CII TerminalCare Infrastructure Intelligence · model v1.2
pilot · 57,911 facilities
LIVE SIGNALS
ENFWE CARE PROVIDER, PLLCTX · 2026-08-04 · HHSC: closure noticeENFAXIS HEALTHCARE LLCTX · 2026-08-04 · HHSC: ENFORCEMENT ACTION PENDENFCENTEX CAREGIVERS LLCTX · 2026-08-01 · HHSC: closure noticeENFPROVIDENCE PERSONAL ASSISTANCE SERVICES INCTX · 2026-07-31 · HHSC: closure noticeENFSWIFT RESPONSE INCTX · 2026-07-31 · HHSC: ENFORCEMENT ACTION PENDENFRGV GUARDIANS OF CARE LLCTX · 2026-07-31 · HHSC: ENFORCEMENT ACTION PENDENFDOVE HOSPICE CARE LLCTX · 2026-07-28 · HHSC: closure noticeENFCHRIST HOME CARE LLCTX · 2026-07-24 · HHSC: closure noticeENFAMOR CURA PHC LLCTX · 2026-07-24 · HHSC: closure noticeENFKINDER HEALTHCARE SOLUTIONS LLCTX · 2026-07-20 · HHSC: closure noticeENFSUPREME TOUCH HEALTHCARE SERVICES LLCTX · 2026-07-20 · HHSC: closure noticeENFSAMNENAA CARE, INCTX · 2026-07-19 · HHSC: closure noticeENFINDEPENDENCE CARE OF TEXAS LLCTX · 2026-07-18 · HHSC: ENFORCEMENT ACTION PENDENFLA FAMILIA DEL PASO INCTX · 2026-07-10 · HHSC: closure noticeMOVECrouse Community Center Inc+98.5NY · composite 0.0 → 98.5MOVEHOME INSTEAD-92.9FL · composite 98.3 → 5.4MOVEHOMEWELL CARE SERVICES-92.0FL · composite 98.3 → 6.3MOVEHOME INSTEAD-90.9FL · composite 97.2 → 6.3MOVEHOME HEART FLORIDA-90.3FL · composite 97.7 → 7.4MOVEVITALCARING GROUP-87.7FL · composite 98.1 → 10.4MOVESENIOR CARE SOLUTIONS-87.6FL · composite 90.6 → 3.0MOVERIGHT AT HOME-85.6FL · composite 93.8 → 8.2EXITSCANDINAVIAN HOME INC54.7%RI · p(termination 12m)EXITBEADLES NEW BEGINNINGS37.9%OK · p(termination 12m)EXITBlue Valley Lutheran Nursing Home36.5%NE · p(termination 12m)EXITPRESBYTERIAN HOME FOR CENTRAL NEW YORK INC35.1%NY · p(termination 12m)CHOWBEARTOOTH REHABILITATION AND NURSING LLC76.9%MT · p(sale 12m)CHOWStonehaven Senior Living39.4%CA · p(sale 12m)CHOWAvoyelles Manor Nursing Home31.6%LA · p(sale 12m)CHOWKIT CARSON NURSING & REHABILITATION CENTER30.5%CA · p(sale 12m)ENFWE CARE PROVIDER, PLLCTX · 2026-08-04 · HHSC: closure noticeENFAXIS HEALTHCARE LLCTX · 2026-08-04 · HHSC: ENFORCEMENT ACTION PENDENFCENTEX CAREGIVERS LLCTX · 2026-08-01 · HHSC: closure noticeENFPROVIDENCE PERSONAL ASSISTANCE SERVICES INCTX · 2026-07-31 · HHSC: closure noticeENFSWIFT RESPONSE INCTX · 2026-07-31 · HHSC: ENFORCEMENT ACTION PENDENFRGV GUARDIANS OF CARE LLCTX · 2026-07-31 · HHSC: ENFORCEMENT ACTION PENDENFDOVE HOSPICE CARE LLCTX · 2026-07-28 · HHSC: closure noticeENFCHRIST HOME CARE LLCTX · 2026-07-24 · HHSC: closure noticeENFAMOR CURA PHC LLCTX · 2026-07-24 · HHSC: closure noticeENFKINDER HEALTHCARE SOLUTIONS LLCTX · 2026-07-20 · HHSC: closure noticeENFSUPREME TOUCH HEALTHCARE SERVICES LLCTX · 2026-07-20 · HHSC: closure noticeENFSAMNENAA CARE, INCTX · 2026-07-19 · HHSC: closure noticeENFINDEPENDENCE CARE OF TEXAS LLCTX · 2026-07-18 · HHSC: ENFORCEMENT ACTION PENDENFLA FAMILIA DEL PASO INCTX · 2026-07-10 · HHSC: closure noticeMOVECrouse Community Center Inc+98.5NY · composite 0.0 → 98.5MOVEHOME INSTEAD-92.9FL · composite 98.3 → 5.4MOVEHOMEWELL CARE SERVICES-92.0FL · composite 98.3 → 6.3MOVEHOME INSTEAD-90.9FL · composite 97.2 → 6.3MOVEHOME HEART FLORIDA-90.3FL · composite 97.7 → 7.4MOVEVITALCARING GROUP-87.7FL · composite 98.1 → 10.4MOVESENIOR CARE SOLUTIONS-87.6FL · composite 90.6 → 3.0MOVERIGHT AT HOME-85.6FL · composite 93.8 → 8.2EXITSCANDINAVIAN HOME INC54.7%RI · p(termination 12m)EXITBEADLES NEW BEGINNINGS37.9%OK · p(termination 12m)EXITBlue Valley Lutheran Nursing Home36.5%NE · p(termination 12m)EXITPRESBYTERIAN HOME FOR CENTRAL NEW YORK INC35.1%NY · p(termination 12m)CHOWBEARTOOTH REHABILITATION AND NURSING LLC76.9%MT · p(sale 12m)CHOWStonehaven Senior Living39.4%CA · p(sale 12m)CHOWAvoyelles Manor Nursing Home31.6%LA · p(sale 12m)CHOWKIT CARSON NURSING & REHABILITATION CENTER30.5%CA · p(sale 12m)
AS OF 2026-08-05 09:22 UTC
Screener / 676114
C

