Reads as: riskier than 64.9% 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
9
Kind
Finding
Signal
Subject
First seen
connection
Owner fleet risk far above national
+21.5 vs natl
SHANE JAMES
5 facilities
connection
Owner fleet risk far above national
+21.3 vs natl
EASTLAND MEMORIAL HOSPITAL DISTRICT
34 facilities
connection
Owner spans multiple chains
18 chains
CTR PARTNERSHIP LP
99 facilities
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
15 chains
CARETRUST REIT INC
96 facilities
connection
Owner spans multiple chains
11 chains
CARETRUST GP LLC
89 facilities
connection
Owner fleet enforcement cluster
80% fined
SHANE JAMES
5 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
TX median
National median
National p25–p75
Total nurse
2.27
2.67
3.28
2.90–3.77
RN
0.29
0.24
0.39
0.25–0.58
Weekend total
2.09
2.56
3.11
—
Weekday total
2.34
2.72
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
68.7
2.27
0.29
0.63
1.35
2.09
0.0%
2025Q3
92
67.1
2.16
0.14
0.72
1.29
1.94
0.0%
2025Q2
91
66.3
2.67
0.11
0.96
1.60
2.48
0.9%
2025Q1
90
64.2
2.47
0.07
0.85
1.54
2.44
5.3%
2024Q4
92
61.2
2.26
0.16
0.78
1.32
2.10
0.8%
2024Q3
92
54.2
2.43
0.14
0.81
1.48
2.43
0.0%
2024Q2
91
46.2
2.69
0.17
1.00
1.52
2.64
4.4%
2024Q1
91
52.0
3.03
0.23
1.19
1.61
3.03
29.3%
2023Q4
92
54.2
2.93
0.17
1.38
1.37
2.81
18.5%
2023Q3
92
57.4
2.54
0.10
1.24
1.20
2.38
21.1%
2023Q2
91
59.3
2.06
0.17
0.81
1.09
1.99
13.3%
2023Q1
90
58.9
1.91
0.13
0.84
0.94
1.74
5.6%
2022Q4
92
56.8
2.25
0.16
0.98
1.11
1.87
0.0%
2022Q3
92
58.9
2.03
0.17
0.91
0.95
1.80
0.0%
2022Q2
91
63.3
1.94
0.13
0.94
0.87
1.68
0.0%
2022Q1
90
63.3
1.93
0.33
0.78
0.83
1.84
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.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2026-01-10
2025-08-27
Health · complaint
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
2025-08-28
2025-06-24
Health · complaint
F0610
Respond appropriately to all alleged violations.
D
2025-06-25
2025-06-24
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2025-06-25
2025-06-24
Health · complaint
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.
J
2025-06-25
2025-06-05
Health · complaint
F0645
PASARR screening for Mental disorders or Intellectual Disabilities
D
2025-06-06
2024-11-21
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
J
2024-09-27
2024-07-16
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2024-08-06
2024-07-16
Health · complaint
F0690
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
E
2024-08-06
2024-05-08
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.
D
2024-06-03
2024-04-25
Health
F0558
Reasonably accommodate the needs and preferences of each resident.
E
2024-05-30
2024-04-25
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
2024-05-24
2024-04-25
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
E
2024-05-30
2024-04-25
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2024-05-29
2024-04-25
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2024-05-29
2024-04-25
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.
E
2024-05-29
2024-04-25
Health
F0761
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
E
2024-05-29
2023-09-19
Health · complaint
F0636
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
D
2023-10-09
2023-09-19
Health · complaint
F0675
Honor each resident's preferences, choices, values and beliefs.
E
2023-10-09
2023-03-02
Health
F0550
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
D
2023-03-31
2023-03-02
Health
F0561
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
D
2023-03-31
2023-03-02
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
2023-03-31
2023-03-02
Health
F0655
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
D
2023-03-31
2023-03-02
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
E
2023-03-31
2023-03-02
Health
F0679
Provide activities to meet all resident's needs.
E
2023-03-31
2023-03-02
Health
F0692
Provide enough food/fluids to maintain a resident's health.
E
2023-03-31
2023-03-02
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2023-03-31
2023-03-02
Health
F0880
Provide and implement an infection prevention and control program.
E
2023-03-31
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
28
Owner
Role
Pct
From
Status
Source
EASTLAND MEMORIAL HOSPITAL DISTRICT
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2017-04-01
current
pecos_ownership
BURNAM, SOON
CORPORATE OFFICER
—
2017-04-01
current
pecos_ownership
CARETRUST GP LLC
ADP OF THE SNF
—
1999-09-01
current
pecos_ownership
CARETRUST REIT INC
ADP OF THE SNF
—
1999-09-01
current
pecos_ownership
CTR PARTNERSHIP LP
ADP OF THE SNF
—
1999-09-01
current
pecos_ownership
EASTLAND MEMORIAL HOSPITAL DISTRICT
—
—
2026-04-01
current
tx_hhsc_directory
ENSIGN SERVICES INC
ADP OF THE SNF
—
2002-08-01
current
pecos_ownership
HARRIS, MARTIN
MANAGING CONTROL - GOVERNING BODY
—
2017-04-01
current
pecos_ownership
KEETCH, CHAD
CORPORATE OFFICER
—
2011-03-01
current
pecos_ownership
SHANE, JAMES
ADP OF THE SNF
—
2024-01-02
current
pecos_ownership
TAYLOR, STEPHEN
CORPORATE OFFICER
—
2025-07-01
current
pecos_ownership
TEMPLE HEALTH HOLDINGS LLC
ADP OF THE SNF
—
1999-09-01
current
pecos_ownership
WELLINGTON HEALTHCARE INC
—
—
2026-04-01
current
tx_hhsc_directory
WELLINGTON HEALTHCARE, INC.
