Composite
88.7 / 100 percentile
Screener / 675471
D
North Star Ranch Rehabilitation and Health Care Ce
snfTX
709 W Fifth St, Bonham, TX 75418 · CCN 675471 · chain FANNIN COUNTY HOSPITAL AUTHORITY
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
65
Model
v1.2
Reads as: riskier than 88.7% 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.
Score model7ML signals25Components19CHOW radar1Distress radar1Staffing16Penalties2Deficiencies61Licensure0Ownership47Related party5Transactions0Comps12Market rent32
Composite explanation
7| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 97.7 | 96.4 | 0.30 | 0.1875 | 18.32 | in index |
| staffing risk | 85.9 | 85.9 | 0.25 | 0.1563 | 13.42 | in index |
| financial risk | 68.4 | 58.0 | 0.30 | 0.1875 | 12.83 | in index |
| state reg risk | 63.7 | 15.0 | 0.30 | 0.1875 | 11.94 | in index |
| chow risk | 67.9 | 63.2 | 0.15 | 0.0938 | 6.37 | in index |
| billing conduct | 15.3 | 20.0 | 0.30 | 0.1875 | 2.87 | in index |
| ownership opacity | 82.0 | 75.2 | 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
25| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +29.3 vs natl | KISSLING MONICA | 16 facilities |
| connection | Owner fleet risk far above national | +28.5 vs natl | TROMPLER KELLY | 16 facilities |
| connection | Owner fleet risk far above national | +28.5 vs natl | MCBEAN PATRICIA | 16 facilities |
| connection | Owner fleet risk far above national | +28.5 vs natl | HOLT ERIN | 16 facilities |
| connection | Owner fleet risk far above national | +28.5 vs natl | KEETON WENDY | 16 facilities |
| connection | Owner fleet risk far above national | +27.5 vs natl | RINER MEERA | 46 facilities |
| connection | Owner fleet risk far above national | +26.0 vs natl | FALLON JOHN | 20 facilities |
| connection | Owner fleet risk far above national | +25.4 vs natl | NEXION HEALTH INC | 33 facilities |
| connection | Owner fleet risk far above national | +24.8 vs natl | NEXION HEALTH LEASING INC | 33 facilities |
| connection | Owner fleet risk far above national | +24.3 vs natl | PIERCE DANIEL | 16 facilities |
| connection | Owner fleet risk far above national | +23.7 vs natl | NEXION HEALTH OF OHI INC | 31 facilities |
| connection | Owner fleet risk far above national | +23.4 vs natl | KIRLEY FRANCIS | 50 facilities |
| connection | Owner fleet risk far above national | +22.4 vs natl | SANDERSON CLARK | 58 facilities |
| connection | Owner fleet risk far above national | +21.5 vs natl | FANNIN COUNTY HOSPITAL AUTHORITY | 54 facilities |
| connection | Owner spans multiple chains | 10 chains | KIRLEY FRANCIS | 49 facilities |
| connection | Owner spans multiple chains | 8 chains | PIERCE DANIEL | 16 facilities |
| connection | Owner spans multiple chains | 8 chains | FALLON JOHN | 20 facilities |
| connection | Owner spans multiple chains | 8 chains | RINER MEERA | 46 facilities |
| connection | Owner fleet enforcement cluster | 75% fined | PIERCE DANIEL | 16 facilities |
| connection | Owner fleet enforcement cluster | 50% fined | MCBEAN PATRICIA | 16 facilities |
| connection | Owner fleet enforcement cluster | 50% fined | TROMPLER KELLY | 16 facilities |
| connection | Owner fleet enforcement cluster | 50% fined | HOLT ERIN | 16 facilities |
| connection | Owner fleet enforcement cluster | 50% fined | KEETON WENDY | 16 facilities |
| connection | Owner fleet enforcement cluster | 50% fined | KISSLING MONICA | 16 facilities |
| connection | Owner fleet enforcement cluster | 46% fined | RINER MEERA | 46 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
19| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 20.0 | A | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 25.0 | B | 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. |
| chow risk | 72.1 | D | v0.1-txhhsc | default · in composite | Texas licence reissue timing as an ownership-transfer proxy. |
| chow risk | 92.6 | F | v0.6 | default · in composite | |
| financial risk | 58.0 | C | v0.5 | default · in composite | R18. |
| ownership opacity | 75.2 | D | v0.1-txhhsc | default · in composite | Texas HHSC directory ownership structure: chain size, absentee owner, management company, entity form, owner closure history. |
| p adverse action 12m | 0.0 | — | v0.1 | default · in composite | 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. |
| p chow 12m | 8.2 | — | v0.1 | default · in 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. |
| regulatory risk | 96.4 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 85.9 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| state reg risk | 15.0 | A | v0.5 | default · in composite | |
| financial risk | 82.7 | 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 | 62.7 | 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 | 54.4 | 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 | 61.5 | 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. |
| regulatory risk | 96.3 | F | v0.1 | superseded | 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. |
| regulatory risk | 96.3 | F | v0.2 | superseded | 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. |
| staffing risk | 85.9 | F | v0.1 | superseded | 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. |
| staffing risk | 85.9 | F | v0.2 | superseded | 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.
