Reads as: riskier than 20.2% 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
1
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
9 chains
ASTON HEALTHCARE 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.
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
FL median
National median
National p25–p75
Total nurse
2.93
3.42
3.28
2.90–3.77
RN
0.50
0.45
0.39
0.25–0.58
Weekend total
2.90
3.31
3.11
—
Weekday total
2.94
3.48
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
170.1
2.93
0.50
0.57
1.86
2.90
0.0%
2025Q3
92
157.9
2.99
0.49
0.61
1.89
2.88
0.0%
2025Q2
91
158.6
3.22
0.42
0.74
2.06
3.09
0.0%
2025Q1
90
164.8
3.27
0.41
0.79
2.06
3.11
1.0%
2024Q4
92
168.7
3.34
0.34
0.87
2.13
3.19
0.1%
2024Q3
92
170.0
3.29
0.23
0.94
2.12
3.14
0.0%
2024Q2
91
167.5
3.31
0.20
0.99
2.11
3.12
7.5%
2024Q1
91
168.0
3.31
0.20
1.01
2.11
3.14
16.1%
2023Q4
92
168.1
3.37
0.14
1.06
2.16
3.15
20.2%
2023Q3
92
166.8
3.10
0.16
0.89
2.06
3.07
23.9%
2023Q2
91
166.8
3.17
0.18
0.88
2.11
3.06
18.7%
2023Q1
90
171.7
3.20
0.17
0.89
2.13
3.10
29.5%
2022Q4
92
167.9
3.25
0.15
0.89
2.21
3.16
36.3%
2022Q3
92
167.1
3.21
0.23
0.83
2.15
3.24
38.1%
2022Q2
91
153.8
3.35
0.34
0.71
2.31
3.39
29.2%
2022Q1
90
143.4
3.68
0.20
0.92
2.56
3.58
20.7%
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.
Penalties
0
No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
32
D × 25E × 7
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2025-11-05
Health · complaint
F0697
Provide safe, appropriate pain management for a resident who requires such services.
D
2025-12-04
2025-11-05
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
E
2025-12-04
2025-04-17
Health · complaint
F0585
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
E
2025-05-12
2025-04-17
Health · complaint
F0773
Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
D
2025-05-12
2024-08-06
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.
D
2024-09-06
2024-08-06
Health · complaint
F0585
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
D
2024-09-06
2024-08-06
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
2024-09-06
2024-03-07
Health · complaint
F0582
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
E
2024-04-07
2024-03-07
Health
F0641
Ensure each resident receives an accurate assessment.
E
2024-04-07
2024-03-07
Health
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
E
2024-04-07
2024-03-07
Health
F0675
Honor each resident's preferences, choices, values and beliefs.
D
2024-04-07
2024-03-07
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-04-07
2024-03-07
Health
F0690
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
D
2024-04-07
2024-03-07
Health
F0694
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
D
2024-04-07
2024-03-07
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2024-04-07
2024-03-07
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2024-04-07
2024-03-07
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2024-04-07
2024-03-07
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.
D
2024-04-07
2024-03-07
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2024-04-07
2024-03-07
Health · complaint
F0880
Provide and implement an infection prevention and control program.
D
2024-04-07
2024-03-07
Health
F0921
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
D
2024-04-07
2024-03-07
Health
F0925
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
D
2024-04-07
2021-11-18
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2021-12-16
2021-11-18
Health
F0623
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
D
2021-12-16
2021-11-18
Health
F0625
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
D
2021-12-16
2021-11-18
Health
F0692
Provide enough food/fluids to maintain a resident's health.
D
2021-12-16
2021-11-18
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2021-12-16
2021-11-18
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2021-12-16
2021-11-18
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2021-12-16
2021-11-18
Health
F0806
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
E
2021-12-16
2020-02-28
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2020-03-28
2020-02-28
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
2020-03-28
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
HIGHLAND LAKE PROPERTY HOLDINGS LLC
Individual has financial interest in both related organization and provider
33%
2024-01-01
current
hcris_a_8_1
ASTON HEALTHCARE LLC
ADP OF THE SNF
—
2025-07-09
current
pecos_ownership
BURGESS, TAMMIE
OPERATIONAL/MANAGERIAL CONTROL
—
2025-05-08
current
pecos_ownership
GABRIEL LIVING CENTER, LLC
DIRECT OWNERSHIP INTEREST
—
2023-12-15
current
pecos_ownership
HIGHLAND LAKE PROPERTY HOLDINGS LLC
Individual has financial interest in both related organization and provider
—
2023-01-01
current
hcris_a_8_1
HIGHLAND LAKE PROPERTY HOLDINGS LLC
Individual has financial interest in both related organization and provider
—
2022-10-01
current
hcris_a_8_1
HIGHLANDS LAKE HOLDCO LLC
DIRECT OWNERSHIP INTEREST
—
2023-12-15
current
pecos_ownership
LCE PARTNERS LLC
INDIRECT OWNERSHIP INTEREST
—
2021-01-01
current
pecos_ownership
PRASHAD, SHALIZA
OPERATIONAL/MANAGERIAL CONTROL
—
2023-11-07
current
pecos_ownership
REINOSO, JOSE
ADP OF THE SNF
—
2025-07-09
current
pecos_ownership
REINOSO, JOSE
OPERATIONAL/MANAGERIAL CONTROL
—
2022-06-10
current
pecos_ownership
THACKER, TRICIA
OPERATIONAL/MANAGERIAL CONTROL
—
2022-04-04
current
pecos_ownership
WILLIAMS, ELLIS
ADP OF THE SNF
—
2025-03-18
current
pecos_ownership
WILLIAMS, ELLIS
OPERATIONAL/MANAGERIAL CONTROL
—
2024-01-02
current
pecos_ownership
GABRIEL LIVING CENTER, LLC
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2003-04-01
ended 2026-05-18
pecos_ownership
SAMUEL KLEIN
CORPORATE OFFICER
75%
2021-01-01
ended 2026-05-18
pecos_ownership
SAMUEL GUTMAN
5% OR GREATER INDIRECT OWNERSHIP INTEREST
25%
2021-01-01
ended 2026-05-18
pecos_ownership
CYNTHIA AYALA
W-2 MANAGING EMPLOYEE
0%
2022-03-22
ended 2026-05-18
pecos_ownership
HIGHLAND LAKE PROPERTY HOLDINGS LLC
Individual has financial interest in both related organization and provider
—
2021-10-01
ended 2022-09-30
hcris_a_8_1
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.
