1335 N. Waterman Ave., San Bernardino, CA 92404 · CCN 055708 · chain THE ENSIGN GROUP INC
Composite
34.3 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
119
Model
v1.2
Reads as: riskier than 34.3% 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
5
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
18 chains
ENSIGN SERVICES INC
286 facilities
connection
Owner spans multiple chains
17 chains
BURNAM SOON
335 facilities
connection
Owner spans multiple chains
17 chains
KEETCH CHAD
283 facilities
connection
Owner spans multiple chains
12 chains
THE ENSIGN GROUP INC
123 facilities
connection
Owner spans multiple chains
11 chains
STANDARD BEARER HEALTHCARE OP LP
83 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
CA median
National median
National p25–p75
Total nurse
4.38
3.95
3.28
2.90–3.77
RN
0.27
0.38
0.39
0.25–0.58
Weekend total
3.95
3.79
3.11
—
Weekday total
4.55
4.01
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
109.6
4.38
0.27
1.44
2.68
3.95
0.0%
2025Q3
92
107.7
4.55
0.25
1.44
2.86
4.08
0.0%
2025Q2
91
106.5
4.42
0.30
1.46
2.66
3.95
0.0%
2025Q1
90
112.2
4.21
0.25
1.46
2.50
3.74
0.0%
2024Q4
92
110.7
4.10
0.26
1.41
2.44
3.75
0.0%
2024Q3
92
111.2
3.99
0.26
1.34
2.40
3.61
0.0%
2024Q2
91
112.3
4.00
0.24
1.37
2.38
3.62
0.5%
2024Q1
91
111.2
3.93
0.26
1.39
2.28
3.62
0.6%
2023Q4
92
105.8
4.15
0.27
1.54
2.35
3.87
1.0%
2023Q3
92
105.9
4.11
0.27
1.50
2.34
3.87
1.4%
2023Q2
91
101.0
4.05
0.23
1.59
2.22
3.61
8.6%
2023Q1
90
99.3
4.21
0.42
1.65
2.13
3.82
5.8%
2022Q4
92
92.7
4.63
0.51
1.81
2.31
4.30
7.8%
2022Q3
92
89.5
4.74
0.58
1.96
2.20
4.46
5.9%
2022Q2
91
92.4
4.79
0.62
1.81
2.36
4.25
15.5%
2022Q1
90
90.7
3.11
0.39
1.16
1.56
2.66
2.3%
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
32
D × 26E × 4F × 2
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2025-04-24
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.
D
2025-05-16
2025-04-24
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
2025-05-16
2025-04-24
Health · complaint
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2025-05-16
2025-04-24
Health · complaint
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.
D
2025-05-16
2025-04-24
Health · complaint
F0814
Dispose of garbage and refuse properly.
F
2025-05-16
2025-04-24
Health · complaint
F0880
Provide and implement an infection prevention and control program.
D
2025-05-16
2025-03-07
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2025-03-17
2025-02-12
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2025-02-24
2024-11-06
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-11-15
2024-05-24
Health · complaint
F0880
Provide and implement an infection prevention and control program.
D
2024-06-06
2023-09-01
Health · complaint
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
2023-09-14
2023-08-31
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
E
2023-09-14
2022-05-26
Health
F0578
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
D
2022-06-22
2022-05-26
Health
F0688
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
D
2022-06-22
2022-05-26
Health
F0692
Provide enough food/fluids to maintain a resident's health.
D
2022-06-22
2022-05-26
Health
F0693
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
D
2022-06-22
2022-05-26
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2022-06-22
2022-05-26
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
2022-06-22
2022-05-26
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2022-06-22
2022-05-26
Health
F0880
Provide and implement an infection prevention and control program.
D
2022-06-22
2022-05-26
Health
F0908
Keep all essential equipment working safely.
F
2022-06-22
2019-10-18
Health
F0558
Reasonably accommodate the needs and preferences of each resident.
D
2019-11-12
2019-10-18
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
2019-11-12
2019-10-18
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
2019-11-12
2019-10-18
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2019-11-12
2019-10-18
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2019-11-12
2019-10-18
Health
F0802
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
D
2019-11-12
2019-10-18
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
2019-11-12
2019-10-18
Health
F0806
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
D
2019-11-12
2019-10-18
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2019-11-12
2019-10-18
Health
F0880
Provide and implement an infection prevention and control program.
D
2019-11-12
2019-10-18
Health
F0908
Keep all essential equipment working safely.
