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 17:24 UTC
Screener / 505183
B

Avalon Healthcare - Tacoma

snfWA
7411 PACIFIC AVENUE, TACOMA, WA 98408 · CCN 505183
Composite
58.2 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
81
Model
v1.2
Reads as: riskier than 58.2% 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 model5ML signals2Components16CHOW radar1Distress radar1Staffing16Penalties1Deficiencies82Licensure0Ownership53Related party5Transactions1Comps12Market rent34

Composite explanation

5
ComponentPercentileRawWeightWeight shareContributionCounts
financial risk93.682.30.300.230821.60in index
regulatory risk91.088.70.300.230821.00in index
chow risk62.361.50.150.11547.19in index
staffing risk8.28.30.250.19231.58in index
billing conduct0.00.00.300.23080.00in 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.

ML signals — parallel engine

2
KindFindingSignalSubjectFirst seen
connectionOwner fleet enforcement cluster40% finedTHE BYRON A KIRTON INDIVIDUAL TR5 facilities
connectionOwner fleet enforcement cluster40% finedHYRUM A KIRTON INDIVIDUAL TR5 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

16
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 risk97.9Fv0.6default · in composite
financial risk82.3Fv0.5default · in compositeR18.
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 12m0.0—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 risk88.7Fv0.3default · in compositeDeficiency-based, SNF population. Runs alongside v0.5-pos.
staffing risk8.3Av0.3default · in compositeCost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS.
financial risk93.0Fv0.1supersededPre-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 risk73.0Dv0.2supersededPre-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 risk73.2Dv0.3supersededPre-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 risk80.8Fv0.4supersededPre-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 risk88.6Fv0.1supersededPre-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 risk88.6Fv0.2supersededPre-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 risk8.3Av0.1supersededPre-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 risk8.3Av0.2supersededPre-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)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
7.0
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
DriverValuePull on odds
Current owner tenure (years)1.38-1.71
Never sold on record0.00-1.62
Ownership changes, last 5 years1.00-0.87
For-profit ownership1.00+0.69
Deficiencies, last 12 months25.00+0.44
No PBJ staffing report0.00+0.42
Chain size (log)0.00-0.40
Total nurse staffing (HPRD)4.49-0.29
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
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 months25.00-3.21
Chain size (log)0.00+1.20
For-profit ownership1.00-0.69
Fine amount, 12m (log)10.55-0.59
Occupancy0.62+0.56
Total nurse staffing (HPRD)4.49-0.54
No PBJ staffing report0.00+0.39
Never sold on record0.00-0.28
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

16
2025Q4 HPRDThis facilityWA medianNational medianNational p25–p75
Total nurse4.493.703.282.90–3.77
RN0.630.620.390.25–0.58
Weekend total4.193.513.11—
Weekday total4.603.793.35—
QuarterDaysAvg censusTotal HPRDRNLPNCNAWeekendContract %
2025Q49249.94.490.630.793.074.191.1%
2025Q39251.34.260.510.812.944.091.0%
2025Q29162.03.920.340.962.623.885.0%
2025Q19062.93.670.230.982.463.5510.2%
2024Q49257.43.990.520.872.603.6118.5%
2024Q39255.33.650.440.872.333.3512.7%
2024Q29159.43.480.221.202.063.431.0%
2024Q19161.43.640.261.092.293.502.4%
2023Q49256.73.990.540.952.503.872.4%
2023Q39253.03.300.380.981.943.102.7%
2023Q29152.53.530.201.102.223.2614.5%
2023Q19055.53.580.111.122.353.2824.9%
2022Q49244.83.940.331.262.353.5413.3%
2022Q39239.54.020.401.292.323.7025.7%
2022Q29120.14.400.881.292.233.693.6%
2022Q19021.34.231.151.042.043.957.7%
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.

