Reads as: riskier than 42.4% 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
8
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
18 chains
ENSIGN SERVICES INC
286 facilities
connection
Owner spans multiple chains
17 chains
BURNAM SOON
335 facilities
connection
Owner spans multiple chains
17 chains
KEETCH CHAD
283 facilities
connection
Owner spans multiple chains
10 chains
NATIONAL HEALTH INVESTORS INC
31 facilities
connection
Owner spans multiple chains
7 chains
KROL MICHAEL
8 facilities
connection
Owner spans multiple chains
6 chains
TEXAS NHI INVESTORS LLC
20 facilities
connection
Owner fleet enforcement cluster
44% fined
GANN KODY
25 facilities
connection
Owner fleet enforcement cluster
42% fined
GUADALUPE COUNTY HOSPITAL BOARD
26 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
2.60
2.67
3.28
2.90–3.77
RN
0.17
0.24
0.39
0.25–0.58
Weekend total
2.32
2.56
3.11
—
Weekday total
2.72
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
116.1
2.60
0.17
0.75
1.68
2.32
0.0%
2025Q3
92
112.4
2.62
0.14
0.79
1.69
2.44
0.0%
2025Q2
91
113.4
2.59
0.17
0.77
1.65
2.35
0.0%
2025Q1
90
116.3
2.44
0.18
0.73
1.53
2.29
0.0%
2024Q4
92
114.4
2.44
0.22
0.68
1.53
2.34
0.0%
2024Q3
92
108.3
2.51
0.26
0.68
1.57
2.37
0.0%
2024Q2
91
105.8
2.53
0.25
0.71
1.57
2.38
0.0%
2024Q1
91
116.7
2.29
0.21
0.66
1.42
2.21
0.0%
2023Q4
92
108.4
2.42
0.28
0.67
1.47
2.31
0.0%
2023Q3
92
112.8
2.40
0.26
0.68
1.47
2.28
0.2%
2023Q2
91
108.2
2.44
0.25
0.72
1.47
2.32
2.5%
2023Q1
90
108.8
2.32
0.22
0.67
1.43
2.31
2.5%
2022Q4
92
105.5
2.52
0.20
0.73
1.59
2.54
1.2%
2022Q3
92
102.4
2.55
0.22
0.78
1.54
2.55
13.6%
2022Q2
91
98.5
2.70
0.15
0.86
1.68
2.51
25.3%
2022Q1
90
87.5
2.48
0.32
0.62
1.53
2.26
15.8%
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.
Ensure that residents are fully informed and understand their health status, care and treatments.
D
2026-02-19
2026-01-29
Health · complaint
F0584
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
E
2026-02-19
2025-12-12
Health
F0636
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
D
2025-12-18
2025-12-12
Health
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
G
2025-12-18
2025-12-12
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2025-12-15
2025-12-12
Health
F0880
Provide and implement an infection prevention and control program.
D
2025-12-15
2024-11-20
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2024-11-21
2024-11-20
Health · complaint
F0880
Provide and implement an infection prevention and control program.
E
2024-11-21
2024-09-05
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
E
2024-09-06
2024-09-05
Health
F0578
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
D
2024-09-06
2024-09-05
Health
F0583
Keep residents' personal and medical records private and confidential.
E
2024-09-06
2024-09-05
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2024-09-06
2024-09-05
Health
F0791
Provide or obtain dental services for each resident.
D
2024-10-07
2024-09-05
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2024-09-06
2024-09-05
Health
F0919
Make sure that a working call system is available in each resident's bathroom and bathing area.
D
2024-09-06
2023-11-21
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2024-01-26
2023-08-10
Health · complaint
F0552
Ensure that residents are fully informed and understand their health status, care and treatments.
E
2023-08-22
2023-08-10
Health · complaint
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
E
2023-08-22
2023-08-10
Health · complaint
F0758
Implement 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.
E
2023-08-22
2023-06-30
Health
F0578
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
D
2023-07-28
2023-06-30
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2023-07-28
2023-06-30
Health
F0698
Provide safe, appropriate dialysis care/services for a resident who requires such services.
D
2023-07-28
2023-06-30
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
E
2023-07-28
2023-06-30
Health
F0758
Implement 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.
D
2023-07-28
2023-06-30
Health
F0805
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
D
2023-07-28
2023-06-30
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2023-07-28
2023-06-30
Health
F0814
Dispose of garbage and refuse properly.
D
2023-07-28
2023-06-13
Health · complaint
F0800
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
E
2023-06-22
2023-06-13
Health · complaint
F0803
Ensure 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.
E
2023-06-22
2023-06-13
Health · complaint
F0806
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
E
2023-06-22
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
18
Owner
Role
Pct
From
Status
Source
GUADALUPE COUNTY HOSPITAL BOARD
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2017-04-01
current
pecos_ownership
BURNAM, SOON
CORPORATE OFFICER
—
2017-04-01
current
pecos_ownership
ENSIGN SERVICES INC
ADP OF THE SNF
—
2016-05-01
current
pecos_ownership
FOWERS, MATTHEW
OPERATIONAL/MANAGERIAL CONTROL
—
2019-03-12
current
pecos_ownership
GANN, KODY
CORPORATE OFFICER
—
2021-02-01
current
pecos_ownership
GUADALUPE COUNTY HOSPITAL BOARD
—
—
2026-04-01
current
tx_hhsc_directory
KEETCH, CHAD
CORPORATE OFFICER
—
2011-03-01
current
pecos_ownership
KROL, MICHAEL
ADP OF THE SNF
—
2016-05-01
current
pecos_ownership
NATIONAL HEALTH INVESTORS, INC.
