Composite
74.9 / 100 percentile
Screener / 675949
C
AVIR AT COWHORN CREEK
snfTX
5524 COWHORN CREEK, TEXARKANA, TX 75503 · CCN 675949 · chain CITY OF ENNIS
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
0
Model
v1.2
Reads as: riskier than 74.9% 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.
Score model8ML signals15Components20CHOW radar1Distress radar1Staffing16Penalties2Deficiencies65Licensure0Ownership28Related party0Transactions1Comps12Market rent33
Composite explanation
8| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| state reg risk | 97.5 | 56.0 | 0.30 | 0.1714 | 16.71 | in index |
| regulatory risk | 91.8 | 89.5 | 0.30 | 0.1714 | 15.74 | in index |
| staffing risk | 82.3 | 82.3 | 0.25 | 0.1429 | 11.76 | in index |
| billing conduct | 30.4 | 31.8 | 0.30 | 0.1714 | 5.21 | in index |
| chow risk | 59.0 | 47.8 | 0.15 | 0.0857 | 5.06 | in index |
| financial risk | 16.4 | 24.5 | 0.30 | 0.1714 | 2.81 | in index |
| lease risk | 9.4 | 32.6 | 0.15 | 0.0857 | 0.81 | in index |
| ownership opacity | 71.3 | 62.1 | 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
15| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner spans multiple chains | 35 chains | WELLTOWER INC | 135 facilities |
| connection | Owner spans multiple chains | 33 chains | WELLTOWER OP LLC | 147 facilities |
| connection | Owner spans multiple chains | 28 chains | FREUND NOCHUM | 109 facilities |
| connection | Owner spans multiple chains | 28 chains | TRAVITSKY AARON | 106 facilities |
| connection | Owner spans multiple chains | 27 chains | DAGAN AMITAI | 101 facilities |
| connection | Owner spans multiple chains | 27 chains | GOLDBERGER ABRAHAM | 100 facilities |
| connection | Owner spans multiple chains | 27 chains | WELLTOWER NNN GROUP LLC | 102 facilities |
| connection | Owner fleet risk far above national | +20.5 vs natl | GOLDBERGER FAIGY | 111 facilities |
| connection | Owner spans multiple chains | 20 chains | GOLDBERGER FAIGY | 68 facilities |
| connection | Owner fleet risk far above national | +20.0 vs natl | TRAVITSKY AARON | 153 facilities |
| connection | Owner spans multiple chains | 9 chains | FERGUSON CLAY | 12 facilities |
| connection | Owner fleet enforcement cluster | 50% fined | FERGUSON CLAY | 14 facilities |
| connection | Owner fleet enforcement cluster | 46% fined | WELLTOWER NNN GROUP LLC | 111 facilities |
| connection | Owner fleet enforcement cluster | 44% fined | GANN KODY | 25 facilities |
| connection | Owner fleet enforcement cluster | 42% fined | GUADALUPE COUNTY HOSPITAL BOARD | 26 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
20| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 31.8 | B | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 55.0 | C | 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 | 50.1 | C | v0.1-txhhsc | default · in composite | Texas licence reissue timing as an ownership-transfer proxy. |
| chow risk | 37.7 | B | v0.6 | default · in composite | |
| financial risk | 24.5 | A | v0.5 | default · in composite | R18. |
| lease risk | 32.6 | B | v0.5 | default · in composite | |
| ownership opacity | 62.5 | 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 | 0.0 | — | 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 | 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 | 89.5 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 82.3 | 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 | 56.0 | C | v0.5 | default · in composite | |
| financial risk | 56.8 | C | 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 | 36.8 | B | 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 | 29.6 | B | 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 | 30.3 | B | 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 | 89.4 | 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 | 89.4 | 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 | 82.3 | 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 | 82.3 | 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)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
7.0
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Never sold on record | 0.00 | -1.62 | |
| For-profit ownership | 0.00 | -1.24 | |
| Current owner tenure (years) | 7.33 | -1.14 | |
| Occupancy | 0.92 | -0.65 | |
| Deficiencies, last 12 months | 28.00 | +0.51 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Contract staffing share | 0.00 | -0.10 |
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
0.0
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Deficiencies, last 12 months | 28.00 | -3.76 | |
| For-profit ownership | 0.00 | +1.62 | |
| Occupancy | 0.92 | -0.73 | |
