Composite
81.9 / 100 percentile
Screener / 455796
C
Town and Country Nursing and Rehabilitation Center
snfTX
625 N Main St, Boerne, TX 78006 · CCN 455796 · chain MEDINA COUNTY HOSPITAL DISTRICT
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
0
Model
v1.2
Reads as: riskier than 81.9% 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 model7ML signals25Components19CHOW radar1Distress radar1Staffing16Penalties2Deficiencies57Licensure0Ownership59Related party0Transactions0Comps12Market rent34
Composite explanation
7| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 95.6 | 93.9 | 0.30 | 0.1875 | 17.93 | in index |
| billing conduct | 90.3 | 60.1 | 0.30 | 0.1875 | 16.93 | in index |
| staffing risk | 98.8 | 98.8 | 0.25 | 0.1563 | 15.44 | in index |
| financial risk | 33.6 | 35.9 | 0.30 | 0.1875 | 6.30 | in index |
| chow risk | 30.2 | 33.7 | 0.15 | 0.0938 | 2.83 | in index |
| state reg risk | 11.2 | 1.5 | 0.30 | 0.1875 | 2.10 | in index |
| ownership opacity | 18.0 | 48.8 | 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
25| 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 risk far above national | +22.0 vs natl | CARVAJAL ANTONIO | 29 facilities |
| connection | Owner fleet risk far above national | +22.0 vs natl | KAUFMAN NICOLE | 29 facilities |
| connection | Owner fleet risk far above national | +21.3 vs natl | GONZALES VERONICA | 28 facilities |
| connection | Owner fleet risk far above national | +20.8 vs natl | REG BRIDGE OPCO LLC | 20 facilities |
| connection | Owner fleet risk far above national | +20.1 vs natl | REGENCY TEXAS HOLDINGS LLC | 65 facilities |
| connection | Owner fleet risk far above national | +20.1 vs natl | REG OPERATOR HOLDCO LLC | 65 facilities |
| connection | Owner fleet risk far above national | +20.1 vs natl | DWD TX HOLDINGS LLC | 65 facilities |
| connection | Owner spans multiple chains | 8 chains | REGENCY IHS CLINICAL CONSULTING LLC | 67 facilities |
| connection | Owner spans multiple chains | 8 chains | REGENCY IHS REHAB LLC | 68 facilities |
| connection | Owner spans multiple chains | 7 chains | REGENCY INTEGRATED HEALTH SERVICES LLC | 67 facilities |
| connection | Owner spans multiple chains | 7 chains | REG OPERATOR HOLDCO LLC | 64 facilities |
| connection | Owner spans multiple chains | 7 chains | DEKOWSKI DONOVAN | 66 facilities |
| connection | Owner spans multiple chains | 7 chains | MANDELBAUM ELLIOT | 61 facilities |
| connection | Owner spans multiple chains | 7 chains | DWD TX HOLDINGS LLC | 64 facilities |
| connection | Owner spans multiple chains | 7 chains | JACK AND NANCY DWYER WORKFORCE DEVELOPMENT CENTER INC | 65 facilities |
| connection | Owner spans multiple chains | 7 chains | CSV RHEA MANAGEMENT HOLDCO LLC | 63 facilities |
| connection | Owner spans multiple chains | 7 chains | CLAPP BARBARA | 66 facilities |
| connection | Owner spans multiple chains | 7 chains | REGENCY TEXAS HOLDINGS LLC | 64 facilities |
| connection | Owner spans multiple chains | 6 chains | GIBSON PATRICIA | 58 facilities |
| connection | Owner spans multiple chains | 6 chains | CORTESE DAREN | 59 facilities |
| connection | Owner spans multiple chains | 6 chains | BAIRD DANIEL | 59 facilities |
| connection | Owner spans multiple chains | 5 chains | REG HG OPCO LLC | 40 facilities |
| connection | Owner spans multiple chains | 5 chains | REG BRIDGE OPCO LLC | 19 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
19| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 60.1 | C | 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 | 38.5 | B | v0.1-txhhsc | default · in composite | Texas licence reissue timing as an ownership-transfer proxy. |
| chow risk | 37.0 | B | v0.6 | default · in composite | |
| financial risk | 35.9 | B | v0.5 | default · in composite | R18. |
| ownership opacity | 48.8 | 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 | 1.6 | — | 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 | 0.8 | — | 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 | 93.9 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 98.8 | 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 | 1.5 | A | v0.5 | default · in composite | |
| financial risk | 66.2 | D | 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 | 46.2 | C | 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 | 38.9 | 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 | 41.7 | 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 | 93.8 | 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 | 93.8 | 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 | 98.8 | 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 | 98.8 | 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)
0.8%
model v0.1 · computed 2026-07-29
Percentile among SNFs
58.1
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | -1.24 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Total nurse staffing (HPRD) | 1.82 | +0.24 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Contract staffing share | 0.00 | -0.10 | |
| Facility size (log beds) | 4.84 | -0.08 |
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)
1.6%
model v0.1 · computed 2026-07-29
Percentile among SNFs
89.5
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 0.00 | +1.62 | |
| Total nurse staffing (HPRD) | 1.82 | +0.59 | |
| Deficiencies, last 12 months | 5.00 | +0.50 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Fine amount, 12m (log) | 0.00 | +0.18 | |
| Never sold on record | 1.00 | +0.12 | |
| Occupancy | 0.72 | +0.12 | |
| Current owner tenure (years) | 25.00 | +0.11 |
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 | 1.82 | 2.67 | 3.28 | 2.90–3.77 |
| RN | 0.48 | 0.24 | 0.39 | 0.25–0.58 |
| Weekend total | 1.76 | 2.56 | 3.11 | — |
| Weekday total | 1.85 | 2.72 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 90.8 | 1.82 | 0.48 | 0.48 | 0.87 | 1.76 | 0.0% |
| 2025Q3 | 92 | 91.1 | 2.23 | 0.42 | 0.55 | 1.25 | 2.24 | 0.0% |
| 2025Q2 | 91 | 87.9 | 2.23 | 0.37 | 0.63 | 1.22 | 2.26 | 0.0% |
| 2025Q1 | 90 | 87.3 | 2.08 | 0.38 | 0.69 | 1.01 | 2.02 | 0.0% |
| 2024Q4 | 92 | 89.3 | 1.87 | 0.33 | 0.74 | 0.80 | 1.76 | 0.0% |
| 2024Q3 | 92 | 88.5 | 2.19 | 0.26 | 0.81 | 1.13 | 1.97 | 0.0% |
| 2024Q2 | 91 | 91.6 | 2.62 | 0.22 | 0.87 | 1.52 | 2.46 | 0.0% |
| 2024Q1 | 91 | 93.7 | 2.66 | 0.23 | 0.94 | 1.49 | 2.44 | 7.3% |
| 2023Q4 | 92 | 98.8 | 2.47 | 0.21 | 0.83 | 1.43 | 2.40 | 21.0% |
| 2023Q3 | 92 | 94.9 | 2.58 | 0.26 | 0.84 | 1.48 | 2.43 | 30.8% |
| 2023Q2 | 91 | 99.7 | 2.15 | 0.19 | 0.62 | 1.34 | 1.90 | 17.1% |
| 2023Q1 | 90 | 96.4 | 1.98 | 0.19 | 0.60 | 1.19 | 1.95 | 20.2% |
| 2022Q4 | 92 | 92.0 | 2.15 | 0.18 | 0.71 | 1.26 | 2.11 | 3.7% |
| 2022Q3 | 92 | 87.8 | 2.21 | 0.18 | 0.71 | 1.31 | 2.10 | 0.0% |
| 2022Q2 | 91 | 82.4 | 2.36 | 0.17 | 0.87 | 1.33 | 2.21 | 0.0% |
| 2022Q1 | 90 | 78.8 | 2.33 | 0.14 | 0.78 | 1.40 | 2.09 | 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.