CHOW radar — 12-month sale probability
full board →p(CHOW, 12m)
8.2%
model v0.1 · computed 2026-07-29
Percentile among SNFs
96.2
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 1.00 | +0.69 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| Chain size (log) | 4.01 | +0.45 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Contract staffing share | 0.00 | -0.10 | |
| Total nurse staffing (HPRD) | 2.66 | +0.08 |
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.
Distress radar — 12-month termination probability
full board →p(termination, 12m)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
27.7
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Chain size (log) | 4.01 | -1.13 | |
| For-profit ownership | 1.00 | -0.69 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Total nurse staffing (HPRD) | 2.66 | +0.23 | |
| Occupancy | 0.69 | +0.23 | |
| Fine amount, 12m (log) | 0.00 | +0.18 | |
| Deficiencies, last 12 months | 7.00 | +0.13 | |
| Never sold on record | 1.00 | +0.12 |
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 | 2.66 | 2.67 | 3.28 | 2.90–3.77 |
| RN | 0.13 | 0.24 | 0.39 | 0.25–0.58 |
| Weekend total | 2.68 | 2.56 | 3.11 | — |
| Weekday total | 2.65 | 2.72 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 45.1 | 2.66 | 0.13 | 1.02 | 1.50 | 2.68 | 0.0% |
| 2025Q3 | 92 | 49.4 | 2.40 | 0.17 | 0.90 | 1.32 | 2.53 | 0.0% |
| 2025Q2 | 91 | 51.8 | 2.24 | 0.17 | 0.82 | 1.26 | 2.15 | 0.0% |
| 2025Q1 | 90 | 48.5 | 2.48 | 0.19 | 0.85 | 1.44 | 2.46 | 0.0% |
| 2024Q4 | 92 | 45.7 | 2.48 | 0.08 | 1.00 | 1.41 | 2.46 | 0.0% |
| 2024Q3 | 92 | 46.7 | 2.53 | 0.28 | 0.74 | 1.50 | 2.37 | 0.0% |
| 2024Q2 | 91 | 49.0 | 2.38 | 0.22 | 0.69 | 1.46 | 2.34 | 0.0% |
| 2024Q1 | 91 | 47.7 | 2.38 | 0.20 | 0.78 | 1.41 | 2.02 | 0.1% |
| 2023Q4 | 92 | 45.9 | 2.24 | 0.25 | 0.84 | 1.15 | 1.96 | 0.5% |
| 2023Q3 | 92 | 44.9 | 2.40 | 0.32 | 0.78 | 1.29 | 2.28 | 0.0% |
| 2023Q2 | 91 | 47.2 | 2.37 | 0.30 | 0.76 | 1.31 | 2.33 | 13.8% |
| 2023Q1 | 90 | 48.8 | 2.17 | 0.18 | 0.76 | 1.23 | 2.17 | 12.7% |
| 2022Q4 | 92 | 42.3 | 2.13 | 0.28 | 0.70 | 1.15 | 1.80 | 0.0% |
| 2022Q3 | 92 | 37.0 | 2.95 | 0.33 | 0.85 | 1.77 | 2.36 | 6.8% |
| 2022Q2 | 91 | 37.2 | 2.84 | 0.33 | 0.75 | 1.76 | 2.41 | 11.0% |
| 2022Q1 | 90 | 36.8 | 2.84 | 0.40 | 0.69 | 1.75 | 2.29 | 0.8% |
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.