D
2019-11-12
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
18
Owner
Role
Pct
From
Status
Source
ALVARADO HEALTH HOLDINGS LLC
ADP OF THE SNF
—
2022-01-01
current
pecos_ownership
BURNAM, SOON
MANAGING CONTROL - GOVERNING BODY
—
2022-02-01
current
pecos_ownership
ENSIGN SERVICES INC
ADP OF THE SNF
—
2022-02-01
current
pecos_ownership
KEETCH, CHAD
CORPORATE OFFICER
—
2014-01-01
current
pecos_ownership
MANGOBA, LUTHER
OPERATIONAL/MANAGERIAL CONTROL
—
2022-02-01
current
pecos_ownership
PORT, BARRY
CORPORATE OFFICER
—
2019-01-01
current
pecos_ownership
SANCHEZ GONZALEZ, YAMALIEL
OPERATIONAL/MANAGERIAL CONTROL
—
2022-02-01
current
pecos_ownership
STANDARD BEARER HEALTHCARE OP, LP
ADP OF THE SNF
—
2022-01-01
current
pecos_ownership
THE ENSIGN GROUP INC
ADP OF THE SNF
—
2022-01-01
current
pecos_ownership
WILLITS, ADAM
CORPORATE OFFICER
—
2021-03-29
current
pecos_ownership
FLAGSTONE HEALTHCARE CENTRAL LLC
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2022-02-01
ended 2026-05-18
pecos_ownership
THE ENSIGN GROUP INC
5% OR GREATER INDIRECT OWNERSHIP INTEREST
100%
2022-02-01
ended 2026-05-18
pecos_ownership
ADAM WILLITS
CORPORATE OFFICER
0%
2021-03-29
ended 2026-05-18
pecos_ownership
BARRY PORT
CORPORATE OFFICER
0%
2019-01-01
ended 2026-05-18
pecos_ownership
CHAD KEETCH
CORPORATE OFFICER
0%
2014-01-01
ended 2026-05-18
pecos_ownership
SOON BURNAM
CORPORATE OFFICER
0%
2022-02-01
ended 2026-05-18
pecos_ownership
YAMALIEL SANCHEZ GONZALEZ
OPERATIONAL/MANAGERIAL CONTROL
0%
2022-02-01
ended 2026-05-18
pecos_ownership
LUTHER MANGOBA
OPERATIONAL/MANAGERIAL CONTROL
—
2022-02-01
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
$1,836,011
—
$1,215,427
—
—
3
—
2023-12-31
$1,532,710
—
$1,031,091
—
—
3
—
2022-12-31
$1,595,387
—
$1,239,075
—
—
3
—
2022-01-31
$737,195
—
$737,195
—
—
2
—
2020-12-31
$744,576
—
$744,576
—
—
2
—
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
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
36
Geo
Kind
BR
Amount
As of
Source
county 06071
acs median gross
0
$1,374
2024-12-31
CENSUS_ACS5
county 06071
fmr
0
$1,692
2025-10-01
HUD_USER_FMR
county 06071
acs median gross
1
$1,432
2024-12-31
CENSUS_ACS5
county 06071
fmr
1
$1,777
2025-10-01
HUD_USER_FMR
county 06071
acs median gross
2
$1,717
2024-12-31
CENSUS_ACS5
county 06071
fmr
2
$2,201
2025-10-01
HUD_USER_FMR
county 06071
acs median gross
3
$2,050
2024-12-31
CENSUS_ACS5
county 06071
fmr
3
$2,912
2025-10-01
HUD_USER_FMR
county 06071
acs median gross
4
$2,471
2024-12-31
CENSUS_ACS5
county 06071
fmr
4
$3,514
2025-10-01
HUD_USER_FMR
county 06071
acs median gross
5
$2,796
2024-12-31
CENSUS_ACS5
county 06071
acs median gross
$1,801
2024-12-31
CENSUS_ACS5
county 06071
acs recent mover gross
$2,184
2024-12-31
CENSUS_ACS5
zcta 92404
acs median gross
0
$1,261
2024-12-31
CENSUS_ACS5
zcta 92404
acs median gross
1
$1,217
2024-12-31
CENSUS_ACS5
zcta 92404
acs median gross
2
$1,473
2024-12-31
CENSUS_ACS5
zcta 92404
acs median gross
3
$2,025
2024-12-31
CENSUS_ACS5
zcta 92404
acs median gross
4
$2,457
2024-12-31
CENSUS_ACS5
zcta 92404
acs median gross
5
$2,770
2024-12-31
CENSUS_ACS5
zcta 92404
acs median gross
$1,476
2024-12-31
CENSUS_ACS5
zcta 92404
acs recent mover gross
$1,939
2024-12-31
CENSUS_ACS5
zip 92404
payment standard 110
0
$1,760
2025-10-01
HUD_USER_SAFMR
zip 92404
payment standard 90
0
$1,440
2025-10-01
HUD_USER_SAFMR
zip 92404
safmr
0
$1,600
2025-10-01
HUD_USER_SAFMR
zip 92404
payment standard 110
1
$1,837
2025-10-01
HUD_USER_SAFMR
zip 92404
payment standard 90
1
$1,503
2025-10-01
HUD_USER_SAFMR
zip 92404
safmr
1
$1,670
2025-10-01
HUD_USER_SAFMR
zip 92404
payment standard 110
2
$2,288
2025-10-01
HUD_USER_SAFMR
zip 92404
payment standard 90
2
$1,872
2025-10-01
HUD_USER_SAFMR
zip 92404
safmr
2
$2,080
2025-10-01
HUD_USER_SAFMR
zip 92404
payment standard 110
3
$3,058
2025-10-01
HUD_USER_SAFMR
zip 92404
payment standard 90
3
$2,502
2025-10-01
HUD_USER_SAFMR
zip 92404
safmr
3
$2,780
2025-10-01
HUD_USER_SAFMR
zip 92404
payment standard 110
4
$3,718
2025-10-01
HUD_USER_SAFMR
zip 92404
payment standard 90
4
$3,042
2025-10-01
HUD_USER_SAFMR
zip 92404
safmr
4
$3,380
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.