Composite
76.5 / 100 percentile
Screener / 106151
C
ALWYN C CASHE STATE VETERANS NURSING HOME
snfFL
5255 RAYMOND ST, ORLANDO, FL 32803 · CCN 106151 · chain FLORIDA DEPARTMENT OF VETERANS AFFAIRS
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
112
Model
v1.2
Reads as: riskier than 76.5% 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.
Score model4ML signals1Components10CHOW radar1Distress radar1Staffing8Penalties11Deficiencies22Licensure0Ownership11Related party2Transactions0Comps12Market rent35
Composite explanation
4| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 85.7 | 82.8 | 0.30 | 0.3529 | 30.25 | in index |
| chow risk | 83.5 | 38.5 | 0.15 | 0.1765 | 14.74 | in index |
| lease risk | 73.8 | 60.0 | 0.15 | 0.1765 | 13.02 | in index |
| staffing risk | 2.9 | 3.0 | 0.25 | 0.2941 | 0.85 | in index |
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
1| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner spans multiple chains | 4 chains | NURIEL GABRIEL | 4 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.
Component scores and registry models
10| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| chow risk | 38.5 | B | v0.1-pos | default · in composite | 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. |
| lease risk | 60.0 | C | v0.5 | default · in composite | |
| p adverse action 12m | 0.1 | — | v0.1 | default · in composite | 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. |
| p chow 12m | 0.5 | — | v0.1 | default · in 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. |
| regulatory risk | 82.8 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 3.0 | A | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| regulatory risk | 82.8 | F | v0.1 | superseded | 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. |
| regulatory risk | 82.8 | F | v0.2 | superseded | 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. |
| staffing risk | 3.0 | A | v0.1 | superseded | 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. |
| staffing risk | 3.0 | A | v0.2 | superseded | 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.
CHOW radar — 12-month sale probability
full board →p(CHOW, 12m)
0.5%
model v0.1 · computed 2026-07-29
Percentile among SNFs
53.4
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | -1.24 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| Occupancy | 0.86 | -0.47 | |
| Total nurse staffing (HPRD) | 5.22 | -0.43 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Contract staffing share | 0.17 | +0.17 |
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.
Distress radar — 12-month termination probability
full board →p(termination, 12m)
0.1%
model v0.1 · computed 2026-07-29
Percentile among SNFs
38.3
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | +1.62 | |
| Total nurse staffing (HPRD) | 5.22 | -0.84 | |
| Fine amount, 12m (log) | 9.76 | -0.54 | |
| Staffing trend, last 4 quarters | -0.94 | -0.46 | |
| Occupancy | 0.86 | -0.46 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Deficiencies, last 12 months | 6.00 | +0.32 | |
| Never sold on record | 1.00 | +0.12 |
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
8| 2025Q4 HPRD | This facility | FL median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 5.22 | 3.42 | 3.28 | 2.90–3.77 |
| RN | 0.86 | 0.45 | 0.39 | 0.25–0.58 |
| Weekend total | 4.84 | 3.31 | 3.11 | — |
| Weekday total | 5.37 | 3.48 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 96.1 | 5.22 | 0.86 | 1.03 | 3.33 | 4.84 | 17.0% |
| 2025Q3 | 92 | 90.3 | 5.28 | 0.82 | 0.90 | 3.55 | 4.88 | 19.7% |
| 2025Q2 | 91 | 76.1 | 5.75 | 1.04 | 0.90 | 3.80 | 4.90 | 27.2% |
| 2025Q1 | 90 | 54.2 | 6.87 | 1.40 | 0.98 | 4.49 | 5.86 | 40.4% |
| 2024Q4 | 92 | 46.7 | 6.16 | 1.47 | 0.86 | 3.83 | 5.53 | 27.8% |
| 2024Q3 | 92 | 36.0 | 7.12 | 2.08 | 1.01 | 4.03 | 6.66 | 21.2% |
| 2024Q2 | 91 | 23.5 | 8.91 | 2.93 | 1.05 | 4.93 | 7.42 | 32.6% |
| 2024Q1 | 91 | 26.6 | 6.55 | 2.10 | 0.50 | 3.94 | 5.39 | 48.7% |
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
11fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-09-05 | Fine | $17,345 | CMS provider data |
| 2025-01-24 | Fine | $5,249 | CMS provider data |
