Reads as: riskier than 44.6% 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
17
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
24 chains
LUMENT REAL ESTATE CAPITAL LLC
45 facilities
connection
Owner spans multiple chains
18 chains
PLANTE MORAN PLLC
55 facilities
connection
Owner spans multiple chains
15 chains
AEGIS THERAPIES INC
32 facilities
connection
Owner spans multiple chains
9 chains
FELLBAUM ERNEST
26 facilities
connection
Owner spans multiple chains
9 chains
TRIDENT HEALTHCARE SERVICES INC
24 facilities
connection
Owner spans multiple chains
9 chains
STUDER STANLEY
26 facilities
connection
Owner spans multiple chains
8 chains
TOUCHSTONE COMMUNITIES INC
23 facilities
connection
Owner spans multiple chains
8 chains
ZUROVEC DARRELL
23 facilities
connection
Owner spans multiple chains
8 chains
NUTRITIOUS LIFESTYLES INC
18 facilities
connection
Owner spans multiple chains
8 chains
SEHLKE BRYON
22 facilities
connection
Owner spans multiple chains
8 chains
CASTILLO LYNNEA
23 facilities
connection
Owner spans multiple chains
8 chains
CARVAJAL PHARMACY LTC
22 facilities
connection
Owner spans multiple chains
7 chains
CAMPBELL LESLIE
22 facilities
connection
Owner fleet enforcement cluster
50% fined
ALAMO ADVISORS LP
8 facilities
connection
Owner fleet enforcement cluster
41% fined
CAMPBELL LESLIE
22 facilities
connection
Owner fleet enforcement cluster
41% fined
SEHLKE BRYON
22 facilities
connection
Owner fleet enforcement cluster
41% fined
STUDER STANLEY
27 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
2.65
2.67
3.28
2.90–3.77
RN
0.47
0.24
0.39
0.25–0.58
Weekend total
2.26
2.56
3.11
—
Weekday total
2.80
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
76.7
2.65
0.47
0.37
1.81
2.26
2.3%
2025Q3
92
78.3
2.76
0.35
0.56
1.85
2.29
2.4%
2025Q2
91
75.5
2.74
0.30
0.59
1.84
2.31
2.5%
2025Q1
90
79.2
2.65
0.29
0.60
1.75
2.38
2.5%
2024Q4
92
78.5
2.61
0.33
0.55
1.73
2.36
2.5%
2024Q3
92
77.9
2.60
0.39
0.46
1.75
2.46
2.7%
2024Q2
91
80.3
2.33
0.37
0.37
1.59
2.19
0.0%
2024Q1
91
81.7
2.03
0.30
0.41
1.32
1.94
0.0%
2023Q4
92
86.3
1.96
0.27
0.38
1.31
1.85
0.5%
2023Q3
92
83.1
2.14
0.28
0.47
1.40
2.02
7.3%
2023Q2
91
81.6
2.18
0.24
0.47
1.47
2.05
26.0%
2023Q1
90
79.4
2.33
0.24
0.57
1.52
2.15
22.2%
2022Q4
92
79.6
2.24
0.30
0.55
1.40
2.05
15.0%
2022Q3
92
79.3
1.74
0.28
0.53
0.93
1.72
4.5%
2022Q2
91
79.4
1.81
0.27
0.65
0.89
1.68
0.0%
2022Q1
90
76.2
1.99
0.28
0.70
1.01
1.81
9.5%
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 care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
D
2025-12-18
2025-12-17
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
E
2025-12-18
2025-12-17
Health
F0921
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
E
2026-01-31
2025-11-21
Health · complaint
F0555
Honor the resident's right to choose his or her attending physician.
D
2025-11-22
2025-11-21
Health · complaint
F0627
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
D
2025-11-22
2024-09-18
Health · complaint
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
E
2024-09-19
2024-09-18
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
E
2024-09-19
2024-09-18
Health · complaint
F0921
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
E
2024-10-14
2024-09-18
Health · complaint
F0944
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
D
2024-09-19
2023-08-02
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
2023-08-03
2023-08-02
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
2023-08-03
2023-08-02
Health
F0921
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
E
2023-08-03
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
36
Owner
Role
Pct
From
Status
Source
BEXAR COUNTY HOSPITAL DISTRICT
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2015-02-28
current
pecos_ownership
AEGIS THERAPIES, INC.
ADP OF THE SNF
—
2015-02-28
current
pecos_ownership
ALAMO ADVISORS LP
ADP OF THE SNF
—
2015-02-28
current
pecos_ownership
BARBOSA, MARY ANN
OPERATIONAL/MANAGERIAL CONTROL
—
2021-09-13
current
pecos_ownership
BEXAR COUNTY HOSPITAL DISTRICT
—
—
2025-02-28
current
tx_hhsc_directory
CAMPBELL, LESLIE
ADP OF THE SNF
—
2020-04-01
current
pecos_ownership
CARE INN REALTY - LAVERNIA LLC
ADP OF THE SNF
—
2015-02-28
current
pecos_ownership
CARVAJAL PHARMACY LTC
ADP OF THE SNF
—
2017-07-01
current
pecos_ownership
CASTILLO, LYNNEA
ADP OF THE SNF
—
2015-02-28
current
pecos_ownership
CLAYTON, JONATHON
OPERATIONAL/MANAGERIAL CONTROL
—
2023-05-01
current
pecos_ownership
FELLBAUM, ERNEST
ADP OF THE SNF
—
2015-02-28
current
pecos_ownership
HURLEY, CHRISTOPHER
CORPORATE OFFICER
—
2014-09-26
current
pecos_ownership
LUMENT REAL ESTATE CAPITAL LLC
5% OR GREATER MORTGAGE INTEREST
—
2014-05-05
current
pecos_ownership
NUTRITIOUS LIFESTYLES, INC.
