Reads as: riskier than 98.3% 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
6
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+23.1 vs natl
GRAY ARNOLD
5 facilities
connection
Owner fleet risk far above national
+23.1 vs natl
HEWITT HERBERT
5 facilities
connection
Owner fleet risk far above national
+23.1 vs natl
O NEAL GLENDA
5 facilities
connection
Owner fleet risk far above national
+22.3 vs natl
PRICE LARRY
26 facilities
connection
Owner fleet enforcement cluster
42% fined
PRICE LARRY
26 facilities
connection
Owner fleet enforcement cluster
42% fined
SOUTH LIMESTONE HOSPITAL DISTRICT
26 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
TX median
National median
National p25–p75
Total nurse
2.83
2.67
3.28
2.90–3.77
RN
0.22
0.24
0.39
0.25–0.58
Weekend total
2.77
2.56
3.11
—
Weekday total
2.85
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
131.2
2.83
0.22
0.74
1.87
2.77
2.5%
2025Q3
92
126.1
2.83
0.23
0.76
1.84
2.79
1.1%
2025Q2
91
124.3
2.91
0.23
0.85
1.83
2.81
0.4%
2025Q1
90
123.6
2.96
0.27
0.75
1.93
2.92
2.3%
2024Q4
92
128.8
3.00
0.32
0.74
1.95
2.98
0.5%
2024Q3
92
132.2
3.49
0.33
0.88
2.28
3.37
4.3%
2024Q2
91
128.0
3.95
0.31
1.03
2.61
4.15
10.9%
2024Q1
91
121.2
4.09
0.29
1.25
2.55
4.07
22.2%
2023Q4
92
126.0
3.48
0.15
1.11
2.23
3.19
13.1%
2023Q3
92
126.6
3.16
0.07
0.98
2.10
3.11
13.4%
2023Q2
91
120.6
3.19
0.13
0.91
2.15
3.09
4.8%
2023Q1
90
120.7
3.32
0.11
0.93
2.27
3.30
22.1%
2022Q4
92
118.6
3.29
0.13
0.90
2.26
3.31
24.0%
2022Q3
92
109.7
3.58
0.08
1.04
2.47
3.60
31.7%
2022Q2
91
110.6
2.82
0.09
0.97
1.76
2.63
25.4%
2022Q1
90
109.8
2.95
0.10
0.93
1.92
2.85
10.7%
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.
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2025-06-13
2024-08-13
Health · complaint
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
E
2024-09-24
2024-05-30
Health · complaint
F0849
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
E
2024-06-28
2024-04-10
Health
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
2024-04-11
2024-04-10
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2024-04-11
2024-04-05
Health · complaint
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
G
2024-04-06
2024-04-05
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
J
2024-03-21
2024-04-05
Health · complaint
F0620
Not require residents to give up Medicare or Medicaid benefits, or pay privately as a condition of admission; and must tell residents what care they do not provide.
D
2024-04-06
2024-04-05
Health · complaint
F0624
Prepare residents for a safe transfer or discharge from the nursing home.
G
2024-04-06
2024-02-06
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
J
2024-02-07
2024-02-06
Health · complaint
F0678
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
J
2024-02-07
2024-02-06
Health · complaint
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.
D
2024-02-07
2023-03-08
Health
F0732
Post nurse staffing information every day.
C
2023-04-15
2023-03-08
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2023-04-15
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
28
Owner
Role
Pct
From
Status
Source
SOUTH LIMESTONE HOSPITAL DISTRICT
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2019-06-01
current
pecos_ownership
BATES, JOSHUA
OPERATIONAL/MANAGERIAL CONTROL
—
2019-06-01
current
pecos_ownership
BRIARCLIFF HEALTH CARE LLC
—
—
2025-06-01
current
tx_hhsc_directory
GRAY, ARNOLD
CORPORATE OFFICER
—
2019-06-01
current
pecos_ownership
HEWITT, HERBERT
CORPORATE OFFICER
—
2019-06-01
current
pecos_ownership
MILSTEAD, JACK
CORPORATE OFFICER
—
2019-06-01
current
pecos_ownership
O'NEAL, GLENDA
CORPORATE OFFICER
—
2019-06-01
current
pecos_ownership
PRICE, LARRY
CORPORATE OFFICER
—
2019-06-01
current
pecos_ownership
SBS LEASECO BRIARCLIFF LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2019-06-01
current
pecos_ownership
SEELINGER, CHET
CORPORATE OFFICER
—
2019-06-01
