2026-05-18
pecos_ownership
TROY VUGTEVEEN
CORPORATE OFFICER
—
2022-01-01
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.
Related-party costs
5
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$2,181,219
—
—
—
$47,853
1
—
2023-12-31
$2,102,560
—
$1,818,888
—
$18,525
1
—
2022-12-31
$2,520,924
—
$1,674,342
—
$5,803
1
—
2021-12-31
$912,097
—
$288,872
—
$5,791
1
—
2020-12-31
$2,457,092
—
$2,225,410
—
$16,367
1
—
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
35
Geo
Kind
BR
Amount
As of
Source
county 26081
acs median gross
0
$1,041
2024-12-31
CENSUS_ACS5
county 26081
fmr
0
$1,232
2025-10-01
HUD_USER_FMR
county 26081
acs median gross
1
$1,055
2024-12-31
CENSUS_ACS5
county 26081
fmr
1
$1,278
2025-10-01
HUD_USER_FMR
county 26081
acs median gross
2
$1,284
2024-12-31
CENSUS_ACS5
county 26081
fmr
2
$1,531
2025-10-01
HUD_USER_FMR
county 26081
acs median gross
3
$1,524
2024-12-31
CENSUS_ACS5
county 26081
fmr
3
$1,980
2025-10-01
HUD_USER_FMR
county 26081
acs median gross
4
$1,853
2024-12-31
CENSUS_ACS5
county 26081
fmr
4
$2,189
2025-10-01
HUD_USER_FMR
county 26081
acs median gross
5
$1,826
2024-12-31
CENSUS_ACS5
county 26081
acs median gross
$1,243
2024-12-31
CENSUS_ACS5
county 26081
acs recent mover gross
$1,483
2024-12-31
CENSUS_ACS5
zcta 49546
acs median gross
0
$939
2024-12-31
CENSUS_ACS5
zcta 49546
acs median gross
1
$1,220
2024-12-31
CENSUS_ACS5
zcta 49546
acs median gross
2
$1,490
2024-12-31
CENSUS_ACS5
zcta 49546
acs median gross
3
$1,784
2024-12-31
CENSUS_ACS5
zcta 49546
acs median gross
5
$1,449
2024-12-31
CENSUS_ACS5
zcta 49546
acs median gross
$1,408
2024-12-31
CENSUS_ACS5
zcta 49546
acs recent mover gross
$1,550
2024-12-31
CENSUS_ACS5
zip 49546
payment standard 110
0
$1,474
2025-10-01
HUD_USER_SAFMR
zip 49546
payment standard 90
0
$1,206
2025-10-01
HUD_USER_SAFMR
zip 49546
safmr
0
$1,340
2025-10-01
HUD_USER_SAFMR
zip 49546
payment standard 110
1
$1,529
2025-10-01
HUD_USER_SAFMR
zip 49546
payment standard 90
1
$1,251
2025-10-01
HUD_USER_SAFMR
zip 49546
safmr
1
$1,390
2025-10-01
HUD_USER_SAFMR
zip 49546
payment standard 110
2
$1,837
2025-10-01
HUD_USER_SAFMR
zip 49546
payment standard 90
2
$1,503
2025-10-01
HUD_USER_SAFMR
zip 49546
safmr
2
$1,670
2025-10-01
HUD_USER_SAFMR
zip 49546
payment standard 110
3
$2,376
2025-10-01
HUD_USER_SAFMR
zip 49546
payment standard 90
3
$1,944
2025-10-01
HUD_USER_SAFMR
zip 49546
safmr
3
$2,160
2025-10-01
HUD_USER_SAFMR
zip 49546
payment standard 110
4
$2,629
2025-10-01
HUD_USER_SAFMR
zip 49546
payment standard 90
4
$2,151
2025-10-01
HUD_USER_SAFMR
zip 49546
safmr
4
$2,390
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.