| 2025-01-24 | Fine | $5,249 | CMS provider data |
| 2024-09-14 | Fine | $8,018 | CMS provider data |
| 2024-09-14 | Fine | $8,783 | CMS provider data |
| 2024-02-20 | Fine | $4,140 | CMS provider data |
| 2024-02-12 | Fine | $3,764 | CMS provider data |
| 2024-01-22 | Fine | $9,032 | CMS provider data |
| 2024-01-08 | Fine | $2,258 | CMS provider data |
| 2024-01-02 | Fine | $1,748 | CMS provider data |
| 2023-12-11 | Fine | $3,145 | CMS provider data |
Total fines on record: $68,731
Deficiencies
22C × 1D × 10E × 7G × 2J × 2
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-12-23 | Health · complaint | F0559 | Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made. | D | 2026-02-16 |
| 2025-12-23 | 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 | 2026-02-16 |
| 2025-12-23 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2026-02-16 |
| 2025-12-23 | Health · complaint | F0840 | Employ or obtain outside professional resources to provide services in the nursing home when the facility does not employ a qualified professional to furnish a required service. | D | 2026-02-16 |
| 2025-09-05 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | J | — |
| 2025-09-05 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | — |
| 2025-02-27 | Health | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2025-03-27 |
| 2025-02-27 | 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 | 2025-03-27 |
| 2025-02-27 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2025-03-27 |
| 2025-02-27 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2025-03-27 |
| 2025-02-27 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2025-03-27 |
| 2025-01-24 | Health · complaint | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | E | 2025-02-24 |
| 2025-01-24 | Health · complaint | F0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | E | 2025-02-24 |
| 2025-01-24 | Health · complaint | F0773 | Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results. | D | 2025-02-24 |
| 2025-01-24 | Health · complaint | F0777 | Provide or obtain x-rays/tests when ordered and promptly tell the ordering practitioner of the results. | D | 2025-02-24 |
| 2025-01-24 | Health · complaint | F0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | E | 2025-02-24 |
| 2024-09-14 | Health · complaint | F0604 | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | G | 2024-10-14 |
| 2024-09-14 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-10-14 |
| 2024-09-14 | Health · complaint | F0741 | Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents. | G | 2024-10-14 |
| 2024-09-14 | Health · complaint | F0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | E | 2024-10-14 |
| 2023-09-08 | Health | F0732 | Post nurse staffing information every day. | C | 2023-10-09 |
| 2023-09-08 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | E | 2023-10-09 |
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
0No 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
11| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| COLON APONTE, OMAYRA | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-08-01 | current | pecos_ownership |
| MALLARD, LINDSAY | OPERATIONAL/MANAGERIAL CONTROL | — | 2022-11-18 | current | pecos_ownership |
| NURIEL, GABRIEL | ADP OF THE SNF | — | 2025-03-25 | current | pecos_ownership |
| PERRY HUFF, KATIRIA | CORPORATE DIRECTOR | — | 2024-08-01 | current | pecos_ownership |
| PERRY HUFF, KATIRIA | ADP OF THE SNF | — | 2025-04-08 | current | pecos_ownership |
| FLORIDA DEPARTMENT OF VETERANS AFFAIRS | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2023-06-01 | ended 2026-05-18 | pecos_ownership |
| KATIRIA PERRY HUFF | CORPORATE DIRECTOR | 0% | 2024-08-01 | ended 2026-05-18 | pecos_ownership |
| GABRIEL NURIEL | ADP OF THE SNF | — | 2025-03-25 | ended 2026-05-18 | pecos_ownership |
| KATIRIA PERRY HUFF | ADP OF THE SNF | — | 2025-04-08 | ended 2026-05-18 | pecos_ownership |
| LINDSAY MALLARD | OPERATIONAL/MANAGERIAL CONTROL | — | 2022-11-18 | ended 2026-05-18 | pecos_ownership |
| OMAYRA COLON APONTE | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-08-01 | 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.