RIVER HILLS HEALTH AND REHABILITATION CENTER

snfTX
2091 BANDERA HWY, KERRVILLE, TX 78028 · CCN 676114 · chain UVALDE COUNTY HOSPITAL AUTHORITY
Composite
63.0 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
0
Model
v1.2
Reads as: riskier than 63.0% 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 model8ML signals6Components20CHOW radar1Distress radar1Staffing16Penalties3Deficiencies56Licensure0Ownership19Related party5Transactions1Comps12Market rent36

Composite explanation

8
ComponentPercentileRawWeightWeight shareContributionCounts
regulatory risk96.595.00.300.171416.54in index
staffing risk90.690.60.250.142912.94in index
financial risk50.045.50.300.17148.57in index
billing conduct38.635.10.300.17146.62in index
lease risk60.155.50.150.08575.15in index
chow risk40.242.10.150.08573.45in index
state reg risk0.00.00.300.17140.00in index
ownership opacity72.866.1excluded
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

6
KindFindingSignalSubjectFirst seen
connectionOwner fleet risk far above national+24.0 vs natlMARTIN CHRISTOPHER8 facilities
connectionOwner fleet risk far above national+23.4 vs natlRANKIN DEREK7 facilities
connectionOwner spans multiple chains7 chainsLOCKHART CHRISTOPHER10 facilities
connectionOwner spans multiple chains4 chainsMARTIN CHRISTOPHER8 facilities
connectionOwner fleet enforcement cluster50% finedUVALDE COUNTY HOSPITAL AUTHORITY10 facilities
connectionOwner fleet enforcement cluster43% finedRANKIN DEREK7 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

