1919 WEST MEDICAL STREET, TUCSON, AZ 85704 · CCN 035070 · chain THE ENSIGN GROUP INC
Composite
22.5 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
230
Model
v1.2
Reads as: riskier than 22.5% 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
6
Kind
Finding
Signal
Subject
First seen
connection
Owner spans multiple chains
18 chains
ENSIGN SERVICES INC
286 facilities
connection
Owner spans multiple chains
17 chains
BURNAM SOON
335 facilities
connection
Owner spans multiple chains
17 chains
KEETCH CHAD
283 facilities
connection
Owner spans multiple chains
12 chains
THE ENSIGN GROUP INC
123 facilities
connection
Owner spans multiple chains
11 chains
STANDARD BEARER HEALTHCARE OP LP
83 facilities
connection
Owner spans multiple chains
5 chains
FAVORITE HEALTHCARE STAFFING LLC
12 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
AZ median
National median
National p25–p75
Total nurse
3.65
3.53
3.28
2.90–3.77
RN
0.28
0.43
0.39
0.25–0.58
Weekend total
3.38
3.35
3.11
—
Weekday total
3.76
3.62
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
184.5
3.65
0.28
1.01
2.36
3.38
6.1%
2025Q3
92
170.0
3.77
0.32
0.98
2.47
3.58
7.8%
2025Q2
91
159.7
3.90
0.34
1.00
2.56
3.63
7.2%
2025Q1
90
162.7
3.85
0.32
1.10
2.43
3.60
8.5%
2024Q4
92
150.9
3.81
0.20
1.13
2.48
3.60
7.4%
2024Q3
92
146.4
3.77
0.18
1.20
2.39
3.53
5.2%
2024Q2
91
157.0
3.79
0.19
1.18
2.42
3.54
10.9%
2024Q1
91
152.7
3.79
0.17
1.20
2.41
3.60
15.0%
2023Q4
92
150.9
3.77
0.17
1.19
2.41
3.48
10.6%
2023Q3
92
148.0
3.81
0.16
1.20
2.45
3.50
12.5%
2023Q2
91
144.9
3.66
0.05
1.34
2.27
3.29
23.9%
2023Q1
90
132.9
3.84
0.12
1.38
2.34
3.39
21.8%
2022Q4
92
122.1
3.80
0.13
1.31
2.36
3.30
16.3%
2022Q3
92
119.9
3.54
0.17
1.38
1.98
2.55
12.9%
2022Q2
91
116.7
3.07
0.20
1.28
1.59
2.25
6.5%
2022Q1
90
118.0
3.25
0.23
1.26
1.76
2.42
3.4%
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
28
D × 18E × 10
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2026-04-14
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2026-04-15
2025-06-21
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2025-03-24
2025-06-21
Health · complaint
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2025-06-22
2024-06-14
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2024-04-13
2024-04-12
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
E
2024-04-13
2024-03-28
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2024-03-29
2024-03-28
Health
F0638
Assure that each resident’s assessment is updated at least once every 3 months.
D
2024-03-29
2024-03-28
Health · complaint
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
E
2024-03-29
2024-03-28
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2024-03-29
2024-03-28
Health
F0698
Provide safe, appropriate dialysis care/services for a resident who requires such services.
D
2024-03-29
2024-02-14
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
E
2024-02-15
2023-11-22
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2024-01-15
2022-12-08
Health
F0552
Ensure that residents are fully informed and understand their health status, care and treatments.
D
2023-01-29
2022-12-08
Health
F0658
Ensure services provided by the nursing facility meet professional standards of quality.
E
2023-01-29
2022-12-08
Health
F0676
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
D
2023-01-29
2022-12-08
Health
F0698
Provide safe, appropriate dialysis care/services for a resident who requires such services.
E
2023-01-29
2022-12-08
Health
F0842
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
E
2023-01-29
2021-09-08
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
E
2021-10-20
2021-09-08
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
2021-10-20
2021-09-08
Health
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2021-10-20
2021-09-08
Health
F0641
Ensure each resident receives an accurate assessment.
