Reads as: riskier than 65.5% 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.
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
8
Kind
Finding
Signal
Subject
First seen
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
Owner spans multiple chains
18 chains
ENSIGN SERVICES INC
286 facilities
connection
Owner spans multiple chains
17 chains
BURNAM SOON
335 facilities
connection
Owner spans multiple chains
17 chains
KEETCH CHAD
283 facilities
connection
Owner spans multiple chains
10 chains
NATIONAL HEALTH INVESTORS INC
31 facilities
connection
Buyer assembling a chain (5+ takeovers/24mo)
8 facilities
FANNIN COUNTY HOSPITAL AUTHORITY
8 facilities
connection
Owner spans multiple chains
6 chains
TEXAS NHI INVESTORS LLC
20 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
3.06
2.67
3.28
2.90–3.77
RN
0.23
0.24
0.39
0.25–0.58
Weekend total
2.95
2.56
3.11
—
Weekday total
3.10
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
79.3
3.06
0.23
1.06
1.77
2.95
0.0%
2025Q3
92
77.2
3.18
0.19
1.14
1.85
3.11
0.0%
2025Q2
91
85.4
2.94
0.17
1.07
1.70
2.86
0.0%
2025Q1
90
84.1
2.91
0.20
0.97
1.74
2.86
0.0%
2024Q4
92
76.1
3.03
0.20
0.99
1.84
2.86
0.0%
2024Q3
92
81.1
2.83
0.33
0.86
1.64
2.60
0.0%
2024Q2
91
80.9
2.70
0.37
0.82
1.51
2.54
0.0%
2024Q1
91
87.4
2.61
0.26
0.90
1.46
2.51
0.0%
2023Q4
92
85.0
2.79
0.18
1.06
1.54
2.65
0.0%
2023Q3
92
81.9
2.92
0.19
1.13
1.60
2.69
0.0%
2023Q2
91
75.8
2.91
0.30
1.17
1.44
2.67
0.0%
2023Q1
90
80.8
2.70
0.11
1.20
1.39
2.45
0.0%
2022Q4
92
78.4
2.90
0.04
1.35
1.51
2.75
0.0%
2022Q3
92
74.2
2.81
0.13
1.36
1.32
2.60
0.0%
2022Q2
91
60.3
2.82
0.04
1.54
1.24
2.71
0.0%
2022Q1
90
69.3
2.57
0.02
1.39
1.16
2.51
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.
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2026-01-30
2025-11-25
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
2025-11-26
2025-11-25
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2025-11-26
2025-11-25
Health · complaint
F0880
Provide and implement an infection prevention and control program.
D
2025-11-26
2025-11-21
Health · complaint
F0880
Provide and implement an infection prevention and control program.
D
2025-11-22
2024-12-12
Health
F0690
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
D
2024-12-13
2024-12-12
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2024-12-13
2024-07-31
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2024-08-01
2024-02-08
Health · complaint
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
D
2024-02-10
2023-09-29
Health
F0558
Reasonably accommodate the needs and preferences of each resident.
D
2023-09-30
2023-09-29
Health · complaint
F0655
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
D
2023-09-30
2023-09-29
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
2023-09-30
2023-09-29
Health
F0838
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
E
2023-09-30
2022-07-14
Health
F0694
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
D
2022-07-15
2022-07-14
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2022-07-15
2022-07-14
Health
F0880
Provide and implement an infection prevention and control program.
D
2022-08-25
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
18
Owner
Role
Pct
From
Status
Source
FANNIN COUNTY HOSPITAL AUTHORITY
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2023-12-01
current
pecos_ownership
BARRERA, EDIEL
OPERATIONAL/MANAGERIAL CONTROL
—
2023-12-01
current
pecos_ownership
BURNAM, SOON
CORPORATE OFFICER
—
2023-12-01
current
pecos_ownership
ENSIGN SERVICES INC
ADP OF THE SNF
—
2016-05-01
current
pecos_ownership
FANNIN COUNTY HOSPITAL AUTHORITY
—
—
2023-12-01
current
tx_hhsc_directory
KEETCH, CHAD
CORPORATE OFFICER
—
2011-03-01
current
pecos_ownership
KLEMENT HEALTHCARE INC
ADP OF THE SNF
—
2025-09-24
current
pecos_ownership
KLEMENT HEALTHCARE INC
OPERATIONAL/MANAGERIAL CONTROL
—
2023-12-01
current
pecos_ownership
KLEMENT HEALTHCARE, INC
—
—
2023-12-01
current
tx_hhsc_directory
NATIONAL HEALTH INVESTORS, INC.
