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 14:57 UTC
Screener / 676053
D

Merkel Nursing Center

snfTXSFF: SFF Candidate
1704 N 1ST, Merkel, TX 79536 · CCN 676053
Composite
88.1 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
65
Model
v1.2
Reads as: riskier than 88.1% 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 model7ML signals2Components17CHOW radar1Distress radar1Staffing16Penalties4Deficiencies64Licensure0Ownership10Related party0Transactions1Comps12Market rent31

Composite explanation

7
ComponentPercentileRawWeightWeight shareContributionCounts
regulatory risk98.898.10.300.187518.53in index
staffing risk99.499.40.250.156315.53in index
financial risk66.456.70.300.187512.45in index
state reg risk63.715.00.300.187511.94in index
chow risk73.669.70.150.09386.90in index
billing conduct0.00.00.300.18750.00in index
ownership opacity7.635.0excluded
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

2
KindFindingSignalSubjectFirst seen
anomalyFederal penalty spikeno prior finesthis facility2026-07-29
connectionOwner spans multiple chains11 chainsMARTINEZ IRIZARRY AXEL12 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.

Component scores and registry models

17
Score typeScoreGradeModelStatusRegistry model notes
billing conduct0.0Av0.1-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 risk87.0Fv0.1-txhhscdefault · in compositeTexas licence reissue timing as an ownership-transfer proxy.
chow risk97.2Fv0.6default · in composite
financial risk56.7Cv0.5default · in compositeR18.
ownership opacity35.0Bv0.1-txhhscdefault · in compositeTexas HHSC directory ownership structure: chain size, absentee owner, management company, entity form, owner closure history.
p adverse action 12m0.0—v0.1default · 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 12m0.1—v0.1default · 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 risk98.1Fv0.3default · in compositeDeficiency-based, SNF population. Runs alongside v0.5-pos.
staffing risk99.4Fv0.3default · in compositeCost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS.
state reg risk15.0Av0.5default · in composite
financial risk40.3Bv0.3supersededPre-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 risk62.4Cv0.4supersededPre-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 risk98.0Fv0.1supersededPre-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 risk98.0Fv0.2supersededPre-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 risk99.4Fv0.1supersededPre-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 risk99.4Fv0.2supersededPre-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)
0.1%
model v0.1 · computed 2026-07-29
Percentile among SNFs
33.9
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
DriverValuePull on odds
Never sold on record0.00-1.62
Current owner tenure (years)4.57-1.40
Ownership changes, last 5 years1.00-0.87
Occupancy0.42+0.81
For-profit ownership1.00+0.69
Deficiencies, last 12 months29.00+0.53
No PBJ staffing report0.00+0.42
Chain size (log)0.00-0.40
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
0.0
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
DriverValuePull on odds
Deficiencies, last 12 months29.00-3.95
Occupancy0.42+1.39
Chain size (log)0.00+1.20
Fine amount, 12m (log)12.87-0.76
Total nurse staffing (HPRD)1.57+0.69
For-profit ownership1.00-0.69
No PBJ staffing report0.00+0.39
High-severity deficiencies, 12m5.00-0.36
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 facilityTX medianNational medianNational p25–p75
Total nurse1.572.673.282.90–3.77
RN0.240.240.390.25–0.58
Weekend total1.482.563.11—
Weekday total1.612.723.35—
QuarterDaysAvg censusTotal HPRDRNLPNCNAWeekendContract %
2025Q49227.21.570.241.060.281.480.0%
2025Q39227.31.950.121.310.521.810.0%
2025Q29129.51.820.221.050.551.740.0%
2025Q19030.51.970.231.080.661.740.0%
2024Q49233.51.930.201.080.661.780.0%
2024Q39234.91.680.240.860.581.650.0%
2024Q29132.21.840.290.950.601.810.0%
2024Q19134.91.860.200.970.691.910.4%
2023Q49236.51.630.061.040.531.667.6%
2023Q39236.71.570.051.020.491.6012.0%
2023Q29136.71.500.200.840.451.372.5%
2023Q19037.61.250.130.840.281.302.6%
2022Q49233.71.620.190.930.511.649.4%
2022Q39230.21.800.280.870.651.684.4%
2022Q29130.42.070.170.910.991.980.5%
2022Q19026.72.520.301.121.102.180.5%
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.

