Reads as: riskier than 87.1% 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.
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.
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
15
2025Q4 HPRD
This facility
TX median
National median
National p25–p75
Total nurse
2.93
2.67
3.28
2.90–3.77
RN
0.24
0.24
0.39
0.25–0.58
Weekend total
2.82
2.56
3.11
—
Weekday total
2.97
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
78.0
2.93
0.24
0.72
1.97
2.82
0.0%
2025Q3
92
80.7
2.79
0.25
0.71
1.83
2.58
0.0%
2025Q2
91
80.3
2.69
0.32
0.67
1.70
2.54
0.0%
2025Q1
90
84.1
2.57
0.24
0.65
1.69
2.34
0.0%
2024Q4
92
83.0
2.71
0.30
0.68
1.73
2.42
1.4%
2024Q3
92
79.5
2.73
0.32
0.73
1.68
2.57
1.0%
2024Q2
91
83.2
2.79
0.23
0.81
1.75
2.55
11.7%
2024Q1
91
82.2
2.67
0.28
0.78
1.61
2.53
7.8%
2023Q4
92
80.3
2.75
0.15
0.88
1.72
2.56
6.3%
2023Q3
92
82.6
2.57
0.18
0.80
1.59
2.59
4.2%
2023Q2
91
80.6
2.61
0.17
0.87
1.56
2.54
4.6%
2023Q1
90
83.4
2.46
0.29
0.75
1.42
2.43
6.0%
2022Q4
92
76.5
2.65
0.28
0.90
1.47
2.54
9.6%
2022Q3
92
73.0
2.54
0.28
0.82
1.44
2.39
15.0%
2022Q2
91
65.1
2.48
0.37
0.63
1.48
2.18
0.7%
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.
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2026-01-10
2025-12-30
Health
F0732
Post nurse staffing information every day.
C
2026-01-10
2025-04-14
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
K
2025-04-16
2025-04-14
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
K
2025-04-16
2025-04-14
Health · complaint
F0697
Provide safe, appropriate pain management for a resident who requires such services.
K
2025-04-16
2025-04-14
Health · complaint
F0777
Provide or obtain x-rays/tests when ordered and promptly tell the ordering practitioner of the results.
K
2025-04-16
2025-04-14
Health · complaint
F0908
Keep all essential equipment working safely.
E
2025-04-16
2025-02-19
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.
E
2025-03-28
2025-02-19
Health · complaint
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
E
2025-03-28
2024-10-10
Health · complaint
F0558
Reasonably accommodate the needs and preferences of each resident.
E
2024-11-08
2024-10-10
Health · complaint
F0583
Keep residents' personal and medical records private and confidential.
D
2024-11-08
2024-10-10
Health · complaint
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2024-11-08
2024-10-10
Health · complaint
F0880
Provide and implement an infection prevention and control program.
E
2024-11-08
2023-08-24
Health
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
2023-10-02
2023-08-24
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.
D
2023-10-02
2023-08-24
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2023-10-02
2023-08-24
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2023-10-02
2023-08-24
Health
F0825
Provide or get specialized rehabilitative services as required for a resident.
D
2023-10-02
2023-08-24
Health
F0880
Provide and implement an infection prevention and control program.
E
2023-10-02
2023-08-24
Health
F0921
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
D
2023-10-02
2023-08-11
Health · complaint
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
E
2023-09-15
2023-08-11
Health · complaint
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
E
2023-09-15
2023-08-11
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
E
2023-09-15
2023-08-11
Health · complaint
F0610
Respond appropriately to all alleged violations.
