Reads as: riskier than 31.7% 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
25
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+30.3 vs natl
PISANI ADAM
10 facilities
connection
Owner fleet risk far above national
+30.3 vs natl
KING ELIZABETH
10 facilities
connection
Owner fleet risk far above national
+29.2 vs natl
HUGHES RUSTON
7 facilities
connection
Owner fleet risk far above national
+24.1 vs natl
HALEY JEFF
17 facilities
connection
Owner fleet risk far above national
+24.0 vs natl
REG LEASED OPCO LLC
24 facilities
connection
Owner fleet risk far above national
+23.6 vs natl
FREUDENBERGER JOSEPH
35 facilities
connection
Owner fleet risk far above national
+23.0 vs natl
OAKBEND MEDICAL CENTER
32 facilities
connection
Owner fleet risk far above national
+20.1 vs natl
REGENCY TEXAS HOLDINGS LLC
65 facilities
connection
Owner fleet risk far above national
+20.1 vs natl
DWD TX HOLDINGS LLC
65 facilities
connection
Owner fleet risk far above national
+20.1 vs natl
REG OPERATOR HOLDCO LLC
65 facilities
connection
Owner spans multiple chains
8 chains
REGENCY IHS REHAB LLC
68 facilities
connection
Owner spans multiple chains
8 chains
REGENCY IHS CLINICAL CONSULTING LLC
67 facilities
connection
Owner spans multiple chains
7 chains
REGENCY INTEGRATED HEALTH SERVICES LLC
67 facilities
connection
Owner spans multiple chains
7 chains
REG OPERATOR HOLDCO LLC
64 facilities
connection
Owner spans multiple chains
7 chains
DEKOWSKI DONOVAN
66 facilities
connection
Owner spans multiple chains
7 chains
MANDELBAUM ELLIOT
61 facilities
connection
Owner spans multiple chains
7 chains
DWD TX HOLDINGS LLC
64 facilities
connection
Owner spans multiple chains
7 chains
JACK AND NANCY DWYER WORKFORCE DEVELOPMENT CENTER INC
65 facilities
connection
Owner spans multiple chains
7 chains
CSV RHEA MANAGEMENT HOLDCO LLC
63 facilities
connection
Owner spans multiple chains
7 chains
CLAPP BARBARA
66 facilities
connection
Owner spans multiple chains
7 chains
REGENCY TEXAS HOLDINGS LLC
64 facilities
connection
Owner spans multiple chains
6 chains
GIBSON PATRICIA
58 facilities
connection
Owner spans multiple chains
6 chains
CORTESE DAREN
59 facilities
connection
Owner spans multiple chains
6 chains
BAIRD DANIEL
59 facilities
connection
Owner fleet enforcement cluster
71% fined
HUGHES RUSTON
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
16
2025Q4 HPRD
This facility
TX median
National median
National p25–p75
Total nurse
2.32
2.67
3.28
2.90–3.77
RN
0.15
0.24
0.39
0.25–0.58
Weekend total
2.29
2.56
3.11
—
Weekday total
2.34
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
103.0
2.32
0.15
0.66
1.52
2.29
0.0%
2025Q3
92
100.8
2.45
0.22
0.70
1.53
2.42
0.0%
2025Q2
91
93.7
2.66
0.20
0.78
1.67
2.59
0.0%
2025Q1
90
97.3
2.60
0.23
0.71
1.65
2.54
0.0%
2024Q4
92
100.2
2.54
0.21
0.73
1.60
2.42
0.0%
2024Q3
92
99.8
2.49
0.19
0.68
1.63
2.41
0.0%
2024Q2
91
102.4
2.49
0.18
0.67
1.63
2.33
0.0%
2024Q1
91
112.3
2.30
0.20
0.59
1.50
2.22
0.0%
2023Q4
92
112.7
2.29
0.14
0.65
1.50
2.23
0.0%
2023Q3
92
115.2
2.25
0.16
0.63
1.46
2.22
0.0%
2023Q2
91
115.7
2.38
0.20
0.60
1.57
2.19
0.0%
2023Q1
90
114.9
2.12
0.14
0.63
1.36
1.76
0.0%
2022Q4
92
114.9
2.54
0.11
0.86
1.57
2.33
0.1%
2022Q3
92
113.2
2.51
0.06
0.84
1.61
2.31
0.0%
2022Q2
91
114.8
2.46
0.11
0.71
1.64
2.37
0.0%
2022Q1
90
112.0
3.05
0.07
1.34
1.63
2.82
0.1%
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.