| Fine amount, 12m (log) | 10.74 | -0.61 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Never sold on record | 0.00 | -0.28 | |
| Total nurse staffing (HPRD) | 2.75 | +0.19 | |
| Current owner tenure (years) | 7.33 | -0.18 |
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 | 2.75 | 2.67 | 3.28 | 2.90–3.77 |
| RN | 0.21 | 0.24 | 0.39 | 0.25–0.58 |
| Weekend total | 2.70 | 2.56 | 3.11 | — |
| Weekday total | 2.78 | 2.72 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 70.1 | 2.75 | 0.21 | 0.77 | 1.78 | 2.70 | 0.0% |
| 2025Q3 | 92 | 70.9 | 2.76 | 0.13 | 0.78 | 1.84 | 2.76 | 0.0% |
| 2025Q2 | 91 | 71.8 | 2.94 | 0.21 | 0.69 | 2.04 | 2.89 | 0.0% |
| 2025Q1 | 90 | 71.2 | 3.06 | 0.21 | 0.67 | 2.18 | 3.06 | 0.0% |
| 2024Q4 | 92 | 70.9 | 3.07 | 0.23 | 0.66 | 2.19 | 3.09 | 0.0% |
| 2024Q3 | 92 | 68.0 | 3.27 | 0.23 | 0.69 | 2.35 | 3.32 | 0.3% |
| 2024Q2 | 91 | 61.9 | 3.10 | 0.25 | 0.74 | 2.11 | 3.21 | 0.0% |
| 2024Q1 | 91 | 67.8 | 3.08 | 0.25 | 0.71 | 2.12 | 3.17 | 25.1% |
| 2023Q4 | 92 | 64.4 | 3.00 | 0.25 | 0.75 | 2.00 | 3.04 | 22.4% |
| 2023Q3 | 92 | 63.2 | 2.92 | 0.24 | 0.79 | 1.89 | 3.00 | 20.5% |
| 2023Q2 | 91 | 63.5 | 2.95 | 0.21 | 0.80 | 1.95 | 2.94 | 13.9% |
| 2023Q1 | 90 | 54.5 | 3.18 | 0.15 | 0.79 | 2.23 | 3.25 | 6.5% |
| 2022Q4 | 92 | 58.8 | 2.75 | 0.03 | 0.86 | 1.87 | 2.77 | 13.3% |
| 2022Q3 | 92 | 56.8 | 3.02 | 0.05 | 0.98 | 1.99 | 3.16 | 20.9% |
| 2022Q2 | 91 | 57.1 | 2.31 | 0.12 | 0.60 | 1.59 | 2.28 | 0.0% |
| 2022Q1 | 90 | 49.5 | 3.35 | 0.10 | 1.03 | 2.21 | 3.46 | 28.7% |
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
2| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-08-15 | Fine | $46,315 | CMS provider data |
| 2025-08-15 | Payment Denial | — | CMS provider data |
Total fines on record: $46,315
Deficiencies
65B × 1C × 1D × 44E × 14F × 3K × 2
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-04-13 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2026-04-14 |
| 2026-02-12 | Health | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2026-02-13 |
| 2026-02-12 | Health | F0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. | D | 2026-02-13 |
| 2026-02-12 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2026-02-13 |
| 2026-02-12 | Health | F0636 | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | E | 2026-02-13 |
| 2026-02-12 | Health | F0637 | Assess the resident when there is a significant change in condition | D | 2026-02-13 |
| 2026-02-12 | Health | F0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | E | 2026-02-13 |
| 2026-02-12 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2026-02-13 |
| 2026-02-12 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2026-02-13 |
| 2026-02-12 | 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 | 2026-02-13 |
| 2026-02-12 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2026-02-13 |
| 2026-02-12 | Health | F0685 | Assist a resident in gaining access to vision and hearing services. | D | 2026-02-13 |
| 2026-02-12 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2026-02-13 |
| 2026-02-12 | Health | F0727 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | F | 2026-02-13 |
| 2026-02-12 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2026-02-13 |
| 2026-02-12 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2026-02-13 |
| 2026-02-12 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2026-02-13 |
| 2026-02-12 | Health | F0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | 2026-02-13 |
| 2026-02-12 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2026-02-13 |
| 2026-02-12 | Health | F0813 | Have a policy regarding use and storage of foods brought to residents by family and other visitors. | D | 2026-02-13 |
| 2026-02-12 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2026-02-13 |
| 2025-08-15 | Health · complaint | F0561 | Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | D | 2025-08-18 |
| 2025-08-15 | Health · complaint | F0585 | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | E | 2025-08-18 |
| 2025-08-15 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | K | 2025-08-16 |
| 2025-08-15 | Health · complaint | F0675 | Honor each resident's preferences, choices, values and beliefs. | K | 2025-08-16 |
| 2025-08-15 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2025-08-18 |
| 2025-08-15 | Health · complaint | F0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | 2025-08-18 |
| 2025-08-15 | Health · complaint | F0838 | Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies. | D | 2025-08-18 |
| 2025-04-09 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2025-04-10 |
