Composite
7.1 / 100 percentile
Screener / 345484
A
TRANSYLVANIA REGIONAL HOSPITAL
snfNC
260 HOSPITAL DRIVE, BREVARD, NC 28712 · CCN 345484 · chain HCA HEALTHCARE INC
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
10
Model
v1.2
Reads as: riskier than 7.1% 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 model4Components10CHOW radar1Distress radar1Staffing12Penalties2Deficiencies5Licensure0Ownership27Related party0Transactions1Comps12Market rent30
Composite explanation
4| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| billing conduct | 69.3 | 47.4 | 0.30 | 0.3000 | 20.79 | in index |
| chow risk | 25.2 | 25.0 | 0.15 | 0.1500 | 3.78 | in index |
| regulatory risk | 5.5 | 3.4 | 0.30 | 0.3000 | 1.65 | in index |
| staffing risk | 0.2 | 0.3 | 0.25 | 0.2500 | 0.05 | in 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
10| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 47.4 | C | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 25.0 | B | v0.1-pos | default · in composite | 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. |
| p adverse action 12m | 0.0 | — | v0.1 | default · in composite | 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. |
| p chow 12m | 0.1 | — | v0.1 | default · in 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. |
| regulatory risk | 3.4 | A | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 0.3 | A | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| regulatory risk | 3.4 | A | v0.1 | superseded | 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. |
| regulatory risk | 3.4 | A | v0.2 | superseded | 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. |
| staffing risk | 0.3 | A | v0.1 | superseded | 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. |
| staffing risk | 0.3 | A | v0.2 | superseded | 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.
CHOW radar — 12-month sale probability
full board →p(CHOW, 12m)
0.1%
model v0.1 · computed 2026-07-29
Percentile among SNFs
25.3
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Never sold on record | 0.00 | -1.62 | |
| Current owner tenure (years) | 7.49 | -1.12 | |
| Total nurse staffing (HPRD) | 7.64 | -0.91 | |
| For-profit ownership | 1.00 | +0.69 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Chain size (log) | 3.74 | +0.39 | |
| Occupancy | 0.59 | +0.31 | |
| Facility size (log beds) | 2.40 | +0.29 |
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
20.0
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Total nurse staffing (HPRD) | 7.64 | -1.86 | |
| Deficiencies, last 12 months | 2.00 | +1.06 | |
| Chain size (log) | 3.74 | -0.97 | |
| For-profit ownership | 1.00 | -0.69 | |
| Occupancy | 0.59 | +0.67 | |
| Facility size (log beds) | 2.40 | +0.41 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Never sold on record | 0.00 | -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
12| 2025Q4 HPRD | This facility | NC median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 7.64 | 3.08 | 3.28 | 2.90–3.77 |
| RN | 2.84 | 0.30 | 0.39 | 0.25–0.58 |
| Weekend total | 7.86 | 2.93 | 3.11 | — |
| Weekday total | 7.56 | 3.14 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 5.9 | 7.64 | 2.84 | 0.78 | 4.02 | 7.86 | 5.0% |
| 2025Q3 | 92 | 6.3 | 7.25 | 2.66 | 0.78 | 3.80 | 7.41 | 0.0% |
| 2025Q2 | 91 | 5.0 | 9.09 | 3.24 | 1.07 | 4.77 | 9.58 | 0.0% |
| 2025Q1 | 90 | 6.6 | 6.86 | 2.68 | 0.77 | 3.41 | 6.96 | 0.0% |
| 2024Q4 | 92 | 6.6 | 7.07 | 2.73 | 0.84 | 3.51 | 6.84 | 0.2% |
| 2024Q3 | 92 | 6.1 | 6.91 | 2.53 | 0.68 | 3.70 | 6.83 | 0.4% |
| 2024Q2 | 91 | 16.5 | 2.77 | 1.04 | 0.32 | 1.41 | 2.91 | 0.0% |
| 2024Q1 | 91 | 16.0 | 2.80 | 1.17 | 0.20 | 1.43 | 2.84 | 0.0% |
| 2023Q4 | 92 | 11.0 | 4.29 | 2.13 | 0.00 | 2.17 | 4.07 | 0.0% |
| 2023Q3 | 92 | 7.1 | 6.65 | 3.31 | 0.00 | 3.35 | 6.40 | 0.0% |
| 2023Q2 | 91 | 6.7 | 7.07 | 3.64 | 0.00 | 3.42 | 7.29 | 0.3% |
| 2023Q1 | 90 | 4.9 | 7.92 | 4.08 | 0.00 | 3.84 | 8.24 | 0.0% |
HPRD is census-weighted: total hours over the quarter divided by total resident-days, not an average of daily ratios. Source is CMS Payroll-Based Journal daily records; only SNFs report PBJ, so other settings legitimately return zero rows.
