Reads as: riskier than 49.6% 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
9
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
CTR PARTNERSHIP LP
99 facilities
connection
Owner spans multiple chains
18 chains
ENSIGN SERVICES INC
286 facilities
connection
Owner spans multiple chains
17 chains
KEETCH CHAD
283 facilities
connection
Owner spans multiple chains
17 chains
BURNAM SOON
335 facilities
connection
Owner spans multiple chains
15 chains
CARETRUST REIT INC
96 facilities
connection
Owner spans multiple chains
11 chains
CARETRUST GP LLC
89 facilities
connection
Buyer assembling a chain (5+ takeovers/24mo)
8 facilities
FANNIN COUNTY HOSPITAL AUTHORITY
8 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
2.40
2.67
3.28
2.90–3.77
RN
0.42
0.24
0.39
0.25–0.58
Weekend total
2.14
2.56
3.11
—
Weekday total
2.50
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
87.5
2.40
0.42
0.29
1.69
2.14
0.0%
2025Q3
92
86.4
2.46
0.35
0.45
1.65
2.20
0.0%
2025Q2
91
86.5
2.42
0.24
0.57
1.61
2.13
0.0%
2025Q1
90
82.3
2.39
0.19
0.70
1.50
2.09
0.0%
2024Q4
92
85.1
2.40
0.24
0.70
1.45
2.04
0.0%
2024Q3
92
88.3
2.23
0.18
0.72
1.33
2.00
0.0%
2024Q2
91
89.6
2.38
0.15
0.74
1.50
2.12
0.0%
2024Q1
91
85.4
2.31
0.15
0.74
1.42
1.95
0.0%
2023Q4
92
82.1
2.15
0.21
0.65
1.30
1.84
0.0%
2023Q3
92
84.8
2.14
0.22
0.60
1.32
1.85
0.0%
2023Q2
91
80.8
2.27
0.24
0.62
1.42
1.86
0.0%
2023Q1
90
79.4
2.50
0.21
0.63
1.67
2.07
0.0%
2022Q4
92
75.7
2.84
0.07
0.78
2.00
2.57
0.0%
2022Q3
92
79.4
2.65
0.01
0.80
1.84
2.34
0.0%
2022Q2
91
77.1
2.58
0.00
0.82
1.76
2.17
0.0%
2022Q1
90
81.3
2.58
0.03
0.80
1.75
2.37
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.
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
D
2026-04-10
2026-04-09
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2026-04-10
2026-04-09
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2026-04-10
2026-02-18
Health · complaint
F0694
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
D
2026-02-19
2026-02-04
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2026-02-05
2025-12-10
Health · complaint
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.
D
2025-12-11
2025-06-25
Health · complaint
F0602
Protect each resident from the wrongful use of the resident's belongings or money.
D
2025-06-26
2025-06-25
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
2025-06-26
2025-06-25
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-06-26
2025-06-25
Health
F0925
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
E
2025-06-26
2025-05-22
Health · complaint
F0740
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
D
2025-05-23
2025-05-22
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2025-05-23
2024-05-09
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2024-05-23
2024-05-09
Health
F0880
Provide and implement an infection prevention and control program.
D
2024-05-23
2024-04-12
Health · complaint
F0558
Reasonably accommodate the needs and preferences of each resident.
D
2024-04-13
2024-04-12
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2023-12-07
2023-03-03
Health
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2023-03-03
2023-03-03
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2023-03-03
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
20
Owner
Role
Pct
From
Status
Source
FANNIN COUNTY HOSPITAL AUTHORITY
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2019-04-01
current
pecos_ownership
BURNAM, SOON
CORPORATE OFFICER
—
2019-04-01
current
pecos_ownership
CARETRUST GP LLC
ADP OF THE SNF
—
2019-04-01
current
pecos_ownership
CARETRUST REIT INC
ADP OF THE SNF
—
2019-04-01
current
pecos_ownership
CTR PARTNERSHIP LP
ADP OF THE SNF
—
2019-04-01
current
pecos_ownership
ENSIGN SERVICES INC
ADP OF THE SNF
—
2009-12-01
current
pecos_ownership
EXPRESSWAY HEALTH HOLDINGS LLC
ADP OF THE SNF
—
2019-04-01
current
pecos_ownership
EXPRESSWAY HEALTH HOLDINGS LLC
Corporation, partnership or other organization has financial interest in provider
—
2023-01-01
current
hcris_a_8_1
EXPRESSWAY HEALTH HOLDINGS LLC
Corporation, partnership or other organization has financial interest in provider
—
2024-01-01
current
hcris_a_8_1
FANNIN COUNTY HOSPITAL AUTHORITY
—
—
2025-04-01
current
tx_hhsc_directory
HARLINGEN HEALTHCARE, INC
—
—
2025-04-01
current
tx_hhsc_directory
HARLINGEN HEALTHCARE, INC.
