Composite
89.4 / 100 percentile
| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| financial risk | 98.6 | 92.6 | 0.30 | 0.1875 | 18.49 | in index |
| staffing risk | 90.4 | 90.4 | 0.25 | 0.1563 | 14.13 | in index |
| state reg risk | 63.7 | 15.0 | 0.30 | 0.1875 | 11.94 | in index |
| regulatory risk | 52.2 | 41.7 | 0.30 | 0.1875 | 9.79 | in index |
| chow risk | 67.6 | 64.4 | 0.15 | 0.0938 | 6.34 | in index |
| billing conduct | 29.2 | 31.2 | 0.30 | 0.1875 | 5.48 | in index |
| ownership opacity | 58.4 | 55.2 | excluded |
| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +25.1 vs natl | HOOPER GRADY | 61 facilities |
| connection | Owner spans multiple chains | 5 chains | SCHEINER ELIEZER | 27 facilities |
| connection | Owner fleet enforcement cluster | 49% fined | HOOPER GRADY | 61 facilities |
| connection | Owner fleet enforcement cluster | 47% fined | SCHEINER ELIEZER | 32 facilities |
| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 31.2 | B | 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 | 69.7 | D | v0.1-txhhsc | default · in composite | Texas licence reissue timing as an ownership-transfer proxy. |
| chow risk | 98.6 | F | v0.6 | default · in composite | |
| financial risk | 92.6 | F | v0.5 | default · in composite | R18. |
| ownership opacity | 55.2 | C | 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 | 0.1 | — | 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 | 0.0 | — | 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 | 41.7 | B | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 90.4 | 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 | 92.1 | 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 | 72.1 | D | 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 | 73.2 | 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 | 91.1 | F | 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 | 41.6 | B | 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 | 41.6 | B | 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 | 90.4 | 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 | 90.4 | 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. |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Never sold on record | 0.00 | -1.62 | |
| Current owner tenure (years) | 3.41 | -1.51 | |
| For-profit ownership | 0.00 | -1.24 | |
| Ownership changes, last 5 years | 1.00 | -0.87 | |
| Occupancy | 0.40 | +0.86 | |
| Chain size (log) | 4.04 | +0.46 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Deficiencies, last 12 months | 14.00 | +0.17 |
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | +1.62 | |
| Occupancy | 0.40 | +1.47 | |
| Deficiencies, last 12 months | 14.00 | -1.17 | |
| Chain size (log) | 4.04 | -1.15 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Staffing trend, last 4 quarters | -0.65 | -0.33 | |
| Total nurse staffing (HPRD) | 2.52 | +0.29 | |
| Never sold on record | 0.00 | -0.28 |
| 2025Q4 HPRD | This facility | TX median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 2.52 | 2.67 | 3.28 | 2.90–3.77 |
| RN | 0.27 | 0.24 | 0.39 | 0.25–0.58 |
| Weekend total | 2.47 | 2.56 | 3.11 | — |
| Weekday total | 2.54 | 2.72 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 52.7 | 2.52 | 0.27 | 0.78 | 1.48 | 2.47 | 0.0% |
| 2025Q3 | 92 | 51.6 | 2.65 | 0.31 | 0.75 | 1.59 | 2.48 | 0.0% |
| 2025Q2 | 91 | 48.9 | 2.92 | 0.14 | 1.04 | 1.74 | 2.62 | 0.0% |
| 2025Q1 | 90 | 49.0 | 2.98 | 0.20 | 1.05 | 1.73 | 2.57 | 0.0% |
| 2024Q4 | 92 | 45.4 | 3.17 | 0.38 | 0.91 | 1.88 | 2.74 | 0.0% |
| 2024Q3 | 92 | 45.6 | 3.11 | 0.33 | 0.85 | 1.93 | 2.85 | 0.0% |
| 2024Q2 | 91 | 44.5 | 3.22 | 0.31 | 0.91 | 2.00 | 2.87 | 0.0% |
| 2024Q1 | 91 | 48.7 | 2.85 | 0.39 | 0.94 | 1.52 | 2.54 | 0.0% |
| 2023Q4 | 92 | 50.8 | 2.69 | 0.26 | 0.92 | 1.51 | 2.41 | 0.0% |
| 2023Q3 | 92 | 47.7 | 2.90 | 0.27 | 1.04 | 1.59 | 2.55 | 0.0% |
| 2023Q2 | 91 | 50.0 | 2.77 | 0.18 | 1.09 | 1.50 | 2.45 | 0.0% |
| 2023Q1 | 90 | 46.7 | 3.09 | 0.21 | 1.08 | 1.80 | 2.83 | 0.0% |
| 2022Q4 | 92 | 48.8 | 3.04 | 0.27 | 1.09 | 1.68 | 2.82 | 0.0% |
| 2022Q3 | 92 | 45.6 | 3.10 | 0.42 | 1.10 | 1.57 | 2.98 | 0.0% |
| 2022Q2 | 91 | 46.5 | 3.19 | 0.38 | 1.10 | 1.71 | 2.89 | 0.0% |
| 2022Q1 | 90 | 47.9 | 3.16 | 0.35 | 1.11 | 1.70 | 2.88 | 0.0% |
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-04-14 | Health · complaint | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | 2026-04-30 |
| 2025-12-10 | Health | F0553 | Allow resident to participate in the development and implementation of his or her person-centered plan of care. | D | 2026-01-06 |
| 2025-12-10 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2026-01-06 |
| 2025-12-10 | 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 | 2026-01-06 |
| 2025-12-10 | Health | F0676 | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | 2026-01-06 |
| 2025-12-10 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2026-01-06 |
| 2025-12-10 | Health | F0699 | Provide care or services that was trauma informed and/or culturally competent. | E | 2026-01-06 |
| 2025-12-10 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | E | 2026-01-06 |
| 2025-12-10 | Health | F0760 | Ensure that residents are free from significant medication errors. | D | 2026-01-06 |
| 2025-12-10 | 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 | 2026-01-06 |
| 2025-12-10 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2026-01-06 |
| 2025-12-10 | Health | F0810 | Provide special eating equipment and utensils for residents who need them and appropriate assistance. | D | 2026-01-06 |
| 2025-12-10 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2026-01-06 |
