Reads as: riskier than 67.4% 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
9
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+22.4 vs natl
SANDERSON CLARK
58 facilities
connection
Owner fleet risk far above national
+21.5 vs natl
FANNIN COUNTY HOSPITAL AUTHORITY
54 facilities
connection
Owner spans multiple chains
18 chains
CTR PARTNERSHIP LP
99 facilities
connection
Owner spans multiple chains
18 chains
ENSIGN SERVICES INC
286 facilities
connection
Owner spans multiple chains
17 chains
KEETCH CHAD
283 facilities
connection
Owner spans multiple chains
17 chains
BURNAM SOON
335 facilities
connection
Owner spans multiple chains
15 chains
CARETRUST REIT INC
96 facilities
connection
Owner spans multiple chains
11 chains
CARETRUST GP LLC
89 facilities
connection
Buyer assembling a chain (5+ takeovers/24mo)
8 facilities
FANNIN COUNTY HOSPITAL AUTHORITY
8 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
2.63
2.67
3.28
2.90–3.77
RN
0.13
0.24
0.39
0.25–0.58
Weekend total
2.49
2.56
3.11
—
Weekday total
2.69
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
82.2
2.63
0.13
0.66
1.84
2.49
0.0%
2025Q3
92
77.5
2.60
0.23
0.66
1.71
2.43
0.0%
2025Q2
91
79.7
2.62
0.11
0.71
1.79
2.40
0.0%
2025Q1
90
75.9
2.65
0.20
0.69
1.75
2.52
0.0%
2024Q4
92
77.0
2.74
0.21
0.69
1.84
2.64
0.0%
2024Q3
92
79.2
2.40
0.15
0.64
1.62
2.31
0.0%
2024Q2
91
81.2
2.51
0.11
0.65
1.74
2.33
0.0%
2024Q1
91
79.9
2.50
0.15
0.61
1.75
2.46
0.0%
2023Q4
92
77.1
2.48
0.19
0.64
1.65
2.41
0.0%
2023Q3
92
83.4
2.43
0.16
0.68
1.59
2.38
0.0%
2023Q2
91
85.6
2.42
0.19
0.63
1.59
2.23
0.0%
2023Q1
90
87.0
2.27
0.22
0.58
1.47
2.16
0.0%
2022Q4
92
87.9
2.34
0.25
0.60
1.49
2.23
0.0%
2022Q3
92
85.4
2.18
0.21
0.59
1.38
2.08
0.0%
2022Q2
91
87.3
2.23
0.18
0.61
1.43
2.13
0.0%
2022Q1
90
86.3
2.14
0.18
0.55
1.42
2.00
0.0%
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.
Ensure that residents are fully informed and understand their health status, care and treatments.
D
2026-03-14
2026-03-13
Health · complaint
F0605
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
D
2026-03-14
2026-03-13
Health · complaint
F0761
Ensure 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.
D
2026-03-14
2025-11-19
Health
F0552
Ensure that residents are fully informed and understand their health status, care and treatments.
D
2025-11-20
2025-11-19
Health
F0641
Ensure each resident receives an accurate assessment.
D
2025-11-20
2025-11-19
Health
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
2025-11-20
2025-11-19
Health
F0675
Honor each resident's preferences, choices, values and beliefs.
D
2025-11-20
2025-11-19
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2025-11-20
2025-11-19
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2025-11-20
2025-11-19
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-11-20
2025-08-27
Health · complaint
F0641
Ensure each resident receives an accurate assessment.
D
2025-08-28
2024-08-22
Health
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
2024-08-23
2024-08-22
Health
F0657
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
2024-08-23
2024-08-22
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
E
2024-08-23
2024-08-22
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.
D
2024-08-23
2024-08-22
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
2024-08-23
2024-07-31
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2024-08-01
2023-09-22
Health · complaint
F0580
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
J
2023-09-23
2023-09-22
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
J
2023-09-23
2023-09-22
Health · complaint
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.
J
2023-09-23
2023-09-22
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2023-09-23
2023-05-15
Health
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
E
2023-05-26
2023-05-15
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2023-05-15
2023-05-15
Health
F0760
Ensure that residents are free from significant medication errors.
K
2023-05-19
2023-05-15
Health
F0880
Provide and implement an infection prevention and control program.
