Reads as: riskier than 88.1% 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
19
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+21.8 vs natl
GILCREASE CYNTHIA
7 facilities
connection
Owner spans multiple chains
18 chains
PLANTE MORAN PLLC
55 facilities
connection
Owner spans multiple chains
15 chains
AEGIS THERAPIES INC
32 facilities
connection
Owner spans multiple chains
9 chains
FELLBAUM ERNEST
26 facilities
connection
Owner spans multiple chains
9 chains
TRIDENT HEALTHCARE SERVICES INC
24 facilities
connection
Owner spans multiple chains
9 chains
STUDER STANLEY
26 facilities
connection
Owner spans multiple chains
8 chains
CASTILLO LYNNEA
23 facilities
connection
Owner spans multiple chains
8 chains
TOUCHSTONE COMMUNITIES INC
23 facilities
connection
Owner spans multiple chains
8 chains
ZUROVEC DARRELL
23 facilities
connection
Owner spans multiple chains
8 chains
NUTRITIOUS LIFESTYLES INC
18 facilities
connection
Owner spans multiple chains
8 chains
SEHLKE BRYON
22 facilities
connection
Owner spans multiple chains
8 chains
CARVAJAL PHARMACY LTC
22 facilities
connection
Owner spans multiple chains
7 chains
CAMPBELL LESLIE
22 facilities
connection
Owner spans multiple chains
5 chains
THE BRYON AND RENA SEHLKE LIVING TRUST
12 facilities
connection
Owner fleet enforcement cluster
58% fined
THE BRYON AND RENA SEHLKE LIVING TRUST
12 facilities
connection
Owner fleet enforcement cluster
43% fined
GILCREASE CYNTHIA
7 facilities
connection
Owner fleet enforcement cluster
41% fined
CAMPBELL LESLIE
22 facilities
connection
Owner fleet enforcement cluster
41% fined
SEHLKE BRYON
22 facilities
connection
Owner fleet enforcement cluster
41% fined
STUDER STANLEY
27 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 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
2.78
2.67
3.28
2.90–3.77
RN
0.16
0.24
0.39
0.25–0.58
Weekend total
2.63
2.56
3.11
—
Weekday total
2.84
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
88.0
2.78
0.16
0.86
1.76
2.63
2.3%
2025Q3
92
89.5
2.78
0.11
0.89
1.78
2.54
2.2%
2025Q2
91
89.9
2.72
0.10
0.91
1.71
2.48
2.3%
2025Q1
90
83.9
2.70
0.10
0.93
1.67
2.52
1.1%
2024Q4
92
84.2
2.44
0.07
0.86
1.51
2.35
0.0%
2024Q3
92
7.7
11.24
0.30
3.68
7.25
13.36
0.0%
2024Q2
91
72.8
3.27
0.17
1.01
2.09
3.32
0.0%
2024Q1
91
91.9
2.77
0.24
0.85
1.68
2.72
0.0%
2023Q4
92
92.7
2.58
0.21
0.86
1.51
2.63
0.0%
2023Q3
92
92.2
2.40
0.14
0.83
1.42
2.16
0.0%
2023Q2
91
88.0
2.23
0.14
0.87
1.22
2.00
0.0%
2023Q1
90
82.7
2.17
0.32
0.71
1.14
1.92
0.0%
2022Q4
92
65.1
2.38
0.40
0.76
1.21
2.01
0.0%
2022Q3
92
60.2
2.11
0.47
0.78
0.86
1.77
0.0%
2022Q2
91
57.8
1.97
0.20
0.90
0.88
1.83
0.0%
2022Q1
90
45.5
2.61
0.19
1.28
1.14
2.48
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.
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2026-04-23
2025-03-12
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2025-03-13
2025-03-12
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-03-13
2025-02-01
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
J
2025-02-02
2025-02-01
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2025-02-02
2025-02-01
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
2025-02-02
2025-02-01
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2025-02-02
2024-01-26
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
K
2024-01-29
2024-01-26
Health · complaint
F0692
Provide enough food/fluids to maintain a resident's health.