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
2026-03-09
2026-03-06
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
2026-03-09
2025-06-27
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2025-06-28
2025-06-27
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2025-06-21
2025-06-27
Health
F0759
Ensure medication error rates are not 5 percent or greater.
E
2025-06-28
2025-06-17
Health · complaint
F0635
Provide doctor's orders for the resident's immediate care at the time the resident was admitted.
D
2025-06-18
2025-05-22
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
H
2025-06-12
2025-05-22
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2025-06-22
2024-06-14
Health · complaint
F0580
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
D
2024-07-05
2024-06-14
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2024-07-05
2024-06-14
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-07-05
2024-05-23
Health
F0641
Ensure each resident receives an accurate assessment.
D
2024-06-13
2024-05-23
Health · complaint
F0645
PASARR screening for Mental disorders or Intellectual Disabilities
E
2024-06-13
2024-05-23
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2024-06-13
2024-03-21
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2024-03-23
2024-03-21
Health · complaint
F0839
Employ staff that are licensed, certified, or registered in accordance with state laws.
E
2024-03-23
2024-01-22
Health · complaint
F0580
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
J
2024-01-23
2024-01-22
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.
E
2024-04-30
2024-01-22
Health · complaint
F0678
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
J
2024-01-23
2023-04-06
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
2023-04-20
2023-04-06
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2023-04-20
2023-04-06
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
2023-04-20
2023-04-06
Health
F0814
Dispose of garbage and refuse properly.
C
2023-04-20
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
46
Owner
Role
Pct
From
Status
Source
OAKBEND MEDICAL CENTER
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2015-02-28
current
pecos_ownership
BAIRD, DANIEL
MANAGING CONTROL - GOVERNING BODY
—
2021-04-13
current
pecos_ownership
BERSOLA, CHARLES
ADP OF THE SNF
—
2025-01-01
current
pecos_ownership
CARTER, ELIZABETH
ADP OF THE SNF
—
2025-03-24
current
pecos_ownership
CLAPP, BARBARA
MANAGING CONTROL - GOVERNING BODY
—
2021-06-01
current
pecos_ownership
CORTESE, DAREN
MANAGING CONTROL - GOVERNING BODY
—
2021-08-10
current
pecos_ownership
CSV RHEA MANAGEMENT HOLDCO, LLC
INDIRECT OWNERSHIP INTEREST
—
2024-12-16
current
pecos_ownership
DEKOWSKI, DONOVAN
ADP OF THE SNF
