Reads as: riskier than 75.2% 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
14
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+28.5 vs natl
MAK DAVID
31 facilities
connection
Owner fleet risk far above national
+27.5 vs natl
RINER MEERA
46 facilities
connection
Owner fleet risk far above national
+26.4 vs natl
LEE BRIAN
46 facilities
connection
Owner fleet risk far above national
+26.0 vs natl
FALLON JOHN
20 facilities
connection
Owner fleet risk far above national
+23.4 vs natl
KIRLEY FRANCIS
50 facilities
connection
Owner spans multiple chains
10 chains
KIRLEY FRANCIS
49 facilities
connection
Owner spans multiple chains
8 chains
FALLON JOHN
20 facilities
connection
Owner spans multiple chains
8 chains
RINER MEERA
46 facilities
connection
Owner spans multiple chains
7 chains
LEE BRIAN
46 facilities
connection
Owner fleet enforcement cluster
46% fined
RINER MEERA
46 facilities
connection
Owner fleet enforcement cluster
45% fined
FALLON JOHN
20 facilities
connection
Owner fleet enforcement cluster
44% fined
KIRLEY FRANCIS
50 facilities
connection
Owner fleet enforcement cluster
44% fined
LEE BRIAN
46 facilities
connection
Owner fleet enforcement cluster
42% fined
MAK DAVID
31 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
2.98
2.67
3.28
2.90–3.77
RN
0.22
0.24
0.39
0.25–0.58
Weekend total
2.96
2.56
3.11
—
Weekday total
2.99
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
44.3
2.98
0.22
1.13
1.63
2.96
0.0%
2025Q3
92
50.6
2.57
0.21
0.99
1.37
2.60
0.0%
2025Q2
91
51.7
2.27
0.23
0.94
1.10
2.41
0.0%
2025Q1
90
51.4
2.58
0.26
1.02
1.30
2.70
0.0%
2024Q4
92
49.5
2.63
0.26
1.13
1.25
2.72
0.0%
2024Q3
92
49.0
2.50
0.36
0.98
1.16
2.36
0.0%
2024Q2
91
49.6
2.26
0.35
0.75
1.16
2.23
0.0%
2024Q1
91
47.9
2.43
0.40
0.74
1.30
2.46
0.0%
2023Q4
92
47.0
2.59
0.44
0.74
1.41
2.58
0.0%
2023Q3
92
47.9
2.57
0.37
0.76
1.44
2.43
0.0%
2023Q2
91
47.1
2.60
0.38
0.81
1.41
2.61
0.0%
2023Q1
90
41.5
2.89
0.41
0.93
1.55
2.91
0.0%
2022Q4
92
47.2
2.67
0.32
0.83
1.51
2.65
0.0%
2022Q3
92
46.1
2.71
0.28
0.82
1.60
2.76
0.0%
2022Q2
91
42.3
2.96
0.31
0.98
1.68
2.95
0.0%
2022Q1
90
40.5
2.89
0.23
1.13
1.53
3.03
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.
Penalties
0
No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
22
C × 1D × 17E × 3F × 1
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2026-04-27
Health · complaint
F0551
Give the resident's representative the ability to exercise the resident's rights.
D
2026-05-05
2026-04-27
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
E
2026-05-05
2026-02-19
Health
F0583
Keep residents' personal and medical records private and confidential.
D
2026-04-03
2026-02-19
Health
F0760
Ensure that residents are free from significant medication errors.
D
2026-04-03
2026-02-19
Health
F0880
Provide and implement an infection prevention and control program.
D
2026-04-03
2025-07-16
Health · complaint
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
D
2025-08-25
2025-07-07
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2025-07-29
2025-07-07
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2025-07-29
2025-07-07
Health · complaint
F0880
Provide and implement an infection prevention and control program.
D
2025-07-29
2025-03-22
Health · complaint
F0732
Post nurse staffing information every day.
C
2025-04-07
2024-12-04
Health
F0580
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
D
2024-12-23
2024-12-04
Health
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
E
2024-12-23
2024-12-04
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.
D
2024-12-23
2024-12-04
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-12-23
2024-12-04
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-12-23
2024-12-04
Health
F0726
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
D
2024-12-23
2024-12-04
Health · complaint
F0760
Ensure that residents are free from significant medication errors.
D
2024-12-23
2023-09-14
Health · complaint
F0558
Reasonably accommodate the needs and preferences of each resident.
E
2023-10-05
2023-09-14
Health · complaint
F0692
Provide enough food/fluids to maintain a resident's health.