D
2023-05-26
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
22
Owner
Role
Pct
From
Status
Source
FANNIN COUNTY HOSPITAL AUTHORITY
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2024-01-01
current
pecos_ownership
BROWNSVILLE CARE ASSOCIATES, INC
OPERATIONAL/MANAGERIAL CONTROL
—
2024-01-01
current
pecos_ownership
BROWNSVILLE CARE ASSOCIATES, INC
—
—
2024-01-01
current
tx_hhsc_directory
BROWNSVILLE CARE ASSOCIATES, INC
ADP OF THE SNF
—
2025-09-29
current
pecos_ownership
BURNAM, SOON
CORPORATE OFFICER
—
2024-01-01
current
pecos_ownership
CARETRUST GP LLC
ADP OF THE SNF
—
2024-01-01
current
pecos_ownership
CARETRUST REIT INC
ADP OF THE SNF
—
2024-01-01
current
pecos_ownership
CTR PARTNERSHIP LP
ADP OF THE SNF
—
2024-01-01
current
pecos_ownership
ENSIGN SERVICES INC
ADP OF THE SNF
—
2009-12-01
current
pecos_ownership
FANNIN COUNTY HOSPITAL AUTHORITY
—
—
2024-01-01
current
tx_hhsc_directory
GUERRERO, NORMA
MANAGING CONTROL - GOVERNING BODY
—
2024-01-01
current
pecos_ownership
KEETCH, CHAD
CORPORATE OFFICER
—
2011-03-01
current
pecos_ownership
PAREDES HEALTH HOLDINGS LLC
Corporation, partnership or other organization has financial interest in provider
—
2024-01-01
current
hcris_a_8_1
PAREDES HEALTH HOLDINGS LLC
Corporation, partnership or other organization has financial interest in provider
—
2023-01-01
current
hcris_a_8_1
PAREDES HEALTH HOLDINGS LLC
ADP OF THE SNF
—
2024-01-01
current
pecos_ownership
ROBLES, LUIS
OPERATIONAL/MANAGERIAL CONTROL
—
2025-02-01
current
pecos_ownership
SANDERSON, CLARK
CORPORATE OFFICER
—
2024-01-01
current
pecos_ownership
CLARK SANDERSON
CORPORATE OFFICER
0%
2024-01-01
ended 2026-05-18
pecos_ownership
CRAIG FITCH
CORPORATE OFFICER
0%
2024-01-01
ended 2026-05-18
pecos_ownership
NORMA GUERRERO
OPERATIONAL/MANAGERIAL CONTROL
0%
2024-01-01
ended 2026-05-18
pecos_ownership
PAUL LENZ
CONTRACTED MANAGING EMPLOYEE
0%
2024-01-01
ended 2026-05-18
pecos_ownership
SOON BURNAM
OPERATIONAL/MANAGERIAL CONTROL
0%
2024-01-01
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
5
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$977,521
—
$673,020
—
—
4
propco
2023-12-31
$882,585
—
$647,943
—
—
4
propco
2022-12-31
$799,357
—
$596,458
—
—
4
—
2021-12-31
$828,266
—
$494,782
—
—
3
—
2020-12-31
$741,945
—
$427,078
—
—
3
—
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
Most recent same-state, same-setting trades. Most CHOW-derived trades carry no disclosed consideration, so price, $/bed, and cap rate show only where a sale price was resolved from a deed or filing — blanks are honest, not missing data.
Market rent context
35
Geo
Kind
BR
Amount
As of
Source
county 48061
acs median gross
0
$724
2024-12-31
CENSUS_ACS5
county 48061
fmr
0
$773
2025-10-01
HUD_USER_FMR
county 48061
acs median gross
1
$729
2024-12-31
CENSUS_ACS5
county 48061
fmr
1
$866
2025-10-01
HUD_USER_FMR
county 48061
acs median gross
2
$893
2024-12-31
CENSUS_ACS5
county 48061
fmr
2
$1,047
2025-10-01
HUD_USER_FMR
county 48061
acs median gross
3
$1,112
2024-12-31
CENSUS_ACS5
county 48061
fmr
3
$1,414
2025-10-01
HUD_USER_FMR
county 48061
acs median gross
4
$1,170
2024-12-31
CENSUS_ACS5
county 48061
fmr
4
$1,479
2025-10-01
HUD_USER_FMR
county 48061
acs median gross
5
$1,575
2024-12-31
CENSUS_ACS5
county 48061
acs median gross
$912
2024-12-31
CENSUS_ACS5
county 48061
acs recent mover gross
$1,019
2024-12-31
CENSUS_ACS5
zcta 78521
acs median gross
0
$790
2024-12-31
CENSUS_ACS5
zcta 78521
acs median gross
1
$755
2024-12-31
CENSUS_ACS5
zcta 78521
acs median gross
2
$878
2024-12-31
CENSUS_ACS5
zcta 78521
acs median gross
3
$992
2024-12-31
CENSUS_ACS5
zcta 78521
acs median gross
4
$1,165
2024-12-31
CENSUS_ACS5
zcta 78521
acs median gross
$889
2024-12-31
CENSUS_ACS5
zcta 78521
acs recent mover gross
$1,058
2024-12-31
CENSUS_ACS5
zip 78521
payment standard 110
0
$858
2025-10-01
HUD_USER_SAFMR
zip 78521
payment standard 90
0
$702
2025-10-01
HUD_USER_SAFMR
zip 78521
safmr
0
$780
2025-10-01
HUD_USER_SAFMR
zip 78521
payment standard 110
1
$957
2025-10-01
HUD_USER_SAFMR
zip 78521
payment standard 90
1
$783
2025-10-01
HUD_USER_SAFMR
zip 78521
safmr
1
$870
2025-10-01
HUD_USER_SAFMR
zip 78521
payment standard 110
2
$1,155
2025-10-01
HUD_USER_SAFMR
zip 78521
payment standard 90
2
$945
2025-10-01
HUD_USER_SAFMR
zip 78521
safmr
2
$1,050
2025-10-01
HUD_USER_SAFMR
zip 78521
payment standard 110
3
$1,562
2025-10-01
HUD_USER_SAFMR
zip 78521
payment standard 90
3
$1,278
2025-10-01
HUD_USER_SAFMR
zip 78521
safmr
3
$1,420
2025-10-01
HUD_USER_SAFMR
zip 78521
payment standard 110
4
$1,628
2025-10-01
HUD_USER_SAFMR
zip 78521
payment standard 90
4
$1,332
2025-10-01
HUD_USER_SAFMR
zip 78521
safmr
4
$1,480
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.