20
Score typeScoreGradeModelStatusRegistry model notes
billing conduct35.1Bv0.1-pacpuf-snfdefault · in compositeR22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup.
chow risk24.3Av0.1-posdefault · in compositeChange-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 risk60.5Cv0.1-txhhscdefault · in compositeTexas licence reissue timing as an ownership-transfer proxy.
chow risk40.9Bv0.6default · in composite
financial risk45.5Cv0.5default · in compositeR18.
lease risk55.5Cv0.5default · in composite
ownership opacity66.1Dv0.1-txhhscdefault · in compositeTexas HHSC directory ownership structure: chain size, absentee owner, management company, entity form, owner closure history.
p adverse action 12m0.0—v0.1default · in compositeR23/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 12m0.3—v0.1default · in compositeR22/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 risk95.0Fv0.3default · in compositeDeficiency-based, SNF population. Runs alongside v0.5-pos.
staffing risk90.6Fv0.3default · in compositeCost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS.
state reg risk0.0Av0.5default · in composite
financial risk54.1Cv0.1supersededPre-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 risk34.1Bv0.2supersededPre-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 risk49.9Cv0.3supersededPre-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 risk49.7Cv0.4supersededPre-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 risk95.0Fv0.1supersededPre-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 risk95.0Fv0.2supersededPre-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 risk90.6Fv0.1supersededPre-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 risk90.6Fv0.2supersededPre-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
45.8
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
DriverValuePull on odds
Never sold on record0.00-1.62
Current owner tenure (years)9.33-0.94
For-profit ownership1.00+0.69
No PBJ staffing report0.00+0.42
Contract staffing share0.33+0.42
Chain size (log)3.56+0.35
Ownership changes, last 5 years0.00+0.20
Total nurse staffing (HPRD)2.52+0.11
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)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
33.6
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
DriverValuePull on odds
Chain size (log)3.56-0.87
For-profit ownership1.00-0.69
Deficiencies, last 12 months4.00+0.69
No PBJ staffing report0.00+0.39
Occupancy0.67+0.34
Total nurse staffing (HPRD)2.52+0.29
Never sold on record0.00-0.28
Contract staffing share0.33+0.28
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 HPRDThis facilityTX medianNational medianNational p25–p75
Total nurse2.522.673.282.90–3.77
RN0.080.240.390.25–0.58
Weekend total2.402.563.11—
Weekday total2.562.723.35—
QuarterDaysAvg censusTotal HPRDRNLPNCNAWeekendContract %
2025Q492100.02.520.080.911.532.4033.2%
2025Q392105.92.400.040.771.592.3732.2%
2025Q291101.82.600.080.901.612.6527.0%
2025Q190108.52.670.090.861.722.5424.9%
2024Q492113.82.960.061.141.762.6012.0%
2024Q392120.02.700.130.781.792.5313.5%
2024Q291124.32.590.030.761.802.4617.8%
2024Q191115.92.530.070.731.722.168.9%
2023Q492122.82.480.120.701.662.439.6%
2023Q392123.02.560.090.691.792.5316.3%
2023Q291109.52.670.070.781.822.744.8%
2023Q190104.62.310.110.721.482.197.8%
2022Q49292.72.170.240.601.331.990.2%
2022Q39289.32.300.200.691.412.220.1%
2022Q29197.72.150.170.701.281.970.0%
2022Q19091.72.270.140.751.382.060.0%
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

3
fines by year
$62.7k$31.4k2425
DateTypeFineSource
2025-02-08Fine$49,392CMS provider data
2024-12-21Fine$47,467CMS provider data
2024-01-10Fine$15,274CMS provider data
Total fines on record: $112,133