Transactions
0No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Comparable trades — FL snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-02-01 | MARIANNA HEALTH AND REHABILITATION | — | — | — | 180 | MARIANNA REHABILITATION CENTER, LLC |
| 2024-11-20 | SOLARIS HEALTHCARE LELY PALMS | — | — | — | 117 | LP SNF OPERATIONS LLC |
| 2024-11-01 | GULF COAST MEDICAL CENTER SKILLED NURSING UNIT | — | — | — | 75 | LEE HEALTH SYSTEM INC |
| 2024-09-19 | ARABELLA HEALTH & WELLNESS OF PENSACOLA | — | — | — | 118 | ARABELLA HEALTH & WELLNESS OF PENSACOLA OPCO LLC |
| 2024-08-01 | PENINSULA HEALTH CENTER BY HARBORVIEW | — | — | — | 120 | PENINSULA CARE AND REHABILITATION CENTER BY HARBORVIEW LLC |
| 2024-07-15 | BAYONET POINT HEALTH CENTER BY HARBORVIEW | — | — | — | 120 | LIVING CENTER OF BAYONET POINT BY HARBORVIEW LLC |
| 2024-07-15 | KISSIMMEE NURSING & REHABILITATION CENTER | — | — | — | 120 | KISSIMMEE NURSING AND REHABILITATION CENTER BY HARBORVIEW LLC |
| 2024-07-15 | HARBORVIEW HEALTH CENTER WEST ALTAMONTE | — | — | — | 116 | WEST ALTAMONTE NURSING AND REHABILITATION CENTER BY HARBORVIEW LLC |
| 2024-07-15 | HARBORVIEW SARASOTA | — | — | — | 81 | SARASOTA CENTER FOR NURSING AND REHABILITATION BY HARBORVIEW LLC |
| 2024-07-15 | NURSING & REHABILITATION CENTER OF MELBOURNE | — | — | — | 167 | NURSING AND REHABILITATION CENTER OF MELBOURNE BY HARBORVIEW LLC |
| 2024-07-09 | WATERS EDGE HEALTH AND REHABILITATION | — | — | — | 36 | SANDHILL COVE LLC |
| 2024-07-01 | RIVERWOOD HEALTHCARE & REHABILITATION CENTER | — | — | — | 120 | RIVERWOOD NURSING SNF LLC |
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 12095 | acs median gross | 0 | $1,575 | 2024-12-31 | CENSUS_ACS5 |
| county 12095 | fmr | 0 | $1,650 | 2025-10-01 | HUD_USER_FMR |
| county 12095 | acs median gross | 1 | $1,549 | 2024-12-31 | CENSUS_ACS5 |
| county 12095 | fmr | 1 | $1,731 | 2025-10-01 | HUD_USER_FMR |
| county 12095 | acs median gross | 2 | $1,753 | 2024-12-31 | CENSUS_ACS5 |
| county 12095 | fmr | 2 | $1,972 | 2025-10-01 | HUD_USER_FMR |
| county 12095 | acs median gross | 3 | $2,040 | 2024-12-31 | CENSUS_ACS5 |
| county 12095 | fmr | 3 | $2,476 | 2025-10-01 | HUD_USER_FMR |
| county 12095 | acs median gross | 4 | $2,341 | 2024-12-31 | CENSUS_ACS5 |
| county 12095 | fmr | 4 | $2,924 | 2025-10-01 | HUD_USER_FMR |
| county 12095 | acs median gross | 5 | $2,841 | 2024-12-31 | CENSUS_ACS5 |
| county 12095 | acs median gross | $1,775 | 2024-12-31 | CENSUS_ACS5 | |
| county 12095 | acs recent mover gross | $1,956 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 32803 | acs median gross | 0 | $1,583 | 2024-12-31 | CENSUS_ACS5 |
| zcta 32803 | acs median gross | 1 | $1,698 | 2024-12-31 | CENSUS_ACS5 |
| zcta 32803 | acs median gross | 2 | $2,026 | 2024-12-31 | CENSUS_ACS5 |
| zcta 32803 | acs median gross | 3 | $2,309 | 2024-12-31 | CENSUS_ACS5 |
| zcta 32803 | acs median gross | 4 | $1,525 | 2024-12-31 | CENSUS_ACS5 |
| zcta 32803 | acs median gross | $1,919 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 32803 | acs recent mover gross | $2,199 | 2024-12-31 | CENSUS_ACS5 | |
| zip 32803 | payment standard 110 | 0 | $2,167 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | payment standard 90 | 0 | $1,773 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | safmr | 0 | $1,970 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | payment standard 110 | 1 | $2,266 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | payment standard 90 | 1 | $1,854 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | safmr | 1 | $2,060 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | payment standard 110 | 2 | $2,585 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | payment standard 90 | 2 | $2,115 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | safmr | 2 | $2,350 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | payment standard 110 | 3 | $3,245 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | payment standard 90 | 3 | $2,655 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | safmr | 3 | $2,950 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | payment standard 110 | 4 | $3,828 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | payment standard 90 | 4 | $3,132 | 2025-10-01 | HUD_USER_SAFMR |
| zip 32803 | safmr | 4 | $3,480 | 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.