Related-party costs
6
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$2,529,021
$2,529,021
—
—
—
2
propco
2023-12-31
$1,096,390
$1,096,390
—
—
—
2
propco
2023-09-30
$2,999,958
$2,999,958
—
—
—
2
propco
2022-09-30
$1,375,611
$1,375,611
—
—
—
2
propco
2021-09-30
$594,608
$424,612
—
$169,996
—
3
—
2020-09-30
$786,640
—
—
$742,756
$43,884
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
34
Geo
Kind
BR
Amount
As of
Source
county 12105
acs median gross
0
$1,033
2024-12-31
CENSUS_ACS5
county 12105
fmr
0
$1,226
2025-10-01
HUD_USER_FMR
county 12105
acs median gross
1
$1,044
2024-12-31
CENSUS_ACS5
county 12105
fmr
1
$1,230
2025-10-01
HUD_USER_FMR
county 12105
acs median gross
2
$1,242
2024-12-31
CENSUS_ACS5
county 12105
fmr
2
$1,497
2025-10-01
HUD_USER_FMR
county 12105
acs median gross
3
$1,644
2024-12-31
CENSUS_ACS5
county 12105
fmr
3
$2,023
2025-10-01
HUD_USER_FMR
county 12105
acs median gross
4
$2,115
2024-12-31
CENSUS_ACS5
county 12105
fmr
4
$2,511
2025-10-01
HUD_USER_FMR
county 12105
acs median gross
5
$1,815
2024-12-31
CENSUS_ACS5
county 12105
acs median gross
$1,363
2024-12-31
CENSUS_ACS5
county 12105
acs recent mover gross
$1,718
2024-12-31
CENSUS_ACS5
zcta 33813
acs median gross
1
$1,439
2024-12-31
CENSUS_ACS5
zcta 33813
acs median gross
2
$1,432
2024-12-31
CENSUS_ACS5
zcta 33813
acs median gross
3
$1,745
2024-12-31
CENSUS_ACS5
zcta 33813
acs median gross
4
$2,225
2024-12-31
CENSUS_ACS5
zcta 33813
acs median gross
$1,630
2024-12-31
CENSUS_ACS5
zcta 33813
acs recent mover gross
$2,004
2024-12-31
CENSUS_ACS5
zip 33813
payment standard 110
0
$1,760
2025-10-01
HUD_USER_SAFMR
zip 33813
payment standard 90
0
$1,440
2025-10-01
HUD_USER_SAFMR
zip 33813
safmr
0
$1,600
2025-10-01
HUD_USER_SAFMR
zip 33813
payment standard 110
1
$1,760
2025-10-01
HUD_USER_SAFMR
zip 33813
payment standard 90
1
$1,440
2025-10-01
HUD_USER_SAFMR
zip 33813
safmr
1
$1,600
2025-10-01
HUD_USER_SAFMR
zip 33813
payment standard 110
2
$2,145
2025-10-01
HUD_USER_SAFMR
zip 33813
payment standard 90
2
$1,755
2025-10-01
HUD_USER_SAFMR
zip 33813
safmr
2
$1,950
2025-10-01
HUD_USER_SAFMR
zip 33813
payment standard 110
3
$2,893
2025-10-01
HUD_USER_SAFMR
zip 33813
payment standard 90
3
$2,367
2025-10-01
HUD_USER_SAFMR
zip 33813
safmr
3
$2,630
2025-10-01
HUD_USER_SAFMR
zip 33813
payment standard 110
4
$3,597
2025-10-01
HUD_USER_SAFMR
zip 33813
payment standard 90
4
$2,943
2025-10-01
HUD_USER_SAFMR
zip 33813
safmr
4
$3,270
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.