CII TerminalCare Infrastructure Intelligence · model v1.2
pilot · 57,911 facilities
LIVE SIGNALS
ENFAXIS HEALTHCARE LLCTX · 2026-08-04 · HHSC: ENFORCEMENT ACTION PENDENFSWIFT 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: ENFORCEMENT ACTION PENDENFHANDS OF GOLD HOME CARE LLCTX · 2026-07-24 · 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 noticeENFFACO HEALTHCARE SERVICES INCTX · 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 noticeENFFRONTIDA HOSPICE CARE LLCTX · 2026-07-07 · 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)ENFAXIS HEALTHCARE LLCTX · 2026-08-04 · HHSC: ENFORCEMENT ACTION PENDENFSWIFT 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: ENFORCEMENT ACTION PENDENFHANDS OF GOLD HOME CARE LLCTX · 2026-07-24 · 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 noticeENFFACO HEALTHCARE SERVICES INCTX · 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 noticeENFFRONTIDA HOSPICE CARE LLCTX · 2026-07-07 · 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 2026-08-04 22:42 UTC
Screener / 185476
B

Coldspring Transitional Care Center

snfKY
300 Plaza Drive, Cold Spring, KY 41076 · CCN 185476 · chain CARESPRING HEALTH CARE HOLDINGS LP
Composite
36.2 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
143
Model
v1.2
Reads as: riskier than 36.2% 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.

Composite explanation

5
ComponentPercentileRawWeightWeight shareContributionCounts
billing conduct80.553.30.300.230818.58in index
financial risk40.139.60.300.23089.25in index
staffing risk45.545.50.250.19238.75in index
chow risk42.340.60.150.11544.88in index
regulatory risk7.95.00.300.23081.82in index
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.

Component scores and registry models

16
Score typeScoreGradeModelStatusRegistry model notes
billing conduct53.3Cv0.1-pacpuf-snfdefault · in compositeR22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup.
chow risk25.0Bv0.1-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 risk56.2Cv0.6default · in composite
financial risk39.6Bv0.5default · in compositeR18.
p adverse action 12m0.1v0.1default · 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 12m2.3v0.1default · 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 risk5.0Av0.3default · in compositeDeficiency-based, SNF population. Runs alongside v0.5-pos.
staffing risk45.5Cv0.3default · in compositeCost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS.
financial risk77.4Dv0.1supersededPre-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 risk57.4Cv0.2supersededPre-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 risk47.9Cv0.3supersededPre-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 risk44.1Bv0.4supersededPre-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 risk4.9Av0.1supersededPre-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 risk4.9Av0.2supersededPre-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 risk45.5Cv0.1supersededPre-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 risk45.5Cv0.2supersededPre-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)
2.3%
model v0.1 · computed 2026-07-29
Percentile among SNFs
71.9
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
DriverValuePull on odds
For-profit ownership1.00+0.69
Occupancy0.93-0.68
Never sold on record1.00+0.62
Current owner tenure (years)25.00+0.57
No PBJ staffing report0.00+0.42
Ownership changes, last 5 years0.00+0.20
Chain size (log)2.83+0.20
Deficiencies, last 12 months1.00-0.15
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)
0.1%
model v0.1 · computed 2026-07-29
Percentile among SNFs
38.3
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
DriverValuePull on odds
Deficiencies, last 12 months1.00+1.24
Occupancy0.93-0.77
For-profit ownership1.00-0.69
Chain size (log)2.83-0.45
No PBJ staffing report0.00+0.39
Fine amount, 12m (log)0.00+0.18
Facility size (log beds)4.97-0.13
Never sold on record1.00+0.12
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 facilityKY medianNational medianNational p25–p75
Total nurse3.363.113.282.90–3.77
RN0.350.410.390.25–0.58
Weekend total3.173.013.11
Weekday total3.433.163.35
QuarterDaysAvg censusTotal HPRDRNLPNCNAWeekendContract %
2025Q492133.33.360.350.752.253.171.1%
2025Q392136.23.130.400.682.043.002.3%
2025Q291135.92.730.280.651.802.581.5%
2025Q190138.32.730.230.621.882.651.4%
2024Q492129.93.140.340.642.152.971.2%
2024Q392126.33.080.340.622.112.901.2%
2024Q291123.02.920.370.522.032.641.1%
2024Q191122.32.410.440.551.422.231.5%
2023Q492117.72.450.420.531.502.321.1%
2023Q392112.62.460.420.551.492.311.2%
2023Q291121.22.070.310.681.081.881.6%
2023Q190127.92.190.300.671.212.130.0%
2022Q492124.62.370.300.721.362.310.0%
2022Q392123.22.400.220.691.492.250.0%
2022Q291120.52.640.220.731.692.440.0%
2022Q190118.52.560.270.871.422.460.0%
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

