Reads as: riskier than 88.5% 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
3
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+35.4 vs natl
BELL BILLIE
7 facilities
connection
Owner fleet risk far above national
+33.6 vs natl
MEDINA COUNTY HOSPITAL DISTRICT
6 facilities
connection
Owner fleet enforcement cluster
43% fined
BELL BILLIE
7 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
15
2025Q4 HPRD
This facility
TX median
National median
National p25–p75
Total nurse
2.07
2.67
3.28
2.90–3.77
RN
0.34
0.24
0.39
0.25–0.58
Weekend total
2.04
2.56
3.11
—
Weekday total
2.08
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
88.3
2.07
0.34
0.83
0.90
2.04
14.5%
2025Q3
92
85.9
2.02
0.38
0.77
0.88
1.90
19.4%
2025Q2
91
81.0
1.94
0.38
0.85
0.71
1.71
2.9%
2025Q1
90
84.1
2.28
0.43
0.81
1.03
1.92
16.6%
2024Q4
92
82.6
2.10
0.30
0.95
0.85
1.88
11.4%
2024Q3
92
83.9
2.23
0.26
1.02
0.94
2.22
12.5%
2024Q2
91
82.7
2.56
0.33
1.20
1.04
2.34
8.8%
2024Q1
91
87.8
2.43
0.20
1.20
1.04
2.17
23.9%
2023Q4
92
84.3
2.29
0.26
1.15
0.88
2.04
21.2%
2023Q3
92
89.8
1.96
0.26
0.97
0.72
1.69
5.9%
2023Q2
91
84.5
2.02
0.36
0.93
0.73
1.69
8.3%
2023Q1
90
88.6
1.94
0.20
0.82
0.92
1.77
24.6%
2022Q4
92
82.6
2.26
0.23
0.95
1.08
2.23
26.1%
2022Q3
92
95.2
2.15
0.27
0.79
1.10
2.06
23.9%
2022Q1
90
92.6
2.05
0.26
0.97
0.82
2.06
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.
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
E
2025-09-25
2025-09-05
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
2025-09-25
2025-09-05
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2025-09-06
2025-09-05
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2025-09-25
2025-09-05
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
E
2025-09-25
2025-09-05
Health
F0908
Keep all essential equipment working safely.
E
2025-09-25
2024-11-23
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.
J
2024-11-19
2024-11-23
Health · complaint
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
2024-11-24
2024-11-23
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
J
2024-11-19
2024-11-23
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2024-11-24
2024-11-23
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
E
2024-11-24
2024-11-23
Health · complaint
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
2024-11-24
2024-08-02
Health
F0558
Reasonably accommodate the needs and preferences of each resident.
E
2024-08-03
2024-08-02
Health
F0583
Keep residents' personal and medical records private and confidential.
D
2024-08-03
2024-08-02
Health
F0641
Ensure each resident receives an accurate assessment.
D
2024-08-03
2024-08-02
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2024-08-03
2024-08-02
Health
F0880
Provide and implement an infection prevention and control program.
E
2024-08-03
2023-12-29
Health · complaint
F0602
Protect each resident from the wrongful use of the resident's belongings or money.
D
2023-10-02
2023-12-29
Health · complaint
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
D
2023-08-28
2023-12-29
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2023-10-07
2023-05-26
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2023-05-27
2023-05-26
Health
F0760
Ensure that residents are free from significant medication errors.
E
2023-05-27
2023-05-26
Health
F0808
Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
D
2023-05-27
2023-05-26
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
2023-05-27
2023-05-26
Health
F0847
Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
F
2023-05-27
2023-05-26
Health
F0848
Provide a neutral and fair arbitration process and agree to arbitrator and venue.
