Reads as: riskier than 76.0% 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
2
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
8 chains
MISTRETTA CASSANDRA
9 facilities
connection
Owner spans multiple chains
7 chains
PFEIFER MARY
7 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
12
2025Q4 HPRD
This facility
TX median
National median
National p25–p75
Total nurse
2.71
2.67
3.28
2.90–3.77
RN
0.05
0.24
0.39
0.25–0.58
Weekend total
2.58
2.56
3.11
—
Weekday total
2.75
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
33.9
2.71
0.05
0.81
1.85
2.58
0.0%
2025Q2
91
35.3
2.69
0.06
0.71
1.92
2.76
0.0%
2024Q4
92
39.2
2.38
0.07
0.73
1.57
2.45
0.0%
2024Q2
91
36.4
2.49
0.06
0.88
1.55
2.56
0.0%
2024Q1
91
32.8
2.66
0.06
0.97
1.62
2.81
10.7%
2023Q4
92
31.9
2.55
0.07
0.98
1.50
2.83
2.1%
2023Q3
92
31.2
2.21
0.06
0.73
1.43
2.37
1.3%
2023Q2
91
30.4
2.83
0.06
1.02
1.74
3.01
2.0%
2023Q1
90
35.7
2.56
0.06
0.93
1.57
2.67
0.0%
2022Q4
92
35.9
2.69
0.03
0.95
1.71
2.60
0.0%
2022Q3
92
37.1
2.57
0.07
0.65
1.84
2.40
0.0%
2022Q2
91
38.6
2.40
0.19
0.56
1.66
2.29
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.
Penalties
0
No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
28
C × 1D × 6E × 12F × 7G × 2
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2025-11-26
Health · complaint
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
2025-12-01
2025-11-26
Health · complaint
F0801
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
E
2025-12-04
2025-11-26
Health · complaint
F0908
Keep all essential equipment working safely.
E
2025-12-04
2025-11-26
Health · complaint
F0919
Make sure that a working call system is available in each resident's bathroom and bathing area.
D
2025-12-01
2025-11-26
Health · complaint
F0921
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
E
2025-12-05
2025-11-26
Health · complaint
F0925
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
E
2025-11-27
2025-11-10
Health · complaint
F0835
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
F
2025-11-19
2025-06-04
Health · complaint
F0835
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
E
2025-06-25
2025-03-21
Health · complaint
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
2025-03-22
2025-01-21
Health · complaint
F0776
Provide timely, approved x-ray services, or have an agreement with an approved provider to obtain them.
D
2025-02-06
2024-11-21
Health
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
E
2024-12-16
2024-11-21
Health
F0645
PASARR screening for Mental disorders or Intellectual Disabilities
E
2024-12-16
2024-11-21
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
2024-12-16
2024-11-21
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
2024-12-16
2024-11-21
Health
F0758
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
E
2024-12-16
2024-11-21
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2024-12-16
2024-11-21
Health
F0880
Provide and implement an infection prevention and control program.
E
2024-12-16
2023-10-05
Health
F0641
Ensure each resident receives an accurate assessment.
D
2023-11-01
2023-10-05
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2023-11-01
2022-08-24
Health
F0582
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
D
2022-09-14
2022-08-24
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
2022-09-14
2022-08-24
Health
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
C
2022-09-14
2022-08-24
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
2022-09-14
2022-08-24
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
G
2022-09-14
2022-08-24
Health
F0758
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
D
2022-09-14
2022-08-24
Health
F0760
Ensure that residents are free from significant medication errors.