current
pecos_ownership
SHELTON, CHANA
OPERATIONAL/MANAGERIAL CONTROL
—
2019-06-01
current
pecos_ownership
SIMS, DEBRA
OPERATIONAL/MANAGERIAL CONTROL
—
2019-06-01
current
pecos_ownership
SINCLAIR, LAUREN
CORPORATE OFFICER
—
2019-06-01
current
pecos_ownership
SOUTH LIMESTONE HOSPITAL DISTRICT
—
—
2025-06-01
current
tx_hhsc_directory
STANTON, MARTHA
CORPORATE OFFICER
—
2019-06-01
current
pecos_ownership
WILLIAMS, MICHAEL
CORPORATE OFFICER
—
2019-06-01
current
pecos_ownership
JOSHUA BATES
OPERATIONAL/MANAGERIAL CONTROL
33%
2019-06-01
ended 2026-05-18
pecos_ownership
CHANA SHELTON
OPERATIONAL/MANAGERIAL CONTROL
33%
2019-06-01
ended 2026-05-18
pecos_ownership
DEBRA SIMS
OPERATIONAL/MANAGERIAL CONTROL
33%
2019-06-01
ended 2026-05-18
pecos_ownership
ARNOLD GRAY
CORPORATE OFFICER
0%
2019-06-01
ended 2026-05-18
pecos_ownership
CHET SEELINGER
CORPORATE OFFICER
0%
2019-06-01
ended 2026-05-18
pecos_ownership
GLENDA O'NEAL
CORPORATE OFFICER
0%
2019-06-01
ended 2026-05-18
pecos_ownership
HERBERT HEWITT
CORPORATE OFFICER
0%
2019-06-01
ended 2026-05-18
pecos_ownership
JACK MILSTEAD
CORPORATE OFFICER
0%
2019-06-01
ended 2026-05-18
pecos_ownership
LARRY PRICE
CORPORATE OFFICER
0%
2019-06-01
ended 2026-05-18
pecos_ownership
MARTHA STANTON
CORPORATE OFFICER
0%
2019-06-01
ended 2026-05-18
pecos_ownership
MICHAEL WILLIAMS
CORPORATE OFFICER
0%
2019-06-01
ended 2026-05-18
pecos_ownership
LAUREN SINCLAIR
CORPORATE OFFICER
—
2019-06-01
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
4
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2023-09-30
$1,751,491
—
—
$1,333,065
—
1
—
2022-09-30
$1,758,427
—
—
$1,364,477
—
1
—
2021-09-30
$1,842,875
—
—
$1,388,026
—
1
—
2020-09-30
$2,114,367
—
—
$1,665,367
—
1
—
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
35
Geo
Kind
BR
Amount
As of
Source
county 48423
acs median gross
0
$952
2024-12-31
CENSUS_ACS5
county 48423
fmr
0
$984
2025-10-01
HUD_USER_FMR
county 48423
acs median gross
1
$992
2024-12-31
CENSUS_ACS5
county 48423
fmr
1
$1,089
2025-10-01
HUD_USER_FMR
county 48423
acs median gross
2
$1,214
2024-12-31
CENSUS_ACS5
county 48423
fmr
2
$1,338
2025-10-01
HUD_USER_FMR
county 48423
acs median gross
3
$1,506
2024-12-31
CENSUS_ACS5
county 48423
fmr
3
$1,793
2025-10-01
HUD_USER_FMR
county 48423
acs median gross
4
$1,650
2024-12-31
CENSUS_ACS5
county 48423
fmr
4
$1,981
2025-10-01
HUD_USER_FMR
county 48423
acs median gross
5
$1,355
2024-12-31
CENSUS_ACS5
county 48423
acs median gross
$1,238
2024-12-31
CENSUS_ACS5
county 48423
acs recent mover gross
$1,357
2024-12-31
CENSUS_ACS5
zcta 75701
acs median gross
0
$1,164
2024-12-31
CENSUS_ACS5
zcta 75701
acs median gross
1
$885
2024-12-31
CENSUS_ACS5
zcta 75701
acs median gross
2
$1,281
2024-12-31
CENSUS_ACS5
zcta 75701
acs median gross
3
$1,592
2024-12-31
CENSUS_ACS5
zcta 75701
acs median gross
4
$2,218
2024-12-31
CENSUS_ACS5
zcta 75701
acs median gross
$1,336
2024-12-31
CENSUS_ACS5
zcta 75701
acs recent mover gross
$1,285
2024-12-31
CENSUS_ACS5
zip 75701
payment standard 110
0
$1,111
2025-10-01
HUD_USER_SAFMR
zip 75701
payment standard 90
0
$909
2025-10-01
HUD_USER_SAFMR
zip 75701
safmr
0
$1,010
2025-10-01
HUD_USER_SAFMR
zip 75701
payment standard 110
1
$1,232
2025-10-01
HUD_USER_SAFMR
zip 75701
payment standard 90
1
$1,008
2025-10-01
HUD_USER_SAFMR
zip 75701
safmr
1
$1,120
2025-10-01
HUD_USER_SAFMR
zip 75701
payment standard 110
2
$1,507
2025-10-01
HUD_USER_SAFMR
zip 75701
payment standard 90
2
$1,233
2025-10-01
HUD_USER_SAFMR
zip 75701
safmr
2
$1,370
2025-10-01
HUD_USER_SAFMR
zip 75701
payment standard 110
3
$2,024
2025-10-01
HUD_USER_SAFMR
zip 75701
payment standard 90
3
$1,656
2025-10-01
HUD_USER_SAFMR
zip 75701
safmr
3
$1,840
2025-10-01
HUD_USER_SAFMR
zip 75701
payment standard 110
4
$2,233
2025-10-01
HUD_USER_SAFMR
zip 75701
payment standard 90
4
$1,827
2025-10-01
HUD_USER_SAFMR
zip 75701
safmr
4
$2,030
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.