Composite
60.2 / 100 percentile
Screener / 059111
C
SAN DIEGO HOME HEALTH CARE SERVICES INC
home healthCA
5050 AVENIDA ENCINAS, CARLSBAD, CA 92008 · CCN 059111 · chain COVENANT CARE LLC
Peer group
home health n = 24,351
Evidence depth
deep
Certified beds
—
Model
v1.2
Reads as: riskier than 60.2% of the 24,351 facilities in the home health 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 signals2Components16Quality measures21Penalties0Deficiencies0Licensure1Ownership26Related party0Transactions0Market rent35
Composite explanation
7| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| state reg risk | 42.3 | 10.0 | 0.30 | 0.1818 | 7.69 | in index |
| financial risk | 40.6 | 48.2 | 0.30 | 0.1818 | 7.38 | in index |
| quality risk | 40.5 | 44.4 | 0.30 | 0.1818 | 7.36 | in index |
| billing conduct | 40.0 | 14.4 | 0.30 | 0.1818 | 7.27 | in index |
| regulatory risk | 38.3 | 45.0 | 0.30 | 0.1818 | 6.96 | in index |
| chow risk | 70.8 | 27.1 | 0.15 | 0.0909 | 6.44 | in index |
| ownership opacity | 89.3 | 55.0 | excluded |
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| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner spans multiple chains | 4 chains | MIDCAP FUNDING IV TRUST | 36 facilities |
| connection | Owner fleet enforcement cluster | 43% fined | MIDCAP FUNDING IV TRUST | 37 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 type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 14.4 | A | v0.1-pacpuf | default · in composite | R21. CMS PAC PUF home health 2023. Outlier share, risk-adjusted episode churn, LUPA rate. |
| chow risk | 41.0 | B | v0.1-pecoshha | default · in composite | Home health change of ownership from PECOS owner association dates, the created-for-acquisition flag, owner cohort churn and investment or holding company layering. |
| chow risk | 13.1 | A | v0.1-pos | default · in composite | Change-of-ownership footprint in the CMS Provider of Services file: control-family, legal-name and address deltas across quarterly snapshots, plus certification reset recency and Medicare tenure. |
| financial risk | 32.6 | B | v0.1-cacdph | default · in composite | California home health operating scale, public payer visit concentration, service intensity and lack-of-funds discharges. |
| financial risk | 63.7 | C | v0.5 | default · in composite | R18. |
| ownership opacity | 55.0 | C | v0.1-cacdph | default · in composite | CDPH licensee chain size, parent corporation and domicile. |
| quality risk | 46.7 | C | v0.1 | default · in composite | |
| quality risk | 42.1 | B | v0.1-cacdph | default · in composite | California home health discharge to hospital and discharge by death rates, not case mix adjusted. |
| regulatory risk | 45.0 | C | v0.6-pos | default · in composite | R31. Extends v0.5-pos to hospices (provider type 12): same fields, same weights, no expression change. Hospice regulatory coverage before this was 148 of 6,535 scored hospices, all from the TX HCSSA state model. SNF/NF (type 20) deliberately excluded: the deficiency-based v0.3 already covers 14,315 of 14,720 and is richer evidence than a POS compliance flag. |
| state reg risk | 10.0 | A | v0.1-cacdph | default · in composite | CDPH licence tenure, expiry, branch role and failure to file the mandatory HCAI annual utilization report. |
| financial risk | 79.7 | D | v0.1 | superseded | Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
| financial risk | 59.7 | C | v0.2 | superseded | Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
| financial risk | 62.2 | C | v0.3 | superseded | Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
| financial risk | 62.6 | C | v0.4 | superseded | Pre-registry model iteration, superseded by a later financial_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity. |
| ownership opacity | 20.0 | A | v0.1-pecos | addressable | R21. Retained as a description of ownership structure. Deliberately NOT in any composite: inversely related to billing conduct. |
| regulatory risk | 45.0 | C | v0.5-pos | superseded | R20. Corrects the acptbl_poc_sw error in v0.4-pos; covers provider types 3 and 8. Superseded by v0.6-pos, which extends the population to hospices with no expression change. |
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.
