Composite
93.6 / 100 percentile
Screener / 447583
D
TRISTAR HEALTHCARE AT HOME
home healthTN
310 25TH AVE NORTH, STE 303, NASHVILLE, TN 37203 · CCN 447583 · chain HCA HEALTHCARE INC
Peer group
home health n = 24,351
Evidence depth
deep
Certified beds
—
Model
v1.2
Reads as: riskier than 93.6% 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 model5ML signals6Components12Quality measures21Penalties0Deficiencies0Licensure0Ownership16Related party0Transactions0Market rent34
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| financial risk | 92.7 | 74.6 | 0.30 | 0.2222 | 20.60 | in index |
| regulatory risk | 78.0 | 90.0 | 0.30 | 0.2222 | 17.33 | in index |
| quality risk | 71.4 | 65.5 | 0.30 | 0.2222 | 15.87 | in index |
| billing conduct | 48.2 | 15.7 | 0.30 | 0.2222 | 10.71 | in index |
| chow risk | 52.0 | 25.6 | 0.15 | 0.1111 | 5.78 | in 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
6| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +26.9 vs natl | ARC THERAPY SERVICES LLC | 9 facilities |
| connection | Owner fleet risk far above national | +22.7 vs natl | H3OT CORP LLC | 25 facilities |
| connection | Owner fleet risk far above national | +22.7 vs natl | HEALTH AT HOME BHS LLC | 27 facilities |
| connection | Owner fleet risk far above national | +21.3 vs natl | MICHAEL MARKS | 26 facilities |
| connection | Owner fleet risk far above national | +20.8 vs natl | HCA SQUARED LLC | 26 facilities |
| connection | Owner fleet risk far above national | +20.8 vs natl | HOSPITAL CORP LLC | 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.
Component scores and registry models
12| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 15.7 | A | v0.1-pacpuf | default · in composite | R21. CMS PAC PUF home health 2023. Outlier share, risk-adjusted episode churn, LUPA rate. |
| chow risk | 45.0 | C | 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 | 6.2 | 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 | 74.6 | D | v0.5 | default · in composite | R18. |
| quality risk | 65.5 | D | v0.1 | default · in composite | |
| regulatory risk | 90.0 | F | 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. |
| financial risk | 81.7 | F | 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 | 61.7 | 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 | 76.0 | D | 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 | 75.3 | D | 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 | 90.0 | F | 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 | 93.8 | — | 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 | 93.8 | — | 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 | 90.9 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| How often patients' breathing improved | 97.6 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| Discharge Function Score | 71.6 | — | 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 | 92.5 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| DTC Risk-Standardized Rate | 75.1 | — | 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 | 2.3 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| PPH Risk-Standardized Rate | 12.4 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| PPR Risk-Standardized Rate | 3.4 | — | 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 | 1.1 | — | hha_quality | https://data.cms.gov/provider-data/sites/default/files/resources/0260f790d69086d7330c10bcd51b9c3c_1782764087/HH_Provider_Jul2026.csv |
| Quality of patient care star rating | 3.5 | 3.5 | 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 | 94.0 | — | 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 | 88.0 | — | 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) | 82.0 | — | 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 | 77.0 | — | hhcahps | https://data.cms.gov/provider-data/sites/default/files/resources/706e7ad48548f6f3893109f403dd9fd8_1782764088/HHCAHPS_Provider_Jul2026.csv |
| Survey response rate | 22.0 | — | 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 | 132.0 | — | 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
0No 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
16| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| ARC THERAPY SERVICES LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2025-03-19 | current | pecos_ownership |