—
2024-12-16
current
pecos_ownership
DWD TX HOLDINGS LLC
INDIRECT OWNERSHIP INTEREST
—
2024-12-16
current
pecos_ownership
FRANSAW, DOMINIQUE
ADP OF THE SNF
—
2025-01-01
current
pecos_ownership
FREUDENBERGER, JOSEPH
CORPORATE OFFICER
—
2007-06-19
current
pecos_ownership
GIBSON, PATRICIA
MANAGING CONTROL - GOVERNING BODY
—
2021-08-01
current
pecos_ownership
HALEY, JEFF
MANAGING CONTROL - GOVERNING BODY
—
2016-07-15
current
pecos_ownership
HUGHES, RUSTON
MANAGING CONTROL - GOVERNING BODY
—
2024-01-01
current
pecos_ownership
JACK AND NANCY DWYER WORKFORCE DEVELOPMENT CENTER INC
INDIRECT OWNERSHIP INTEREST
—
2024-12-16
current
pecos_ownership
KING, ELIZABETH
MANAGING CONTROL - GOVERNING BODY
—
2023-01-17
current
pecos_ownership
MANDELBAUM, ELLIOT
MANAGING CONTROL - GOVERNING BODY
—
2025-01-01
current
pecos_ownership
OAKBEND MEDICAL CENTER
—
—
2025-02-28
current
tx_hhsc_directory
OAKBEND MEDICAL CENTER
ADP OF THE SNF
—
2025-04-12
current
pecos_ownership
PISANI, ADAM
MANAGING CONTROL - GOVERNING BODY
—
2019-01-15
current
pecos_ownership
REG LEASED OPCO LLC
INDIRECT OWNERSHIP INTEREST
—
2024-12-16
current
pecos_ownership
REG OPERATOR HOLDCO LLC
INDIRECT OWNERSHIP INTEREST
—
2024-12-16
current
pecos_ownership
REGENCY IHS CLINICAL CONSULTING, LLC
ADP OF THE SNF
—
2024-12-16
current
pecos_ownership
REGENCY IHS REHAB LLC
ADP OF THE SNF
—
2024-12-16
current
pecos_ownership
REGENCY INTEGRATED HEALTH SERVICES LLC
INDIRECT OWNERSHIP INTEREST
—
2024-12-16
current
pecos_ownership
REGENCY INTEGRATED HEALTH SERVICES LLC
ADP OF THE SNF
—
2025-04-12
current
pecos_ownership
REGENCY TEXAS HOLDINGS LLC
INDIRECT OWNERSHIP INTEREST
—
2024-12-16
current
pecos_ownership
WELLSENTIAL OF HOUSTON HEIGHTS LLC
ADP OF THE SNF
—
2025-04-12
current
pecos_ownership
WELLSENTIAL OF HOUSTON HEIGHTS LLC
—
—
2025-02-28
current
tx_hhsc_directory
WELLSENTIAL OF HOUSTON HEIGHTS LLC
DIRECT OWNERSHIP INTEREST
—
2024-12-16
current
pecos_ownership
ZAHARIA, ADRIAN
ADP OF THE SNF
—
2023-06-14
current
pecos_ownership
JOSEPH FREUDENBERGER
CORPORATE OFFICER
0%
2007-06-19
ended 2026-05-18
pecos_ownership
ADAM PISANI
MANAGING CONTROL - GOVERNING BODY
—
2019-01-15
ended 2026-05-18
pecos_ownership
ADRIAN ZAHARIA
OPERATIONAL/MANAGERIAL CONTROL
—
2023-06-14
ended 2026-05-18
pecos_ownership
BARBARA CLAPP
MANAGING CONTROL - GOVERNING BODY
—
2021-06-01
ended 2026-05-18
pecos_ownership
CHARLES BERSOLA
ADP OF THE SNF
—
2025-01-01
ended 2026-05-18
pecos_ownership
DANIEL BAIRD
MANAGING CONTROL - GOVERNING BODY
—
2021-04-13
ended 2026-05-18
pecos_ownership
DAREN CORTESE
MANAGING CONTROL - GOVERNING BODY
—
2021-08-10
ended 2026-05-18
pecos_ownership
DOMINIQUE FRANSAW
ADP OF THE SNF
—
2025-01-01
ended 2026-05-18
pecos_ownership
DONOVAN DEKOWSKI
ADP OF THE SNF
—
2024-12-16
