Reads as: riskier than 70.5% 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 fleet risk far above national
+25.1 vs natl
HOOPER GRADY
61 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 fleet enforcement cluster
49% fined
HOOPER GRADY
61 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
2.48
2.67
3.28
2.90–3.77
RN
0.21
0.24
0.39
0.25–0.58
Weekend total
2.33
2.56
3.11
—
Weekday total
2.53
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
118.6
2.48
0.21
0.89
1.38
2.33
0.0%
2025Q3
92
117.2
2.68
0.18
1.00
1.51
2.50
0.0%
2025Q2
91
119.5
2.57
0.11
1.00
1.45
2.43
3.9%
2025Q1
90
116.9
2.60
0.18
0.94
1.48
2.46
6.6%
2024Q4
92
102.4
2.88
0.17
1.08
1.63
2.77
3.2%
2024Q3
92
98.6
2.78
0.11
1.03
1.64
2.69
14.0%
2024Q2
91
87.1
2.68
0.09
0.98
1.61
2.61
12.5%
2024Q1
91
85.0
2.92
0.08
1.12
1.73
2.87
24.6%
2023Q4
92
87.3
2.58
0.08
0.92
1.58
2.59
28.1%
2023Q3
92
84.2
2.45
0.07
0.84
1.53
2.47
20.4%
2023Q2
91
80.6
2.40
0.04
0.86
1.49
2.40
25.4%
2023Q1
90
84.5
2.31
0.02
0.92
1.37
2.27
32.1%
2022Q4
92
76.9
2.45
0.05
0.92
1.48
2.32
28.1%
2022Q3
92
79.7
2.32
0.10
0.86
1.36
2.23
50.2%
2022Q2
91
81.8
2.96
0.09
1.11
1.75
2.68
29.3%
2022Q1
90
93.0
2.68
0.16
1.06
1.45
2.37
7.0%
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.
Reasonably accommodate the needs and preferences of each resident.
D
2026-02-20
2025-09-17
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
E
2025-09-18
2025-09-17
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
2025-09-18
2025-09-17
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2025-09-18
2025-09-10
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
G
2025-09-11
2025-09-10
Health · complaint
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2025-09-11
2025-09-10
Health · complaint
F0880
Provide and implement an infection prevention and control program.
E
2025-09-11
2025-08-18
Health · complaint
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
2025-09-05
2025-06-02
Health · complaint
F0580
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
D
2025-06-17
2025-05-28
Health · complaint
F0695
Provide safe and appropriate respiratory care for a resident when needed.
H
2025-06-12
2025-04-29
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
G
2025-05-14
2025-01-10
Health · complaint
F0641
Ensure each resident receives an accurate assessment.
D
2025-01-11
2025-01-10
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
2025-01-11
2024-08-08
Health
F0557
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
E
2024-08-09
2024-08-08
Health
F0565
Honor the resident's right to organize and participate in resident/family groups in the facility.
E
2024-08-09
2024-08-08
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.
D
2024-08-09
2024-08-08
Health
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
E
2024-08-09
2024-08-08
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2024-08-09
2024-08-08
Health
F0679
Provide activities to meet all resident's needs.
D
2024-08-09
2024-08-08
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-08-09
2024-08-08
Health
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
2024-08-09
2024-08-08
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
E
2024-08-09
2024-08-08
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2024-08-09
2024-08-08
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.
E
2024-08-09
2024-08-08
Health
F0806
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
D
2024-08-09
2024-08-08
Health
F0809
Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
E
2024-08-09
2024-08-08
Health
F0880
Provide and implement an infection prevention and control program.
D
2024-08-09
2024-08-02
Health · complaint
F0690
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
D
2024-08-09
2024-07-21
Health · complaint
F0697
Provide safe, appropriate pain management for a resident who requires such services.
K
2024-07-22
2024-07-21
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
K
2024-07-22
2023-11-16
Health · complaint
F0602
Protect each resident from the wrongful use of the resident's belongings or money.
D
2023-12-06
2023-11-16
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
H
2023-12-06
2023-10-11
Health · complaint
F0690
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
H
2023-11-01
2023-06-14
Health
F0655
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
D
2023-07-12
2023-06-14
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
2023-07-12
2023-06-14
Health
F0680
Ensure the activities program is directed by a qualified professional.
E
2023-07-12
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
16
Owner
Role
Pct
From
Status
Source
BURNAM, SOON
CORPORATE OFFICER
—
2022-07-01
current
pecos_ownership
CASTRO POU, GRACIELA
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-27
current
pecos_ownership
CHUDLEIGH, GEOFF
OPERATIONAL/MANAGERIAL CONTROL
—
2022-07-01
current
pecos_ownership
HAMILTON COUNTY HOSPITAL DISTRICT
—
—
2025-05-01
current
tx_hhsc_directory
HOOPER, GRADY
CORPORATE OFFICER
—
2015-12-01
current
pecos_ownership
KEETCH, CHAD
CORPORATE OFFICER
—
2011-03-01
current
pecos_ownership
SAGE MEADOW HEALTHCARE, INC
—
—
2025-05-01
current
tx_hhsc_directory
SAGE MEADOW HEALTHCARE, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
2022-07-01
current
pecos_ownership
SAGE MEADOW HEALTHCARE, INC.