Penalties

1
DateTypeFineSource
2025-07-30Fine$38,175CMS provider data
Total fines on record: $38,175

Deficiencies

82
C × 3D × 44E × 32F × 2G × 1
deficiencies by survey year
341723242526
SurveyTypeTagDeficiencyScopeCorrected
2026-03-06Health · complaintF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.D2026-04-07
2025-07-30HealthF0582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.E2025-09-10
2025-07-30HealthF0584Honor 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.E2025-09-10
2025-07-30HealthF0604Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.E2025-09-10
2025-07-30HealthF0605Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.D2025-09-10
2025-07-30HealthF0628Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.D2025-09-10
2025-07-30HealthF0637Assess the resident when there is a significant change in conditionD2025-09-10
2025-07-30HealthF0641Ensure each resident receives an accurate assessment.D2025-09-10
2025-07-30HealthF0645PASARR screening for Mental disorders or Intellectual DisabilitiesE2025-09-10
2025-07-30HealthF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.E2025-09-10
2025-07-30HealthF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.D2025-09-10
2025-07-30HealthF0679Provide activities to meet all resident's needs.D2025-09-10
2025-07-30HealthF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.D2025-09-10
2025-07-30HealthF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.D2025-09-10
2025-07-30HealthF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.D2025-09-10
2025-07-30HealthF0692Provide enough food/fluids to maintain a resident's health.D2025-09-10
2025-07-30HealthF0693Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.D2025-09-10
2025-07-30HealthF0757Ensure each resident’s drug regimen must be free from unnecessary drugs.E2025-09-10
2025-07-30HealthF0790Provide routine and 24-hour emergency dental care for each resident.D2025-09-10
2025-07-30HealthF0791Provide or obtain dental services for each resident.E2025-09-10
2025-07-30HealthF0804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.F2025-09-10
2025-07-30HealthF0880Provide and implement an infection prevention and control program.D2025-09-10
2025-07-30HealthF0881Implement a program that monitors antibiotic use.E2025-09-10
2025-07-30HealthF0883Develop and implement policies and procedures for flu and pneumonia vaccinations.E2025-09-10
2025-07-30HealthF0919Make sure that a working call system is available in each resident's bathroom and bathing area.D2025-09-10
2025-05-07Health · complaintF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.E2025-06-10
2025-03-11Health · complaintF0660Plan the resident's discharge to meet the resident's goals and needs.E2025-04-15
2025-03-11Health · complaintF0677Provide care and assistance to perform activities of daily living for any resident who is unable.D2025-04-15
2025-03-11Health · complaintF0807Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.E2025-04-15
2024-12-30Health · complaintF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.G2025-01-14
2024-10-09HealthF0550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.D2024-11-22
2024-10-09HealthF0561Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.D2024-11-22
2024-10-09HealthF0565Honor the resident's right to organize and participate in resident/family groups in the facility.E2024-11-22
2024-10-09HealthF0567Honor the resident's right to manage his or her financial affairs.E2024-11-22
2024-10-09HealthF0568Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.E2024-11-22
2024-10-09HealthF0584Honor 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.E2024-11-22
2024-10-09HealthF0585Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.D2024-11-22
2024-10-09HealthF0623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.D2024-11-22
2024-10-09HealthF0625Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.D2024-11-22
2024-10-09HealthF0641Ensure each resident receives an accurate assessment.D2024-11-22
2024-10-09HealthF0644Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.D2024-11-22
2024-10-09HealthF0645PASARR screening for Mental disorders or Intellectual DisabilitiesD2024-11-22
2024-10-09HealthF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.E2024-11-22
2024-10-09HealthF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.E2024-11-22
2024-10-09HealthF0677Provide care and assistance to perform activities of daily living for any resident who is unable.D2024-11-22
2024-10-09HealthF0679Provide activities to meet all resident's needs.D2024-11-22
2024-10-09HealthF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.E2024-11-22
2024-10-09HealthF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.D2024-11-22
2024-10-09HealthF0688Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.D2024-11-22
2024-10-09HealthF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.D2024-11-22
2024-10-09HealthF0692Provide enough food/fluids to maintain a resident's health.D2024-11-22
2024-10-09HealthF0695Provide safe and appropriate respiratory care for a resident when needed.D2024-11-22
2024-10-09HealthF0756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.D2024-11-22
2024-10-09HealthF0757Ensure each resident’s drug regimen must be free from unnecessary drugs.E2024-11-22
2024-10-09HealthF0758Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.D2024-11-22
2024-10-09HealthF0761Ensure 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.D2024-11-22
2024-10-09HealthF0791Provide or obtain dental services for each resident.D2024-11-22
2024-10-09HealthF0804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.F2024-11-22
2024-10-09HealthF0808Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.E2024-11-22
2024-10-09HealthF0881Implement a program that monitors antibiotic use.E2024-11-22
2024-10-09HealthF0883Develop and implement policies and procedures for flu and pneumonia vaccinations.E2024-11-22
2024-10-09HealthF0887Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.E2024-11-22
2024-01-26Health · complaintF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.D2024-02-27
2023-11-09HealthF0552Ensure that residents are fully informed and understand their health status, care and treatments.D2023-12-21
2023-11-09HealthF0565Honor the resident's right to organize and participate in resident/family groups in the facility.E2023-12-21
2023-11-09HealthF0584Honor 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.E2023-12-21
2023-11-09HealthF0625Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.C2023-12-21
2023-11-09HealthF0655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedD2023-12-21
2023-11-09HealthF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.E2023-12-21
2023-11-09HealthF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.D2023-12-21
2023-11-09HealthF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.D2023-12-21
2023-11-09HealthF0695Provide safe and appropriate respiratory care for a resident when needed.D2023-12-21
2023-11-09HealthF0698Provide safe, appropriate dialysis care/services for a resident who requires such services.D2023-12-21
2023-11-09HealthF0732Post nurse staffing information every day.D2023-12-21
2023-11-09HealthF0756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.E2023-12-21
2023-11-09HealthF0757Ensure each resident’s drug regimen must be free from unnecessary drugs.E2023-12-21
2023-11-09HealthF0758Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.E2023-12-21
2023-11-09HealthF0761Ensure 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.E2023-12-21
2023-11-09HealthF0847Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.C2023-12-21
2023-11-09HealthF0848Provide a neutral and fair arbitration process and agree to arbitrator and venue.C2023-12-21
2023-11-03Health · complaintF0584Honor 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.D2023-12-05
2023-09-01Health · complaintF0880Provide and implement an infection prevention and control program.E2023-09-20
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