Penalties
2| Date | Type | Fine | Source |
|---|---|---|---|
| 2023-06-20 | Fine | $6,207 | CMS provider data |
| 2023-06-20 | Fine | $6,208 | CMS provider data |
Total fines on record: $12,415
Deficiencies
5D × 1E × 3F × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-11-25 | Health | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | D | 2026-01-01 |
| 2025-11-25 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2025-12-24 |
| 2024-09-25 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2024-10-28 |
| 2024-09-25 | Health | F0880 | Provide and implement an infection prevention and control program. | F | 2024-10-28 |
| 2023-06-20 | Health | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | E | 2023-08-22 |
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
0No 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
27| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| MH MASTER HOLDING LLLP | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 99% | 2019-02-01 | current | pecos_ownership |
| COPE, RANDALL | ADP OF THE SNF | — | 2025-03-01 | current | pecos_ownership |
| FRISCO HOLDING II | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-02-01 | current | pecos_ownership |
| GROESSER, TYLER | CORPORATE OFFICER | — | 2025-04-03 | current | pecos_ownership |
| GROESSER, TYLER | ADP OF THE SNF | — | 2025-04-30 | current | pecos_ownership |
| HARTZ, THOMAS | ADP OF THE SNF | — | 2025-03-01 | current | pecos_ownership |
| HCA HEALTHCARE INC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-02-01 | current | pecos_ownership |
| HCA INC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-02-01 | current | pecos_ownership |
| HEALTHTRUST INC - THE HOSPITAL COMPANY | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-02-01 | current | pecos_ownership |
| HERCULES HOLDING II | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-02-01 | current | pecos_ownership |
| HTI HOSPITAL HOLDINGS INC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-02-01 | current | pecos_ownership |
| MH HOSPITAL HOLDING INC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-02-01 | current | pecos_ownership |
| MH MASTER LLC | GENERAL PARTNERSHIP INTEREST | — | 2019-02-01 | current | pecos_ownership |
| PILON, MICHELE | CORPORATE OFFICER | — | 2019-02-01 | current | pecos_ownership |
| PILON, MICHELE | ADP OF THE SNF | — | 2019-09-01 | current | pecos_ownership |
| SMITH, ERIC | CORPORATE OFFICER | — | 2021-03-01 | current | pecos_ownership |
| SMITH, ERIC | ADP OF THE SNF | — | 2025-03-01 | current | pecos_ownership |
| SMITH, ERIC | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-10-01 | current | pecos_ownership |
| FRISCO INC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 10% | 2019-02-01 | ended 2026-04-01 | pecos_ownership |
| ERIC SMITH | CORPORATE OFFICER | 0% | 2021-03-01 | ended 2026-05-18 | pecos_ownership |
| MICHELE PILON | CORPORATE OFFICER | 0% | 2019-02-01 | ended 2026-05-18 | pecos_ownership |
| TYLER GROESSER | CORPORATE OFFICER | 0% | 2025-04-03 | ended 2026-05-18 | pecos_ownership |
| ERIC SMITH | ADP OF THE SNF | — | 2025-03-01 | ended 2026-05-18 | pecos_ownership |
| MICHELE PILON | ADP OF THE SNF | — | 2019-09-01 | ended 2026-05-18 | pecos_ownership |
| RANDALL COPE | ADP OF THE SNF | — | 2025-03-01 | ended 2026-05-18 | pecos_ownership |
| THOMAS HARTZ | ADP OF THE SNF | — | 2025-03-01 | ended 2026-05-18 | pecos_ownership |
| TYLER GROESSER | ADP OF THE SNF | — | 2025-04-30 | 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.
