Composite
99.7 / 100 percentile
Screener / 676086
F
Goldthwaite Health & Rehab Center
snfTX
1207 S Reynolds St, Goldthwaite, TX 76844 · CCN 676086 · chain HAMILTON COUNTY HOSPITAL DISTRICT
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
94
Model
v1.2
Reads as: riskier than 99.7% 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.
Score model7ML signals2Components19CHOW radar1Distress radar1Staffing16Penalties1Deficiencies13Licensure0Ownership8Related party0Transactions1Comps12Market rent32
Composite explanation
7| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| state reg risk | 92.3 | 40.7 | 0.30 | 0.1875 | 17.31 | in index |
| billing conduct | 82.4 | 54.5 | 0.30 | 0.1875 | 15.45 | in index |
| staffing risk | 98.8 | 98.8 | 0.25 | 0.1563 | 15.44 | in index |
| regulatory risk | 79.7 | 76.3 | 0.30 | 0.1875 | 14.94 | in index |
| financial risk | 78.6 | 65.8 | 0.30 | 0.1875 | 14.74 | in index |
| chow risk | 68.1 | 56.2 | 0.15 | 0.0938 | 6.38 | in index |
| ownership opacity | 58.4 | 55.2 | 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
2| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +25.1 vs natl | HOOPER GRADY | 61 facilities |
| connection | Owner fleet enforcement cluster | 49% fined | HOOPER GRADY | 61 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
19| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 54.5 | C | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 55.0 | C | 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. |
| chow risk | 52.5 | C | v0.1-txhhsc | default · in composite | Texas licence reissue timing as an ownership-transfer proxy. |
| chow risk | 61.1 | C | v0.6 | default · in composite | |
| financial risk | 65.8 | D | v0.5 | default · in composite | R18. |
| ownership opacity | 55.2 | C | v0.1-txhhsc | default · in composite | Texas HHSC directory ownership structure: chain size, absentee owner, management company, entity form, owner closure history. |
| 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 | 0.3 | — | 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 | 76.3 | D | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 98.8 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| state reg risk | 40.7 | B | v0.5 | default · in composite | |
| financial risk | 44.0 | B | v0.1 | superseded | 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. |
| financial risk | 24.0 | A | v0.2 | superseded | 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. |
| financial risk | 52.7 | C | v0.3 | superseded | 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. |
| financial risk | 69.5 | D | v0.4 | superseded | 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. |
| regulatory risk | 76.2 | D | 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 | 76.2 | D | 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 | 98.8 | F | 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 | 98.8 | F | 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)
0.3%
model v0.1 · computed 2026-07-29
Percentile among SNFs
44.4
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Never sold on record | 0.00 | -1.62 | |
| Current owner tenure (years) | 7.33 | -1.14 | |
| For-profit ownership | 1.00 | +0.69 | |
| Chain size (log) | 4.04 | +0.46 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Occupancy | 0.57 | +0.38 | |
| Total nurse staffing (HPRD) | 1.82 | +0.24 | |
| Ownership changes, last 5 years | 0.00 | +0.20 |
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
52.1
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Deficiencies, last 12 months | 1.00 | +1.24 | |
| Chain size (log) | 4.04 | -1.15 | |
| Occupancy | 0.57 | +0.77 | |
| For-profit ownership | 1.00 | -0.69 | |
| Total nurse staffing (HPRD) | 1.82 | +0.59 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Never sold on record | 0.00 | -0.28 | |
| Current owner tenure (years) | 7.33 | -0.18 |