53
OwnerRolePctFromStatusSource
AVALON CARE CENTER - TACOMA, L.L.C.ADP OF THE SNF—2024-08-01currentpecos_ownership
AVALON HEALTH CARE INCADP OF THE SNF——currentpecos_ownership
AVALON HEALTH CARE MANAGEMENT INCADP OF THE SNF—2026-04-14currentpecos_ownership
AVALON HEALTH CARE MANAGEMENT INCOPERATIONAL/MANAGERIAL CONTROL—2024-08-01currentpecos_ownership
AVALON HOLDCO EQUITIES, L.L.C.INDIRECT OWNERSHIP INTEREST—2026-04-14currentpecos_ownership
AVALON HOLDING INCADP OF THE SNF—2025-03-12currentpecos_ownership
DANGERFIELD, DAVIDMANAGING CONTROL - GOVERNING BODY—2012-03-12currentpecos_ownership
HASH, ALANOPERATIONAL/MANAGERIAL CONTROL—2025-03-12currentpecos_ownership
HYRUM A KIRTON INDIVIDUAL TRADP OF THE SNF—2025-10-01currentpecos_ownership
IRWIN, MARTINAOPERATIONAL/MANAGERIAL CONTROL—2025-03-12currentpecos_ownership
K-TEAM LLCINDIRECT OWNERSHIP INTEREST—2025-10-01currentpecos_ownership
K-TEAM LLCADP OF THE SNF—2024-10-01currentpecos_ownership
KIRTON, BYRONMANAGING CONTROL - GOVERNING BODY—2025-03-12currentpecos_ownership
KIRTON, BYRONINDIRECT OWNERSHIP INTEREST—2025-10-01currentpecos_ownership
KIRTON, HYRUMCORPORATE DIRECTOR—2024-08-27currentpecos_ownership
KIRTON, HYRUMCORPORATE OFFICER—2024-08-01currentpecos_ownership
KIRTON, HYRUMINDIRECT OWNERSHIP INTEREST—2025-10-01currentpecos_ownership
KIRTON, SPENCERADP OF THE SNF—2025-10-01currentpecos_ownership
KIRTON, SPENCERMANAGING CONTROL - GOVERNING BODY—2025-03-12currentpecos_ownership
KUBU, CHERYLOPERATIONAL/MANAGERIAL CONTROL—2025-12-19currentpecos_ownership
MULTICARE HEALTH SYSTEMADP OF THE SNF—2024-08-01currentpecos_ownership
NELSON, RYANCORPORATE OFFICER—2024-10-01currentpecos_ownership
NELSON, RYANMANAGING CONTROL - GOVERNING BODY—2025-03-12currentpecos_ownership
SEKERAMAYI, FLOYDOPERATIONAL/MANAGERIAL CONTROL—2025-03-12currentpecos_ownership
SEKERAMAYI, FLOYDADP OF THE SNF—2025-09-26currentpecos_ownership
SIEDENSTRANG, LYNNOPERATIONAL/MANAGERIAL CONTROL—2025-03-12currentpecos_ownership
SPENCER K KIRTON INDIVIDUAL TRINDIRECT OWNERSHIP INTEREST—2025-10-01currentpecos_ownership
STENGEL, LAURAOPERATIONAL/MANAGERIAL CONTROL—2025-03-12currentpecos_ownership
