Composite
24.3 / 100 percentile
Screener / 057019
A
MARSHALL HOME CARE
home healthCA
6425 CAPITOL AVE, DIAMOND SPRINGS, CA 95619 · CCN 057019 · chain MARSHALL MEDICAL CENTER
Peer group
home health n = 24,351
Evidence depth
deep
Certified beds
—
Model
v1.2
Reads as: riskier than 24.3% of the 24,351 facilities in the home health 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 model7ML signals1Components11Quality measures21Penalties0Deficiencies0Licensure1Ownership23Related party0Transactions0Market rent32
Composite explanation
7| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| chow risk | 70.5 | 16.4 | 0.15 | 0.0909 | 6.41 | in index |
| billing conduct | 31.6 | 13.0 | 0.30 | 0.1818 | 5.75 | in index |
| regulatory risk | 28.0 | 35.0 | 0.30 | 0.1818 | 5.09 | in index |
| quality risk | 19.4 | 30.8 | 0.30 | 0.1818 | 3.53 | in index |
| financial risk | 5.6 | 32.8 | 0.30 | 0.1818 | 1.02 | in index |
| state reg risk | 0.0 | 0.0 | 0.30 | 0.1818 | 0.00 | in index |
| ownership opacity | 86.9 | 40.0 | excluded |
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 | 7 chains | US BANK NATIONAL ASSOCIATION | 24 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
11| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 13.0 | A | v0.1-pacpuf | default · in composite | R21. CMS PAC PUF home health 2023. Outlier share, risk-adjusted episode churn, LUPA rate. |
| chow risk | 9.0 | A | v0.1-pecoshha | default · in composite | Home health change of ownership from PECOS owner association dates, the created-for-acquisition flag, owner cohort churn and investment or holding company layering. |
| chow risk | 23.8 | A | 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. |
| financial risk | 32.8 | B | v0.1-cacdph | default · in composite | California home health operating scale, public payer visit concentration, service intensity and lack-of-funds discharges. |
| ownership opacity | 40.0 | B | v0.1-cacdph | default · in composite | CDPH licensee chain size, parent corporation and domicile. |
| quality risk | 36.2 | B | v0.1 | default · in composite | |
| quality risk | 25.4 | B | v0.1-cacdph | default · in composite | California home health discharge to hospital and discharge by death rates, not case mix adjusted. |
| regulatory risk | 35.0 | B | v0.6-pos | default · in composite | R31. Extends v0.5-pos to hospices (provider type 12): same fields, same weights, no expression change. Hospice regulatory coverage before this was 148 of 6,535 scored hospices, all from the TX HCSSA state model. SNF/NF (type 20) deliberately excluded: the deficiency-based v0.3 already covers 14,315 of 14,720 and is richer evidence than a POS compliance flag. |
| state reg risk | 0.0 | A | v0.1-cacdph | default · in composite | CDPH licence tenure, expiry, branch role and failure to file the mandatory HCAI annual utilization report. |
| ownership opacity | 5.0 | A | v0.1-pecos | addressable | R21. Retained as a description of ownership structure. Deliberately NOT in any composite: inversely related to billing conduct. |
| regulatory risk | 35.0 | B | v0.5-pos | superseded | R20. Corrects the acptbl_poc_sw error in v0.4-pos; covers provider types 3 and 8. Superseded by v0.6-pos, which extends the population to hospices with no expression change. |
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.
Quality measures
21| Measure | Value | Stars | Period | Source |
|---|---|---|---|---|
| How often patients got better at bathing | 82.5 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How often patients got better at getting in and out of bed | 83.5 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How often patients got better at walking or moving around | 79.1 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How often patients' breathing improved | 77.3 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| Discharge Function Score | 82.5 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How often physician-recommended actions to address medication issues were completely timely | 98.8 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| DTC Risk-Standardized Rate | 90.8 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| Percent of Residents Experiencing One or More Falls with Major Injury | 0.8 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| PPH Risk-Standardized Rate | 6.6 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| PPR Risk-Standardized Rate | 5.3 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| Changes in skin integrity post-acute care: pressure ulcer/injury | 0.5 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How much Medicare spends on an episode of care at this agency, compared to Medicare spending across all agencies nationally | 0.8 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| Quality of patient care star rating | 2.5 | 2.5 | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How often the home health team began their patients' care in a timely manner | 97.8 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| Percent of patients who reported that their home health team communicated well with them | 89.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| Percent of patients who gave their home health agency a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest) | 91.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| Percent of patients who reported that their home health team gave care in a professional way | 92.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| Percent of patients who reported YES, they would definitely recommend the home health agency to friends and family | 87.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| Survey response rate | 29.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| HHCAHPS Survey Summary Star Rating | 5.0 | 5 | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| Number of completed Surveys | 266.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
CMS Care Compare measure values as published; a null value with a footnote means CMS suppressed or could not compute it.
