Reads as: riskier than 36.5% 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 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
JACK AND NANCY DWYER WORKFORCE DEVELOPMENT CENTER INC
65 facilities
connection
Owner spans multiple chains
7 chains
REGENCY INTEGRATED HEALTH SERVICES LLC
67 facilities
connection
Owner spans multiple chains
7 chains
CLAPP BARBARA
66 facilities
connection
Owner spans multiple chains
7 chains
DEKOWSKI DONOVAN
66 facilities
connection
Owner fleet enforcement cluster
43% fined
BOOKER HOSPITAL DISTRICT
7 facilities
connection
Owner fleet enforcement cluster
43% fined
HOOVER SHAWN
7 facilities
connection
Owner fleet enforcement cluster
42% fined
JACK AND NANCY DWYER WORKFORCE DEVELOPMENT CENTER INC
66 facilities
connection
Owner fleet enforcement cluster
42% fined
CLAPP BARBARA
67 facilities
connection
Owner fleet enforcement cluster
42% fined
DEKOWSKI DONOVAN
67 facilities
connection
Owner fleet enforcement cluster
41% fined
REGENCY IHS CLINICAL CONSULTING LLC
68 facilities
connection
Owner fleet enforcement cluster
41% fined
REGENCY INTEGRATED HEALTH SERVICES LLC
68 facilities
connection
Owner fleet enforcement cluster
41% fined
REGENCY IHS REHAB LLC
69 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
2.60
2.67
3.28
2.90–3.77
RN
0.07
0.24
0.39
0.25–0.58
Weekend total
2.46
2.56
3.11
—
Weekday total
2.65
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
108.2
2.60
0.07
0.93
1.60
2.46
0.0%
2025Q3
92
103.6
2.71
0.08
0.99
1.64
2.53
0.0%
2025Q2
91
102.9
2.63
0.13
0.99
1.52
2.50
0.6%
2025Q1
90
93.2
2.40
0.19
0.94
1.27
2.48
0.0%
2024Q4
92
90.0
2.85
0.28
0.98
1.58
2.96
0.0%
2024Q3
92
94.1
2.87
0.21
1.01
1.65
3.00
0.0%
2024Q2
91
96.1
2.78
0.16
1.05
1.57
2.90
0.0%
2024Q1
91
103.6
2.58
0.15
0.98
1.46
2.58
0.0%
2023Q4
92
107.9
2.49
0.13
0.95
1.41
2.46
0.0%
2023Q3
92
107.9
2.60
0.12
0.99
1.50
2.45
0.0%
2023Q2
91
106.0
2.56
0.09
1.03
1.44
2.44
5.0%
2023Q1
90
96.6
2.63
0.09
1.01
1.52
2.50
1.8%
2022Q4
92
96.4
2.70
0.09
1.07
1.53
2.62
5.5%
2022Q3
92
93.5
2.61
0.09
1.02
1.51
2.59
9.8%
2022Q2
91
81.1
2.56
0.10
0.96
1.49
2.52
6.3%
2022Q1
90
78.4
2.46
0.15
0.81
1.50
2.45
4.8%
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
21
D × 15E × 5F × 1
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2026-04-24
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
—
2026-03-12
Health · complaint
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
—
2026-03-05
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2026-04-08
2025-12-01
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2025-12-02
2025-08-19
Health · complaint
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
D
2025-08-20
2025-08-19
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2025-08-20
2025-05-22
Health · complaint
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2025-06-26
2025-05-22
Health · complaint
F0700
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
E
2025-06-26
2025-05-22
Health
F0790
Provide routine and 24-hour emergency dental care for each resident.
D
2025-06-26
2025-05-22
Health · complaint
F0880
Provide and implement an infection prevention and control program.
D
2025-06-26
2025-05-09
Health · complaint
F0584
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
E
2025-05-23
2025-05-09
Health · complaint
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
E
2025-05-23
2025-04-24
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2025-05-02
2023-11-13
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2023-12-08
2023-11-13
Health · complaint
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
E
2023-12-08
2023-06-01
Health · complaint
F0880
Provide and implement an infection prevention and control program.
D
2023-06-15
2023-02-09
Health
F0563
Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing.
F
2023-03-06
2023-02-09
Health
F0693
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
D
2023-03-06
2023-02-09
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2023-03-06
2023-02-09
Health
F0850
Hire a qualified full-time social worker in a facility with more than 120 beds.