THE BYRON A KIRTON INDIVIDUAL TRINDIRECT OWNERSHIP INTEREST—2025-10-01currentpecos_ownership
WOLTIL, ROBERTMANAGING CONTROL - GOVERNING BODY—2025-03-12currentpecos_ownership
CHARLES KIRTONINDIRECT OWNERSHIP INTEREST21%2025-03-12ended 2026-05-18pecos_ownership
ALAN HASHOPERATIONAL/MANAGERIAL CONTROL—2025-03-12ended 2026-05-18pecos_ownership
AVALON HEALTH CARE INCADP OF THE SNF—2025-03-12ended 2026-05-18pecos_ownership
BYRON KIRTONMANAGING CONTROL - GOVERNING BODY—2025-03-12ended 2026-05-18pecos_ownership
CHARLES GONZALESMANAGING CONTROL - GOVERNING BODY—2025-03-12ended 2026-05-18pecos_ownership
CHARLES KIRTON 2011 IRRV TRADP OF THE SNF—2025-03-12ended 2026-05-18pecos_ownership
DAVID DANGERFIELDMANAGING CONTROL - GOVERNING BODY—2012-03-12ended 2026-05-18pecos_ownership
DIANA THOMPSONOPERATIONAL/MANAGERIAL CONTROL—2025-03-12ended 2026-05-18pecos_ownership
DIANA THOMPSONADP OF THE SNF—2025-09-26ended 2026-05-18pecos_ownership
FLOYD SEKERAMAYIADP OF THE SNF—2025-09-26ended 2026-05-18pecos_ownership
FLOYD SEKERAMAYIOPERATIONAL/MANAGERIAL CONTROL—2025-03-12ended 2026-05-18pecos_ownership
HYRUM KIRTONMANAGING CONTROL - GOVERNING BODY—2025-03-12ended 2026-05-18pecos_ownership
JANET KIRTON 2011 IRRV TRADP OF THE SNF—2025-03-12ended 2026-05-18pecos_ownership
KIRTON MANAGEMENT COMPANY, LLCADP OF THE SNF—2025-09-26ended 2026-05-18pecos_ownership
LAURA STENGELOPERATIONAL/MANAGERIAL CONTROL—2025-03-12ended 2026-05-18pecos_ownership
LYNN SIEDENSTRANGOPERATIONAL/MANAGERIAL CONTROL—2025-03-12ended 2026-05-18pecos_ownership
MARTINA IRWINMANAGING CONTROL - GOVERNING BODY—2025-03-12ended 2026-05-18pecos_ownership
MULTICARE HEALTH SYSTEMADP OF THE SNF—2025-09-26ended 2026-05-18pecos_ownership
ROBERT WOLTILMANAGING CONTROL - GOVERNING BODY—2025-03-12ended 2026-05-18pecos_ownership
RYAN NELSONMANAGING CONTROL - GOVERNING BODY—2025-03-12ended 2026-05-18pecos_ownership
RYAN NELSONCORPORATE OFFICER—2024-10-01ended 2026-05-18pecos_ownership
SPENCER KIRTONMANAGING CONTROL - GOVERNING BODY—2025-03-12ended 2026-05-18pecos_ownership
THE CHARLES R KIRTON SR 2000 TRUSTADP OF THE SNF—2025-03-12ended 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
2025-03-12—AVALON HEALTHCARE-TACOMA LLCHERITAGE REHAB, LLCchow

