Reads as: riskier than 81.6% 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.
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
3.59
2.67
3.28
2.90–3.77
RN
0.63
0.24
0.39
0.25–0.58
Weekend total
3.28
2.56
3.11
—
Weekday total
3.71
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
45.9
3.59
0.63
1.10
1.86
3.28
3.8%
2025Q3
92
44.8
3.37
0.56
1.04
1.77
3.07
6.4%
2025Q2
91
39.6
3.49
0.68
0.92
1.89
3.26
0.1%
2025Q1
90
50.6
3.22
0.65
0.89
1.68
2.90
3.3%
2024Q4
92
39.0
3.33
0.59
0.90
1.84
3.24
0.0%
2024Q3
92
42.3
3.57
0.70
0.83
2.05
3.45
1.0%
2024Q2
91
36.5
3.46
0.83
0.95
1.68
3.31
0.0%
2024Q1
91
48.4
3.30
0.43
1.15
1.73
3.21
3.4%
2023Q4
92
37.9
3.39
0.59
1.00
1.80
3.32
0.0%
2023Q3
92
36.5
3.23
0.44
1.03
1.76
3.10
0.1%
2023Q2
91
40.9
2.98
0.21
1.22
1.55
2.83
0.0%
2023Q1
90
52.5
3.45
0.37
1.41
1.67
3.23
7.0%
2022Q4
92
123.6
1.41
0.19
0.45
0.76
1.38
10.4%
2022Q3
92
55.6
2.89
0.41
1.07
1.41
2.80
1.5%
2022Q2
91
46.7
3.32
0.42
1.28
1.62
3.21
0.6%
2022Q1
90
40.1
3.96
0.46
1.43
2.06
3.86
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.
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
D
2026-05-16
2026-04-06
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2026-05-16
2025-12-09
Health · complaint
F0695
Provide safe and appropriate respiratory care for a resident when needed.
K
2025-12-10
2025-06-19
Health
F0628
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
E
2025-07-11
2024-07-10
Health · complaint
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
K
2024-08-07
2024-05-23
Health
F0693
Ensure 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.
D
2024-06-21
2024-05-23
Health
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
2024-06-21
2023-11-01
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.
D
2023-12-09
2023-11-01
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2023-12-09
2023-11-01
Health · complaint
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
G
2023-12-09
2023-11-01
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.
E
2023-12-09
2023-11-01
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
H
2023-12-09
2023-11-01
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2023-12-09
2023-10-05
Health · complaint
F0624
Prepare residents for a safe transfer or discharge from the nursing home.
D
2023-11-03
2023-07-25
Health · complaint
F0698
Provide safe, appropriate dialysis care/services for a resident who requires such services.
E
2023-08-15
2023-03-24
Health
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.
E
2023-05-06
2023-03-24
Health
F0880
Provide and implement an infection prevention and control program.
D
2023-05-06
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
19
Owner
Role
Pct
From
Status
Source
CAMBRIDGE R/E INVESTORS
Individual has financial interest in both related organization and provider
100%
2022-12-01
current
hcris_a_8_1
CAMBRIDGE R/E INVESTORS
Individual has financial interest in both related organization and provider
100%
2023-12-01
current
hcris_a_8_1
DEVELOPMENT ENTERPRISE
Individual has financial interest in both related organization and provider
100%
2022-12-01
current
hcris_a_8_1
CAMBRIDGE MEDICAL INVESTORS, LLC
—
—
2026-01-01
current
tx_hhsc_directory
CROSS, CINDY
CORPORATE OFFICER
—
1994-09-22
current
pecos_ownership
LIFE CARE CENTERS OF AMERICA, INC
—
—
2026-01-01
current
tx_hhsc_directory
LIFE CARE CENTERS OF AMERICA, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
1997-01-01
current
pecos_ownership
THURMOND, JOAN
CORPORATE OFFICER
—
2000-09-21
current
pecos_ownership
WASHINGTON, RULKIYA
W-2 MANAGING EMPLOYEE
—
2021-08-31
current
pecos_ownership
CAMBRIDGE R/E INVESTORS