D
2021-10-20
2021-09-08
Health
F0645
PASARR screening for Mental disorders or Intellectual Disabilities
D
2021-10-20
2021-09-08
Health
F0655
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
D
2021-10-20
2021-09-08
Health
F0660
Plan the resident's discharge to meet the resident's goals and needs.
D
2021-10-20
2021-09-08
Health
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
E
2021-10-20
2021-09-08
Health
F0757
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
2021-10-20
2021-09-08
Health
F0880
Provide and implement an infection prevention and control program.
E
2021-10-20
2021-09-08
Health
F0883
Develop and implement policies and procedures for flu and pneumonia vaccinations.
E
2021-10-20
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
26
Owner
Role
Pct
From
Status
Source
BANDERA HEALTHCARE LLC
DIRECT OWNERSHIP INTEREST
—
2014-02-25
current
pecos_ownership
BURNAM, SOON
OPERATIONAL/MANAGERIAL CONTROL
—
2014-02-25
current
pecos_ownership
EAGAR, ROBERT
ADP OF THE SNF
—
2019-06-15
current
pecos_ownership
ENSIGN SERVICES INC
ADP OF THE SNF
—
2014-05-01
current
pecos_ownership
FAVORITE HEALTHCARE STAFFING LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2014-05-01
current
pecos_ownership
FREFER, MOSAB
ADP OF THE SNF
—
2023-11-01
current
pecos_ownership
KEETCH, CHAD
OPERATIONAL/MANAGERIAL CONTROL
—
2011-03-01
current
pecos_ownership
MONTEBELLA HEALTH HOLDINGS LLC
ADP OF THE SNF
—
2022-01-01
current
pecos_ownership
NURSA INC
OPERATIONAL/MANAGERIAL CONTROL
—
2014-05-01
current
pecos_ownership
ONSHIFT INC
OPERATIONAL/MANAGERIAL CONTROL
—
2014-05-01
current
pecos_ownership
PETERSON, FORREST
OPERATIONAL/MANAGERIAL CONTROL
—
2020-02-18
current
pecos_ownership
PORT, BARRY
INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
—
2026-03-20
current
pecos_ownership
PRESTIGE HEALTH STAFFING LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2014-05-01
current
pecos_ownership
STANDARD BEARER HEALTHCARE OP, LP
ADP OF THE SNF
—
2022-01-01
current
pecos_ownership
TERRACE HOLDINGS AZ LLC
Corporation, partnership or other organization has financial interest in provider
—
2024-01-01
current
hcris_a_8_1
TERRACE HOLDINGS AZ LLC
Corporation, partnership or other organization has financial interest in provider
—
2023-01-01
current
hcris_a_8_1
THE ENSIGN GROUP INC
INDIRECT OWNERSHIP INTEREST
—
2006-09-25
current
pecos_ownership
THE ENSIGN GROUP INC
ADP OF THE SNF
—
2022-01-01
current
pecos_ownership
CHRISTINE JONES
CORPORATE OFFICER
0%
2019-02-27
ended 2026-05-18
pecos_ownership
CRAIG FITCH
CORPORATE OFFICER
0%
2019-02-27
ended 2026-05-18
pecos_ownership
JAMES GUSCHL
CORPORATE DIRECTOR
0%
2019-02-27
ended 2026-05-18
pecos_ownership
ROBERT EAGAR
W-2 MANAGING EMPLOYEE
0%
2019-06-15
ended 2026-05-18
pecos_ownership
SOON BURNAM
CORPORATE OFFICER
0%
2014-02-25
ended 2026-05-18
pecos_ownership
TERRACE HOLDINGS AZ LLC
Corporation, partnership or other organization has financial interest in provider
—
2022-01-01
ended 2022-12-31
hcris_a_8_1
TERRACE HOLDINGS AZ LLC
Corporation, partnership or other organization has financial interest in provider
—
2021-01-01
ended 2021-12-31
hcris_a_8_1
TERRACE HOLDINGS AZ LLC
Corporation, partnership or other organization has financial interest in provider
—
2020-01-01
ended 2020-12-31
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
5
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$3,846,384
—
$1,803,435
—
—
6
propco
2023-12-31
$3,426,094
—
$1,392,384
—
$51,933
6
propco
2022-12-31
$3,055,009
—
$1,343,170
—
—
6
propco
2021-12-31
$2,674,061
—
$1,076,456
—
—
6
propco
2020-12-31
$2,219,521
—
$824,852
—
—
6
propco
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
Transactions
0
No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Most recent same-state, same-setting trades. Most CHOW-derived trades carry no disclosed consideration, so price, $/bed, and cap rate show only where a sale price was resolved from a deed or filing — blanks are honest, not missing data.