OPERATIONAL/MANAGERIAL CONTROL
—
2017-04-01
current
pecos_ownership
WELLINGTON HEALTHCARE, INC.
ADP OF THE SNF
—
2025-08-13
current
pecos_ownership
LABAN WRIGHT
CORPORATE OFFICER
100%
2021-11-09
ended 2026-04-01
pecos_ownership
MARTIN HARRIS
OPERATIONAL/MANAGERIAL CONTROL
100%
2017-04-01
ended 2026-05-18
pecos_ownership
EMMETT LASATER
CORPORATE DIRECTOR
0%
2006-05-25
ended 2026-04-01
pecos_ownership
JACQUELYN TUCKER
CORPORATE DIRECTOR
0%
1999-05-20
ended 2026-04-01
pecos_ownership
MISSY MOYLAN
CORPORATE DIRECTOR
0%
2016-05-19
ended 2026-04-01
pecos_ownership
NANCY STEWART
CORPORATE DIRECTOR
0%
2013-05-16
ended 2026-04-01
pecos_ownership
NOBLE SQUIERS
CORPORATE DIRECTOR
0%
2004-05-20
ended 2026-04-01
pecos_ownership
SOON BURNAM
CORPORATE OFFICER
0%
2017-04-01
ended 2026-05-18
pecos_ownership
STEPHEN JOINER
CORPORATE DIRECTOR
0%
1994-05-19
ended 2026-04-01
pecos_ownership
WILLIAM HOFFMAN
CORPORATE OFFICER
0%
—
ended 2026-04-01
pecos_ownership
CHAD KEETCH
CORPORATE OFFICER
—
2011-03-01
ended 2026-05-18
pecos_ownership
JAMES SHANE
OPERATIONAL/MANAGERIAL CONTROL
—
2024-01-02
ended 2026-05-18
pecos_ownership
STEPHEN TAYLOR
CORPORATE OFFICER
—
2025-07-01
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
5
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2025-06-30
$757,306
—
$554,486
—
—
3
—
2024-06-30
$645,591
—
$471,898
—
—
3
—
2023-06-30
$751,762
—
$506,466
—
—
3
—
2022-06-30
$751,847
—
$452,279
—
—
3
—
2021-06-30
$669,929
—
$404,850
—
—
3
—
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
35
Geo
Kind
BR
Amount
As of
Source
county 48027
acs median gross
0
$996
2024-12-31
CENSUS_ACS5
county 48027
fmr
0
$983
2025-10-01
HUD_USER_FMR
county 48027
acs median gross
1
$947
2024-12-31
CENSUS_ACS5
county 48027
fmr
1
$990
2025-10-01
HUD_USER_FMR
county 48027
acs median gross
2
$1,127
2024-12-31
CENSUS_ACS5
county 48027
fmr
2
$1,233
2025-10-01
HUD_USER_FMR
county 48027
acs median gross
3
$1,405
2024-12-31
CENSUS_ACS5
county 48027
fmr
3
$1,711
2025-10-01
HUD_USER_FMR
county 48027
acs median gross
4
$1,824
2024-12-31
CENSUS_ACS5
county 48027
fmr
4
$2,068
2025-10-01
HUD_USER_FMR
county 48027
acs median gross
5
$2,134
2024-12-31
CENSUS_ACS5
county 48027
acs median gross
$1,224
2024-12-31
CENSUS_ACS5
county 48027
acs recent mover gross
$1,352
2024-12-31
CENSUS_ACS5
zcta 76504
acs median gross
0
$1,020
2024-12-31
CENSUS_ACS5
zcta 76504
acs median gross
1
$1,123
2024-12-31
CENSUS_ACS5
zcta 76504
acs median gross
2
$1,143
2024-12-31
CENSUS_ACS5
zcta 76504
acs median gross
3
$1,369
2024-12-31
CENSUS_ACS5
zcta 76504
acs median gross
4
$1,704
2024-12-31
CENSUS_ACS5
zcta 76504
acs median gross
$1,167
2024-12-31
CENSUS_ACS5
zcta 76504
acs recent mover gross
$1,454
2024-12-31
CENSUS_ACS5
zip 76504
payment standard 110
0
$1,199
2025-10-01
HUD_USER_SAFMR
zip 76504
payment standard 90
0
$981
2025-10-01
HUD_USER_SAFMR
zip 76504
safmr
0
$1,090
2025-10-01
HUD_USER_SAFMR
zip 76504
payment standard 110
1
$1,210
2025-10-01
HUD_USER_SAFMR
zip 76504
payment standard 90
1
$990
2025-10-01
HUD_USER_SAFMR
zip 76504
safmr
1
$1,100
2025-10-01
HUD_USER_SAFMR
zip 76504
payment standard 110
2
$1,507
2025-10-01
HUD_USER_SAFMR
zip 76504
payment standard 90
2
$1,233
2025-10-01
HUD_USER_SAFMR
zip 76504
safmr
2
$1,370
2025-10-01
HUD_USER_SAFMR
zip 76504
payment standard 110
3
$2,090
2025-10-01
HUD_USER_SAFMR
zip 76504
payment standard 90
3
$1,710
2025-10-01
HUD_USER_SAFMR
zip 76504
safmr
3
$1,900
2025-10-01
HUD_USER_SAFMR
zip 76504
payment standard 110
4
$2,530
2025-10-01
HUD_USER_SAFMR
zip 76504
payment standard 90
4
$2,070
2025-10-01
HUD_USER_SAFMR
zip 76504
safmr
4
$2,300
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.