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 | 1.82 | 2.67 | 3.28 | 2.90–3.77 |
| RN | 0.35 | 0.24 | 0.39 | 0.25–0.58 |
| Weekend total | 1.57 | 2.56 | 3.11 | — |
| Weekday total | 1.92 | 2.72 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 53.2 | 1.82 | 0.35 | 0.49 | 0.97 | 1.57 | 4.0% |
| 2025Q3 | 92 | 53.1 | 1.91 | 0.46 | 0.40 | 1.05 | 1.62 | 0.0% |
| 2025Q2 | 91 | 52.6 | 1.91 | 0.39 | 0.42 | 1.10 | 1.68 | 0.1% |
| 2025Q1 | 90 | 49.8 | 2.08 | 0.37 | 0.50 | 1.21 | 1.96 | 0.0% |
| 2024Q4 | 92 | 51.4 | 1.89 | 0.41 | 0.43 | 1.05 | 1.78 | 0.1% |
| 2024Q3 | 92 | 49.4 | 1.92 | 0.50 | 0.42 | 0.99 | 1.91 | 0.6% |
| 2024Q2 | 91 | 50.1 | 1.69 | 0.46 | 0.43 | 0.80 | 1.58 | 7.0% |
| 2024Q1 | 91 | 48.3 | 1.80 | 0.47 | 0.45 | 0.89 | 1.69 | 2.3% |
| 2023Q4 | 92 | 46.5 | 1.80 | 0.44 | 0.50 | 0.85 | 1.62 | 0.0% |
| 2023Q3 | 92 | 47.1 | 1.82 | 0.42 | 0.42 | 0.99 | 1.69 | 0.0% |
| 2023Q2 | 91 | 46.2 | 2.11 | 0.35 | 0.57 | 1.19 | 1.96 | 0.3% |
| 2023Q1 | 90 | 44.5 | 2.26 | 0.35 | 0.63 | 1.28 | 2.11 | 3.8% |
| 2022Q4 | 92 | 45.1 | 2.11 | 0.34 | 0.52 | 1.24 | 2.17 | 0.1% |
| 2022Q3 | 92 | 46.1 | 2.24 | 0.39 | 0.69 | 1.16 | 2.20 | 4.6% |
| 2022Q2 | 91 | 44.9 | 2.09 | 0.35 | 0.61 | 1.13 | 2.07 | 0.0% |
| 2022Q1 | 90 | 39.6 | 2.49 | 0.24 | 0.88 | 1.37 | 2.58 | 9.0% |
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
1| Date | Type | Fine | Source |
|---|---|---|---|
| 2024-05-25 | Fine | $32,545 | CMS provider data |
Total fines on record: $32,545
Deficiencies
13D × 6E × 3F × 1K × 3
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-01-09 | Health · complaint | F0627 | Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. | D | 2026-02-09 |
| 2025-03-19 | Health | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | 2025-04-15 |
| 2025-03-19 | Health | F0699 | Provide care or services that was trauma informed and/or culturally competent. | D | 2025-04-15 |
| 2025-03-19 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2025-04-15 |
| 2024-05-25 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | K | 2024-05-27 |
| 2024-05-25 | Health · complaint | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | K | 2024-05-27 |
| 2024-05-25 | Health · complaint | F0835 | Administer the facility in a manner that enables it to use its resources effectively and efficiently. | K | 2024-05-27 |
| 2024-01-31 | Health | F0578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | E | 2024-02-29 |
| 2024-01-31 | Health | F0638 | Assure that each resident’s assessment is updated at least once every 3 months. | D | 2024-02-29 |
| 2024-01-31 | Health | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | 2024-02-29 |
| 2024-01-31 | 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 | 2024-02-29 |
| 2024-01-31 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-02-29 |
| 2024-01-31 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2024-02-29 |
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
8| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| GOLDTHWAITE SKILLED CARE, LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2019-04-01 | current | pecos_ownership |
| BEASLEY, MICHAEL | W-2 MANAGING EMPLOYEE | — | 2019-04-01 | current | pecos_ownership |
| GOLDTHWAITE SKILLED CARE, LLC | — | — | 2025-04-01 | current | tx_hhsc_directory |
| HAMILTON COUNTY HOSPITAL DISTRICT | — | — | 2025-04-01 | current | tx_hhsc_directory |
| HOOPER, GRADY | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-04-01 | current | pecos_ownership |
| HAMILTON COUNTY HOSPITAL DISTRICT | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2019-04-01 | ended 2026-05-18 | pecos_ownership |
| GRADY HOOPER | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 0% | 2019-04-01 | ended 2026-05-18 | pecos_ownership |
| MICHAEL BEASLEY | W-2 MANAGING EMPLOYEE | 0% | 2019-04-01 | 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
1| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2019-04-01 | — | HAMILTON COUNTY HOSPITAL DISTRICT | GOLDTHWAITE SKILLED CARE, LLC | chow |
Comparable trades — TX snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-10-01 | ST. ANTHONY'S CARE CENTER | — | — | — | 120 | SOUTH LIMESTONE HOSPITAL DISTRICT |
| 2025-10-01 | Avir at New Braunfels | — | — | — | 154 | 821 US HIGHWAY 81 W OPCO LLC |
| 2025-09-01 | Avir at Texarkana | — | — | — | 110 | GUADALUPE COUNTY HOSPITAL BOARD |
| 2025-09-01 | PARKS HEALTH CENTER | — | — | — | 90 | WEST COKE COUNTY HOSPITAL DISTRICT |
| 2025-09-01 | WINDMILL VILLAGE REHABILITATION & CARE CENTER | — | — | — | 120 | FANNIN COUNTY HOSPITAL AUTHORITY |
| 2025-08-31 | Las Ventanas De Socorro | — | — | — | 126 | SOCORRO HEALTH CARE LLC |
| 2025-08-01 | Avir at Mineola | — | — | — | 115 | HOPKINS COUNTY HOSPITAL DISTRICT |
| 2025-08-01 | Avir at Orem | — | — | — | 120 | 3730 W OREM DR OPCO LLC |
| 2025-08-01 | Avir at Courtyard | — | — | — | 120 | 7499 STANWICK DR OPCO LLC |
| 2025-08-01 | HILLSIDE MEDICAL LODGE | — | — | — | 128 | CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY |
| 2025-08-01 | Avir at Pasadena | — | — | — | 131 | 4300 VISTA RD OPCO LLC |
| 2025-07-01 | Highland Meadows | — | — | — | 120 | NOCONA HOSPITAL DISTRICT |
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
32| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 48333 | acs median gross | 0 | $485 | 2024-12-31 | CENSUS_ACS5 |
| county 48333 | fmr | 0 | $756 | 2025-10-01 | HUD_USER_FMR |
| county 48333 | acs median gross | 1 | $561 | 2024-12-31 | CENSUS_ACS5 |
| county 48333 | fmr | 1 | $888 | 2025-10-01 | HUD_USER_FMR |
| county 48333 | acs median gross | 2 | $707 | 2024-12-31 | CENSUS_ACS5 |
| county 48333 | fmr | 2 | $973 | 2025-10-01 | HUD_USER_FMR |
| county 48333 | acs median gross | 3 | $1,063 | 2024-12-31 | CENSUS_ACS5 |
| county 48333 | fmr | 3 | $1,353 | 2025-10-01 | HUD_USER_FMR |
| county 48333 | fmr | 4 | $1,432 | 2025-10-01 | HUD_USER_FMR |
| county 48333 | acs median gross | $708 | 2024-12-31 | CENSUS_ACS5 | |
| county 48333 | acs recent mover gross | $693 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 76844 | acs median gross | 0 | $558 | 2024-12-31 | CENSUS_ACS5 |
| zcta 76844 | acs median gross | 1 | $579 | 2024-12-31 | CENSUS_ACS5 |
| zcta 76844 | acs median gross | 2 | $683 | 2024-12-31 | CENSUS_ACS5 |
| zcta 76844 | acs median gross | 3 | $1,208 | 2024-12-31 | CENSUS_ACS5 |
| zcta 76844 | acs median gross | $702 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 76844 | acs recent mover gross | $690 | 2024-12-31 | CENSUS_ACS5 | |
| zip 76844 | payment standard 110 | 0 | $836 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | payment standard 90 | 0 | $684 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | safmr | 0 | $760 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | payment standard 110 | 1 | $979 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | payment standard 90 | 1 | $801 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | safmr | 1 | $890 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | payment standard 110 | 2 | $1,067 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | payment standard 90 | 2 | $873 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | safmr | 2 | $970 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | payment standard 110 | 3 | $1,485 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | payment standard 90 | 3 | $1,215 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | safmr | 3 | $1,350 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | payment standard 110 | 4 | $1,716 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | payment standard 90 | 4 | $1,404 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76844 | safmr | 4 | $1,560 | 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.