ADP OF THE SNF
—
2025-09-25
current
pecos_ownership
HARLINGEN HEALTHCARE, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
2019-04-01
current
pecos_ownership
HESS, JASON
ADP OF THE SNF
—
2019-04-01
current
pecos_ownership
KEETCH, CHAD
CORPORATE OFFICER
—
2011-03-01
current
pecos_ownership
KOTTA, SHRIDHAR
MANAGING CONTROL - GOVERNING BODY
—
2016-03-01
current
pecos_ownership
SANDERSON, CLARK
CORPORATE OFFICER
—
2019-04-01
current
pecos_ownership
CLARK SANDERSON
OPERATIONAL/MANAGERIAL CONTROL
100%
2019-04-01
ended 2026-05-18
pecos_ownership
JASON HESS
OPERATIONAL/MANAGERIAL CONTROL
0%
2019-04-01
ended 2026-05-18
pecos_ownership
EXPRESSWAY HEALTH HOLDINGS LLC
Corporation, partnership or other organization has financial interest in provider
—
2022-01-01
ended 2022-12-31
hcris_a_8_1
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
$1,017,005
—
$815,419
—
—
4
propco
2023-12-31
$860,071
—
$670,181
—
—
4
propco
2022-12-31
$1,740,287
—
$1,551,593
—
—
4
propco
2021-12-31
$796,221
—
$605,613
—
—
3
—
2020-12-31
$760,683
—
$574,262
—
$594
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
35
Geo
Kind
BR
Amount
As of
Source
county 48061
acs median gross
0
$724
2024-12-31
CENSUS_ACS5
county 48061
fmr
0
$773
2025-10-01
HUD_USER_FMR
county 48061
acs median gross
1
$729
2024-12-31
CENSUS_ACS5
county 48061
fmr
1
$866
2025-10-01
HUD_USER_FMR
county 48061
acs median gross
2
$893
2024-12-31
CENSUS_ACS5
county 48061
fmr
2
$1,047
2025-10-01
HUD_USER_FMR
county 48061
acs median gross
3
$1,112
2024-12-31
CENSUS_ACS5
county 48061
fmr
3
$1,414
2025-10-01
HUD_USER_FMR
county 48061
acs median gross
4
$1,170
2024-12-31
CENSUS_ACS5
county 48061
fmr
4
$1,479
2025-10-01
HUD_USER_FMR
county 48061
acs median gross
5
$1,575
2024-12-31
CENSUS_ACS5
county 48061
acs median gross
$912
2024-12-31
CENSUS_ACS5
county 48061
acs recent mover gross
$1,019
2024-12-31
CENSUS_ACS5
zcta 78550
acs median gross
0
$843
2024-12-31
CENSUS_ACS5
zcta 78550
acs median gross
1
$768
2024-12-31
CENSUS_ACS5
zcta 78550
acs median gross
2
$947
2024-12-31
CENSUS_ACS5
zcta 78550
acs median gross
3
$1,114
2024-12-31
CENSUS_ACS5
zcta 78550
acs median gross
4
$1,072
2024-12-31
CENSUS_ACS5
zcta 78550
acs median gross
$900
2024-12-31
CENSUS_ACS5
zcta 78550
acs recent mover gross
$1,020
2024-12-31
CENSUS_ACS5
zip 78550
payment standard 110
0
$869
2025-10-01
HUD_USER_SAFMR
zip 78550
payment standard 90
0
$711
2025-10-01
HUD_USER_SAFMR
zip 78550
safmr
0
$790
2025-10-01
HUD_USER_SAFMR
zip 78550
payment standard 110
1
$968
2025-10-01
HUD_USER_SAFMR
zip 78550
payment standard 90
1
$792
2025-10-01
HUD_USER_SAFMR
zip 78550
safmr
1
$880
2025-10-01
HUD_USER_SAFMR
zip 78550
payment standard 110
2
$1,177
2025-10-01
HUD_USER_SAFMR
zip 78550
payment standard 90
2
$963
2025-10-01
HUD_USER_SAFMR
zip 78550
safmr
2
$1,070
2025-10-01
HUD_USER_SAFMR
zip 78550
payment standard 110
3
$1,584
2025-10-01
HUD_USER_SAFMR
zip 78550
payment standard 90
3
$1,296
2025-10-01
HUD_USER_SAFMR
zip 78550
safmr
3
$1,440
2025-10-01
HUD_USER_SAFMR
zip 78550
payment standard 110
4
$1,661
2025-10-01
HUD_USER_SAFMR
zip 78550
payment standard 90
4
$1,359
2025-10-01
HUD_USER_SAFMR
zip 78550
safmr
4
$1,510
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.