ADP OF THE SNF
—
2025-10-29
current
pecos_ownership
THE ENSIGN GROUP INC
ADP OF THE SNF
—
2022-04-18
current
pecos_ownership
GRADY HOOPER
CORPORATE OFFICER
100%
2015-12-01
ended 2026-05-18
pecos_ownership
HAMILTON COUNTY HOSPITAL DISTRICT
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2019-05-01
ended 2026-05-18
pecos_ownership
GEOFF CHUDLEIGH
OPERATIONAL/MANAGERIAL CONTROL
0%
2022-07-01
ended 2026-05-18
pecos_ownership
CHAD KEETCH
CORPORATE OFFICER
—
2011-03-01
ended 2026-05-18
pecos_ownership
GRACIELA CASTRO POU
MANAGING CONTROL - GOVERNING BODY
—
2024-12-27
ended 2026-05-18
pecos_ownership
SOON BURNAM
CORPORATE OFFICER
—
2022-07-01
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
3
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-09-30
$935,187
—
$701,221
—
—
4
—
2023-09-30
$482,551
—
$414,464
—
—
4
—
2022-09-30
$147,558
—
$108,926
—
—
4
—
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
34
Geo
Kind
BR
Amount
As of
Source
county 48453
acs median gross
0
$1,416
2024-12-31
CENSUS_ACS5
county 48453
fmr
0
$1,474
2025-10-01
HUD_USER_FMR
county 48453
acs median gross
1
$1,553
2024-12-31
CENSUS_ACS5
county 48453
fmr
1
$1,562
2025-10-01
HUD_USER_FMR
county 48453
acs median gross
2
$1,849
2024-12-31
CENSUS_ACS5
county 48453
fmr
2
$1,852
2025-10-01
HUD_USER_FMR
county 48453
acs median gross
3
$2,195
2024-12-31
CENSUS_ACS5
county 48453
fmr
3
$2,347
2025-10-01
HUD_USER_FMR
county 48453
acs median gross
4
$2,463
2024-12-31
CENSUS_ACS5
county 48453
fmr
4
$2,760
2025-10-01
HUD_USER_FMR
county 48453
acs median gross
5
$2,958
2024-12-31
CENSUS_ACS5
county 48453
acs median gross
$1,744
2024-12-31
CENSUS_ACS5
county 48453
acs recent mover gross
$1,845
2024-12-31
CENSUS_ACS5
zcta 78738
acs median gross
1
$1,731
2024-12-31
CENSUS_ACS5
zcta 78738
acs median gross
2
$2,213
2024-12-31
CENSUS_ACS5
zcta 78738
acs median gross
3
$3,501
2024-12-31
CENSUS_ACS5
zcta 78738
acs median gross
4
$3,501
2024-12-31
CENSUS_ACS5
zcta 78738
acs median gross
$1,983
2024-12-31
CENSUS_ACS5
zcta 78738
acs recent mover gross
$1,986
2024-12-31
CENSUS_ACS5
zip 78738
payment standard 110
0
$1,958
2025-10-01
HUD_USER_SAFMR
zip 78738
payment standard 90
0
$1,602
2025-10-01
HUD_USER_SAFMR
zip 78738
safmr
0
$1,780
2025-10-01
HUD_USER_SAFMR
zip 78738
payment standard 110
1
$2,068
2025-10-01
HUD_USER_SAFMR
zip 78738
payment standard 90
1
$1,692
2025-10-01
HUD_USER_SAFMR
zip 78738
safmr
1
$1,880
2025-10-01
HUD_USER_SAFMR
zip 78738
payment standard 110
2
$2,453
2025-10-01
HUD_USER_SAFMR
zip 78738
payment standard 90
2
$2,007
2025-10-01
HUD_USER_SAFMR
zip 78738
safmr
2
$2,230
2025-10-01
HUD_USER_SAFMR
zip 78738
payment standard 110
3
$3,113
2025-10-01
HUD_USER_SAFMR
zip 78738
payment standard 90
3
$2,547
2025-10-01
HUD_USER_SAFMR
zip 78738
safmr
3
$2,830
2025-10-01
HUD_USER_SAFMR
zip 78738
payment standard 110
4
$3,652
2025-10-01
HUD_USER_SAFMR
zip 78738
payment standard 90
4
$2,988
2025-10-01
HUD_USER_SAFMR
zip 78738
safmr
4
$3,320
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.