Market rent context
36
Geo
Kind
BR
Amount
As of
Source
county 04019
acs median gross
0
$864
2024-12-31
CENSUS_ACS5
county 04019
fmr
0
$967
2025-10-01
HUD_USER_FMR
county 04019
acs median gross
1
$1,011
2024-12-31
CENSUS_ACS5
county 04019
fmr
1
$1,081
2025-10-01
HUD_USER_FMR
county 04019
acs median gross
2
$1,275
2024-12-31
CENSUS_ACS5
county 04019
fmr
2
$1,402
2025-10-01
HUD_USER_FMR
county 04019
acs median gross
3
$1,647
2024-12-31
CENSUS_ACS5
county 04019
fmr
3
$1,950
2025-10-01
HUD_USER_FMR
county 04019
acs median gross
4
$1,814
2024-12-31
CENSUS_ACS5
county 04019
fmr
4
$2,245
2025-10-01
HUD_USER_FMR
county 04019
acs median gross
5
$2,356
2024-12-31
CENSUS_ACS5
county 04019
acs median gross
$1,212
2024-12-31
CENSUS_ACS5
county 04019
acs recent mover gross
$1,386
2024-12-31
CENSUS_ACS5
zcta 85704
acs median gross
0
$1,173
2024-12-31
CENSUS_ACS5
zcta 85704
acs median gross
1
$1,272
2024-12-31
CENSUS_ACS5
zcta 85704
acs median gross
2
$1,630
2024-12-31
CENSUS_ACS5
zcta 85704
acs median gross
3
$1,973
2024-12-31
CENSUS_ACS5
zcta 85704
acs median gross
4
$2,668
2024-12-31
CENSUS_ACS5
zcta 85704
acs median gross
5
$2,716
2024-12-31
CENSUS_ACS5
zcta 85704
acs median gross
$1,561
2024-12-31
CENSUS_ACS5
zcta 85704
acs recent mover gross
$1,698
2024-12-31
CENSUS_ACS5
zip 85704
payment standard 110
0
$1,254
2025-10-01
HUD_USER_SAFMR
zip 85704
payment standard 90
0
$1,026
2025-10-01
HUD_USER_SAFMR
zip 85704
safmr
0
$1,140
2025-10-01
HUD_USER_SAFMR
zip 85704
payment standard 110
1
$1,397
2025-10-01
HUD_USER_SAFMR
zip 85704
payment standard 90
1
$1,143
2025-10-01
HUD_USER_SAFMR
zip 85704
safmr
1
$1,270
2025-10-01
HUD_USER_SAFMR
zip 85704
payment standard 110
2
$1,815
2025-10-01
HUD_USER_SAFMR
zip 85704
payment standard 90
2
$1,485
2025-10-01
HUD_USER_SAFMR
zip 85704
safmr
2
$1,650
2025-10-01
HUD_USER_SAFMR
zip 85704
payment standard 110
3
$2,519
2025-10-01
HUD_USER_SAFMR
zip 85704
payment standard 90
3
$2,061
2025-10-01
HUD_USER_SAFMR
zip 85704
safmr
3
$2,290
2025-10-01
HUD_USER_SAFMR
zip 85704
payment standard 110
4
$2,904
2025-10-01
HUD_USER_SAFMR
zip 85704
payment standard 90
4
$2,376
2025-10-01
HUD_USER_SAFMR
zip 85704
safmr
4
$2,640
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.