Reads as: riskier than 90.4% 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
+39.6 vs natl
RAMOS BRIAN
8 facilities
connection
Owner fleet risk far above national
+22.4 vs natl
SANDERSON CLARK
58 facilities
connection
Owner fleet risk far above national
+21.5 vs natl
FANNIN COUNTY HOSPITAL AUTHORITY
54 facilities
connection
Buyer assembling a chain (5+ takeovers/24mo)
8 facilities
FANNIN COUNTY HOSPITAL AUTHORITY
8 facilities
connection
Owner fleet enforcement cluster
88% fined
RAMOS BRIAN
8 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
2.47
2.67
3.28
2.90–3.77
RN
0.20
0.24
0.39
0.25–0.58
Weekend total
2.28
2.56
3.11
—
Weekday total
2.55
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
66.2
2.47
0.20
0.89
1.39
2.28
5.6%
2025Q3
92
65.4
2.41
0.23
0.85
1.33
2.02
3.2%
2025Q2
91
64.5
2.29
0.30
0.74
1.25
2.08
0.3%
2025Q1
90
62.9
2.43
0.47
0.63
1.32
2.27
0.0%
2024Q4
92
68.9
2.35
0.47
0.63
1.25
2.38
0.0%
2024Q3
92
72.3
2.33
0.36
0.68
1.30
2.24
0.0%
2024Q2
91
72.4
2.03
0.18
0.81
1.04
1.88
0.0%
2024Q1
91
75.8
1.09
0.11
0.99
0.00
1.06
0.0%
2023Q4
92
82.0
1.02
0.08
0.90
0.04
1.02
2.0%
2023Q3
92
79.5
1.02
0.05
0.92
0.05
0.90
10.6%
2023Q2
91
70.5
1.23
0.07
1.00
0.16
1.13
23.3%
2023Q1
90
71.0
1.11
0.06
0.96
0.08
0.97
33.4%
2022Q4
92
73.0
1.29
0.20
0.97
0.12
1.06
36.5%
2022Q3
92
74.8
1.38
0.14
1.09
0.14
1.27
21.1%
2022Q2
91
77.0
1.33
0.12
1.00
0.21
1.36
26.3%
2022Q1
90
81.3
1.94
0.03
0.96
0.95
1.69
11.8%
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.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2025-11-17
2025-05-19
Health · complaint
F0627
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
D
2025-06-13
2025-03-13
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
2025-04-06
2025-03-13
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2025-01-07
2025-03-13
Health
F0645
PASARR screening for Mental disorders or Intellectual Disabilities
D
2025-04-07
2025-03-13
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
2025-04-06
2025-03-13
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2025-04-06
2025-03-13
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2025-04-06
2024-12-27
Health · complaint
F0623
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
D
2025-01-17
2024-12-27
Health · complaint
F0624
Prepare residents for a safe transfer or discharge from the nursing home.
D
2025-01-17
2024-12-27
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
2025-01-17
2024-02-01
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
K
2024-02-03
2024-02-01
Health
F0727
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
E
2024-02-03
2024-02-01
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2024-02-03
2024-02-01
Health
F0880
Provide and implement an infection prevention and control program.
E
2024-02-03
2024-02-01
Health
F0921
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
E
2024-02-03
2024-02-01
Health
F0925
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
E
2024-02-03
2023-08-11
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
K
2023-08-12
2023-08-11
Health · complaint
F0760
Ensure that residents are free from significant medication errors.