| 2025-12-10 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2026-01-06 |
| 2024-09-18 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-10-03 |
| 2024-09-18 | Health | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | 2024-10-03 |
| 2024-09-18 | 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 | 2024-10-03 |
| 2024-09-18 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2024-10-03 |
| 2023-08-16 | 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 | 2023-09-08 |
| 2023-08-16 | Health | F0636 | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | D | 2023-09-08 |
| 2023-08-16 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2023-09-08 |
| 2023-08-16 | 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 | 2023-09-08 |
| 2023-08-16 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2023-09-08 |
| 2023-08-16 | Health | F0699 | Provide care or services that was trauma informed and/or culturally competent. | D | 2023-09-08 |
| 2023-08-16 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2023-09-08 |
| 2023-08-16 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2023-09-08 |
| 2023-08-16 | 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 | 2023-09-08 |
| 2023-08-16 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2023-09-08 |
| 2023-08-16 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2023-09-08 |
| 2023-08-16 | Health | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | E | 2023-09-08 |
| 2023-08-16 | Health | F0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | E | 2023-09-08 |
| 2023-08-09 | Health · complaint | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | 2023-08-29 |
| 2023-08-09 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-08-29 |
| 2023-08-09 | 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 | 2023-08-29 |
| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| CLARKSVILLE HC LLC | — | — | 2026-03-01 | current | tx_hhsc_directory |
| CLARKSVILLE HC LLC | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-03-01 | current | pecos_ownership |
| FAULKNER, GARREL | W-2 MANAGING EMPLOYEE | — | 2023-03-01 | current | pecos_ownership |
| HAMILTON COUNTY HOSPITAL DISTRICT | — | — | 2026-03-01 | current | tx_hhsc_directory |
| HOOPER, GRADY | CORPORATE DIRECTOR | — | 2023-03-01 | current | pecos_ownership |
| SCHEINER, ELIEZER | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-03-01 | current | pecos_ownership |
| HAMILTON COUNTY HOSPITAL DISTRICT | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2023-03-01 | ended 2026-05-18 | pecos_ownership |
| ELIEZER SCHEINER | OPERATIONAL/MANAGERIAL CONTROL | 0% | 2023-03-01 | ended 2026-05-18 | pecos_ownership |
| GARREL FAULKNER | W-2 MANAGING EMPLOYEE | 0% | 2023-03-01 | ended 2026-05-18 | pecos_ownership |
| GRADY HOOPER | CORPORATE DIRECTOR | 0% | 2023-03-01 | ended 2026-05-18 | pecos_ownership |
| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2023-03-01 | — | HAMILTON COUNTY HOSPITAL DISTRICT | CLARKSVILLE SNF LLC | chow |
| 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 |
| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 48387 | acs median gross | 0 | $286 | 2024-12-31 | CENSUS_ACS5 |
| county 48387 | fmr | 0 | $671 | 2025-10-01 | HUD_USER_FMR |
| county 48387 | acs median gross | 1 | $495 | 2024-12-31 | CENSUS_ACS5 |
| county 48387 | fmr | 1 | $778 | 2025-10-01 | HUD_USER_FMR |
| county 48387 | acs median gross | 2 | $988 | 2024-12-31 | CENSUS_ACS5 |
| county 48387 | fmr | 2 | $973 | 2025-10-01 | HUD_USER_FMR |
| county 48387 | acs median gross | 3 | $1,142 | 2024-12-31 | CENSUS_ACS5 |
| county 48387 | fmr | 3 | $1,353 | 2025-10-01 | HUD_USER_FMR |
| county 48387 | acs median gross | 4 | $1,125 | 2024-12-31 | CENSUS_ACS5 |
| county 48387 | fmr | 4 | $1,632 | 2025-10-01 | HUD_USER_FMR |
| county 48387 | acs median gross | $1,044 | 2024-12-31 | CENSUS_ACS5 | |
| county 48387 | acs recent mover gross | $1,104 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 75426 | acs median gross | 1 | $480 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75426 | acs median gross | 2 | $1,147 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75426 | acs median gross | 3 | $1,139 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75426 | acs median gross | $1,088 | 2024-12-31 | CENSUS_ACS5 | |
| zip 75426 | payment standard 110 | 0 | $737 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | payment standard 90 | 0 | $603 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | safmr | 0 | $670 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | payment standard 110 | 1 | $858 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | payment standard 90 | 1 | $702 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | safmr | 1 | $780 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | payment standard 110 | 2 | $1,067 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | payment standard 90 | 2 | $873 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | safmr | 2 | $970 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | payment standard 110 | 3 | $1,485 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | payment standard 90 | 3 | $1,215 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | safmr | 3 | $1,350 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | payment standard 110 | 4 | $1,804 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | payment standard 90 | 4 | $1,476 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75426 | safmr | 4 | $1,640 | 2025-10-01 | HUD_USER_SAFMR |