Penalties
2fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-02-27 | Fine | $168,236 | CMS provider data |
| 2024-01-12 | Fine | $109,769 | CMS provider data |
Total fines on record: $278,005
Deficiencies
61C × 1D × 35E × 16F × 4G × 1J × 3K × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-03-06 | Health · complaint | F0628 | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | 2026-03-09 |
| 2026-02-20 | Health · complaint | F0692 | Provide enough food/fluids to maintain a resident's health. | E | 2026-02-23 |
| 2025-12-01 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2025-12-02 |
| 2025-12-01 | Health · complaint | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | F | 2025-12-02 |
| 2025-12-01 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2025-12-02 |
| 2025-12-01 | Health · complaint | F0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | D | 2025-12-02 |
| 2025-12-01 | Health · complaint | F0825 | Provide or get specialized rehabilitative services as required for a resident. | D | 2025-12-02 |
| 2025-05-24 | 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 | 2025-05-25 |
| 2025-05-24 | 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 | 2025-05-25 |
| 2025-04-24 | Health | F0552 | Ensure that residents are fully informed and understand their health status, care and treatments. | D | 2025-04-25 |
| 2025-04-24 | Health | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2025-04-25 |
| 2025-04-24 | 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 | 2025-04-25 |
| 2025-04-24 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2025-04-25 |
| 2025-04-24 | Health | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2025-04-25 |
| 2025-04-24 | Health | F0610 | Respond appropriately to all alleged violations. | D | 2025-04-25 |
| 2025-04-24 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2025-04-25 |
| 2025-04-24 | Health | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | 2025-04-25 |
| 2025-04-24 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | K | 2025-04-25 |
| 2025-04-24 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | 2025-04-25 |
| 2025-04-24 | Health | F0732 | Post nurse staffing information every day. | C | 2025-04-25 |
| 2025-04-24 | Health | F0757 | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | 2025-04-25 |
| 2025-04-24 | 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. | F | 2025-04-25 |
| 2025-04-24 | Health | F0770 | Provide timely, quality laboratory services/tests to meet the needs of residents. | D | 2025-04-25 |
| 2025-04-24 | Health | F0773 | Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results. | D | 2025-04-25 |
| 2025-04-24 | 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. | D | 2025-04-25 |
| 2025-04-24 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2025-04-25 |
| 2025-04-24 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2025-04-25 |
| 2025-04-24 | Health | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | F | 2025-04-25 |
| 2025-04-24 | Health | F0926 | Have policies on smoking. | D | 2025-04-25 |
| 2025-02-27 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2025-02-28 |
| 2025-02-27 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | 2025-02-28 |
| 2024-03-06 | Health | 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 | 2024-03-28 |
| 2024-03-06 | Health | F0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | D | 2024-03-28 |
| 2024-03-06 | Health | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | 2024-03-28 |
| 2024-03-06 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2024-03-28 |
| 2024-03-06 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | 2024-03-28 |
| 2024-03-06 | Health | 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 | 2024-03-28 |
| 2024-03-06 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2024-03-28 |
| 2024-03-06 | 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. | D | 2024-03-28 |
| 2024-03-06 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | D | 2024-03-28 |
| 2024-03-06 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-03-28 |
| 2024-03-06 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2024-03-28 |
| 2024-01-12 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | 2024-01-13 |
| 2024-01-12 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2024-01-13 |
| 2024-01-12 | Health · complaint | F0740 | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | J | 2024-01-13 |
| 2022-12-01 | Health | F0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | 2022-12-23 |
| 2022-12-01 | Health | F0583 | Keep residents' personal and medical records private and confidential. | D | 2022-12-23 |
| 2022-12-01 | Health | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | E | 2022-12-23 |
| 2022-12-01 | Health | F0638 | Assure that each resident’s assessment is updated at least once every 3 months. | D | 2022-12-23 |
| 2022-12-01 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2022-12-23 |
| 2022-12-01 | Health | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | 2022-12-23 |
| 2022-12-01 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | 2022-12-23 |
| 2022-12-01 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2022-12-23 |
| 2022-12-01 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2022-12-23 |
| 2022-12-01 | Health | F0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | 2022-12-23 |
