Reads as: riskier than 82.2% 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
25
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+24.0 vs natl
REG LEASED OPCO LLC
24 facilities
connection
Owner fleet risk far above national
+22.3 vs natl
PRICE LARRY
26 facilities
connection
Owner fleet risk far above national
+20.1 vs natl
DWD TX HOLDINGS LLC
65 facilities
connection
Owner fleet risk far above national
+20.1 vs natl
REGENCY TEXAS HOLDINGS LLC
65 facilities
connection
Owner fleet risk far above national
+20.1 vs natl
REG OPERATOR HOLDCO LLC
65 facilities
connection
Owner spans multiple chains
8 chains
REGENCY IHS REHAB LLC
68 facilities
connection
Owner spans multiple chains
8 chains
REGENCY IHS CLINICAL CONSULTING LLC
67 facilities
connection
Owner spans multiple chains
7 chains
CSV RHEA MANAGEMENT HOLDCO LLC
63 facilities
connection
Owner spans multiple chains
7 chains
CLAPP BARBARA
66 facilities
connection
Owner spans multiple chains
7 chains
REGENCY TEXAS HOLDINGS LLC
64 facilities
connection
Owner spans multiple chains
7 chains
REGENCY INTEGRATED HEALTH SERVICES LLC
67 facilities
connection
Owner spans multiple chains
7 chains
JACK AND NANCY DWYER WORKFORCE DEVELOPMENT CENTER INC
65 facilities
connection
Owner spans multiple chains
7 chains
DWD TX HOLDINGS LLC
64 facilities
connection
Owner spans multiple chains
7 chains
MANDELBAUM ELLIOT
61 facilities
connection
Owner spans multiple chains
7 chains
DEKOWSKI DONOVAN
66 facilities
connection
Owner spans multiple chains
7 chains
REG OPERATOR HOLDCO LLC
64 facilities
connection
Owner fleet enforcement cluster
46% fined
REG LEASED OPCO LLC
24 facilities
connection
Owner fleet enforcement cluster
43% fined
REGENCY TEXAS HOLDINGS LLC
65 facilities
connection
Owner fleet enforcement cluster
43% fined
REG OPERATOR HOLDCO LLC
65 facilities
connection
Owner fleet enforcement cluster
43% fined
DWD TX HOLDINGS LLC
65 facilities
connection
Owner fleet enforcement cluster
42% fined
JACK AND NANCY DWYER WORKFORCE DEVELOPMENT CENTER INC
66 facilities
connection
Owner fleet enforcement cluster
42% fined
SOUTH LIMESTONE HOSPITAL DISTRICT
26 facilities
connection
Owner fleet enforcement cluster
42% fined
PRICE LARRY
26 facilities
connection
Owner fleet enforcement cluster
42% fined
MANDELBAUM ELLIOT
62 facilities
connection
Owner fleet enforcement cluster
42% fined
DEKOWSKI DONOVAN
67 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
2.86
2.67
3.28
2.90–3.77
RN
0.30
0.24
0.39
0.25–0.58
Weekend total
2.69
2.56
3.11
—
Weekday total
2.92
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
92.5
2.86
0.30
0.74
1.82
2.69
0.0%
2025Q3
92
75.1
2.82
0.33
0.58
1.91
2.62
0.0%
2025Q2
91
71.4
3.18
0.31
0.74
2.13
2.88
13.8%
2025Q1
90
75.0
3.05
0.23
0.78
2.04
2.75
16.6%
2024Q4
92
76.5
3.00
0.31
0.70
2.00
2.75
12.4%
2024Q3
92
78.2
2.94
0.22
0.75
1.98
2.69
11.5%
2024Q2
91
82.2
2.90
0.24
0.76
1.90
2.60
7.3%
2024Q1
91
77.4
3.09
0.26
0.83
2.00
2.79
4.0%
2023Q4
92
81.1
3.22
0.29
0.82
2.10
2.87
2.8%
2023Q3
92
90.4
3.17
0.25
0.82
2.10
2.84
6.7%
2023Q2
91
93.8
3.39
0.23
0.92
2.24
3.13
9.7%
2023Q1
90
95.5
3.49
0.32
0.85
2.32
3.21
12.9%
2022Q4
92
102.5
3.49
0.23
0.91
2.35
3.13
13.9%
2022Q3
92
106.1
3.61
0.14
0.95
2.52
3.36
23.6%
2022Q2
91
111.0
3.60
0.16
0.97
2.48
3.17
35.4%
2022Q1
90
107.4
3.43
0.19
1.05
2.19
3.10
22.8%
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.