Penalties

4
fines by year
$210.9k$105.5k23242526
DateTypeFineSource
2026-02-16Fine$210,935CMS provider data
2025-08-22Fine$178,172CMS provider data
2023-06-26Fine$4,196CMS provider data
2023-06-20Fine$3,846CMS provider data
Total fines on record: $397,149

Deficiencies

64
B × 4C × 3D × 8E × 35F × 9K × 5
deficiencies by survey year
261323242526
SurveyTypeTagDeficiencyScopeCorrected
2026-02-16Health · complaintF0600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.K2026-03-04
2026-02-16Health · complaintF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.K2026-03-04
2026-02-16Health · complaintF0725Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.K2026-03-04
2026-02-16Health · complaintF0726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.K2026-03-04
2026-02-16Health · complaintF0727Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.F2026-03-04
2026-02-16Health · complaintF0728Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training.F2026-03-04
2026-02-16Health · complaintF0881Implement a program that monitors antibiotic use.F2026-03-04
2026-02-16Health · complaintF0882Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.F2026-03-04
2025-12-04HealthF0695Provide safe and appropriate respiratory care for a resident when needed.E2026-01-07
2025-12-04HealthF0842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.D2026-01-07
2025-12-04HealthF0849Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.E2026-01-07
2025-12-04HealthF0867Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.F2026-01-07
2025-12-04HealthF0880Provide and implement an infection prevention and control program.D2026-01-07
2025-12-04HealthF0909Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.E2026-01-07
2025-12-04HealthF0940Develop, implement, and/or maintain an effective training program for all new and existing staff members.E2026-01-07
2025-12-04HealthF0941Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.E2026-01-07
2025-12-04HealthF0942Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.E2026-01-07
2025-12-04HealthF0943Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.E2026-01-07
2025-12-04HealthF0944Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.E2026-01-07
2025-12-04HealthF0945Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.E2026-01-07
2025-12-04HealthF0949Provide behavior health training consistent with the requirements and as determined by a facility assessment.E2026-01-07
2025-08-22Health · complaintF0607Develop and implement policies and procedures to prevent abuse, neglect, and theft.E2025-09-17
2025-08-22Health · complaintF0609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.E2025-09-17
2025-08-22Health · complaintF0610Respond appropriately to all alleged violations.E2025-09-17
2025-08-22Health · complaintF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.K2025-09-01
2025-08-22Health · complaintF0801Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.F2025-09-25
2025-08-22Health · complaintF0835Administer the facility in a manner that enables it to use its resources effectively and efficiently.F2025-09-15
2025-08-22Health · complaintF0838Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.F2025-09-16
2025-08-22Health · complaintF0844Follow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel.C2025-09-18
2024-12-12Health · complaintF0880Provide and implement an infection prevention and control program.D2025-01-01
2024-10-17Health · complaintF0580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.E2024-11-08