ended 2026-05-18
pecos_ownership
ELIZABETH CARTER
ADP OF THE SNF
—
2025-03-24
ended 2026-05-18
pecos_ownership
ELIZABETH KING
MANAGING CONTROL - GOVERNING BODY
—
2023-01-17
ended 2026-05-18
pecos_ownership
ELLIOT MANDELBAUM
MANAGING CONTROL - GOVERNING BODY
—
2025-01-01
ended 2026-05-18
pecos_ownership
JEFF HALEY
MANAGING CONTROL - GOVERNING BODY
—
2016-07-15
ended 2026-05-18
pecos_ownership
PATRICIA GIBSON
MANAGING CONTROL - GOVERNING BODY
—
2021-08-01
ended 2026-05-18
pecos_ownership
RUSTON HUGHES
MANAGING CONTROL - GOVERNING BODY
—
2024-01-01
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
35
Geo
Kind
BR
Amount
As of
Source
county 48201
acs median gross
0
$1,177
2024-12-31
CENSUS_ACS5
county 48201
fmr
0
$1,280
2025-10-01
HUD_USER_FMR
county 48201
acs median gross
1
$1,196
2024-12-31
CENSUS_ACS5
county 48201
fmr
1
$1,323
2025-10-01
HUD_USER_FMR
county 48201
acs median gross
2
$1,425
2024-12-31
CENSUS_ACS5
county 48201
fmr
2
$1,573
2025-10-01
HUD_USER_FMR
county 48201
acs median gross
3
$1,764
2024-12-31
CENSUS_ACS5
county 48201
fmr
3
$2,116
2025-10-01
HUD_USER_FMR
county 48201
acs median gross
4
$2,148
2024-12-31
CENSUS_ACS5
county 48201
fmr
4
$2,639
2025-10-01
HUD_USER_FMR
county 48201
acs median gross
5
$2,339
2024-12-31
CENSUS_ACS5
county 48201
acs median gross
$1,401
2024-12-31
CENSUS_ACS5
county 48201
acs recent mover gross
$1,495
2024-12-31
CENSUS_ACS5
zcta 77091
acs median gross
0
$975
2024-12-31
CENSUS_ACS5
zcta 77091
acs median gross
1
$934
2024-12-31
CENSUS_ACS5
zcta 77091
acs median gross
2
$1,189
2024-12-31
CENSUS_ACS5
zcta 77091
acs median gross
3
$1,483
2024-12-31
CENSUS_ACS5
zcta 77091
acs median gross
4
$1,848
2024-12-31
CENSUS_ACS5
zcta 77091
acs median gross
$1,064
2024-12-31
CENSUS_ACS5
zcta 77091
acs recent mover gross
$1,085
2024-12-31
CENSUS_ACS5
zip 77091
payment standard 110
0
$1,122
2025-10-01
HUD_USER_SAFMR
zip 77091
payment standard 90
0
$918
2025-10-01
HUD_USER_SAFMR
zip 77091
safmr
0
$1,020
2025-10-01
HUD_USER_SAFMR
zip 77091
payment standard 110
1
$1,166
2025-10-01
HUD_USER_SAFMR
zip 77091
payment standard 90
1
$954
2025-10-01
HUD_USER_SAFMR
zip 77091
safmr
1
$1,060
2025-10-01
HUD_USER_SAFMR
zip 77091
payment standard 110
2
$1,386
2025-10-01
HUD_USER_SAFMR
zip 77091
payment standard 90
2
$1,134
2025-10-01
HUD_USER_SAFMR
zip 77091
safmr
2
$1,260
2025-10-01
HUD_USER_SAFMR
zip 77091
payment standard 110
3
$1,870
2025-10-01
HUD_USER_SAFMR
zip 77091
payment standard 90
3
$1,530
2025-10-01
HUD_USER_SAFMR
zip 77091
safmr
3
$1,700
2025-10-01
HUD_USER_SAFMR
zip 77091
payment standard 110
4
$2,321
2025-10-01
HUD_USER_SAFMR
zip 77091
payment standard 90
4
$1,899
2025-10-01
HUD_USER_SAFMR
zip 77091
safmr
4
$2,110
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.