Transactions
1| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2019-02-01 | — | MH TRANSYLVANIA REGIONAL HOSPITAL, LLLP | TRANSYLVANIA COMMUNITY HOSPITAL INC | chow |
Comparable trades — NC snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-07-15 | Juniper Gardens Center for Nursing and Rehabilitat | — | — | — | 50 | WILKINSON BLVD OPERATING COMPANY, LLC |
| 2025-07-01 | Warsaw Rehabilitation and Healthcare Center | — | — | — | 100 | WARSAW OPCO LLC |
| 2025-06-01 | Walnut Cove Health and Rehabilitation | — | — | — | 90 | 511 WINDMILL STREET OPCO LLC |
| 2025-06-01 | Wilora Lake Healthcare | — | — | — | 70 | 6001 WILORA LAKE ROAD OPCO LLC |
| 2025-06-01 | Clay County Health and Rehabilitation | — | — | — | 90 | 86 VALLEY HIDEAWAY DRIVE OPCO LLC |
| 2025-06-01 | Emerald Ridge Health and Rehabilitation | — | — | — | 100 | 25 REYNOLDS MOUNTAIN BOULEVARD OPCO LLC |
| 2025-06-01 | Willowbrook Rehabilitation and Care | — | — | — | 76 | 333 EAST LEE AVENUE OPCO LLC |
| 2025-06-01 | Westwood Health and Rehabilitation | — | — | — | 68 | 625 ASHLAND STREET OPCO LLC |
| 2025-06-01 | Hibriten Mountain Nursing and Rehabilitation | — | — | — | 100 | 2030 HARPER AVENUE OPCO LLC |
| 2025-06-01 | Forrest Oakes Healthcare | — | — | — | 60 | 620 HEATHWOOD DRIVE OPCO LLC |
| 2025-06-01 | Cardinal Healthcare and Rehabilitation | — | — | — | 63 | 931 NORTH ASPEN STREET OPCO LLC |
| 2025-06-01 | Valley View Care and Rehabilitation | — | — | — | 76 | 551 KENT STREET OPCO 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
30| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 37175 | acs median gross | 0 | $3,352 | 2024-12-31 | CENSUS_ACS5 |
| county 37175 | fmr | 0 | $881 | 2025-10-01 | HUD_USER_FMR |
| county 37175 | acs median gross | 1 | $642 | 2024-12-31 | CENSUS_ACS5 |
| county 37175 | fmr | 1 | $887 | 2025-10-01 | HUD_USER_FMR |
| county 37175 | acs median gross | 2 | $867 | 2024-12-31 | CENSUS_ACS5 |
| county 37175 | fmr | 2 | $1,164 | 2025-10-01 | HUD_USER_FMR |
| county 37175 | acs median gross | 3 | $1,175 | 2024-12-31 | CENSUS_ACS5 |
| county 37175 | fmr | 3 | $1,396 | 2025-10-01 | HUD_USER_FMR |
| county 37175 | fmr | 4 | $1,749 | 2025-10-01 | HUD_USER_FMR |
| county 37175 | acs median gross | $967 | 2024-12-31 | CENSUS_ACS5 | |
| county 37175 | acs recent mover gross | $1,435 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 28712 | acs median gross | 0 | $3,352 | 2024-12-31 | CENSUS_ACS5 |
| zcta 28712 | acs median gross | 2 | $850 | 2024-12-31 | CENSUS_ACS5 |
| zcta 28712 | acs median gross | 3 | $1,184 | 2024-12-31 | CENSUS_ACS5 |
| zcta 28712 | acs median gross | $1,021 | 2024-12-31 | CENSUS_ACS5 | |
| zip 28712 | payment standard 110 | 0 | $1,155 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | payment standard 90 | 0 | $945 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | safmr | 0 | $1,050 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | payment standard 110 | 1 | $1,166 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | payment standard 90 | 1 | $954 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | safmr | 1 | $1,060 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | payment standard 110 | 2 | $1,529 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | payment standard 90 | 2 | $1,251 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | safmr | 2 | $1,390 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | payment standard 110 | 3 | $1,837 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | payment standard 90 | 3 | $1,503 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | safmr | 3 | $1,670 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | payment standard 110 | 4 | $2,299 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | payment standard 90 | 4 | $1,881 | 2025-10-01 | HUD_USER_SAFMR |
| zip 28712 | safmr | 4 | $2,090 | 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.