E
2023-03-06
2023-02-09
Health
F0880
Provide and implement an infection prevention and control program.
D
2023-03-06
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
54
Owner
Role
Pct
From
Status
Source
BOOKER HOSPITAL DISTRICT
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2021-12-01
current
pecos_ownership
ARMSTRONG, DWAYNE
CORPORATE DIRECTOR
—
2004-03-01
current
pecos_ownership
BARTOSIEWIEZ, MATTHEW
CORPORATE DIRECTOR
—
2008-01-17
current
pecos_ownership
BOOKER HOSPITAL DISTRICT
ADP OF THE SNF
—
2025-02-26
current
pecos_ownership
BOOKER HOSPITAL DISTRICT
—
—
2025-02-10
current
tx_hhsc_directory
CLAPP, BARBARA
ADP OF THE SNF
—
2021-06-01
current
pecos_ownership
CLEVENGER, JOSH
CORPORATE DIRECTOR
—
2021-08-05
current
pecos_ownership
DEKOWSKI, DONOVAN
ADP OF THE SNF
—
2024-12-16
current
pecos_ownership
HOOVER, SHAWN
CORPORATE DIRECTOR
—
2021-12-01
current
pecos_ownership
JACK AND NANCY DWYER WORKFORCE DEVELOPMENT CENTER INC
ADP OF THE SNF
—
2025-02-26
current
pecos_ownership
LUCAS, DENISE
ADP OF THE SNF
—
2024-12-16
current
pecos_ownership
MOUGOURIS, TASO
ADP OF THE SNF
—
2024-12-16
current
pecos_ownership
NORMAN, WILLIAM
ADP OF THE SNF
—
2024-12-16
current
pecos_ownership
PECOT, SANDRA
OPERATIONAL/MANAGERIAL CONTROL
—
2025-05-05
current
pecos_ownership
REGENCY IHS CLINICAL CONSULTING, LLC
ADP OF THE SNF
—
2025-02-26
current
pecos_ownership
REGENCY IHS REHAB LLC
ADP OF THE SNF
—
2025-02-26
current
pecos_ownership
REGENCY INTEGRATED HEALTH SERVICES LLC
ADP OF THE SNF
—
2025-02-26
current
pecos_ownership
SHEPPARD, RICHARD
CORPORATE DIRECTOR
—
2002-01-15
current
pecos_ownership
WADE, HUNTER
CORPORATE DIRECTOR
—
2020-12-17
current
pecos_ownership
WELLSENTIAL OF MAGNOLIA CROSSING LLC
—
—
2025-02-10
current
tx_hhsc_directory
WELLSENTIAL OF MAGNOLIA LLC
ADP OF THE SNF
—
2025-02-26
current
pecos_ownership
ANTONIO CARVAJAL
OPERATIONAL/MANAGERIAL CONTROL
—
2024-05-16
ended 2026-05-18
pecos_ownership
BARBARA CLAPP
CORPORATE DIRECTOR
—
2021-06-01
ended 2026-05-18
pecos_ownership
CSV RHEA MANAGEMENT HOLDCO, LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-16
ended 2026-05-18
pecos_ownership
CSV RHEA MANAGEMENT HOLDCO, LLC
ADP OF THE SNF
—
2025-02-26
ended 2026-05-18
pecos_ownership
DANIEL BAIRD
ADP OF THE SNF
—
2021-04-13
ended 2026-05-18
pecos_ownership
DAREN CORTESE
ADP OF THE SNF
—
2021-08-10
ended 2026-05-18
pecos_ownership
DONOVAN DEKOWSKI
ADP OF THE SNF
—
2024-12-16
ended 2026-05-18
pecos_ownership
DWAYNE ARMSTRONG
CORPORATE DIRECTOR
—
2004-03-01
ended 2026-05-18
pecos_ownership
DWD TX HOLDINGS LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-16
ended 2026-05-18
pecos_ownership
DWD TX HOLDINGS LLC
ADP OF THE SNF
—
2025-02-26
ended 2026-05-18
pecos_ownership
ELLIOT MANDELBAUM
ADP OF THE SNF
—
2024-12-16
ended 2026-05-18
pecos_ownership
HUNTER WADE
CORPORATE DIRECTOR
—
2020-12-17
ended 2026-05-18
pecos_ownership
JACK AND NANCY DWYER WORKFORCE DEVELOPMENT CENTER INC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-16
ended 2026-05-18
pecos_ownership
JOSH CLEVENGER
ADP OF THE SNF
—
2021-08-05
ended 2026-05-18
pecos_ownership
KARA GARMAN
ADP OF THE SNF
—
2024-12-16
ended 2026-05-18