| 2022-12-01 | 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 | 2022-12-23 |
| 2022-12-01 | Health | F0770 | Provide timely, quality laboratory services/tests to meet the needs of residents. | E | 2022-12-23 |
| 2022-12-01 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2022-12-23 |
| 2022-12-01 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | E | 2022-12-23 |
| 2022-12-01 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2022-12-23 |
| 2022-12-01 | Health | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | D | 2022-12-23 |
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
47| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| FANNIN COUNTY HOSPITAL AUTHORITY | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2025-05-01 | current | pecos_ownership |
| CORRERA, KRISTY | ADP OF THE SNF | — | 2025-11-17 | current | pecos_ownership |
| FALLON, JOHN | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-05-01 | current | pecos_ownership |
| FANNIN COUNTY HOSPITAL AUTHORITY | — | — | 2025-05-01 | current | tx_hhsc_directory |
| HOLT, ERIN | MANAGING CONTROL - GOVERNING BODY | — | 2020-02-25 | current | pecos_ownership |
| KEETON, WENDY | MANAGING CONTROL - GOVERNING BODY | — | 2012-10-29 | current | pecos_ownership |
| KIRLEY, CHRISTOPHER | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-05-01 | current | pecos_ownership |
| KIRLEY, FRANCIS | ADP OF THE SNF | — | 2025-05-01 | current | pecos_ownership |
| KISSLING, MONICA | MANAGING CONTROL - GOVERNING BODY | — | 2017-06-21 | current | pecos_ownership |
| LIBERATORE, DANTE | ADP OF THE SNF | — | 2025-05-01 | current | pecos_ownership |
| LIBERATORE, DANTE | MANAGING CONTROL - GOVERNING BODY | — | 2022-12-19 | current | pecos_ownership |
| MCBEAN, PATRICIA | MANAGING CONTROL - GOVERNING BODY | — | 2021-08-30 | current | pecos_ownership |
| MITCHELL, RYAN | ADP OF THE SNF | — | 2025-05-01 | current | pecos_ownership |
| NEXION HEALTH AT BONHAM, INC | — | — | 2025-05-01 | current | tx_hhsc_directory |
| NEXION HEALTH AT BONHAM, INC. | ADP OF THE SNF | — | 2025-05-01 | current | pecos_ownership |
| NEXION HEALTH LEASING, INC. | ADP OF THE SNF | — | 2025-05-01 | current | pecos_ownership |
| NEXION HEALTH OF OHI INC | ADP OF THE SNF | — | 2025-05-01 | current | pecos_ownership |
| NEXION HEALTH, INC. | ADP OF THE SNF | — | 2025-05-01 | current | pecos_ownership |
| OWENS, ANGELA | MANAGING CONTROL - GOVERNING BODY | — | 2016-06-22 | current | pecos_ownership |
| PIERCE, DANIEL | ADP OF THE SNF | — | 2025-05-01 | current | pecos_ownership |
| RINER, MEERA | MANAGING CONTROL - GOVERNING BODY | — | 2012-02-01 | current | pecos_ownership |
| RINER, MEERA | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-05-01 | current | pecos_ownership |
| SANDERSON, CLARK | ADP OF THE SNF | — | 2025-05-01 | current | pecos_ownership |
| SANDERSON, CLARK | MANAGING CONTROL - GOVERNING BODY | — | 2012-10-29 | current | pecos_ownership |
| SHAH, JAGDISH | ADP OF THE SNF | — | 2025-05-01 | current | pecos_ownership |
| THOMISON, ISAAC | ADP OF THE SNF | — | 2025-05-01 | current | pecos_ownership |
| TROMPLER, KELLY | MANAGING CONTROL - GOVERNING BODY | — | 2022-02-22 | current | pecos_ownership |
| ANGELA OWENS | MANAGING CONTROL - GOVERNING BODY | — | 2016-06-22 | ended 2026-05-18 | pecos_ownership |
| CHRISTOPHER KIRLEY | ADP OF THE SNF | — | 2025-05-01 | ended 2026-05-18 | pecos_ownership |
| CLARK SANDERSON | MANAGING CONTROL - GOVERNING BODY | — | 2012-10-29 | ended 2026-05-18 | pecos_ownership |
| CLARK SANDERSON | CORPORATE OFFICER | — | 2025-05-01 | ended 2026-05-18 | pecos_ownership |
| DANIEL PIERCE | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-05-01 | ended 2026-05-18 | pecos_ownership |
| DANTE LIBERATORE | MANAGING CONTROL - GOVERNING BODY | — | 2022-12-19 | ended 2026-05-18 | pecos_ownership |
| DANTE LIBERATORE | ADP OF THE SNF | — | 2025-05-01 | ended 2026-05-18 | pecos_ownership |
| ERIN HOLT | MANAGING CONTROL - GOVERNING BODY | — | 2020-02-25 | ended 2026-05-18 | pecos_ownership |
| FRANCIS KIRLEY | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-05-01 | ended 2026-05-18 | pecos_ownership |
| ISAAC THOMISON | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-05-01 | ended 2026-05-18 | pecos_ownership |
| JAGDISH SHAH | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-05-01 | ended 2026-05-18 | pecos_ownership |
| JOHN FALLON | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-05-01 | ended 2026-05-18 | pecos_ownership |
| KELLY TROMPLER | MANAGING CONTROL - GOVERNING BODY | — | 2022-02-22 | ended 2026-05-18 | pecos_ownership |
| KRISTY CORRERA | ADP OF THE SNF | — | 2025-11-17 | ended 2026-05-18 | pecos_ownership |
| MEERA RINER | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-05-01 | ended 2026-05-18 | pecos_ownership |
| MEERA RINER | MANAGING CONTROL - GOVERNING BODY | — | 2012-02-01 | ended 2026-05-18 | pecos_ownership |
| MONICA KISSLING | MANAGING CONTROL - GOVERNING BODY | — | 2017-06-21 | ended 2026-05-18 | pecos_ownership |
| PATRICIA MCBEAN | MANAGING CONTROL - GOVERNING BODY | — | 2021-08-30 | ended 2026-05-18 | pecos_ownership |
| RYAN MITCHELL | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-05-01 | ended 2026-05-18 | pecos_ownership |
| WENDY KEETON | MANAGING CONTROL - GOVERNING BODY | — | 2012-10-29 | 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.