11
D × 7E × 3F × 1
deficiencies by survey year
5319212325
SurveyTypeTagDeficiencyScopeCorrected
2025-11-24Health · complaintF0658Ensure services provided by the nursing facility meet professional standards of quality.D
2025-05-15HealthF0584Honor 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.D2025-07-07
2025-05-15HealthF0636Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.D2025-07-07
2025-05-15HealthF0809Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.F2025-07-07
2025-05-15HealthF0880Provide and implement an infection prevention and control program.E2025-07-07
2020-01-31HealthF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.D2020-03-06
2020-01-31HealthF0685Assist a resident in gaining access to vision and hearing services.D2020-03-06
2020-01-31HealthF0880Provide and implement an infection prevention and control program.D2020-03-06
2020-01-31HealthF0921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.E2020-03-06
2019-01-17HealthF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.D2019-02-15
2019-01-17HealthF0761Ensure 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.E2019-02-15
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

13
OwnerRolePctFromStatusSource
CARESPRING HEALTH CARE HOLDINGS LP5% OR GREATER DIRECT OWNERSHIP INTEREST100%2014-02-01currentpecos_ownership
BARRY N BORTZ 06042009 TR5% OR GREATER INDIRECT OWNERSHIP INTEREST72%2014-02-01currentpecos_ownership
EPPERS, DAVID5% OR GREATER INDIRECT OWNERSHIP INTEREST15%2014-02-01currentpecos_ownership
BORTZ FAMILY IRREVOCABLE T/A5% OR GREATER INDIRECT OWNERSHIP INTEREST9%2014-02-01currentpecos_ownership
CARECO LLCOPERATIONAL/MANAGERIAL CONTROL2014-09-15currentpecos_ownership
CARESPRING HEALTH CARE MANAGEMENT, LLCOPERATIONAL/MANAGERIAL CONTROL2014-09-15currentpecos_ownership
CHIRUMBOLO, CHRISTOPHERCORPORATE OFFICER2016-09-01currentpecos_ownership
EPPERS, DAVIDCORPORATE OFFICER2008-05-12currentpecos_ownership
LEWANDOWSKI, ADAMW-2 MANAGING EMPLOYEE2018-07-09currentpecos_ownership
CHRISTOPHER CHIRUMBOLOCORPORATE OFFICER100%2016-09-01ended 2026-05-18pecos_ownership
DAVID EPPERS5% OR GREATER INDIRECT OWNERSHIP INTEREST15%2014-02-01ended 2026-05-18pecos_ownership
ADAM LEWANDOWSKIW-2 MANAGING EMPLOYEE2018-07-09ended 2026-05-18pecos_ownership
DAVID EPPERSCORPORATE OFFICER2008-05-12ended 2026-05-18pecos_ownership
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.