K
2024-01-29
2023-12-18
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2023-12-20
2023-12-18
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
K
2023-12-20
2023-12-18
Health
F0760
Ensure that residents are free from significant medication errors.
D
2023-12-20
2023-10-03
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2023-10-13
2022-09-13
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2022-09-23
2022-09-13
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
2022-09-23
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
36
Owner
Role
Pct
From
Status
Source
VAL VERDE COUNTY HOSPITAL DISTRICT
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2024-03-01
current
pecos_ownership
AEGIS THERAPIES, INC.
ADP OF THE SNF
—
2024-03-01
current
pecos_ownership
CAMPBELL, LESLIE
ADP OF THE SNF
—
2020-04-01
current
pecos_ownership
CARVAJAL PHARMACY LTC
ADP OF THE SNF
—
2024-03-01
current
pecos_ownership
CASTILLO, LYNNEA
ADP OF THE SNF
—
2024-03-01
current
pecos_ownership
FELLBAUM, ERNEST
ADP OF THE SNF
—
2019-07-17
current
pecos_ownership
FROST BANK
5% OR GREATER SECURITY INTEREST
—
2024-02-15
current
pecos_ownership
GILCREASE, CYNTHIA
OPERATIONAL/MANAGERIAL CONTROL
—
2024-03-01
current
pecos_ownership
GILCREASE, CYNTHIA
ADP OF THE SNF
—
2016-12-01
current
pecos_ownership
HINOJOSA, ROSA
OPERATIONAL/MANAGERIAL CONTROL
—
2024-03-18
current
pecos_ownership
JURADO, JORGE
CORPORATE OFFICER
—
2024-01-26
current
pecos_ownership
NUTRITIOUS LIFESTYLES, INC.
ADP OF THE SNF
—
2024-03-01
current
pecos_ownership
OLIVAREZ, YVONNE
OPERATIONAL/MANAGERIAL CONTROL
—
2024-05-06
current
pecos_ownership
PLANTE & MORAN PLLC
ADP OF THE SNF
—
2024-03-01
current
pecos_ownership
SEHLKE, BRYON
OPERATIONAL/MANAGERIAL CONTROL
—
2024-03-01
current
pecos_ownership
STUDER, STANLEY
ADP OF THE SNF
—
2019-07-17
current
pecos_ownership
THE BRYON AND RENA SEHLKE LIVING TRUST
ADP OF THE SNF
—
2023-01-01
current
pecos_ownership
TOUCHSTONE COMMUNITIES INC
ADP OF THE SNF
—
2024-03-01
current
pecos_ownership
TOUCHSTONE COMMUNITIES, INC
—
—
2024-03-01
current
tx_hhsc_directory
TOUCHSTONE REALTY - PENITAS LLC
ADP OF THE SNF
—
2024-03-01
current
pecos_ownership
TOUCHSTONE STRATEGIES - PENITAS, LLC
ADP OF THE SNF
—
2025-08-08
current
pecos_ownership
TOUCHSTONE STRATEGIES - PENITAS, LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-03-01
current
pecos_ownership
TRIDENT HEALTH SERVICES INC
ADP OF THE SNF
—
2024-03-01
current
pecos_ownership
VAL VERDE COUNTY HOSPITAL DISTRICT
—
—
2024-03-01
current
tx_hhsc_directory
ZUROVEC, DARRELL
ADP OF THE SNF
—
2024-03-01
current
pecos_ownership
JORGE JURADO
CORPORATE OFFICER
0%
2024-01-26
ended 2026-05-18
pecos_ownership
BRYON SEHLKE
OPERATIONAL/MANAGERIAL CONTROL
—
2024-03-01
ended 2026-05-18
pecos_ownership
CYNTHIA GILCREASE
OPERATIONAL/MANAGERIAL CONTROL
—