Quality measures
21| Measure | Value | Stars | Period | Source |
|---|---|---|---|---|
| How often patients got better at bathing | 86.4 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How often patients got better at getting in and out of bed | 86.5 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How often patients got better at walking or moving around | 84.7 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How often patients' breathing improved | 91.9 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| Discharge Function Score | 72.3 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How often physician-recommended actions to address medication issues were completely timely | 92.1 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| DTC Risk-Standardized Rate | 84.8 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| Percent of Residents Experiencing One or More Falls with Major Injury | 0.6 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| PPH Risk-Standardized Rate | 8.3 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| PPR Risk-Standardized Rate | 4.7 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| Changes in skin integrity post-acute care: pressure ulcer/injury | 0.4 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How much Medicare spends on an episode of care at this agency, compared to Medicare spending across all agencies nationally | 0.9 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| Quality of patient care star rating | 3.0 | 3 | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How often the home health team began their patients' care in a timely manner | 94.4 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| Percent of patients who reported that their home health team communicated well with them | 89.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| Percent of patients who gave their home health agency a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest) | 86.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| Percent of patients who reported that their home health team gave care in a professional way | 90.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| Percent of patients who reported YES, they would definitely recommend the home health agency to friends and family | 81.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| Survey response rate | 27.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| HHCAHPS Survey Summary Star Rating | 4.0 | 4 | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| Number of completed Surveys | 317.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
CMS Care Compare measure values as published; a null value with a footnote means CMS suppressed or could not compute it.
Penalties
0No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
0No deficiencies on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
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
1| Date | Action | Agency | Detail |
|---|---|---|---|
| 2009-03-27 | new_license | — | — |
Ownership
26| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| ANDREW TOROK | CORPORATE OFFICER | 100% | 2015-02-04 | current | pecos_ownership |
| BRETT FRANKENBERG | OPERATIONAL/MANAGERIAL CONTROL | 100% | 2022-03-04 | current | pecos_ownership |
| COVENANT CARE CALIFORNIA, LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2015-02-04 | current | pecos_ownership |
| COVENANT CARE, LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2015-02-04 | current | pecos_ownership |
| COVENANT HOLDCO, LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2015-02-04 | current | pecos_ownership |
| COVENANT SUBCO, LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2015-02-04 | current | pecos_ownership |
| DAVA ASHLEY | CORPORATE OFFICER | 100% | 2015-02-04 | current | pecos_ownership |
| ELEVATE HOME HEALTH, LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2015-02-04 | current | pecos_ownership |
| FOCUS HEALTHCARE HOLDINGS, INC. | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2013-09-09 | current | pecos_ownership |
| HCS HOLDCO LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2015-02-04 | current | pecos_ownership |
| KEVIN CARNEY | CORPORATE DIRECTOR | 100% | 2015-02-04 | current | pecos_ownership |
| REHABFOCUS HOME HEALTH, INC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2013-03-01 | current | pecos_ownership |
| ROBERT LEVIN | CORPORATE OFFICER | 100% | 2015-02-04 | current | pecos_ownership |
| MIDCAP FUNDING IV TRUST | 5% OR GREATER SECURITY INTEREST | 40% | 2015-02-04 | current | pecos_ownership |
| CENTRE COVENANT PURCHASER (B), LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 24% | 2015-02-04 | current | pecos_ownership |
| CENTRE V SECONDARY FUND, L.P. | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 24% | 2008-07-17 | current | pecos_ownership |
| CENTRE CAPITAL INVESTORS V, LP | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 12% | 2015-02-04 | current | pecos_ownership |
| CENTRE COVENANT PURCHASER (Q), LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 12% | 2015-02-04 | current | pecos_ownership |
| CENTRE COVENANT PURCHASER (S), LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 12% | 2015-02-04 | current | pecos_ownership |
| STOCKWELL FUND II LP | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 12% | 2015-02-04 | current | pecos_ownership |
| STATE TREASURER OF MICH CUSTODIAN OF PUBLIC SCHOOL EMPL RTMNT SYSTEMS | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 12% | 2015-02-04 | current | pecos_ownership |
| CHRISTINE SIMS | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 11% | 2015-02-04 | current | pecos_ownership |
| MARY EVANS | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 11% | 2015-02-04 | current | pecos_ownership |
| CAROL SPARKS | W-2 MANAGING EMPLOYEE | — | 2015-02-04 | current | pecos_ownership |
| Elevate Home Health | — | — | 2009-03-27 | current | ca_cdph_elms |
| SAN DIEGO HOME HEALTH CARE SERVICES, INC. | — | — | 2009-03-27 | current | ca_cdph_elms |
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.