Transactions

0
No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.

Comparable trades — KY snf

12
CloseFacilityPrice$/bedCap rateBedsBuyer
2025-08-07Auburn Nursing and Rehabilitation Center66AUBURN OPCO LLC
2025-01-01Henson Park Health & Rehabilitation90HENSON SNF OPERATIONS LLC
2025-01-01Chestnut Ridge Health & Rehabilitation92CHESTNUT SNF OPERATIONS LLC
2024-11-01Green Meadows Health & Rehabilitation122GREEN MEADOWS SNF OPERATIONS LLC
2024-09-01Maple Grove Senior Living LLC90MAPLE GROVE SENIOR LIVING LLC
2024-08-30Sam Swope Care Center136MASONIC HOMES OF LOUISVILLE LLC
2024-08-01Lyndon Crossing145LYNDON CROSSING, LLC
2024-08-01Clifton Heights110CLIFTON HEIGHTS, LLC
2024-08-01Green River Trails118GREEN RIVER TRAILS, LLC
2024-08-01Mountain Ridge Health and Rehabilitation59MONTICELLO KY OPCO LLC
2024-08-01Frankfort Trails100FRANKFORT TRAILS, LLC
2024-08-01Vanceburg Hills94VANCEBURG HILLS, LLC
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

33
GeoKindBRAmountAs ofSource
county 21037acs median gross0$8132024-12-31CENSUS_ACS5
county 21037fmr0$9582025-10-01HUD_USER_FMR
county 21037acs median gross1$9692024-12-31CENSUS_ACS5
county 21037fmr1$1,0512025-10-01HUD_USER_FMR
county 21037acs median gross2$1,2092024-12-31CENSUS_ACS5
county 21037fmr2$1,3532025-10-01HUD_USER_FMR
county 21037acs median gross3$1,4532024-12-31CENSUS_ACS5
county 21037fmr3$1,7852025-10-01HUD_USER_FMR
county 21037acs median gross4$1,7072024-12-31CENSUS_ACS5
county 21037fmr4$1,9762025-10-01HUD_USER_FMR
county 21037acs median gross$1,1452024-12-31CENSUS_ACS5
county 21037acs recent mover gross$1,3922024-12-31CENSUS_ACS5
zcta 41076acs median gross0$1,0062024-12-31CENSUS_ACS5
zcta 41076acs median gross1$1,1352024-12-31CENSUS_ACS5
zcta 41076acs median gross2$1,2192024-12-31CENSUS_ACS5
zcta 41076acs median gross3$1,5272024-12-31CENSUS_ACS5
zcta 41076acs median gross$1,2032024-12-31CENSUS_ACS5
zcta 41076acs recent mover gross$1,3022024-12-31CENSUS_ACS5
zip 41076payment standard 1100$1,0892025-10-01HUD_USER_SAFMR
zip 41076payment standard 900$8912025-10-01HUD_USER_SAFMR
zip 41076safmr0$9902025-10-01HUD_USER_SAFMR
zip 41076payment standard 1101$1,1992025-10-01HUD_USER_SAFMR
zip 41076payment standard 901$9812025-10-01HUD_USER_SAFMR
zip 41076safmr1$1,0902025-10-01HUD_USER_SAFMR
zip 41076payment standard 1102$1,5402025-10-01HUD_USER_SAFMR
zip 41076payment standard 902$1,2602025-10-01HUD_USER_SAFMR
zip 41076safmr2$1,4002025-10-01HUD_USER_SAFMR
zip 41076payment standard 1103$2,0352025-10-01HUD_USER_SAFMR
zip 41076payment standard 903$1,6652025-10-01HUD_USER_SAFMR
zip 41076safmr3$1,8502025-10-01HUD_USER_SAFMR
zip 41076payment standard 1104$2,2442025-10-01HUD_USER_SAFMR
zip 41076payment standard 904$1,8362025-10-01HUD_USER_SAFMR
zip 41076safmr4$2,0402025-10-01HUD_USER_SAFMR
ACS median gross rents and HUD FMR/SAFMR for the facility's county and ZIP. Context for underwriting, not facility pricing.