Reads as: riskier than 98.7% 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
4
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+37.2 vs natl
HOPKINS COUNTY HOSPITAL DISTRICT
5 facilities
connection
Owner spans multiple chains
7 chains
SMITH MICHAEL
12 facilities
connection
Owner fleet enforcement cluster
60% fined
HOPKINS COUNTY HOSPITAL DISTRICT
5 facilities
connection
Owner fleet enforcement cluster
44% fined
SMITH MICHAEL
16 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
14
2025Q4 HPRD
This facility
TX median
National median
National p25–p75
Total nurse
2.57
2.67
3.28
2.90–3.77
RN
0.12
0.24
0.39
0.25–0.58
Weekend total
2.65
2.56
3.11
—
Weekday total
2.54
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
69.6
2.57
0.12
0.70
1.75
2.65
3.7%
2025Q3
92
65.4
2.56
0.18
0.69
1.68
2.41
3.8%
2025Q1
90
62.3
2.79
0.14
0.64
2.01
2.51
0.5%
2024Q4
92
62.1
2.76
0.05
0.80
1.91
2.40
1.1%
2024Q3
92
66.2
2.64
0.08
0.78
1.77
2.39
1.8%
2024Q2
91
66.9
2.38
0.09
0.77
1.52
1.98
1.0%
2024Q1
91
61.6
2.56
0.09
0.83
1.63
2.15
0.0%
2023Q4
92
64.1
2.54
0.13
0.72
1.69
2.25
1.8%
2023Q3
92
61.0
2.62
0.11
0.82
1.69
2.52
15.2%
2023Q2
91
61.7
1.00
0.06
0.25
0.70
0.88
44.6%
2022Q4
92
66.7
3.58
0.67
1.07
1.84
3.45
38.7%
2022Q3
92
70.4
3.00
0.31
0.82
1.88
2.74
28.5%
2022Q2
91
67.4
3.19
0.19
0.94
2.06
2.72
15.4%
2022Q1
90
64.8
2.86
0.20
0.73
1.92
2.64
23.6%
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.
D
2026-03-27
2026-03-18
Health
F0640
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
B
2026-03-27
2026-03-18
Health
F0641
Ensure each resident receives an accurate assessment.
D
2026-03-27
2026-03-18
Health
F0692
Provide enough food/fluids to maintain a resident's health.
E
2026-03-27
2026-03-18
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
E
2026-03-27
2025-11-25
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2025-12-01
2025-01-08
Health
F0641
Ensure each resident receives an accurate assessment.
E
2025-02-21
2025-01-08
Health
F0693
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
D
2025-02-21
2025-01-08
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.
F
2025-02-21
2025-01-08
Health
F0731
Request a waiver if it can't meet the nurse staffing requirements.
F
2025-02-21
2025-01-08
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2025-02-21
2025-01-08
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2025-02-21
2025-01-08
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2025-02-21
2025-01-08
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2025-02-21
2025-01-08
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-02-21
2024-12-27
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
K
2024-12-28
2024-12-27
Health · complaint
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
K
2024-12-28
2024-12-27
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2024-12-28
2024-07-10
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-08-24
2024-07-10
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2024-08-24
2023-12-12
Health
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
2024-01-12
2023-12-12
Health
F0725
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
E
2024-01-02
2023-12-12
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
2024-01-02
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
6
Owner
Role
Pct
From
Status
Source
HOPKINS COUNTY HOSPITAL DISTRICT
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2017-03-31
current
pecos_ownership
HEATH LINDALE MANAGER LLC
—
—
2026-03-31
current
tx_hhsc_directory
HOPKINS COUNTY HOSPITAL DISTRICT
—
—
2026-03-31
current
tx_hhsc_directory
SMITH, MICHAEL
CORPORATE OFFICER
—
2021-12-01
current
pecos_ownership
MICHAEL SMITH
W-2 MANAGING EMPLOYEE
—
2023-05-01
ended 2026-05-18
pecos_ownership
MICHAEL SMITH
CORPORATE OFFICER
—
2021-12-01
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.
Transactions
0
No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
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 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 75771
acs median gross
1
$955
2024-12-31
CENSUS_ACS5
zcta 75771
acs median gross
2
$1,208
2024-12-31
CENSUS_ACS5
zcta 75771
acs median gross
3
$1,456
2024-12-31
CENSUS_ACS5
zcta 75771
acs median gross
4
$1,581
2024-12-31
CENSUS_ACS5
zcta 75771
acs median gross
$1,344
2024-12-31
CENSUS_ACS5
zcta 75771
acs recent mover gross
$1,175
2024-12-31
CENSUS_ACS5
zip 75771
payment standard 110
0
$1,188
2025-10-01
HUD_USER_SAFMR
zip 75771
payment standard 90
0
$972
2025-10-01
HUD_USER_SAFMR
zip 75771
safmr
0
$1,080
2025-10-01
HUD_USER_SAFMR
zip 75771
payment standard 110
1
$1,320
2025-10-01
HUD_USER_SAFMR
zip 75771
payment standard 90
1
$1,080
2025-10-01
HUD_USER_SAFMR
zip 75771
safmr
1
$1,200
2025-10-01
HUD_USER_SAFMR
zip 75771
payment standard 110
2
$1,617
2025-10-01
HUD_USER_SAFMR
zip 75771
payment standard 90
2
$1,323
2025-10-01
HUD_USER_SAFMR
zip 75771
safmr
2
$1,470
2025-10-01
HUD_USER_SAFMR
zip 75771
payment standard 110
3
$2,167
2025-10-01
HUD_USER_SAFMR
zip 75771
payment standard 90
3
$1,773
2025-10-01
HUD_USER_SAFMR
zip 75771
safmr
3
$1,970
2025-10-01
HUD_USER_SAFMR
zip 75771
payment standard 110
4
$2,398
2025-10-01
HUD_USER_SAFMR
zip 75771
payment standard 90
4
$1,962
2025-10-01
HUD_USER_SAFMR
zip 75771
safmr
4
$2,180
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.