2024-10-17Health · complaintF0655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedD2024-11-08
2024-10-17Health · complaintF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.E2024-11-08
2024-10-17Health · complaintF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.D2024-11-08
2024-10-17Health · complaintF0842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.E2024-11-08
2024-10-17Health · complaintF0926Have policies on smoking.E2024-11-08
2024-07-31Health · complaintF0550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.E2024-09-01
2024-07-31Health · complaintF0558Reasonably accommodate the needs and preferences of each resident.D2024-09-01
2024-07-31Health · complaintF0576Ensure residents have reasonable access to and privacy in their use of communication methods.C2024-08-31
2024-07-31Health · complaintF0607Develop and implement policies and procedures to prevent abuse, neglect, and theft.D2024-09-15
2024-07-31Health · complaintF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.E2024-09-01
2024-07-31Health · complaintF0680Ensure the activities program is directed by a qualified professional.C2024-08-19
2024-07-31Health · complaintF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.D2024-09-01
2024-07-31Health · complaintF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.E2024-09-05
2024-07-31Health · complaintF0695Provide safe and appropriate respiratory care for a resident when needed.E2024-09-05
2024-07-31Health · complaintF0728Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training.E2024-09-15
2024-07-31Health · complaintF0732Post nurse staffing information every day.B2024-09-05
2024-07-31Health · complaintF0803Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.E2024-09-02
2024-07-31Health · complaintF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E2024-09-02
2024-07-31Health · complaintF0868Have the Quality Assessment and Assurance group have the required members and meet at least quarterlyF2024-09-15
2024-07-31Health · complaintF0880Provide and implement an infection prevention and control program.E2024-09-02
2024-07-31Health · complaintF0909Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.E2024-08-20
2024-07-31Health · complaintF0941Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.B2024-09-05
2024-07-31Health · complaintF0944Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.B2024-09-05
2024-07-31Health · complaintF0949Provide behavior health training consistent with the requirements and as determined by a facility assessment.B2024-09-05
2023-12-15Health · complaintF0908Keep all essential equipment working safely.E2023-12-20
2023-06-08Health · complaintF0558Reasonably accommodate the needs and preferences of each resident.E2023-07-07
2023-06-08Health · complaintF0567Honor the resident's right to manage his or her financial affairs.E2023-07-07
2023-06-08Health · complaintF0711Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.E2023-07-07
2023-06-08Health · complaintF0727Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.E2023-07-07
2023-06-08Health · complaintF0761Ensure 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.E2023-07-07
2023-06-08Health · complaintF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E2023-07-07
2023-06-08Health · complaintF0868Have the Quality Assessment and Assurance group have the required members and meet at least quarterlyE2023-07-07
2023-06-08Health · complaintF0880Provide and implement an infection prevention and control program.E2023-07-07
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