Deficiencies

56
C × 1D × 27E × 19F × 3J × 6
deficiencies by survey year
221123242526
SurveyTypeTagDeficiencyScopeCorrected
2026-02-04Health · complaintF0628Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.D2026-02-06
2026-02-04Health · complaintF0641Ensure each resident receives an accurate assessment.D2026-02-06
2025-11-26Health · complaintF0882Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.F2025-12-19
2025-09-16Health · complaintF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.D2025-10-01
2025-06-13HealthF0583Keep residents' personal and medical records private and confidential.D2025-07-11
2025-06-13HealthF0584Honor 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.D2025-07-11
2025-06-13Health · complaintF0605Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.D2025-07-11
2025-06-13HealthF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.E2025-07-11
2025-06-13HealthF0677Provide care and assistance to perform activities of daily living for any resident who is unable.E2025-07-11
2025-06-13HealthF0685Assist a resident in gaining access to vision and hearing services.D2025-07-11
2025-06-13HealthF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.D2025-07-11
2025-06-13HealthF0690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.E2025-07-11
2025-06-13HealthF0727Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.E2025-07-11
2025-06-13HealthF0760Ensure that residents are free from significant medication errors.D2025-07-11
2025-06-13HealthF0761Ensure 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.E2025-07-11
2025-06-13HealthF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E2025-07-11
2025-06-13HealthF0813Have a policy regarding use and storage of foods brought to residents by family and other visitors.D2025-07-11
2025-06-13HealthF0880Provide and implement an infection prevention and control program.D2025-07-11
2025-05-13Health · complaintF0558Reasonably accommodate the needs and preferences of each resident.E2025-06-03
2025-05-13Health · complaintF0641Ensure each resident receives an accurate assessment.D2025-06-03
2025-02-08Health · complaintF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.J2025-02-09
2025-02-08Health · complaintF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.J2025-02-09
2025-02-08Health · complaintF0760Ensure that residents are free from significant medication errors.J2025-02-09
2025-02-08Health · complaintF0770Provide timely, quality laboratory services/tests to meet the needs of residents.D2025-02-09
2024-12-21Health · complaintF0655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedD2024-12-22
2024-12-21Health · complaintF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.D2024-12-22
2024-12-21Health · complaintF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.D2024-12-22
2024-12-21Health · complaintF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.J2024-12-22
2024-12-21Health · complaintF0727Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.F2024-12-22
2024-09-09Health · complaintF0607Develop and implement policies and procedures to prevent abuse, neglect, and theft.E2024-09-30
2024-09-09Health · complaintF0609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.E2024-09-30
2024-09-09Health · complaintF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.D2024-09-30
2024-09-09Health · complaintF0839Employ staff that are licensed, certified, or registered in accordance with state laws.D2024-09-30
2024-04-19HealthF0583Keep residents' personal and medical records private and confidential.E2024-05-31
2024-04-19HealthF0641Ensure each resident receives an accurate assessment.D2024-05-31
2024-04-19HealthF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.D2024-05-31
2024-04-19HealthF0758Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.D2024-05-31
2024-04-19HealthF0759Ensure medication error rates are not 5 percent or greater.D2024-05-31
2024-04-19HealthF0801Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.E2024-05-31
2024-04-19HealthF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.F2024-05-31
2024-04-19HealthF0813Have a policy regarding use and storage of foods brought to residents by family and other visitors.D2024-05-31
2024-04-19HealthF0849Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.E2024-05-31
2024-04-19HealthF0880Provide and implement an infection prevention and control program.E2024-05-31
2024-04-19HealthF0921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.E2024-05-31
2024-01-10Health · complaintF0580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.J2024-01-29
2024-01-10Health · complaintF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.J2024-01-29
2023-07-07Health · complaintF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.D2023-08-07
2023-07-07Health · complaintF0757Ensure each resident’s drug regimen must be free from unnecessary drugs.D2023-08-07
2023-06-23Health · complaintF0842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.D2023-07-23
2023-03-04HealthF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.E2023-03-05
2023-03-04HealthF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.D2023-03-05
2023-03-04HealthF0727Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.E2023-03-05
2023-03-04HealthF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.E2023-03-05
2023-03-04HealthF0761Ensure 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.E2023-03-05
2023-03-04HealthF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E2023-03-05
2023-03-04HealthF0814Dispose of garbage and refuse properly.C2023-03-05
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
OwnerRolePctFromStatusSource
MARTIN, CHRISTOPHER5% OR GREATER DIRECT OWNERSHIP INTEREST50%2017-04-01currentpecos_ownership
RANKIN, DEREK5% OR GREATER DIRECT OWNERSHIP INTEREST50%2017-04-01currentpecos_ownership
2091KV LLCADP OF THE SNF—2017-04-01currentpecos_ownership
APOLINAR, ADAMCORPORATE OFFICER—2022-08-01currentpecos_ownership
CONTRERAS, TERRICORPORATE OFFICER—2019-04-29currentpecos_ownership
HERNANDEZ, LAURENADP OF THE SNF—2025-05-19currentpecos_ownership
LOCKHART, CHRISTOPHERADP OF THE SNF—2024-05-01currentpecos_ownership
LOPEZ, ALANOPERATIONAL/MANAGERIAL CONTROL—2025-03-11currentpecos_ownership
RIVER HILLS CHM LLC——2026-04-01currenttx_hhsc_directory
RIVER HILLS CHM LLCADP OF THE SNF—2017-04-01currentpecos_ownership
UVALDE COUNTY HOSPITAL AUTHORITYINDIRECT OWNERSHIP INTEREST—2017-04-01currentpecos_ownership
UVALDE COUNTY HOSPITAL AUTHORITY——2026-04-01currenttx_hhsc_directory
CHRISTOPHER MARTIN5% OR GREATER DIRECT OWNERSHIP INTEREST50%2017-04-01ended 2026-05-18pecos_ownership
DEREK RANKIN5% OR GREATER DIRECT OWNERSHIP INTEREST50%2017-04-01ended 2026-05-18pecos_ownership
ADAM APOLINARCORPORATE OFFICER—2022-08-01ended 2026-05-18pecos_ownership
ALAN LOPEZOPERATIONAL/MANAGERIAL CONTROL—2025-03-11ended 2026-05-18pecos_ownership
CHRISTOPHER LOCKHARTCORPORATE DIRECTOR—2024-05-01ended 2026-05-18pecos_ownership
LAUREN HERNANDEZCORPORATE DIRECTOR—2025-05-19ended 2026-05-18pecos_ownership
TERRI CONTRERASCORPORATE OFFICER—2019-04-29ended 2026-05-18pecos_ownership
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.