G
2022-09-14
2022-08-24
Health
F0804
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
F
2022-09-14
2022-08-24
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2022-09-14
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
13
Owner
Role
Pct
From
Status
Source
NOCONA HOSPITAL DISTRICT
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2025-11-19
current
pecos_ownership
DICKEY, CARLA
OPERATIONAL/MANAGERIAL CONTROL
—
2024-10-01
current
pecos_ownership
DINGLER, LEONARD
ADP OF THE SNF
—
2025-11-19
current
pecos_ownership
MEEKINS, GREG
CORPORATE DIRECTOR
—
2014-09-01
current
pecos_ownership
MISTRETTA, CASSANDRA
INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
—
2026-03-18
current
pecos_ownership
NOCONA HOSPITAL DISTRICT
—
—
2025-11-19
current
tx_hhsc_directory
NOCONATX LLC
—
—
2025-11-19
current
tx_hhsc_directory
NOCONATX LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2025-11-19
current
pecos_ownership
PFEIFER, MARY
OPERATIONAL/MANAGERIAL CONTROL
—
2025-11-19
current
pecos_ownership
CARLA DICKEY
OPERATIONAL/MANAGERIAL CONTROL
—
2024-10-01
ended 2026-05-18
pecos_ownership
GREG MEEKINS
CORPORATE DIRECTOR
—
2014-09-01
ended 2026-05-18
pecos_ownership
LEONARD DINGLER
ADP OF THE SNF
—
2025-11-19
ended 2026-05-18
pecos_ownership
MARY PFEIFER
OPERATIONAL/MANAGERIAL CONTROL
—
2025-11-19
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
30
Geo
Kind
BR
Amount
As of
Source
county 48337
fmr
0
$820
2025-10-01
HUD_USER_FMR
county 48337
acs median gross
1
$421
2024-12-31
CENSUS_ACS5
county 48337
fmr
1
$856
2025-10-01
HUD_USER_FMR
county 48337
acs median gross
2
$904
2024-12-31
CENSUS_ACS5
county 48337
fmr
2
$1,055
2025-10-01
HUD_USER_FMR
county 48337
acs median gross
3
$1,280
2024-12-31
CENSUS_ACS5
county 48337
fmr
3
$1,467
2025-10-01
HUD_USER_FMR
county 48337
acs median gross
4
$1,406
2024-12-31
CENSUS_ACS5
county 48337
fmr
4
$1,552
2025-10-01
HUD_USER_FMR
county 48337
acs median gross
$1,008
2024-12-31
CENSUS_ACS5
county 48337
acs recent mover gross
$1,085
2024-12-31
CENSUS_ACS5
zcta 76255
acs median gross
1
$389
2024-12-31
CENSUS_ACS5
zcta 76255
acs median gross
2
$782
2024-12-31
CENSUS_ACS5
zcta 76255
acs median gross
3
$1,089
2024-12-31
CENSUS_ACS5
zcta 76255
acs median gross
$796
2024-12-31
CENSUS_ACS5
zip 76255
payment standard 110
0
$836
2025-10-01
HUD_USER_SAFMR
zip 76255
payment standard 90
0
$684
2025-10-01
HUD_USER_SAFMR
zip 76255
safmr
0
$760
2025-10-01
HUD_USER_SAFMR
zip 76255
payment standard 110
1
$869
2025-10-01
HUD_USER_SAFMR
zip 76255
payment standard 90
1
$711
2025-10-01
HUD_USER_SAFMR
zip 76255
safmr
1
$790
2025-10-01
HUD_USER_SAFMR
zip 76255
payment standard 110
2
$1,089
2025-10-01
HUD_USER_SAFMR
zip 76255
payment standard 90
2
$891
2025-10-01
HUD_USER_SAFMR
zip 76255
safmr
2
$990
2025-10-01
HUD_USER_SAFMR
zip 76255
payment standard 110
3
$1,485
2025-10-01
HUD_USER_SAFMR
zip 76255
payment standard 90
3
$1,215
2025-10-01
HUD_USER_SAFMR
zip 76255
safmr
3
$1,350
2025-10-01
HUD_USER_SAFMR
zip 76255
payment standard 110
4
$1,628
2025-10-01
HUD_USER_SAFMR
zip 76255
payment standard 90
4
$1,332
2025-10-01
HUD_USER_SAFMR
zip 76255
safmr
4
$1,480
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.