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.
Comparable trades — TX snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-10-01 | ST. ANTHONY'S CARE CENTER | — | — | — | 120 | SOUTH LIMESTONE HOSPITAL DISTRICT |
| 2025-10-01 | Avir at New Braunfels | — | — | — | 154 | 821 US HIGHWAY 81 W OPCO LLC |
| 2025-09-01 | Avir at Texarkana | — | — | — | 110 | GUADALUPE COUNTY HOSPITAL BOARD |
| 2025-09-01 | PARKS HEALTH CENTER | — | — | — | 90 | WEST COKE COUNTY HOSPITAL DISTRICT |
| 2025-09-01 | WINDMILL VILLAGE REHABILITATION & CARE CENTER | — | — | — | 120 | FANNIN COUNTY HOSPITAL AUTHORITY |
| 2025-08-31 | Las Ventanas De Socorro | — | — | — | 126 | SOCORRO HEALTH CARE LLC |
| 2025-08-01 | Avir at Mineola | — | — | — | 115 | HOPKINS COUNTY HOSPITAL DISTRICT |
| 2025-08-01 | Avir at Orem | — | — | — | 120 | 3730 W OREM DR OPCO LLC |
| 2025-08-01 | Avir at Courtyard | — | — | — | 120 | 7499 STANWICK DR OPCO LLC |
| 2025-08-01 | HILLSIDE MEDICAL LODGE | — | — | — | 128 | CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY |
| 2025-08-01 | Avir at Pasadena | — | — | — | 131 | 4300 VISTA RD OPCO LLC |
| 2025-07-01 | Highland Meadows | — | — | — | 120 | NOCONA HOSPITAL DISTRICT |
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
32| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 48147 | acs median gross | 0 | $425 | 2024-12-31 | CENSUS_ACS5 |
| county 48147 | fmr | 0 | $679 | 2025-10-01 | HUD_USER_FMR |
| county 48147 | acs median gross | 1 | $621 | 2024-12-31 | CENSUS_ACS5 |
| county 48147 | fmr | 1 | $751 | 2025-10-01 | HUD_USER_FMR |
| county 48147 | acs median gross | 2 | $1,068 | 2024-12-31 | CENSUS_ACS5 |
| county 48147 | fmr | 2 | $985 | 2025-10-01 | HUD_USER_FMR |
| county 48147 | acs median gross | 3 | $1,111 | 2024-12-31 | CENSUS_ACS5 |
| county 48147 | fmr | 3 | $1,370 | 2025-10-01 | HUD_USER_FMR |
| county 48147 | acs median gross | 4 | $1,735 | 2024-12-31 | CENSUS_ACS5 |
| county 48147 | fmr | 4 | $1,652 | 2025-10-01 | HUD_USER_FMR |
| county 48147 | acs median gross | $1,035 | 2024-12-31 | CENSUS_ACS5 | |
| county 48147 | acs recent mover gross | $1,144 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 75418 | acs median gross | 1 | $783 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75418 | acs median gross | 2 | $1,131 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75418 | acs median gross | 3 | $1,155 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75418 | acs median gross | $1,074 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 75418 | acs recent mover gross | $1,196 | 2024-12-31 | CENSUS_ACS5 | |
| zip 75418 | payment standard 110 | 0 | $737 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | payment standard 90 | 0 | $603 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | safmr | 0 | $670 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | payment standard 110 | 1 | $814 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | payment standard 90 | 1 | $666 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | safmr | 1 | $740 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | payment standard 110 | 2 | $1,067 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | payment standard 90 | 2 | $873 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | safmr | 2 | $970 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | payment standard 110 | 3 | $1,485 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | payment standard 90 | 3 | $1,215 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | safmr | 3 | $1,350 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | payment standard 110 | 4 | $1,804 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | payment standard 90 | 4 | $1,476 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75418 | safmr | 4 | $1,640 | 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.