Comparable trades — WA snf

12
CloseFacilityPrice$/bedCap rateBedsBuyer
2025-06-01Bremerton Trails Post Acute———125RINCON BEACH, LLC
2025-06-01Othello Post Acute———39DOHENY BEACH, LLC
2025-06-01Edmonds Post Acute———128SALT CREEK BEACH, LLC
2025-05-21AURORA VALLEY CARE———124AURORA VALLEY CARE LLC
2025-05-21THREE RIVERS CARE———83THREE RIVERS CARE LLC
2025-05-21FIR LANE CARE———135FIR LANE CARE LLC
2025-05-21SPOKANE FALLS CARE———100SPOKANE FALLS CARE LLC
2025-05-01MARIANWOOD HEALTH AND REHABILITATION———117LUNA VEGA HEALTHCARE LLC
2025-04-01WOODARD CREEK HEALTH & REHABILITATION———152WOODARD SNF OPERATIONS LLC
2025-03-12Avalon Healthcare - Tacomathis facility———81AVALON HEALTHCARE-TACOMA LLC
2025-03-01SOUTH HILL REHABILITATION AND CARE CENTER———113LAST EMPIRE HEALTHCARE LLC
2024-08-01PINE RIDGE POST ACUTE———80PINE RIDGE SNF HEALTHCARE 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

34
GeoKindBRAmountAs ofSource
county 53053acs median gross0$1,2892024-12-31CENSUS_ACS5
county 53053fmr0$1,4282025-10-01HUD_USER_FMR
county 53053acs median gross1$1,4652024-12-31CENSUS_ACS5
county 53053fmr1$1,6052025-10-01HUD_USER_FMR
county 53053acs median gross2$1,7942024-12-31CENSUS_ACS5
county 53053fmr2$1,9712025-10-01HUD_USER_FMR
county 53053acs median gross3$2,2332024-12-31CENSUS_ACS5
county 53053fmr3$2,7332025-10-01HUD_USER_FMR
county 53053acs median gross4$2,5642024-12-31CENSUS_ACS5
county 53053fmr4$3,1022025-10-01HUD_USER_FMR
county 53053acs median gross5$2,8102024-12-31CENSUS_ACS5
county 53053acs median gross$1,8062024-12-31CENSUS_ACS5
county 53053acs recent mover gross$1,9632024-12-31CENSUS_ACS5
zcta 98408acs median gross1$1,5172024-12-31CENSUS_ACS5
zcta 98408acs median gross2$1,6372024-12-31CENSUS_ACS5
zcta 98408acs median gross3$2,2182024-12-31CENSUS_ACS5
zcta 98408acs median gross4$2,2892024-12-31CENSUS_ACS5
zcta 98408acs median gross$1,6542024-12-31CENSUS_ACS5
zcta 98408acs recent mover gross$1,8302024-12-31CENSUS_ACS5
zip 98408payment standard 1100$1,4742025-10-01HUD_USER_SAFMR
zip 98408payment standard 900$1,2062025-10-01HUD_USER_SAFMR
zip 98408safmr0$1,3402025-10-01HUD_USER_SAFMR
zip 98408payment standard 1101$1,6612025-10-01HUD_USER_SAFMR
zip 98408payment standard 901$1,3592025-10-01HUD_USER_SAFMR
zip 98408safmr1$1,5102025-10-01HUD_USER_SAFMR
zip 98408payment standard 1102$2,0462025-10-01HUD_USER_SAFMR
zip 98408payment standard 902$1,6742025-10-01HUD_USER_SAFMR
zip 98408safmr2$1,8602025-10-01HUD_USER_SAFMR
zip 98408payment standard 1103$2,8602025-10-01HUD_USER_SAFMR
zip 98408payment standard 903$2,3402025-10-01HUD_USER_SAFMR
zip 98408safmr3$2,6002025-10-01HUD_USER_SAFMR
zip 98408payment standard 1104$3,2672025-10-01HUD_USER_SAFMR
zip 98408payment standard 904$2,6732025-10-01HUD_USER_SAFMR
zip 98408safmr4$2,9702025-10-01HUD_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 · Avalon Healthcare - Tacoma (505183) · 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