D
2023-05-27
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
15
Owner
Role
Pct
From
Status
Source
MEDINA COUNTY HOSPITAL DISTRICT
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2021-05-01
current
pecos_ownership
BELL, BILLIE
CORPORATE OFFICER
—
2023-06-03
current
pecos_ownership
BOERNE HC LLC
ADP OF THE SNF
—
2021-05-01
current
pecos_ownership
CASCADE-KENDALL HEALTH SERVICES, LTD
OPERATIONAL/MANAGERIAL CONTROL
—
2021-05-01
current
pecos_ownership
CASCADEKENDALL HEALTH SERVICES, LTD
—
—
2024-05-01
current
tx_hhsc_directory
COLLIER, TAYLOR
ADP OF THE SNF
—
2023-08-22
current
pecos_ownership
DORROW, MARJORIE
INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
—
2025-11-17
current
pecos_ownership
HANEY, MAX
INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
—
2025-11-17
current
pecos_ownership
HANEY, RONALD
ADP OF THE SNF
—
2021-05-01
current
pecos_ownership
MEDINA COUNTY HOSPITAL DISTRICT
—
—
2024-05-01
current
tx_hhsc_directory
SORRELLS, JOHN
ADP OF THE SNF
—
2021-05-01
current
pecos_ownership
RONALD HANEY
OPERATIONAL/MANAGERIAL CONTROL
50%
2021-05-01
ended 2026-05-18
pecos_ownership
BILLIE BELL
CORPORATE OFFICER
—
2023-06-03
ended 2026-05-18
pecos_ownership
JOHN SORRELLS
ADP OF THE SNF
—
2021-05-01
ended 2026-05-18
pecos_ownership
TAYLOR COLLIER
ADP OF THE SNF
—
2023-08-22
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
6
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-09-30
$24,572
—
—
—
—
1
—
2023-09-30
$24,732
—
—
—
—
1
—
2022-09-30
$27,222
—
—
—
—
1
—
2021-09-30
$20,466
—
—
—
—
1
—
2021-04-30
$360,659
$172,738
$187,921
—
—
2
—
2020-12-31
$1,081,643
$517,880
$563,763
—
—
2
—
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
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 48259
acs median gross
0
$1,597
2024-12-31
CENSUS_ACS5
county 48259
fmr
0
$1,301
2025-10-01
HUD_USER_FMR
county 48259
acs median gross
1
$1,224
2024-12-31
CENSUS_ACS5
county 48259
fmr
1
$1,311
2025-10-01
HUD_USER_FMR
county 48259
acs median gross
2
$1,550
2024-12-31
CENSUS_ACS5
county 48259
fmr
2
$1,650
2025-10-01
HUD_USER_FMR
county 48259
acs median gross
3
$1,982
2024-12-31
CENSUS_ACS5
county 48259
fmr
3
$2,176
2025-10-01
HUD_USER_FMR
county 48259
acs median gross
4
$1,717
2024-12-31
CENSUS_ACS5
county 48259
fmr
4
$2,185
2025-10-01
HUD_USER_FMR
county 48259
acs median gross
$1,606
2024-12-31
CENSUS_ACS5
county 48259
acs recent mover gross
$1,626
2024-12-31
CENSUS_ACS5
zcta 78006
acs median gross
0
$1,597
2024-12-31
CENSUS_ACS5
zcta 78006
acs median gross
1
$1,316
2024-12-31
CENSUS_ACS5
zcta 78006
acs median gross
2
$1,618
2024-12-31
CENSUS_ACS5
zcta 78006
acs median gross
3
$1,980
2024-12-31
CENSUS_ACS5
zcta 78006
acs median gross
4
$1,928
2024-12-31
CENSUS_ACS5
zcta 78006
acs median gross
$1,650
2024-12-31
CENSUS_ACS5
zcta 78006
acs recent mover gross
$1,549
2024-12-31
CENSUS_ACS5
zip 78006
payment standard 110
0
$1,474
2025-10-01
HUD_USER_SAFMR
zip 78006
payment standard 90
0
$1,206
2025-10-01
HUD_USER_SAFMR
zip 78006
safmr
0
$1,340
2025-10-01
HUD_USER_SAFMR
zip 78006
payment standard 110
1
$1,507
2025-10-01
HUD_USER_SAFMR
zip 78006
payment standard 90
1
$1,233
2025-10-01
HUD_USER_SAFMR
zip 78006
safmr
1
$1,370
2025-10-01
HUD_USER_SAFMR
zip 78006
payment standard 110
2
$1,881
2025-10-01
HUD_USER_SAFMR
zip 78006
payment standard 90
2
$1,539
2025-10-01
HUD_USER_SAFMR
zip 78006
safmr
2
$1,710
2025-10-01
HUD_USER_SAFMR
zip 78006
payment standard 110
3
$2,475
2025-10-01
HUD_USER_SAFMR
zip 78006
payment standard 90
3
$2,025
2025-10-01
HUD_USER_SAFMR
zip 78006
safmr
3
$2,250
2025-10-01
HUD_USER_SAFMR
zip 78006
payment standard 110
4
$2,541
2025-10-01
HUD_USER_SAFMR
zip 78006
payment standard 90
4
$2,079
2025-10-01
HUD_USER_SAFMR
zip 78006
safmr
4
$2,310
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.