10
OwnerRolePctFromStatusSource
ALEXANDER, JOEADP OF THE SNF—2022-01-01currentpecos_ownership
ALEXANDER, RAINEYOPERATIONAL/MANAGERIAL CONTROL—2022-01-01currentpecos_ownership
EMI HEALTH CARE CENTER, LLC——2026-01-01currenttx_hhsc_directory
MARTINEZ IRIZARRY, AXELADP OF THE SNF—2025-01-01currentpecos_ownership
STROH PROPERTIES LPADP OF THE SNF—2022-01-01currentpecos_ownership
STROH, CLARENCEADP OF THE SNF—2022-01-01currentpecos_ownership
RAINEY ALEXANDERDIRECT OWNERSHIP INTEREST100%2022-01-01ended 2026-05-18pecos_ownership
AXEL MARTINEZ IRIZARRYADP OF THE SNF—2025-01-01ended 2026-05-18pecos_ownership
CLARENCE STROHADP OF THE SNF—2022-01-01ended 2026-05-18pecos_ownership
JOE ALEXANDERADP OF THE SNF—2022-01-01ended 2026-05-18pecos_ownership
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.

Transactions

1
Close datePriceBuyerSellerEvidence
2022-01-01—EMI HEALTHCARE LLCDISTINGUISHED HEALTH CARE INC.chow

Comparable trades — TX snf

12
CloseFacilityPrice$/bedCap rateBedsBuyer
2025-10-01ST. ANTHONY'S CARE CENTER———120SOUTH LIMESTONE HOSPITAL DISTRICT
2025-10-01Avir at New Braunfels———154821 US HIGHWAY 81 W OPCO LLC
2025-09-01Avir at Texarkana———110GUADALUPE COUNTY HOSPITAL BOARD
2025-09-01PARKS HEALTH CENTER———90WEST COKE COUNTY HOSPITAL DISTRICT
2025-09-01WINDMILL VILLAGE REHABILITATION & CARE CENTER———120FANNIN COUNTY HOSPITAL AUTHORITY
2025-08-31Las Ventanas De Socorro———126SOCORRO HEALTH CARE LLC
2025-08-01Avir at Mineola———115HOPKINS COUNTY HOSPITAL DISTRICT
2025-08-01Avir at Orem———1203730 W OREM DR OPCO LLC
2025-08-01Avir at Courtyard———1207499 STANWICK DR OPCO LLC
2025-08-01HILLSIDE MEDICAL LODGE———128CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
2025-08-01Avir at Pasadena———1314300 VISTA RD OPCO LLC
2025-07-01Highland Meadows———120NOCONA 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

31
GeoKindBRAmountAs ofSource
county 48441acs median gross0$8382024-12-31CENSUS_ACS5
county 48441fmr0$1,0102025-10-01HUD_USER_FMR
county 48441acs median gross1$8942024-12-31CENSUS_ACS5
county 48441fmr1$1,0202025-10-01HUD_USER_FMR
county 48441acs median gross2$1,1362024-12-31CENSUS_ACS5
county 48441fmr2$1,2762025-10-01HUD_USER_FMR
county 48441acs median gross3$1,4852024-12-31CENSUS_ACS5
county 48441fmr3$1,6532025-10-01HUD_USER_FMR
county 48441acs median gross4$1,6592024-12-31CENSUS_ACS5
county 48441fmr4$1,9872025-10-01HUD_USER_FMR
county 48441acs median gross5$1,3462024-12-31CENSUS_ACS5
county 48441acs median gross$1,1592024-12-31CENSUS_ACS5
county 48441acs recent mover gross$1,1852024-12-31CENSUS_ACS5
zcta 79536acs median gross2$7552024-12-31CENSUS_ACS5
zcta 79536acs median gross3$1,1962024-12-31CENSUS_ACS5
zcta 79536acs median gross$1,1982024-12-31CENSUS_ACS5
zip 79536payment standard 1100$1,2762025-10-01HUD_USER_SAFMR
zip 79536payment standard 900$1,0442025-10-01HUD_USER_SAFMR
zip 79536safmr0$1,1602025-10-01HUD_USER_SAFMR
zip 79536payment standard 1101$1,2872025-10-01HUD_USER_SAFMR
zip 79536payment standard 901$1,0532025-10-01HUD_USER_SAFMR
zip 79536safmr1$1,1702025-10-01HUD_USER_SAFMR
zip 79536payment standard 1102$1,6062025-10-01HUD_USER_SAFMR
zip 79536payment standard 902$1,3142025-10-01HUD_USER_SAFMR
zip 79536safmr2$1,4602025-10-01HUD_USER_SAFMR
zip 79536payment standard 1103$2,0792025-10-01HUD_USER_SAFMR
zip 79536payment standard 903$1,7012025-10-01HUD_USER_SAFMR
zip 79536safmr3$1,8902025-10-01HUD_USER_SAFMR
zip 79536payment standard 1104$2,4972025-10-01HUD_USER_SAFMR
zip 79536payment standard 904$2,0432025-10-01HUD_USER_SAFMR
zip 79536safmr4$2,2702025-10-01HUD_USER_SAFMR
ACS median gross rents and HUD FMR/SAFMR for the facility's county and ZIP. Context for underwriting, not facility pricing.
CII Terminal tearsheet · Merkel Nursing Center (676053) · generated 2026-08-04 · every number derives from public records (CMS Care Compare, PBJ, POS, penalty and survey files, state licensure registers) · scores are published model outputs with holdout metrics disclosed at cii-terminal.vercel.app/transparency