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
E
2025-05-30
2025-04-30
Health
F0558
Reasonably accommodate the needs and preferences of each resident.
E
2025-05-30
2025-04-30
Health
F0604
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
D
2025-06-16
2025-04-30
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
E
2025-05-27
2025-04-30
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
2025-05-30
2025-04-30
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
2025-05-23
2025-04-30
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2025-05-01
2025-04-30
Health
F0880
Provide and implement an infection prevention and control program.
E
2025-05-30
2025-03-17
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
J
2025-03-23
2025-03-17
Health · complaint
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2025-04-12
2025-03-03
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2025-02-07
2025-03-03
Health · complaint
F0603
Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
D
2025-02-07
2024-02-29
Health
F0552
Ensure that residents are fully informed and understand their health status, care and treatments.
D
2024-03-01
2024-02-29
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.
E
2024-04-21
2024-02-29
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2024-03-01
2022-12-09
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
2023-01-13
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
31
Owner
Role
Pct
From
Status
Source
4011 WILLIAMS DRIVE LLC
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
CHANEY, DENA
OPERATIONAL/MANAGERIAL CONTROL
—
2025-03-01
current
pecos_ownership
CLAPP, BARBARA
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
CSV RHEA MANAGEMENT HOLDCO, LLC
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
DEKOWSKI, DONOVAN
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
DONOHUE, LORENA
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
DWD TX HOLDINGS LLC
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
JACK AND NANCY DWYER WORKFORCE DEVELOPMENT CENTER INC
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
MANDELBAUM, ELLIOT
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
PRICE, LARRY
CORPORATE DIRECTOR
—
2017-04-01
current
pecos_ownership
REG LEASED OPCO LLC
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
REG OPERATOR HOLDCO LLC
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
REGENCY IHS CLINICAL CONSULTING, LLC
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
REGENCY IHS REHAB LLC
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
REGENCY INTEGRATED HEALTH SERVICES LLC
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
REGENCY TEXAS HOLDINGS LLC
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
SMITHVILLE HOSPITAL AUTHORITY
—
—
2026-06-01
current
tx_hhsc_directory
SOUTH LIMESTONE HOSPITAL DISTRICT
OPERATIONAL/MANAGERIAL CONTROL
—
2017-04-01
current
pecos_ownership
SOUTH LIMESTONE HOSPITAL DISTRICT
ADP OF THE SNF
—
2025-09-30
current
pecos_ownership
STRONG, TYLER
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
SUGUNAN, BINU