| 2025-04-09 | Health · complaint | F0585 | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | D | 2025-04-10 |
| 2025-04-09 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2025-04-10 |
| 2024-12-04 | Health | F0553 | Allow resident to participate in the development and implementation of his or her person-centered plan of care. | E | 2024-12-06 |
| 2024-12-04 | Health | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2024-12-06 |
| 2024-12-04 | Health | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | 2024-12-06 |
| 2024-12-04 | Health | F0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | B | 2024-12-06 |
| 2024-12-04 | Health | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | 2024-12-06 |
| 2024-12-04 | Health · complaint | F0685 | Assist a resident in gaining access to vision and hearing services. | D | 2024-12-06 |
| 2024-12-04 | Health | F0688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | 2024-12-06 |
| 2024-12-04 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2024-12-06 |
| 2024-12-04 | Health | F0758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | 2024-12-06 |
| 2024-12-04 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2024-12-06 |
| 2024-12-04 | Health | F0809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | E | 2024-12-06 |
| 2024-12-04 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-12-06 |
| 2024-10-29 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-10-31 |
| 2024-10-29 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2024-10-30 |
| 2024-10-29 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-10-30 |
| 2024-10-29 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2024-10-30 |
| 2024-10-29 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2024-11-01 |
| 2024-10-29 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2024-10-30 |
| 2024-03-13 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-03-15 |
| 2024-03-13 | Health · complaint | F0805 | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | D | 2024-03-15 |
| 2023-11-16 | Health · complaint | F0575 | Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency. | C | 2023-11-17 |
| 2023-11-16 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2023-11-17 |
| 2023-11-16 | Health | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | 2023-11-22 |
| 2023-11-16 | Health | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | 2023-11-22 |
| 2023-11-16 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2023-11-17 |
| 2023-11-16 | Health | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | 2023-11-17 |
| 2023-11-16 | Health | F0688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | 2023-11-17 |
| 2023-11-16 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2023-11-17 |
| 2023-11-16 | Health | F0712 | Ensure that the resident and his/her doctor meet face-to-face at all required visits. | E | 2023-11-17 |
| 2023-11-16 | Health | F0758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | 2023-11-21 |
| 2023-11-16 | 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 | 2023-11-17 |
| 2023-11-16 | Health | F0849 | Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | D | 2023-11-17 |
| 2023-11-16 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2023-11-17 |
| 2023-11-16 | Health | F0940 | Develop, implement, and/or maintain an effective training program for all new and existing staff members. | D | 2023-11-17 |
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
28| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| GUADALUPE COUNTY HOSPITAL BOARD | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2025-09-01 | current | pecos_ownership |
| 5524 COWHORN CREEK OPCO LLC | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-09-01 | current | pecos_ownership |
| 5524 COWHORN CREEK OPCO, LLC | — | — | 2025-09-01 | current | tx_hhsc_directory |
| 5524 COWHORN CREEK PROPERTY OWNER, LLC | ADP OF THE SNF | — | 2025-09-01 | current | pecos_ownership |
| BETTS, BRITNEY | ADP OF THE SNF | — | 2025-09-01 | current | pecos_ownership |
| DAGAN, AMITAI | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-09-14 | current | pecos_ownership |
| FERGUSON, CLAY | ADP OF THE SNF | — | 2025-09-01 | current | pecos_ownership |
| FREUND, NOCHUM | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-09-14 | current | pecos_ownership |
| GANN, KODY | CORPORATE OFFICER | — | 2025-09-01 | current | pecos_ownership |
| GOLDBERGER, ABRAHAM | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-09-14 | current | pecos_ownership |
| GOLDBERGER, FAIGY | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-09-14 | current | pecos_ownership |