Transactions

1
Close datePriceBuyerSellerEvidence
2017-04-01—UVALDE COUNTY HOSPITAL AUTHORITYSOUTHWEST LTC KERRVILLE LTD.chow

Comparable trades — TX snf

12
CloseFacilityPrice$/bedCap rateBedsBuyer
2025-10-01ST. ANTHONY'S CARE CENTER———120SOUTH LIMESTONE HOSPITAL DISTRICT
2025-10-01Avir at New Braunfels———154821 US HIGHWAY 81 W OPCO LLC
2025-09-01Avir at Texarkana———110GUADALUPE COUNTY HOSPITAL BOARD
2025-09-01PARKS HEALTH CENTER———90WEST COKE COUNTY HOSPITAL DISTRICT
2025-09-01WINDMILL VILLAGE REHABILITATION & CARE CENTER———120FANNIN COUNTY HOSPITAL AUTHORITY
2025-08-31Las Ventanas De Socorro———126SOCORRO HEALTH CARE LLC
2025-08-01Avir at Mineola———115HOPKINS COUNTY HOSPITAL DISTRICT
2025-08-01Avir at Orem———1203730 W OREM DR OPCO LLC
2025-08-01Avir at Courtyard———1207499 STANWICK DR OPCO LLC
2025-08-01HILLSIDE MEDICAL LODGE———128CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
2025-08-01Avir at Pasadena———1314300 VISTA RD OPCO LLC
2025-07-01Highland Meadows———120NOCONA 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

36
GeoKindBRAmountAs ofSource
county 48265acs median gross0$1,2432024-12-31CENSUS_ACS5
county 48265fmr0$8692025-10-01HUD_USER_FMR
county 48265acs median gross1$8972024-12-31CENSUS_ACS5
county 48265fmr1$9652025-10-01HUD_USER_FMR
county 48265acs median gross2$1,0762024-12-31CENSUS_ACS5
county 48265fmr2$1,1182025-10-01HUD_USER_FMR
county 48265acs median gross3$1,3762024-12-31CENSUS_ACS5
county 48265fmr3$1,4752025-10-01HUD_USER_FMR
county 48265acs median gross4$1,2142024-12-31CENSUS_ACS5
county 48265fmr4$1,5232025-10-01HUD_USER_FMR
county 48265acs median gross5$8612024-12-31CENSUS_ACS5
county 48265acs median gross$1,1092024-12-31CENSUS_ACS5
county 48265acs recent mover gross$1,2602024-12-31CENSUS_ACS5
zcta 78028acs median gross0$1,2072024-12-31CENSUS_ACS5
zcta 78028acs median gross1$8882024-12-31CENSUS_ACS5
zcta 78028acs median gross2$1,0872024-12-31CENSUS_ACS5
zcta 78028acs median gross3$1,4392024-12-31CENSUS_ACS5
zcta 78028acs median gross4$1,2252024-12-31CENSUS_ACS5
zcta 78028acs median gross5$8612024-12-31CENSUS_ACS5
zcta 78028acs median gross$1,1382024-12-31CENSUS_ACS5
zcta 78028acs recent mover gross$1,2602024-12-31CENSUS_ACS5
zip 78028payment standard 1100$9682025-10-01HUD_USER_SAFMR
zip 78028payment standard 900$7922025-10-01HUD_USER_SAFMR
zip 78028safmr0$8802025-10-01HUD_USER_SAFMR
zip 78028payment standard 1101$1,0782025-10-01HUD_USER_SAFMR
zip 78028payment standard 901$8822025-10-01HUD_USER_SAFMR
zip 78028safmr1$9802025-10-01HUD_USER_SAFMR
zip 78028payment standard 1102$1,2432025-10-01HUD_USER_SAFMR
zip 78028payment standard 902$1,0172025-10-01HUD_USER_SAFMR
zip 78028safmr2$1,1302025-10-01HUD_USER_SAFMR
zip 78028payment standard 1103$1,6392025-10-01HUD_USER_SAFMR
zip 78028payment standard 903$1,3412025-10-01HUD_USER_SAFMR
zip 78028safmr3$1,4902025-10-01HUD_USER_SAFMR
zip 78028payment standard 1104$1,6502025-10-01HUD_USER_SAFMR
zip 78028payment standard 904$1,3502025-10-01HUD_USER_SAFMR
zip 78028safmr4$1,5002025-10-01HUD_USER_SAFMR
ACS median gross rents and HUD FMR/SAFMR for the facility's county and ZIP. Context for underwriting, not facility pricing.
CII Terminal tearsheet · RIVER HILLS HEALTH AND REHABILITATION CENTER (676114) · generated 2026-08-05 · every number derives from public records (CMS Care Compare, PBJ, POS, penalty and survey files, state licensure registers) · scores are published model outputs with holdout metrics disclosed at cii-terminal.vercel.app/transparency