K
2023-07-25
2022-11-22
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
2022-11-23
2022-11-22
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2022-11-23
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
10
Owner
Role
Pct
From
Status
Source
FANNIN COUNTY HOSPITAL AUTHORITY
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2018-04-01
current
pecos_ownership
CAPSTONEENNIS OPCO LLC
—
—
2024-04-01
current
tx_hhsc_directory
ENNIS NURSING AND REHAB CENTER LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2022-02-01
current
pecos_ownership
FANNIN COUNTY HOSPITAL AUTHORITY
—
—
2024-04-01
current
tx_hhsc_directory
RAMOS, BRIAN
OPERATIONAL/MANAGERIAL CONTROL
—
2022-02-01
current
pecos_ownership
SANDERSON, CLARK
CORPORATE DIRECTOR
—
2018-04-01
current
pecos_ownership
WYATT, JULIE
W-2 MANAGING EMPLOYEE
—
2021-04-01
current
pecos_ownership
BRIAN RAMOS
OPERATIONAL/MANAGERIAL CONTROL
—
2022-02-01
ended 2026-05-18
pecos_ownership
CLARK SANDERSON
CORPORATE DIRECTOR
—
2018-04-01
ended 2026-05-18
pecos_ownership
JULIE WYATT
W-2 MANAGING EMPLOYEE
—
2021-04-01
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
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
34
Geo
Kind
BR
Amount
As of
Source
county 48139
acs median gross
0
$1,221
2024-12-31
CENSUS_ACS5
county 48139
fmr
0
$1,582
2025-10-01
HUD_USER_FMR
county 48139
acs median gross
1
$1,285
2024-12-31
CENSUS_ACS5
county 48139
fmr
1
$1,648
2025-10-01
HUD_USER_FMR
county 48139
acs median gross
2
$1,482
2024-12-31
CENSUS_ACS5
county 48139
fmr
2
$1,931
2025-10-01
HUD_USER_FMR
county 48139
acs median gross
3
$1,861
2024-12-31
CENSUS_ACS5
county 48139
fmr
3
$2,431
2025-10-01
HUD_USER_FMR
county 48139
acs median gross
4
$2,453
2024-12-31
CENSUS_ACS5
county 48139
fmr
4
$3,091
2025-10-01
HUD_USER_FMR
county 48139
acs median gross
5
$3,180
2024-12-31
CENSUS_ACS5
county 48139
acs median gross
$1,594
2024-12-31
CENSUS_ACS5
county 48139
acs recent mover gross
$1,560
2024-12-31
CENSUS_ACS5
zcta 75119
acs median gross
1
$972
2024-12-31
CENSUS_ACS5
zcta 75119
acs median gross
2
$1,341
2024-12-31
CENSUS_ACS5
zcta 75119
acs median gross
3
$1,719
2024-12-31
CENSUS_ACS5
zcta 75119
acs median gross
4
$1,223
2024-12-31
CENSUS_ACS5
zcta 75119
acs median gross
$1,375
2024-12-31
CENSUS_ACS5
zcta 75119
acs recent mover gross
$1,382
2024-12-31
CENSUS_ACS5
zip 75119
payment standard 110
0
$1,397
2025-10-01
HUD_USER_SAFMR
zip 75119
payment standard 90
0
$1,143
2025-10-01
HUD_USER_SAFMR
zip 75119
safmr
0
$1,270
2025-10-01
HUD_USER_SAFMR
zip 75119
payment standard 110
1
$1,452
2025-10-01
HUD_USER_SAFMR
zip 75119
payment standard 90
1
$1,188
2025-10-01
HUD_USER_SAFMR
zip 75119
safmr
1
$1,320
2025-10-01
HUD_USER_SAFMR
zip 75119
payment standard 110
2
$1,705
2025-10-01
HUD_USER_SAFMR
zip 75119
payment standard 90
2
$1,395
2025-10-01
HUD_USER_SAFMR
zip 75119
safmr
2
$1,550
2025-10-01
HUD_USER_SAFMR
zip 75119
payment standard 110
3
$2,145
2025-10-01
HUD_USER_SAFMR
zip 75119
payment standard 90
3
$1,755
2025-10-01
HUD_USER_SAFMR
zip 75119
safmr
3
$1,950
2025-10-01
HUD_USER_SAFMR
zip 75119
payment standard 110
4
$2,728
2025-10-01
HUD_USER_SAFMR
zip 75119
payment standard 90
4
$2,232
2025-10-01
HUD_USER_SAFMR
zip 75119
safmr
4
$2,480
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.