Composite
16.0 / 100 percentile
Screener / 675880
A
Sterling Nursing and Rehab
snfTX
309 FIFTH ST, STERLING CITY, TX 76951 · CCN 675880
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
44
Model
v1.2
Reads as: riskier than 16.0% 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 model5Components16CHOW radar1Distress radar1Staffing16Penalties2Deficiencies13Licensure0Ownership7Related party0Transactions0Comps12Market rent26
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| financial risk | 82.4 | 69.2 | 0.30 | 0.2308 | 19.02 | in index |
| chow risk | 77.6 | 55.9 | 0.15 | 0.1154 | 8.95 | in index |
| regulatory risk | 15.9 | 10.3 | 0.30 | 0.2308 | 3.67 | in index |
| staffing risk | 10.8 | 10.9 | 0.25 | 0.1923 | 2.08 | in index |
| billing conduct | 0.0 | 0.0 | 0.30 | 0.2308 | 0.00 | 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
16| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 0.0 | A | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 45.0 | C | 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. |
| chow risk | 66.7 | D | v0.6 | default · in composite | |
| financial risk | 69.2 | D | v0.5 | default · in composite | R18. |
| p adverse action 12m | 13.1 | — | 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 | 0.8 | — | 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 | 10.3 | A | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 10.9 | A | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 51.4 | C | v0.1 | superseded | 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. |
| financial risk | 31.4 | B | v0.2 | superseded | 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. |
| financial risk | 61.3 | C | v0.3 | superseded | 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. |
| financial risk | 70.8 | D | v0.4 | superseded | 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. |
| regulatory risk | 10.2 | 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 | 10.2 | 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 | 10.9 | 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 | 10.9 | 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)
0.8%
model v0.1 · computed 2026-07-29
Percentile among SNFs
57.9
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | -1.24 | |
| Occupancy | 0.48 | +0.62 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Chain size (log) | 0.00 | -0.40 | |
| Total nurse staffing (HPRD) | 4.31 | -0.25 | |
| Ownership changes, last 5 years | 0.00 | +0.20 |
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)
13.1%
model v0.1 · computed 2026-07-29
Percentile among SNFs
99.5
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | +1.62 | |
| Chain size (log) | 0.00 | +1.20 | |
| Occupancy | 0.48 | +1.12 | |
| Deficiencies, last 12 months | 4.00 | +0.69 | |
| Staffing trend, last 4 quarters | 1.38 | +0.62 | |
| Total nurse staffing (HPRD) | 4.31 | -0.46 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Fine amount, 12m (log) | 0.00 | +0.18 |
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 | 4.31 | 2.67 | 3.28 | 2.90–3.77 |
| RN | 0.31 | 0.24 | 0.39 | 0.25–0.58 |
| Weekend total | 3.81 | 2.56 | 3.11 | — |
| Weekday total | 4.51 | 2.72 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 21.2 | 4.31 | 0.31 | 1.10 | 2.90 | 3.81 | 6.9% |
| 2025Q3 | 92 | 22.2 | 4.47 | 0.34 | 1.09 | 3.03 | 3.62 | 8.3% |
| 2025Q2 | 91 | 23.8 | 4.02 | 0.41 | 1.02 | 2.59 | 3.45 | 12.6% |
| 2025Q1 | 90 | 28.0 | 3.45 | 0.41 | 0.82 | 2.22 | 3.13 | 7.5% |
| 2024Q4 | 92 | 31.1 | 2.93 | 0.26 | 0.83 | 1.84 | 2.56 | 10.5% |
| 2024Q3 | 92 | 30.3 | 3.21 | 0.44 | 0.70 | 2.07 | 2.95 | 14.7% |
| 2024Q2 | 91 | 27.5 | 3.48 | 0.37 | 0.94 | 2.16 | 3.17 | 3.5% |
| 2024Q1 | 91 | 28.5 | 3.39 | 0.25 | 0.96 | 2.18 | 3.25 | 10.6% |
| 2023Q4 | 92 | 27.8 | 3.48 | 0.20 | 1.02 | 2.26 | 3.27 | 11.7% |
| 2023Q3 | 92 | 30.2 | 3.36 | 0.21 | 0.97 | 2.18 | 3.15 | 27.4% |
| 2023Q2 | 91 | 29.8 | 3.52 | 0.23 | 0.97 | 2.32 | 2.94 | 27.9% |
| 2023Q1 | 90 | 28.0 | 3.40 | 0.31 | 1.06 | 2.04 | 2.95 | 21.1% |
| 2022Q4 | 92 | 26.9 | 3.42 | 0.31 | 1.02 | 2.10 | 2.92 | 15.9% |
| 2022Q3 | 92 | 24.5 | 4.11 | 0.28 | 1.29 | 2.54 | 3.54 | 29.0% |
| 2022Q2 | 91 | 23.6 | 3.74 | 0.20 | 1.27 | 2.27 | 3.53 | 28.0% |
| 2022Q1 | 90 | 23.1 | 3.77 | 0.19 | 1.34 | 2.24 | 3.45 | 11.8% |
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
2fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2024-08-23 | Payment Denial | — | CMS provider data |
| 2023-06-22 | Fine | $7,443 | CMS provider data |
Total fines on record: $7,443
Deficiencies
13D × 1E × 7F × 4G × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-09-11 | Health · complaint | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | 2025-09-20 |
| 2025-09-11 | Health · complaint | F0805 | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | E | 2025-10-01 |
| 2025-09-11 | Health | F0880 | Provide and implement an infection prevention and control program. | F | 2025-10-10 |
| 2025-09-11 | Health · complaint | F0908 | Keep all essential equipment working safely. | F | 2025-09-15 |