ADP OF THE SNF
—
2025-03-07
current
pecos_ownership
WELLSENTIAL OF GEORGETOWN LLC
ADP OF THE SNF
—
2025-09-15
current
pecos_ownership
WELLSENTIAL OF GEORGETOWN LLC
—
—
2026-06-01
current
tx_hhsc_directory
BARBARA CLAPP
ADP OF THE SNF
—
2025-09-15
ended 2026-05-18
pecos_ownership
BINU SUGUNAN
ADP OF THE SNF
—
2025-03-07
ended 2026-05-18
pecos_ownership
DENA CHANEY
OPERATIONAL/MANAGERIAL CONTROL
—
2025-03-01
ended 2026-05-18
pecos_ownership
DONOVAN DEKOWSKI
ADP OF THE SNF
—
2025-09-15
ended 2026-05-18
pecos_ownership
ELLIOT MANDELBAUM
ADP OF THE SNF
—
2025-09-15
ended 2026-05-18
pecos_ownership
LARRY PRICE
CORPORATE DIRECTOR
—
2017-04-01
ended 2026-05-18
pecos_ownership
LORENA DONOHUE
OPERATIONAL/MANAGERIAL CONTROL
—
2025-09-15
ended 2026-05-18
pecos_ownership
TYLER STRONG
ADP OF THE SNF
—
2025-09-15
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
0
No related-party cost years on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
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 48491
acs median gross
0
$1,577
2024-12-31
CENSUS_ACS5
county 48491
fmr
0
$1,474
2025-10-01
HUD_USER_FMR
county 48491
acs median gross
1
$1,457
2024-12-31
CENSUS_ACS5
county 48491
fmr
1
$1,562
2025-10-01
HUD_USER_FMR
county 48491
acs median gross
2
$1,781
2024-12-31
CENSUS_ACS5
county 48491
fmr
2
$1,852
2025-10-01
HUD_USER_FMR
county 48491
acs median gross
3
$2,154
2024-12-31
CENSUS_ACS5
county 48491
fmr
3
$2,347
2025-10-01
HUD_USER_FMR
county 48491
acs median gross
4
$2,584
2024-12-31
CENSUS_ACS5
county 48491
fmr
4
$2,760
2025-10-01
HUD_USER_FMR
county 48491
acs median gross
5
$2,617
2024-12-31
CENSUS_ACS5
county 48491
acs median gross
$1,796
2024-12-31
CENSUS_ACS5
county 48491
acs recent mover gross
$1,868
2024-12-31
CENSUS_ACS5
zcta 78628
acs median gross
0
$1,218
2024-12-31
CENSUS_ACS5
zcta 78628
acs median gross
1
$1,494
2024-12-31
CENSUS_ACS5
zcta 78628
acs median gross
2
$1,632
2024-12-31
CENSUS_ACS5
zcta 78628
acs median gross
3
$2,104
2024-12-31
CENSUS_ACS5
zcta 78628
acs median gross
4
$2,465
2024-12-31
CENSUS_ACS5
zcta 78628
acs median gross
$1,687
2024-12-31
CENSUS_ACS5
zcta 78628
acs recent mover gross
$1,891
2024-12-31
CENSUS_ACS5
zip 78628
payment standard 110
0
$1,540
2025-10-01
HUD_USER_SAFMR
zip 78628
payment standard 90
0
$1,260
2025-10-01
HUD_USER_SAFMR
zip 78628
safmr
0
$1,400
2025-10-01
HUD_USER_SAFMR
zip 78628
payment standard 110
1
$1,639
2025-10-01
HUD_USER_SAFMR
zip 78628
payment standard 90
1
$1,341
2025-10-01
HUD_USER_SAFMR
zip 78628
safmr
1
$1,490
2025-10-01
HUD_USER_SAFMR
zip 78628
payment standard 110
2
$1,936
2025-10-01
HUD_USER_SAFMR
zip 78628
payment standard 90
2
$1,584
2025-10-01
HUD_USER_SAFMR
zip 78628
safmr
2
$1,760
2025-10-01
HUD_USER_SAFMR
zip 78628
payment standard 110
3
$2,464
2025-10-01
HUD_USER_SAFMR
zip 78628
payment standard 90
3
$2,016
2025-10-01
HUD_USER_SAFMR
zip 78628
safmr
3
$2,240
2025-10-01
HUD_USER_SAFMR
zip 78628
payment standard 110
4
$2,860
2025-10-01
HUD_USER_SAFMR
zip 78628
payment standard 90
4
$2,340
2025-10-01
HUD_USER_SAFMR
zip 78628
safmr
4
$2,600
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.