ADP OF THE SNF
—
2023-12-01
current
pecos_ownership
PENA, JOSE
OPERATIONAL/MANAGERIAL CONTROL
—
2023-08-01
current
pecos_ownership
SANDERSON, CLARK
CORPORATE OFFICER
—
2023-12-01
current
pecos_ownership
TEXAS NHI INVESTORS, LLC
ADP OF THE SNF
—
2023-12-01
current
pecos_ownership
CLARK SANDERSON
CORPORATE OFFICER
0%
2023-12-01
ended 2026-05-18
pecos_ownership
EDIEL BARRERA
OPERATIONAL/MANAGERIAL CONTROL
0%
2023-12-01
ended 2026-05-18
pecos_ownership
SOON BURNAM
CORPORATE OFFICER
0%
2023-12-01
ended 2026-05-18
pecos_ownership
CHAD KEETCH
CORPORATE OFFICER
—
2011-03-01
ended 2026-05-18
pecos_ownership
JOSE PENA
ADP OF THE SNF
—
2023-08-01
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.
Related-party costs
5
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$896,750
—
$896,463
—
—
3
—
2023-11-30
$827,544
—
$571,056
—
—
3
—
2022-12-31
$803,764
—
$601,334
—
—
3
—
2021-12-31
$859,679
—
$551,912
—
—
3
—
2020-12-31
$808,925
—
$556,370
—
—
3
—
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 48215
acs median gross
0
$837
2024-12-31
CENSUS_ACS5
county 48215
fmr
0
$842
2025-10-01
HUD_USER_FMR
county 48215
acs median gross
1
$716
2024-12-31
CENSUS_ACS5
county 48215
fmr
1
$847
2025-10-01
HUD_USER_FMR
county 48215
acs median gross
2
$956
2024-12-31
CENSUS_ACS5
county 48215
fmr
2
$1,060
2025-10-01
HUD_USER_FMR
county 48215
acs median gross
3
$1,138
2024-12-31
CENSUS_ACS5
county 48215
fmr
3
$1,376
2025-10-01
HUD_USER_FMR
county 48215
acs median gross
4
$1,310
2024-12-31
CENSUS_ACS5
county 48215
fmr
4
$1,522
2025-10-01
HUD_USER_FMR
county 48215
acs median gross
5
$1,409
2024-12-31
CENSUS_ACS5
county 48215
acs median gross
$957
2024-12-31
CENSUS_ACS5
county 48215
acs recent mover gross
$996
2024-12-31
CENSUS_ACS5
zcta 78503
acs median gross
1
$845
2024-12-31
CENSUS_ACS5
zcta 78503
acs median gross
2
$1,160
2024-12-31
CENSUS_ACS5
zcta 78503
acs median gross
3
$1,236
2024-12-31
CENSUS_ACS5
zcta 78503
acs median gross
4
$944
2024-12-31
CENSUS_ACS5
zcta 78503
acs median gross
$1,110
2024-12-31
CENSUS_ACS5
zcta 78503
acs recent mover gross
$1,038
2024-12-31
CENSUS_ACS5
zip 78503
payment standard 110
0
$1,078
2025-10-01
HUD_USER_SAFMR
zip 78503
payment standard 90
0
$882
2025-10-01
HUD_USER_SAFMR
zip 78503
safmr
0
$980
2025-10-01
HUD_USER_SAFMR
zip 78503
payment standard 110
1
$1,089
2025-10-01
HUD_USER_SAFMR
zip 78503
payment standard 90
1
$891
2025-10-01
HUD_USER_SAFMR
zip 78503
safmr
1
$990
2025-10-01
HUD_USER_SAFMR
zip 78503
payment standard 110
2
$1,364
2025-10-01
HUD_USER_SAFMR
zip 78503
payment standard 90
2
$1,116
2025-10-01
HUD_USER_SAFMR
zip 78503
safmr
2
$1,240
2025-10-01
HUD_USER_SAFMR
zip 78503
payment standard 110
3
$1,771
2025-10-01
HUD_USER_SAFMR
zip 78503
payment standard 90
3
$1,449
2025-10-01
HUD_USER_SAFMR
zip 78503
safmr
3
$1,610
2025-10-01
HUD_USER_SAFMR
zip 78503
payment standard 110
4
$1,958
2025-10-01
HUD_USER_SAFMR
zip 78503
payment standard 90
4
$1,602
2025-10-01
HUD_USER_SAFMR
zip 78503
safmr
4
$1,780
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.