pecos_ownership
MATTHEW BARTOSIEWIEZ
ADP OF THE SNF
—
2008-01-17
ended 2026-05-18
pecos_ownership
NICOLE KAUFMAN
CORPORATE DIRECTOR
—
2021-08-10
ended 2026-05-18
pecos_ownership
NICOLE KAUFMAN
ADP OF THE SNF
—
2021-08-01
ended 2026-05-18
pecos_ownership
PATRICIA GIBSON
ADP OF THE SNF
—
2021-08-01
ended 2026-05-18
pecos_ownership
REG HG OPCO 1, LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-16
ended 2026-05-18
pecos_ownership
REG HG OPCO 1, LLC
ADP OF THE SNF
—
2025-02-26
ended 2026-05-18
pecos_ownership
REG OPERATOR HOLDCO LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-16
ended 2026-05-18
pecos_ownership
REG OPERATOR HOLDCO LLC
ADP OF THE SNF
—
2025-02-26
ended 2026-05-18
pecos_ownership
REGENCY IHS CLINICAL CONSULTING, LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-16
ended 2026-05-18
pecos_ownership
REGENCY IHS REHAB LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-16
ended 2026-05-18
pecos_ownership
REGENCY INTEGRATED HEALTH SERVICES LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-16
ended 2026-05-18
pecos_ownership
REGENCY TEXAS HOLDINGS LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-16
ended 2026-05-18
pecos_ownership
REGENCY TEXAS HOLDINGS LLC
ADP OF THE SNF
—
2025-02-26
ended 2026-05-18
pecos_ownership
RICHARD SHEPPARD
CORPORATE DIRECTOR
—
2002-01-15
ended 2026-05-18
pecos_ownership
SHAWN HOOVER
ADP OF THE SNF
—
2021-12-01
ended 2026-05-18
pecos_ownership
TASO MOUGOURIS
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-16
ended 2026-05-18
pecos_ownership
VERONICA GONZALES
CORPORATE DIRECTOR
—
2024-05-16
ended 2026-05-18
pecos_ownership
WELLSENTIAL OF MAGNOLIA LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-12-16
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.
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 77089
acs median gross
0
$1,366
2024-12-31
CENSUS_ACS5
zcta 77089
acs median gross
1
$1,236
2024-12-31
CENSUS_ACS5
zcta 77089
acs median gross
2
$1,310
2024-12-31
CENSUS_ACS5
zcta 77089
acs median gross
3
$1,808
2024-12-31
CENSUS_ACS5
zcta 77089
acs median gross
4
$2,331
2024-12-31
CENSUS_ACS5
zcta 77089
acs median gross
$1,475
2024-12-31
CENSUS_ACS5
zcta 77089
acs recent mover gross
$1,421
2024-12-31
CENSUS_ACS5
zip 77089
payment standard 110
0
$1,485
2025-10-01
HUD_USER_SAFMR
zip 77089
payment standard 90
0
$1,215
2025-10-01
HUD_USER_SAFMR
zip 77089
safmr
0
$1,350
2025-10-01
HUD_USER_SAFMR
zip 77089
payment standard 110
1
$1,540
2025-10-01
HUD_USER_SAFMR
zip 77089
payment standard 90
1
$1,260
2025-10-01
HUD_USER_SAFMR
zip 77089
safmr
1
$1,400
2025-10-01
HUD_USER_SAFMR
zip 77089
payment standard 110
2
$1,826
2025-10-01
HUD_USER_SAFMR
zip 77089
payment standard 90
2
$1,494
2025-10-01
HUD_USER_SAFMR
zip 77089
safmr
2
$1,660
2025-10-01
HUD_USER_SAFMR
zip 77089
payment standard 110
3
$2,453
2025-10-01
HUD_USER_SAFMR
zip 77089
payment standard 90
3
$2,007
2025-10-01
HUD_USER_SAFMR
zip 77089
safmr
3
$2,230
2025-10-01
HUD_USER_SAFMR
zip 77089
payment standard 110
4
$3,058
2025-10-01
HUD_USER_SAFMR
zip 77089
payment standard 90
4
$2,502
2025-10-01
HUD_USER_SAFMR
zip 77089
safmr
4
$2,780
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.