Penalties
0No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
0No deficiencies on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
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
1| Date | Action | Agency | Detail |
|---|---|---|---|
| 1979-04-23 | new_license | — | — |
Ownership
23| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT | 5% OR GREATER SECURITY INTEREST | 30% | — | current | pecos_ownership |
| US BANK NATIONAL ASSOCIATION | 5% OR GREATER SECURITY INTEREST | 30% | 2023-05-30 | current | pecos_ownership |
| CYNTHIA RICE | CORPORATE OFFICER | 25% | 2021-12-10 | current | pecos_ownership |
| JONATHAN RUSSELL | CORPORATE OFFICER | 25% | 2020-12-27 | current | pecos_ownership |
| LAURIE ELDRIDGE | W-2 MANAGING EMPLOYEE | 20% | 2002-11-26 | current | pecos_ownership |
| SIRI NELSON | CORPORATE OFFICER | 20% | 2020-01-01 | current | pecos_ownership |
| ALEXIS LONG | CORPORATE DIRECTOR | 7% | 2021-03-25 | current | pecos_ownership |
| ANDREA HOWARD | CORPORATE DIRECTOR | 7% | 2019-03-30 | current | pecos_ownership |
| ANNA-NICOLE BLAIR | CORPORATE DIRECTOR | 7% | 2023-03-31 | current | pecos_ownership |
| BRIAN VEERKAMP | CORPORATE DIRECTOR | 7% | 2020-03-30 | current | pecos_ownership |
| CHRISTEEN REEG | CORPORATE DIRECTOR | 7% | 2017-03-30 | current | pecos_ownership |
| GEORGE NIELSEN | CORPORATE DIRECTOR | 7% | 2018-03-30 | current | pecos_ownership |
| GERARDO GALANG | CORPORATE DIRECTOR | 7% | 2022-07-01 | current | pecos_ownership |
| JOHN KNIGHT | CORPORATE DIRECTOR | 7% | 2020-03-30 | current | pecos_ownership |
| KIM STOLL | CORPORATE DIRECTOR | 7% | 2023-03-31 | current | pecos_ownership |
| SEAN ANDERSON | CORPORATE DIRECTOR | 7% | 2023-01-01 | current | pecos_ownership |
| EDWARD MANANSALA | CORPORATE DIRECTOR | 6% | 2021-03-25 | current | pecos_ownership |
| JON HAUGAARD | CORPORATE DIRECTOR | 6% | 2018-03-30 | current | pecos_ownership |
| THOMAS CUMPSTON | CORPORATE DIRECTOR | 6% | 2019-03-30 | current | pecos_ownership |
| CYNTHIA RICE | W-2 MANAGING EMPLOYEE | — | 2021-08-14 | current | pecos_ownership |
| JONATHAN RUSSELL | W-2 MANAGING EMPLOYEE | — | 2007-02-05 | current | pecos_ownership |
| Marshall Medical | — | — | 1979-04-23 | current | ca_cdph_elms |
| MARSHALL MEDICAL CENTER | — | — | 1979-04-23 | current | ca_cdph_elms |
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.
Market rent context
32| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 06017 | acs median gross | 0 | $846 | 2024-12-31 | CENSUS_ACS5 |
| county 06017 | fmr | 0 | $1,748 | 2025-10-01 | HUD_USER_FMR |
| county 06017 | acs median gross | 1 | $1,249 | 2024-12-31 | CENSUS_ACS5 |
| county 06017 | fmr | 1 | $1,832 | 2025-10-01 | HUD_USER_FMR |
| county 06017 | acs median gross | 2 | $1,711 | 2024-12-31 | CENSUS_ACS5 |
| county 06017 | fmr | 2 | $2,255 | 2025-10-01 | HUD_USER_FMR |
| county 06017 | acs median gross | 3 | $2,038 | 2024-12-31 | CENSUS_ACS5 |
| county 06017 | fmr | 3 | $3,002 | 2025-10-01 | HUD_USER_FMR |
| county 06017 | acs median gross | 4 | $2,887 | 2024-12-31 | CENSUS_ACS5 |
| county 06017 | fmr | 4 | $3,460 | 2025-10-01 | HUD_USER_FMR |
| county 06017 | acs median gross | 5 | $3,038 | 2024-12-31 | CENSUS_ACS5 |
| county 06017 | acs median gross | $1,715 | 2024-12-31 | CENSUS_ACS5 | |
| county 06017 | acs recent mover gross | $2,260 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 95619 | acs median gross | 1 | $1,078 | 2024-12-31 | CENSUS_ACS5 |
| zcta 95619 | acs median gross | 2 | $1,140 | 2024-12-31 | CENSUS_ACS5 |
| zcta 95619 | acs median gross | 3 | $1,802 | 2024-12-31 | CENSUS_ACS5 |
| zcta 95619 | acs median gross | $1,669 | 2024-12-31 | CENSUS_ACS5 | |
| zip 95619 | payment standard 110 | 0 | $1,980 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | payment standard 90 | 0 | $1,620 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | safmr | 0 | $1,800 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | payment standard 110 | 1 | $2,079 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | payment standard 90 | 1 | $1,701 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | safmr | 1 | $1,890 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | payment standard 110 | 2 | $2,552 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | payment standard 90 | 2 | $2,088 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | safmr | 2 | $2,320 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | payment standard 110 | 3 | $3,399 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | payment standard 90 | 3 | $2,781 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | safmr | 3 | $3,090 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | payment standard 110 | 4 | $3,916 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | payment standard 90 | 4 | $3,204 | 2025-10-01 | HUD_USER_SAFMR |
| zip 95619 | safmr | 4 | $3,560 | 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.