| GUADALUPE COUNTY HOSPITAL BOARD | — | — | 2025-09-01 | current | tx_hhsc_directory |
| TRAVITSKY, AARON | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-09-01 | current | pecos_ownership |
| WELLTOWER INC | ADP OF THE SNF | — | 2025-09-01 | current | pecos_ownership |
| WELLTOWER NNN GROUP, LLC | ADP OF THE SNF | — | 2025-09-01 | current | pecos_ownership |
| WELLTOWER OP, LLC | ADP OF THE SNF | — | 2025-09-01 | current | pecos_ownership |
| 5524 COWHORN CREEK PROPERTY OWNER, LLC | 5% OR GREATER SECURITY INTEREST | 100% | 2025-03-01 | ended 2026-05-18 | pecos_ownership |
| CITY OF ENNIS | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2019-04-01 | ended 2026-05-18 | pecos_ownership |
| HCCF MANAGEMENT GROUP XI LLC | 5% OR GREATER SECURITY INTEREST | 100% | 2025-03-01 | ended 2026-04-01 | pecos_ownership |
| WELLTOWER INC | 5% OR GREATER SECURITY INTEREST | 100% | 2025-03-01 | ended 2026-05-18 | pecos_ownership |
| WELLTOWER NNN GROUP, LLC | 5% OR GREATER SECURITY INTEREST | 100% | 2025-03-01 | ended 2026-05-18 | pecos_ownership |
| WELLTOWER OP, LLC | 5% OR GREATER SECURITY INTEREST | 100% | 2025-03-01 | ended 2026-05-18 | pecos_ownership |
| ANGELA WADE | CORPORATE OFFICER | 0% | 2025-03-01 | ended 2026-05-18 | pecos_ownership |
| AARON TRAVITSKY | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-03-01 | ended 2026-05-18 | pecos_ownership |
| BRITNEY BETTS | ADP OF THE SNF | — | 2025-03-01 | ended 2026-05-18 | pecos_ownership |
| CLAY FERGUSON | ADP OF THE SNF | — | 2025-03-01 | ended 2026-05-18 | pecos_ownership |
| NOCHUM FREUND | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-03-01 | ended 2026-05-18 | pecos_ownership |
| WELLTOWER INC | ADP OF THE SNF | — | 2021-03-01 | 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.
Transactions
1| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2019-04-01 | — | CITY OF ENNIS | MSHC THE WATERTON AT COWHORN CREEK, LLC | chow |
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
33| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 48037 | acs median gross | 0 | $650 | 2024-12-31 | CENSUS_ACS5 |
| county 48037 | fmr | 0 | $859 | 2025-10-01 | HUD_USER_FMR |
| county 48037 | acs median gross | 1 | $732 | 2024-12-31 | CENSUS_ACS5 |
| county 48037 | fmr | 1 | $868 | 2025-10-01 | HUD_USER_FMR |
| county 48037 | acs median gross | 2 | $971 | 2024-12-31 | CENSUS_ACS5 |
| county 48037 | fmr | 2 | $1,101 | 2025-10-01 | HUD_USER_FMR |
| county 48037 | acs median gross | 3 | $1,194 | 2024-12-31 | CENSUS_ACS5 |
| county 48037 | fmr | 3 | $1,369 | 2025-10-01 | HUD_USER_FMR |
| county 48037 | acs median gross | 4 | $1,493 | 2024-12-31 | CENSUS_ACS5 |
| county 48037 | fmr | 4 | $1,657 | 2025-10-01 | HUD_USER_FMR |
| county 48037 | acs median gross | 5 | $1,367 | 2024-12-31 | CENSUS_ACS5 |
| county 48037 | acs median gross | $988 | 2024-12-31 | CENSUS_ACS5 | |
| county 48037 | acs recent mover gross | $1,195 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 75503 | acs median gross | 1 | $978 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75503 | acs median gross | 2 | $1,232 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75503 | acs median gross | 3 | $1,453 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75503 | acs median gross | $1,251 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 75503 | acs recent mover gross | $1,540 | 2024-12-31 | CENSUS_ACS5 | |
| zip 75503 | payment standard 110 | 0 | $1,111 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | payment standard 90 | 0 | $909 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | safmr | 0 | $1,010 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | payment standard 110 | 1 | $1,133 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | payment standard 90 | 1 | $927 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | safmr | 1 | $1,030 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | payment standard 110 | 2 | $1,430 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | payment standard 90 | 2 | $1,170 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | safmr | 2 | $1,300 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | payment standard 110 | 3 | $1,782 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | payment standard 90 | 3 | $1,458 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | safmr | 3 | $1,620 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | payment standard 110 | 4 | $2,156 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | payment standard 90 | 4 | $1,764 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75503 | safmr | 4 | $1,960 | 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.