| 2024-08-08 | 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 | 2024-08-16 |
| 2024-08-08 | Health | F0700 | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | D | 2024-08-16 |
| 2024-08-08 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-08-16 |
| 2024-08-08 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2024-08-16 |
| 2023-06-22 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2023-07-14 |
| 2023-06-22 | Health | F0726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | E | 2023-07-14 |
| 2023-06-22 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2023-07-14 |
| 2023-06-22 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2023-07-14 |
| 2023-06-22 | Health | F0914 | Provide bedrooms that don't allow residents to see each other when privacy is needed. | E | 2023-07-14 |
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
7| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| STERLING COUNTY NURSING HOME | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2001-07-20 | current | pecos_ownership |
| COUNTS, BELINDA | MANAGING CONTROL - GOVERNING BODY | — | 2024-12-01 | current | pecos_ownership |
| FOWLER, JASON | ADP OF THE SNF | — | 2020-07-01 | current | pecos_ownership |
| HUNT, JOHN | OPERATIONAL/MANAGERIAL CONTROL | — | 2020-07-01 | current | pecos_ownership |
| DOUG HUDSON | CONTRACTED MANAGING EMPLOYEE | 100% | 2011-07-18 | ended 2026-05-18 | pecos_ownership |
| JEFFERY TOMPKINS | W-2 MANAGING EMPLOYEE | 0% | 2017-03-20 | ended 2026-05-18 | pecos_ownership |
| STERLING CITY HEALTHCARE PARTNERS LLC | OPERATIONAL/MANAGERIAL CONTROL | 0% | 2011-07-25 | 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
0No 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 — TX snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-10-01 | ST. ANTHONY'S CARE CENTER | — | — | — | 120 | SOUTH LIMESTONE HOSPITAL DISTRICT |
| 2025-10-01 | Avir at New Braunfels | — | — | — | 154 | 821 US HIGHWAY 81 W OPCO LLC |
| 2025-09-01 | Avir at Texarkana | — | — | — | 110 | GUADALUPE COUNTY HOSPITAL BOARD |
| 2025-09-01 | PARKS HEALTH CENTER | — | — | — | 90 | WEST COKE COUNTY HOSPITAL DISTRICT |
| 2025-09-01 | WINDMILL VILLAGE REHABILITATION & CARE CENTER | — | — | — | 120 | FANNIN COUNTY HOSPITAL AUTHORITY |
| 2025-08-31 | Las Ventanas De Socorro | — | — | — | 126 | SOCORRO HEALTH CARE LLC |
| 2025-08-01 | Avir at Mineola | — | — | — | 115 | HOPKINS COUNTY HOSPITAL DISTRICT |
| 2025-08-01 | Avir at Orem | — | — | — | 120 | 3730 W OREM DR OPCO LLC |
| 2025-08-01 | Avir at Courtyard | — | — | — | 120 | 7499 STANWICK DR OPCO LLC |
| 2025-08-01 | HILLSIDE MEDICAL LODGE | — | — | — | 128 | CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY |
| 2025-08-01 | Avir at Pasadena | — | — | — | 131 | 4300 VISTA RD OPCO LLC |
| 2025-07-01 | Highland Meadows | — | — | — | 120 | NOCONA HOSPITAL DISTRICT |
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
26| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 48431 | fmr | 0 | $789 | 2025-10-01 | HUD_USER_FMR |
| county 48431 | fmr | 1 | $899 | 2025-10-01 | HUD_USER_FMR |
| county 48431 | acs median gross | 2 | $993 | 2024-12-31 | CENSUS_ACS5 |
| county 48431 | fmr | 2 | $1,133 | 2025-10-01 | HUD_USER_FMR |
| county 48431 | acs median gross | 3 | $979 | 2024-12-31 | CENSUS_ACS5 |
| county 48431 | fmr | 3 | $1,519 | 2025-10-01 | HUD_USER_FMR |
| county 48431 | fmr | 4 | $1,871 | 2025-10-01 | HUD_USER_FMR |
| county 48431 | acs median gross | $952 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 76951 | acs median gross | 2 | $993 | 2024-12-31 | CENSUS_ACS5 |
| zcta 76951 | acs median gross | 3 | $979 | 2024-12-31 | CENSUS_ACS5 |
| zcta 76951 | acs median gross | $952 | 2024-12-31 | CENSUS_ACS5 | |
| zip 76951 | payment standard 110 | 0 | $968 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | payment standard 90 | 0 | $792 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | safmr | 0 | $880 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | payment standard 110 | 1 | $990 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | payment standard 90 | 1 | $810 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | safmr | 1 | $900 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | payment standard 110 | 2 | $1,254 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | payment standard 90 | 2 | $1,026 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | safmr | 2 | $1,140 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | payment standard 110 | 3 | $1,683 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | payment standard 90 | 3 | $1,377 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | safmr | 3 | $1,530 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | payment standard 110 | 4 | $2,068 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | payment standard 90 | 4 | $1,692 | 2025-10-01 | HUD_USER_SAFMR |
| zip 76951 | safmr | 4 | $1,880 | 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.