ADP OF THE SNF
—
2015-02-28
current
pecos_ownership
PLANTE & MORAN PLLC
ADP OF THE SNF
—
2015-02-28
current
pecos_ownership
SEHLKE, BRYON
OPERATIONAL/MANAGERIAL CONTROL
—
2016-12-16
current
pecos_ownership
STUDER, STANLEY
ADP OF THE SNF
—
2015-02-28
current
pecos_ownership
THOMPSON, CHASE
OPERATIONAL/MANAGERIAL CONTROL
—
2020-08-16
current
pecos_ownership
TOUCHSTONE COMMUNITIES INC
ADP OF THE SNF
—
2015-02-28
current
pecos_ownership
TOUCHSTONE STRATEGIES LA VERNIA LLC
—
—
2025-02-28
current
tx_hhsc_directory
TOUCHSTONE STRATEGIES - LAVERNIA LLC
ADP OF THE SNF
—
2025-07-24
current
pecos_ownership
TOUCHSTONE STRATEGIES - LAVERNIA LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2016-03-01
current
pecos_ownership
TRIDENT HEALTH SERVICES INC
ADP OF THE SNF
—
2015-02-28
current
pecos_ownership
ZERTUCHE, BENJAMIN
OPERATIONAL/MANAGERIAL CONTROL
—
2016-12-01
current
pecos_ownership
ZUROVEC, DARRELL
OPERATIONAL/MANAGERIAL CONTROL
—
2017-08-01
current
pecos_ownership
BENJAMIN ZERTUCHE
ADP OF THE SNF
—
2016-12-01
ended 2026-05-18
pecos_ownership
BRYON SEHLKE
ADP OF THE SNF
—
2016-12-16
ended 2026-05-18
pecos_ownership
CHASE THOMPSON
OPERATIONAL/MANAGERIAL CONTROL
—
2020-08-16
ended 2026-05-18
pecos_ownership
CHRISTOPHER HURLEY
CORPORATE OFFICER
—
2014-09-26
ended 2026-05-18
pecos_ownership
DARRELL ZUROVEC
OPERATIONAL/MANAGERIAL CONTROL
—
2017-08-01
ended 2026-05-18
pecos_ownership
ERNEST FELLBAUM
ADP OF THE SNF
—
2015-02-28
ended 2026-05-18
pecos_ownership
JONATHON CLAYTON
OPERATIONAL/MANAGERIAL CONTROL
—
2023-05-01
ended 2026-05-18
pecos_ownership
LESLIE CAMPBELL
ADP OF THE SNF
—
2020-04-01
ended 2026-05-18
pecos_ownership
LYNNEA CASTILLO
OPERATIONAL/MANAGERIAL CONTROL
—
2015-02-28
ended 2026-05-18
pecos_ownership
MARY ANN BARBOSA
OPERATIONAL/MANAGERIAL CONTROL
—
2021-09-13
ended 2026-05-18
pecos_ownership
STANLEY STUDER
ADP OF THE SNF
—
2015-02-28
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.
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.
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
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 78121
acs median gross
1
$947
2024-12-31
CENSUS_ACS5
zcta 78121
acs median gross
2
$1,037
2024-12-31
CENSUS_ACS5
zcta 78121
acs median gross
3
$1,507
2024-12-31
CENSUS_ACS5
zcta 78121
acs median gross
4
$3,501
2024-12-31
CENSUS_ACS5
zcta 78121
acs median gross
$1,192
2024-12-31
CENSUS_ACS5
zcta 78121
acs recent mover gross
$1,342
2024-12-31
CENSUS_ACS5
zip 78121
payment standard 110
0
$1,100
2025-10-01
HUD_USER_SAFMR
zip 78121
payment standard 90
0
$900
2025-10-01
HUD_USER_SAFMR
zip 78121
safmr
0
$1,000
2025-10-01
HUD_USER_SAFMR
zip 78121
payment standard 110
1
$1,199
2025-10-01
HUD_USER_SAFMR
zip 78121
payment standard 90
1
$981
2025-10-01
HUD_USER_SAFMR
zip 78121
safmr
1
$1,090
2025-10-01
HUD_USER_SAFMR
zip 78121
payment standard 110
2
$1,463
2025-10-01
HUD_USER_SAFMR
zip 78121
payment standard 90
2
$1,197
2025-10-01
HUD_USER_SAFMR
zip 78121
safmr
2
$1,330
2025-10-01
HUD_USER_SAFMR
zip 78121
payment standard 110
3
$1,859
2025-10-01
HUD_USER_SAFMR
zip 78121
payment standard 90
3
$1,521
2025-10-01
HUD_USER_SAFMR
zip 78121
safmr
3
$1,690
2025-10-01
HUD_USER_SAFMR
zip 78121
payment standard 110
4
$2,178
2025-10-01
HUD_USER_SAFMR
zip 78121
payment standard 90
4
$1,782
2025-10-01
HUD_USER_SAFMR
zip 78121
safmr
4
$1,980
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.