Transactions
0No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Market rent context
35| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 06073 | acs median gross | 0 | $1,761 | 2024-12-31 | CENSUS_ACS5 |
| county 06073 | fmr | 0 | $2,288 | 2025-10-01 | HUD_USER_FMR |
| county 06073 | acs median gross | 1 | $1,888 | 2024-12-31 | CENSUS_ACS5 |
| county 06073 | fmr | 1 | $2,459 | 2025-10-01 | HUD_USER_FMR |
| county 06073 | acs median gross | 2 | $2,290 | 2024-12-31 | CENSUS_ACS5 |
| county 06073 | fmr | 2 | $3,001 | 2025-10-01 | HUD_USER_FMR |
| county 06073 | acs median gross | 3 | $2,826 | 2024-12-31 | CENSUS_ACS5 |
| county 06073 | fmr | 3 | $3,998 | 2025-10-01 | HUD_USER_FMR |
| county 06073 | acs median gross | 4 | $3,451 | 2024-12-31 | CENSUS_ACS5 |
| county 06073 | fmr | 4 | $4,845 | 2025-10-01 | HUD_USER_FMR |
| county 06073 | acs median gross | 5 | $3,501 | 2024-12-31 | CENSUS_ACS5 |
| county 06073 | acs median gross | $2,246 | 2024-12-31 | CENSUS_ACS5 | |
| county 06073 | acs recent mover gross | $2,729 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 92008 | acs median gross | 0 | $1,876 | 2024-12-31 | CENSUS_ACS5 |
| zcta 92008 | acs median gross | 1 | $2,110 | 2024-12-31 | CENSUS_ACS5 |
| zcta 92008 | acs median gross | 2 | $2,622 | 2024-12-31 | CENSUS_ACS5 |
| zcta 92008 | acs median gross | 3 | $3,501 | 2024-12-31 | CENSUS_ACS5 |
| zcta 92008 | acs median gross | 4 | $3,501 | 2024-12-31 | CENSUS_ACS5 |
| zcta 92008 | acs median gross | $2,429 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 92008 | acs recent mover gross | $2,713 | 2024-12-31 | CENSUS_ACS5 | |
| zip 92008 | payment standard 110 | 0 | $2,915 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | payment standard 90 | 0 | $2,385 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | safmr | 0 | $2,650 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | payment standard 110 | 1 | $3,124 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | payment standard 90 | 1 | $2,556 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | safmr | 1 | $2,840 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | payment standard 110 | 2 | $3,817 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | payment standard 90 | 2 | $3,123 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | safmr | 2 | $3,470 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | payment standard 110 | 3 | $5,082 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | payment standard 90 | 3 | $4,158 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | safmr | 3 | $4,620 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | payment standard 110 | 4 | $6,160 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | payment standard 90 | 4 | $5,040 | 2025-10-01 | HUD_USER_SAFMR |
| zip 92008 | safmr | 4 | $5,600 | 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.