Reads as: riskier than 96.7% 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.
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
16
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
+27.2 vs natl
REID JOHN
18 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
+24.6 vs natl
HERDRICH WILLIAM
33 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
3.17
2.67
3.28
2.90–3.77
RN
0.35
0.24
0.39
0.25–0.58
Weekend total
3.04
2.56
3.11
—
Weekday total
3.22
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
59.2
3.17
0.35
0.64
2.18
3.04
0.1%
2025Q3
92
57.4
2.95
0.17
0.70
2.07
2.83
0.4%
2025Q2
91
60.4
2.60
0.17
0.63
1.80
2.48
0.7%
2025Q1
90
58.0
2.89
0.18
0.82
1.89
2.86
0.7%
2024Q4
92
53.5
2.80
0.10
0.87
1.83
2.78
0.8%
2024Q3
92
54.8
2.68
0.08
0.84
1.76
2.63
0.0%
2024Q2
91
62.0
2.40
0.04
0.79
1.57
2.39
0.0%
2024Q1
91
62.8
2.29
0.05
0.73
1.50
2.33
0.0%
2023Q4
92
57.3
2.36
0.07
0.80
1.49
2.35
0.1%
2023Q3
92
62.3
2.37
0.09
0.78
1.50
2.37
16.2%
2023Q2
91
61.9
2.56
0.13
0.63
1.80
2.37
24.5%
2023Q1
90
59.9
2.51
0.15
0.59
1.77
2.46
18.6%
2022Q4
92
61.7
2.53
0.06
0.63
1.84
2.51
25.8%
2022Q3
92
55.1
2.74
0.11
0.82
1.81
2.60
29.9%
2022Q2
91
54.0
2.35
0.06
0.71
1.58
2.15
10.9%
2022Q1
90
52.4
2.41
0.04
0.82
1.55
2.34
4.5%
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.
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
E
2026-02-21
2026-02-20
Health · complaint
F0690
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
E
2026-02-21
2026-02-20
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
E
2026-02-21
2026-01-04
Health · complaint
F0583
Keep residents' personal and medical records private and confidential.
D
2026-01-05
2026-01-04
Health · complaint
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
J
2026-01-05
2026-01-04
Health · complaint
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
J
2026-01-24
2026-01-04
Health · complaint
F0880
Provide and implement an infection prevention and control program.
D
2026-01-05
2026-01-04
Health · complaint
F0925
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
J
2026-01-05
2025-08-29
Health
F0690
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
E
2025-08-30
2025-08-29
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
E
2025-08-30
2025-08-29
Health
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
2025-08-30
2025-08-29
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2025-08-30
2025-08-29
Health
F0814
Dispose of garbage and refuse properly.
C
2025-08-30
2025-06-06
Health · complaint
F0839
Employ staff that are licensed, certified, or registered in accordance with state laws.
D
2025-07-06
2025-06-06
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2025-07-06
2024-11-27
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2024-11-28
2024-11-27
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2024-11-28
2024-11-27
Health · complaint
F0732
Post nurse staffing information every day.
C
2024-11-28
2024-07-26
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
2024-09-07
2024-07-26
Health · complaint
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2024-09-07
2024-07-26
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
2024-09-05
2024-07-26
Health · complaint
F0801
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
E
2024-09-07
2024-07-26
Health · complaint
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2024-09-07
2023-06-09
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2023-07-27
2023-06-09
Health
F0849
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
D
2023-07-27
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
BRENDE, MARTI
W-2 MANAGING EMPLOYEE
—
2021-04-01
current
pecos_ownership
FALLON, JOHN
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
current
pecos_ownership
HERDRICH, WILLIAM
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
OPERATIONAL/MANAGERIAL CONTROL
—
2021-05-18
current
pecos_ownership
NEXION HEALTH AT FLORESVILLE, INC
—
—
2025-04-01
current
tx_hhsc_directory
NEXION HEALTH AT FLORESVILLE, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
current
pecos_ownership
REID, JOHN
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
current
pecos_ownership
RINER, MEERA
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
current
pecos_ownership
WEST WHARTON COUNTY HOSPITAL DISTRICT
—
—
2025-04-01
current
tx_hhsc_directory
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
DAVID MAK
OPERATIONAL/MANAGERIAL CONTROL
—
2021-05-18
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 REID
OPERATIONAL/MANAGERIAL CONTROL
—
2021-04-01
ended 2026-05-18
pecos_ownership
MARTI BRENDE
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
WILLIAM HERDRICH
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
3
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2021-03-31
$66,103
—
—
—
$7,596
5
—
2020-12-31
$196,478
—
—
—
$22,499
5
—
2020-03-31
$134,160
—
$69,076
$65,084
—
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
32
Geo
Kind
BR
Amount
As of
Source
county 48493
acs median gross
0
$335
2024-12-31
CENSUS_ACS5
county 48493
fmr
0
$1,077
2025-10-01
HUD_USER_FMR
county 48493
acs median gross
1
$783
2024-12-31
CENSUS_ACS5
county 48493
fmr
1
$1,177
2025-10-01
HUD_USER_FMR
county 48493
acs median gross
2
$1,050
2024-12-31
CENSUS_ACS5
county 48493
fmr
2
$1,426
2025-10-01
HUD_USER_FMR
county 48493
acs median gross
3
$1,273
2024-12-31
CENSUS_ACS5
county 48493
fmr
3
$1,830
2025-10-01
HUD_USER_FMR
county 48493
acs median gross
4
$2,080
2024-12-31
CENSUS_ACS5
county 48493
fmr
4
$2,132
2025-10-01
HUD_USER_FMR
county 48493
acs median gross
$1,069
2024-12-31
CENSUS_ACS5
county 48493
acs recent mover gross
$1,267
2024-12-31
CENSUS_ACS5
zcta 78114
acs median gross
1
$804
2024-12-31
CENSUS_ACS5
zcta 78114
acs median gross
2
$1,084
2024-12-31
CENSUS_ACS5
zcta 78114
acs median gross
3
$1,221
2024-12-31
CENSUS_ACS5
zcta 78114
acs median gross
$1,042
2024-12-31
CENSUS_ACS5
zcta 78114
acs recent mover gross
$1,287
2024-12-31
CENSUS_ACS5
zip 78114
payment standard 110
0
$1,056
2025-10-01
HUD_USER_SAFMR
zip 78114
payment standard 90
0
$864
2025-10-01
HUD_USER_SAFMR
zip 78114
safmr
0
$960
2025-10-01
HUD_USER_SAFMR
zip 78114
payment standard 110
1
$1,155
2025-10-01
HUD_USER_SAFMR
zip 78114
payment standard 90
1
$945
2025-10-01
HUD_USER_SAFMR
zip 78114
safmr
1
$1,050
2025-10-01
HUD_USER_SAFMR
zip 78114
payment standard 110
2
$1,397
2025-10-01
HUD_USER_SAFMR
zip 78114
payment standard 90
2
$1,143
2025-10-01
HUD_USER_SAFMR
zip 78114
safmr
2
$1,270
2025-10-01
HUD_USER_SAFMR
zip 78114
payment standard 110
3
$1,793
2025-10-01
HUD_USER_SAFMR
zip 78114
payment standard 90
3
$1,467
2025-10-01
HUD_USER_SAFMR
zip 78114
safmr
3
$1,630
2025-10-01
HUD_USER_SAFMR
zip 78114
payment standard 110
4
$2,090
2025-10-01
HUD_USER_SAFMR
zip 78114
payment standard 90
4
$1,710
2025-10-01
HUD_USER_SAFMR
zip 78114
safmr
4
$1,900
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.