D
2023-10-05
2023-09-14
Health · complaint
F0880
Provide and implement an infection prevention and control program.
F
2023-10-05
2023-09-14
Health
F0940
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
D
2023-10-05
2023-08-17
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2023-09-06
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
19
Owner
Role
Pct
From
Status
Source
FALLON, JOHN
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
current
pecos_ownership
KIRLEY, FRANCIS
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
current
pecos_ownership
LEE, BRIAN
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
current
pecos_ownership
MAK, DAVID
CORPORATE OFFICER
—
2021-05-18
current
pecos_ownership
NEXION HEALTH AT FALFURRIAS, INC
—
—
2025-04-01
current
tx_hhsc_directory
NEXION HEALTH AT FALFURRIAS, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
current
pecos_ownership
RINER, MEERA
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
current
pecos_ownership
SANTANA, MARY
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
current
pecos_ownership
WEST WHARTON COUNTY HOSPITAL DISTRICT
—
—
2025-04-01
current
tx_hhsc_directory
DAVID MAK
CORPORATE OFFICER
100%
2021-05-18
ended 2026-05-18
pecos_ownership
WEST WHARTON COUNTY HOSPITAL DISTRICT
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2021-04-01
ended 2026-05-18
pecos_ownership
BRIAN LEE
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
ended 2026-05-18
pecos_ownership
DANIEL PIERCE
OTHER
—
2021-03-16
ended 2026-05-18
pecos_ownership
DANTE LIBERATORE
OTHER
—
2022-12-19
ended 2026-05-18
pecos_ownership
FRANCIS KIRLEY
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
ended 2026-05-18
pecos_ownership
JOHN FALLON
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
ended 2026-05-18
pecos_ownership
JOHN OSWALD
OTHER
—
2022-03-24
ended 2026-05-18
pecos_ownership
MARY SANTANA
W-2 MANAGING EMPLOYEE
—
2021-04-01
ended 2026-05-18
pecos_ownership
MEERA RINER
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
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.
Related-party costs
2
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2021-03-31
$93,188
—
—
—
$7,700
5
—
2020-11-30
$469,109
—
$187,309
$281,800
—
2
—
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
26
Geo
Kind
BR
Amount
As of
Source
county 48047
fmr
0
$756
2025-10-01
HUD_USER_FMR
county 48047
fmr
1
$778
2025-10-01
HUD_USER_FMR
county 48047
fmr
2
$973
2025-10-01
HUD_USER_FMR
county 48047
acs median gross
3
$835
2024-12-31
CENSUS_ACS5
county 48047
fmr
3
$1,353
2025-10-01
HUD_USER_FMR
county 48047
acs median gross
4
$99
2024-12-31
CENSUS_ACS5
county 48047
fmr
4
$1,432
2025-10-01
HUD_USER_FMR
county 48047
acs median gross
$719
2024-12-31
CENSUS_ACS5
zcta 78355
acs median gross
3
$780
2024-12-31
CENSUS_ACS5
zcta 78355
acs median gross
4
$99
2024-12-31
CENSUS_ACS5
zcta 78355
acs median gross
$712
2024-12-31
CENSUS_ACS5
zip 78355
payment standard 110
0
$880
2025-10-01
HUD_USER_SAFMR
zip 78355
payment standard 90
0
$720
2025-10-01
HUD_USER_SAFMR
zip 78355
safmr
0
$800
2025-10-01
HUD_USER_SAFMR
zip 78355
payment standard 110
1
$891
2025-10-01
HUD_USER_SAFMR
zip 78355
payment standard 90
1
$729
2025-10-01
HUD_USER_SAFMR
zip 78355
safmr
1
$810
2025-10-01
HUD_USER_SAFMR
zip 78355
payment standard 110
2
$1,177
2025-10-01
HUD_USER_SAFMR
zip 78355
payment standard 90
2
$963
2025-10-01
HUD_USER_SAFMR
zip 78355
safmr
2
$1,070
2025-10-01
HUD_USER_SAFMR
zip 78355
payment standard 110
3
$1,485
2025-10-01
HUD_USER_SAFMR
zip 78355
payment standard 90
3
$1,215
2025-10-01
HUD_USER_SAFMR
zip 78355
safmr
3
$1,350
2025-10-01
HUD_USER_SAFMR
zip 78355
payment standard 110
4
$1,749
2025-10-01
HUD_USER_SAFMR
zip 78355
payment standard 90
4
$1,431
2025-10-01
HUD_USER_SAFMR
zip 78355
safmr
4
$1,590
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.