ADP OF THE SNF
—
2017-04-01
current
pecos_ownership
TEXAS NHI INVESTORS, LLC
ADP OF THE SNF
—
2017-04-01
current
pecos_ownership
TREATY HEALTHCARE, INC
OPERATIONAL/MANAGERIAL CONTROL
—
2017-04-01
current
pecos_ownership
TREATY HEALTHCARE, INC
—
—
2026-04-01
current
tx_hhsc_directory
TREATY HEALTHCARE, INC
ADP OF THE SNF
—
2025-10-07
current
pecos_ownership
KODY GANN
CORPORATE OFFICER
0%
2021-02-01
ended 2026-05-18
pecos_ownership
MATTHEW FOWERS
OPERATIONAL/MANAGERIAL CONTROL
0%
2019-03-12
ended 2026-05-18
pecos_ownership
CHAD KEETCH
CORPORATE OFFICER
—
2011-03-01
ended 2026-05-18
pecos_ownership
MICHAEL KROL
MANAGING CONTROL - GOVERNING BODY
—
2016-05-01
ended 2026-05-18
pecos_ownership
SOON BURNAM
CORPORATE OFFICER
—
2017-04-01
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
2024-09-30
$1,033,332
—
$659,452
—
—
3
—
2023-09-30
$1,027,403
—
$668,802
—
—
3
—
2022-09-30
$1,209,368
—
$540,486
—
—
3
—
2021-09-30
$1,281,482
—
$670,100
—
—
3
—
2020-09-30
$1,619,530
—
$987,334
—
—
3
—
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
Transactions
0
No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Most recent same-state, same-setting trades. Most CHOW-derived trades carry no disclosed consideration, so price, $/bed, and cap rate show only where a sale price was resolved from a deed or filing — blanks are honest, not missing data.
Market rent context
36
Geo
Kind
BR
Amount
As of
Source
county 48209
acs median gross
0
$1,340
2024-12-31
CENSUS_ACS5
county 48209
fmr
0
$1,474
2025-10-01
HUD_USER_FMR
county 48209
acs median gross
1
$1,347
2024-12-31
CENSUS_ACS5
county 48209
fmr
1
$1,562
2025-10-01
HUD_USER_FMR
county 48209
acs median gross
2
$1,504
2024-12-31
CENSUS_ACS5
county 48209
fmr
2
$1,852
2025-10-01
HUD_USER_FMR
county 48209
acs median gross
3
$1,853
2024-12-31
CENSUS_ACS5
county 48209
fmr
3
$2,347
2025-10-01
HUD_USER_FMR
county 48209
acs median gross
4
$2,007
2024-12-31
CENSUS_ACS5
county 48209
fmr
4
$2,760
2025-10-01
HUD_USER_FMR
county 48209
acs median gross
5
$2,662
2024-12-31
CENSUS_ACS5
county 48209
acs median gross
$1,495
2024-12-31
CENSUS_ACS5
county 48209
acs recent mover gross
$1,517
2024-12-31
CENSUS_ACS5
zcta 78640
acs median gross
0
$1,582
2024-12-31
CENSUS_ACS5
zcta 78640
acs median gross
1
$1,444
2024-12-31
CENSUS_ACS5
zcta 78640
acs median gross
2
$1,776
2024-12-31
CENSUS_ACS5
zcta 78640
acs median gross
3
$2,006
2024-12-31
CENSUS_ACS5
zcta 78640
acs median gross
4
$2,215
2024-12-31
CENSUS_ACS5
zcta 78640
acs median gross
5
$2,929
2024-12-31
CENSUS_ACS5
zcta 78640
acs median gross
$1,730
2024-12-31
CENSUS_ACS5
zcta 78640
acs recent mover gross
$1,729
2024-12-31
CENSUS_ACS5
zip 78640
payment standard 110
0
$1,584
2025-10-01
HUD_USER_SAFMR
zip 78640
payment standard 90
0
$1,296
2025-10-01
HUD_USER_SAFMR
zip 78640
safmr
0
$1,440
2025-10-01
HUD_USER_SAFMR
zip 78640
payment standard 110
1
$1,683
2025-10-01
HUD_USER_SAFMR
zip 78640
payment standard 90
1
$1,377
2025-10-01
HUD_USER_SAFMR
zip 78640
safmr
1
$1,530
2025-10-01
HUD_USER_SAFMR
zip 78640
payment standard 110
2
$1,991
2025-10-01
HUD_USER_SAFMR
zip 78640
payment standard 90
2
$1,629
2025-10-01
HUD_USER_SAFMR
zip 78640
safmr
2
$1,810
2025-10-01
HUD_USER_SAFMR
zip 78640
payment standard 110
3
$2,519
2025-10-01
HUD_USER_SAFMR
zip 78640
payment standard 90
3
$2,061
2025-10-01
HUD_USER_SAFMR
zip 78640
safmr
3
$2,290
2025-10-01
HUD_USER_SAFMR
zip 78640
payment standard 110
4
$2,970
2025-10-01
HUD_USER_SAFMR
zip 78640
payment standard 90
4
$2,430
2025-10-01
HUD_USER_SAFMR
zip 78640
safmr
4
$2,700
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.