2024-03-01
ended 2026-05-18
pecos_ownership
CYNTHIA GILCREASE
ADP OF THE SNF
—
2016-12-01
ended 2026-05-18
pecos_ownership
DARRELL ZUROVEC
ADP OF THE SNF
—
2024-03-01
ended 2026-05-18
pecos_ownership
ERNEST FELLBAUM
ADP OF THE SNF
—
2019-07-17
ended 2026-05-18
pecos_ownership
LESLIE CAMPBELL
ADP OF THE SNF
—
2020-04-01
ended 2026-05-18
pecos_ownership
LYNNEA CASTILLO
OPERATIONAL/MANAGERIAL CONTROL
—
2024-03-01
ended 2026-05-18
pecos_ownership
ROSA HINOJOSA
ADP OF THE SNF
—
2024-03-18
ended 2026-05-18
pecos_ownership
STANLEY STUDER
ADP OF THE SNF
—
2019-07-17
ended 2026-05-18
pecos_ownership
YVONNE OLIVAREZ
ADP OF THE SNF
—
2024-05-06
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
2024-02-29
$120,631
—
—
—
$6,340
2
—
2023-12-31
$723,783
—
—
—
$38,039
2
—
2022-12-31
$543,470
—
—
—
$36,005
2
—
2021-12-31
$160,959
—
—
—
$6,147
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
32
Geo
Kind
BR
Amount
As of
Source
county 48215
acs median gross
0
$837
2024-12-31
CENSUS_ACS5
county 48215
fmr
0
$842
2025-10-01
HUD_USER_FMR
county 48215
acs median gross
1
$716
2024-12-31
CENSUS_ACS5
county 48215
fmr
1
$847
2025-10-01
HUD_USER_FMR
county 48215
acs median gross
2
$956
2024-12-31
CENSUS_ACS5
county 48215
fmr
2
$1,060
2025-10-01
HUD_USER_FMR
county 48215
acs median gross
3
$1,138
2024-12-31
CENSUS_ACS5
county 48215
fmr
3
$1,376
2025-10-01
HUD_USER_FMR
county 48215
acs median gross
4
$1,310
2024-12-31
CENSUS_ACS5
county 48215
fmr
4
$1,522
2025-10-01
HUD_USER_FMR
county 48215
acs median gross
5
$1,409
2024-12-31
CENSUS_ACS5
county 48215
acs median gross
$957
2024-12-31
CENSUS_ACS5
county 48215
acs recent mover gross
$996
2024-12-31
CENSUS_ACS5
zcta 78576
acs median gross
2
$950
2024-12-31
CENSUS_ACS5
zcta 78576
acs median gross
3
$589
2024-12-31
CENSUS_ACS5
zcta 78576
acs median gross
$697
2024-12-31
CENSUS_ACS5
zcta 78576
acs recent mover gross
$860
2024-12-31
CENSUS_ACS5
zip 78576
payment standard 110
0
$847
2025-10-01
HUD_USER_SAFMR
zip 78576
payment standard 90
0
$693
2025-10-01
HUD_USER_SAFMR
zip 78576
safmr
0
$770
2025-10-01
HUD_USER_SAFMR
zip 78576
payment standard 110
1
$858
2025-10-01
HUD_USER_SAFMR
zip 78576
payment standard 90
1
$702
2025-10-01
HUD_USER_SAFMR
zip 78576
safmr
1
$780
2025-10-01
HUD_USER_SAFMR
zip 78576
payment standard 110
2
$1,067
2025-10-01
HUD_USER_SAFMR
zip 78576
payment standard 90
2
$873
2025-10-01
HUD_USER_SAFMR
zip 78576
safmr
2
$970
2025-10-01
HUD_USER_SAFMR
zip 78576
payment standard 110
3
$1,386
2025-10-01
HUD_USER_SAFMR
zip 78576
payment standard 90
3
$1,134
2025-10-01
HUD_USER_SAFMR
zip 78576
safmr
3
$1,260
2025-10-01
HUD_USER_SAFMR
zip 78576
payment standard 110
4
$1,540
2025-10-01
HUD_USER_SAFMR
zip 78576
payment standard 90
4
$1,260
2025-10-01
HUD_USER_SAFMR
zip 78576
safmr
4
$1,400
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.