E
2023-09-15
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
14
Owner
Role
Pct
From
Status
Source
NOCONA HOSPITAL DISTRICT
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2018-04-01
current
pecos_ownership
GAMBLE GUEST CARE HEALTH & REHAB MANAGEMENT, LLC
—
—
2024-04-01
current
tx_hhsc_directory
GAMBLE, DENNY
ADP OF THE SNF
—
2018-07-01
current
pecos_ownership
GAMVEST TEXAS LLC
5% OR GREATER MORTGAGE INTEREST
—
2018-07-01
current
pecos_ownership
GORDY, OTIS
ADP OF THE SNF
—
2022-03-11
current
pecos_ownership
MEEKINS, GREG
CORPORATE DIRECTOR
—
2018-04-01
current
pecos_ownership
NOCONA HOSPITAL DISTRICT
—
—
2024-04-01
current
tx_hhsc_directory
RIAZ, AHSAN
ADP OF THE SNF
—
2018-07-01
current
pecos_ownership
THE HIGHLANDS GUEST CARE CENTER LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2018-07-01
current
pecos_ownership
THE HIGHLANDS GUEST CARE CENTER LLC
ADP OF THE SNF
—
2025-04-30
current
pecos_ownership
AHSAN RIAZ
ADP OF THE SNF
—
2018-07-01
ended 2026-05-18
pecos_ownership
DENNY GAMBLE
OPERATIONAL/MANAGERIAL CONTROL
—
2018-07-01
ended 2026-05-18
pecos_ownership
GREG MEEKINS
CORPORATE DIRECTOR
—
2018-04-01
ended 2026-05-18
pecos_ownership
OTIS GORDY
ADP OF THE SNF
—
2022-03-11
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 48113
acs median gross
0
$1,385
2024-12-31
CENSUS_ACS5
county 48113
fmr
0
$1,582
2025-10-01
HUD_USER_FMR
county 48113
acs median gross
1
$1,400
2024-12-31
CENSUS_ACS5
county 48113
fmr
1
$1,648
2025-10-01
HUD_USER_FMR
county 48113
acs median gross
2
$1,638
2024-12-31
CENSUS_ACS5
county 48113
fmr
2
$1,931
2025-10-01
HUD_USER_FMR
county 48113
acs median gross
3
$1,823
2024-12-31
CENSUS_ACS5
county 48113
fmr
3
$2,431
2025-10-01
HUD_USER_FMR
county 48113
acs median gross
4
$2,241
2024-12-31
CENSUS_ACS5
county 48113
fmr
4
$3,091
2025-10-01
HUD_USER_FMR
county 48113
acs median gross
5
$2,432
2024-12-31
CENSUS_ACS5
county 48113
acs median gross
$1,565
2024-12-31
CENSUS_ACS5
county 48113
acs recent mover gross
$1,745
2024-12-31
CENSUS_ACS5
zcta 75243
acs median gross
0
$1,133
2024-12-31
CENSUS_ACS5
zcta 75243
acs median gross
1
$1,151
2024-12-31
CENSUS_ACS5
zcta 75243
acs median gross
2
$1,562
2024-12-31
CENSUS_ACS5
zcta 75243
acs median gross
3
$1,834
2024-12-31
CENSUS_ACS5
zcta 75243
acs median gross
4
$2,306
2024-12-31
CENSUS_ACS5
zcta 75243
acs median gross
$1,285
2024-12-31
CENSUS_ACS5
zcta 75243
acs recent mover gross
$1,273
2024-12-31
CENSUS_ACS5
zip 75243
payment standard 110
0
$1,639
2025-10-01
HUD_USER_SAFMR
zip 75243
payment standard 90
0
$1,341
2025-10-01
HUD_USER_SAFMR
zip 75243
safmr
0
$1,490
2025-10-01
HUD_USER_SAFMR
zip 75243
payment standard 110
1
$1,705
2025-10-01
HUD_USER_SAFMR
zip 75243
payment standard 90
1
$1,395
2025-10-01
HUD_USER_SAFMR
zip 75243
safmr
1
$1,550
2025-10-01
HUD_USER_SAFMR
zip 75243
payment standard 110
2
$2,002
2025-10-01
HUD_USER_SAFMR
zip 75243
payment standard 90
2
$1,638
2025-10-01
HUD_USER_SAFMR
zip 75243
safmr
2
$1,820
2025-10-01
HUD_USER_SAFMR
zip 75243
payment standard 110
3
$2,519
2025-10-01
HUD_USER_SAFMR
zip 75243
payment standard 90
3
$2,061
2025-10-01
HUD_USER_SAFMR
zip 75243
safmr
3
$2,290
2025-10-01
HUD_USER_SAFMR
zip 75243
payment standard 110
4
$3,201
2025-10-01
HUD_USER_SAFMR
zip 75243
payment standard 90
4
$2,619
2025-10-01
HUD_USER_SAFMR
zip 75243
safmr
4
$2,910
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.