Individual has financial interest in both related organization and provider
100%
2021-12-01
ended 2022-11-30
hcris_a_8_1
CAMBRIDGE R/E INVESTORS
Individual has financial interest in both related organization and provider
100%
2019-12-01
ended 2020-11-30
hcris_a_8_1
CAMBRIDGE R/E INVESTORS
Individual has financial interest in both related organization and provider
100%
2020-12-01
ended 2021-11-30
hcris_a_8_1
DEVELOPMENT ENT
Individual has financial interest in both related organization and provider
100%
2020-12-01
ended 2021-11-30
hcris_a_8_1
DEVELOPMENT ENTERPRISE
Individual has financial interest in both related organization and provider
100%
2021-12-01
ended 2022-11-30
hcris_a_8_1
DEVELOPMENT ENTERPRISE
Individual has financial interest in both related organization and provider
100%
2019-12-01
ended 2020-11-30
hcris_a_8_1
FORREST PRESTON
5% OR GREATER DIRECT OWNERSHIP INTEREST
99%
1994-09-22
ended 2026-05-18
pecos_ownership
CINDY CROSS
CORPORATE OFFICER
—
1994-09-22
ended 2026-05-18
pecos_ownership
JOAN THURMOND
CORPORATE OFFICER
—
2000-09-21
ended 2026-05-18
pecos_ownership
RULKIYA WASHINGTON
W-2 MANAGING EMPLOYEE
—
2021-08-31
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
2024-11-30
$1,681,874
$811,463
—
—
$503,393
7
propco
2023-11-30
$1,691,080
$880,560
—
—
$452,351
8
propco
2022-11-30
$1,751,092
$855,764
$266,036
—
$535,263
7
propco
2021-11-30
$1,986,446
$905,670
—
—
$14,422
8
propco
2020-11-30
$2,139,868
$978,964
$294,265
—
$52,879
8
propco
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
34
Geo
Kind
BR
Amount
As of
Source
county 48201
acs median gross
0
$1,177
2024-12-31
CENSUS_ACS5
county 48201
fmr
0
$1,280
2025-10-01
HUD_USER_FMR
county 48201
acs median gross
1
$1,196
2024-12-31
CENSUS_ACS5
county 48201
fmr
1
$1,323
2025-10-01
HUD_USER_FMR
county 48201
acs median gross
2
$1,425
2024-12-31
CENSUS_ACS5
county 48201
fmr
2
$1,573
2025-10-01
HUD_USER_FMR
county 48201
acs median gross
3
$1,764
2024-12-31
CENSUS_ACS5
county 48201
fmr
3
$2,116
2025-10-01
HUD_USER_FMR
county 48201
acs median gross
4
$2,148
2024-12-31
CENSUS_ACS5
county 48201
fmr
4
$2,639
2025-10-01
HUD_USER_FMR
county 48201
acs median gross
5
$2,339
2024-12-31
CENSUS_ACS5
county 48201
acs median gross
$1,401
2024-12-31
CENSUS_ACS5
county 48201
acs recent mover gross
$1,495
2024-12-31
CENSUS_ACS5
zcta 77054
acs median gross
0
$1,193
2024-12-31
CENSUS_ACS5
zcta 77054
acs median gross
1
$1,348
2024-12-31
CENSUS_ACS5
zcta 77054
acs median gross
2
$1,620
2024-12-31
CENSUS_ACS5
zcta 77054
acs median gross
3
$2,236
2024-12-31
CENSUS_ACS5
zcta 77054
acs median gross
$1,440
2024-12-31
CENSUS_ACS5
zcta 77054
acs recent mover gross
$1,385
2024-12-31
CENSUS_ACS5
zip 77054
payment standard 110
0
$1,705
2025-10-01
HUD_USER_SAFMR
zip 77054
payment standard 90
0
$1,395
2025-10-01
HUD_USER_SAFMR
zip 77054
safmr
0
$1,550
2025-10-01
HUD_USER_SAFMR
zip 77054
payment standard 110
1
$1,771
2025-10-01
HUD_USER_SAFMR
zip 77054
payment standard 90
1
$1,449
2025-10-01
HUD_USER_SAFMR
zip 77054
safmr
1
$1,610
2025-10-01
HUD_USER_SAFMR
zip 77054
payment standard 110
2
$2,101
2025-10-01
HUD_USER_SAFMR
zip 77054
payment standard 90
2
$1,719
2025-10-01
HUD_USER_SAFMR
zip 77054
safmr
2
$1,910
2025-10-01
HUD_USER_SAFMR
zip 77054
payment standard 110
3
$2,827
2025-10-01
HUD_USER_SAFMR
zip 77054
payment standard 90
3
$2,313
2025-10-01
HUD_USER_SAFMR
zip 77054
safmr
3
$2,570
2025-10-01
HUD_USER_SAFMR
zip 77054
payment standard 110
4
$3,520
2025-10-01
HUD_USER_SAFMR
zip 77054
payment standard 90
4
$2,880
2025-10-01
HUD_USER_SAFMR
zip 77054
safmr
4
$3,200
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.