| H3OT CORP., LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2021-07-01 | current | pecos_ownership |
| HCA HEALTHCARE INC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2021-07-01 | current | pecos_ownership |
| HCA INC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2021-07-01 | current | pecos_ownership |
| HCA SQUARED LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2021-07-01 | current | pecos_ownership |
| HEALTH AT HOME-BHS, LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2021-07-01 | current | pecos_ownership |
| HEALTHTRUST INC - THE HOSPITAL COMPANY | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2021-08-01 | current | pecos_ownership |
| HOSPITAL CORP LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2021-07-01 | current | pecos_ownership |
| HERCULES HOLDING II | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 25% | 2021-07-01 | current | pecos_ownership |
| FRISCO INC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 13% | 2021-07-01 | current | pecos_ownership |
| CHRISTOPHER SIMMONS | W-2 MANAGING EMPLOYEE | 0% | 2025-03-01 | current | pecos_ownership |
| KARA WIMBERLY | W-2 MANAGING EMPLOYEE | 0% | 2024-12-09 | current | pecos_ownership |
| BRAD PARRISH | CORPORATE OFFICER | — | 2023-03-01 | current | pecos_ownership |
| ERIC SMITH | OPERATIONAL/MANAGERIAL CONTROL | — | 2021-07-01 | current | pecos_ownership |
| JARROD WATSON | CORPORATE OFFICER | — | 2021-07-01 | current | pecos_ownership |
| MICHAEL MARKS | CORPORATE OFFICER | — | 2023-01-01 | current | pecos_ownership |
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
34| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 47037 | acs median gross | 0 | $1,414 | 2024-12-31 | CENSUS_ACS5 |
| county 47037 | fmr | 0 | $1,507 | 2025-10-01 | HUD_USER_FMR |
| county 47037 | acs median gross | 1 | $1,421 | 2024-12-31 | CENSUS_ACS5 |
| county 47037 | fmr | 1 | $1,578 | 2025-10-01 | HUD_USER_FMR |
| county 47037 | acs median gross | 2 | $1,562 | 2024-12-31 | CENSUS_ACS5 |
| county 47037 | fmr | 2 | $1,730 | 2025-10-01 | HUD_USER_FMR |
| county 47037 | acs median gross | 3 | $1,938 | 2024-12-31 | CENSUS_ACS5 |
| county 47037 | fmr | 3 | $2,211 | 2025-10-01 | HUD_USER_FMR |
| county 47037 | acs median gross | 4 | $2,183 | 2024-12-31 | CENSUS_ACS5 |
| county 47037 | fmr | 4 | $2,696 | 2025-10-01 | HUD_USER_FMR |
| county 47037 | acs median gross | 5 | $2,135 | 2024-12-31 | CENSUS_ACS5 |
| county 47037 | acs median gross | $1,582 | 2024-12-31 | CENSUS_ACS5 | |
| county 47037 | acs recent mover gross | $1,787 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 37203 | acs median gross | 0 | $1,748 | 2024-12-31 | CENSUS_ACS5 |
| zcta 37203 | acs median gross | 1 | $2,051 | 2024-12-31 | CENSUS_ACS5 |
| zcta 37203 | acs median gross | 2 | $2,094 | 2024-12-31 | CENSUS_ACS5 |
| zcta 37203 | acs median gross | 3 | $1,898 | 2024-12-31 | CENSUS_ACS5 |
| zcta 37203 | acs median gross | $2,004 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 37203 | acs recent mover gross | $2,190 | 2024-12-31 | CENSUS_ACS5 | |
| zip 37203 | payment standard 110 | 0 | $1,903 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | payment standard 90 | 0 | $1,557 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | safmr | 0 | $1,730 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | payment standard 110 | 1 | $2,002 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | payment standard 90 | 1 | $1,638 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | safmr | 1 | $1,820 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | payment standard 110 | 2 | $2,189 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | payment standard 90 | 2 | $1,791 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | safmr | 2 | $1,990 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | payment standard 110 | 3 | $2,794 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | payment standard 90 | 3 | $2,286 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | safmr | 3 | $2,540 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | payment standard 110 | 4 | $3,410 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | payment standard 90 | 4 | $2,790 | 2025-10-01 | HUD_USER_SAFMR |
| zip 37203 | safmr | 4 | $3,100 | 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.