Penalties
2| Date | Type | Fine | Source |
|---|---|---|---|
| 2024-07-26 | Fine | $75,832 | CMS provider data |
| 2024-03-31 | Fine | $75,090 | CMS provider data |
Total fines on record: $150,922
Deficiencies
57C × 2D × 38E × 13F × 1J × 2K × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-04-24 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2026-04-25 |
| 2026-04-24 | Health · complaint | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2026-04-25 |
| 2026-01-08 | Health · complaint | F0732 | Post nurse staffing information every day. | C | 2026-01-09 |
| 2025-12-17 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2025-12-18 |
| 2025-12-04 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2025-12-05 |
| 2025-05-22 | Health | F0552 | Ensure that residents are fully informed and understand their health status, care and treatments. | D | 2025-06-17 |
| 2025-05-22 | Health | F0553 | Allow resident to participate in the development and implementation of his or her person-centered plan of care. | D | 2025-06-17 |
| 2025-05-22 | Health | F0604 | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | D | 2025-06-17 |
| 2025-05-22 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2025-06-17 |
| 2025-05-22 | 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 | 2025-06-17 |
| 2025-05-22 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-06-17 |
| 2025-05-22 | Health | F0685 | Assist a resident in gaining access to vision and hearing services. | D | 2025-06-17 |
| 2025-05-22 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-06-17 |
| 2025-05-22 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | E | 2025-06-17 |
| 2025-05-22 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2025-06-17 |
| 2025-05-22 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2025-06-17 |
| 2025-05-02 | Health · complaint | F0583 | Keep residents' personal and medical records private and confidential. | D | 2025-05-03 |
| 2025-05-02 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | E | 2024-09-27 |
| 2025-05-02 | Health · complaint | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2025-05-03 |
| 2025-05-02 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2025-05-03 |
| 2025-02-25 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | E | 2025-02-26 |
| 2025-02-25 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | E | 2025-02-26 |
| 2025-02-25 | Health · complaint | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | D | 2025-02-26 |
| 2025-02-25 | 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 | 2025-02-26 |
| 2025-02-25 | Health · complaint | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | E | 2025-02-26 |
| 2025-02-25 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2025-02-26 |
| 2025-02-25 | Health · complaint | F0945 | Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program. | E | 2025-02-26 |
| 2024-07-26 | 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. | D | 2024-07-27 |
| 2024-07-26 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | J | 2024-07-27 |
| 2024-05-03 | 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 | 2024-05-04 |
| 2024-03-31 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | E | 2024-04-03 |
| 2024-03-31 | Health · complaint | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | 2024-04-03 |
| 2024-03-31 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | 2024-04-03 |
| 2024-03-31 | Health · complaint | F0679 | Provide activities to meet all resident's needs. | E | 2024-04-03 |
| 2024-03-31 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | K | 2024-04-03 |
| 2024-03-31 | 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. | J | 2024-04-03 |
| 2024-03-31 | Health · complaint | F0791 | Provide or obtain dental services for each resident. | D | 2024-04-03 |
| 2024-03-31 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-04-03 |
| 2024-02-22 | Health · complaint | 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 | 2024-03-14 |
| 2024-02-22 | Health · complaint | F0624 | Prepare residents for a safe transfer or discharge from the nursing home. | E | 2024-03-14 |
| 2024-02-22 | 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 | 2024-03-14 |
| 2024-02-22 | Health · complaint | F0839 | Employ staff that are licensed, certified, or registered in accordance with state laws. | E | 2024-03-14 |
| 2023-10-05 | Health · complaint | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2023-10-20 |
| 2023-10-05 | Health · complaint | F0759 | Ensure medication error rates are not 5 percent or greater. | E | 2023-10-20 |
| 2023-10-05 | Health · complaint | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2023-10-20 |
| 2023-08-16 | Health · complaint | F0732 | Post nurse staffing information every day. | C | 2023-08-23 |
| 2023-08-16 | Health · complaint | F0919 | Make sure that a working call system is available in each resident's bathroom and bathing area. | D | 2023-08-23 |
| 2023-08-01 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2023-08-25 |
| 2023-08-01 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | 2023-08-25 |
| 2023-08-01 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2023-08-25 |
| 2023-08-01 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2023-08-25 |
| 2023-02-10 | 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. | D | 2023-02-11 |
| 2023-02-10 | Health | 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 | 2023-02-11 |
| 2023-02-10 | Health | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-02-11 |
| 2023-02-10 | 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 | 2023-02-11 |
| 2023-02-10 | Health | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | 2023-02-11 |
| 2023-02-10 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2023-02-11 |
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
59| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| MEDINA COUNTY HOSPITAL DISTRICT | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2014-06-01 | current | pecos_ownership |
| 625 N MAIN STREET LLC | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| AGHA, YASMEEN | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-01-01 | current | pecos_ownership |
| BAIN, WILLIAM | CORPORATE OFFICER | — | 2011-05-23 | current | pecos_ownership |
| BAIRD, DANIEL | MANAGING CONTROL - GOVERNING BODY | — | 2021-04-13 | current | pecos_ownership |
| BEAUMONT, JAIME | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| BELL, BILLIE | CORPORATE OFFICER | — | 2023-06-03 | current | pecos_ownership |
| CARVAJAL, ANTONIO | MANAGING CONTROL - GOVERNING BODY | — | 2024-05-16 | current | pecos_ownership |
| CLAPP, BARBARA | MANAGING CONTROL - GOVERNING BODY | — | 2021-06-01 | current | pecos_ownership |
| CORTESE, DAREN | MANAGING CONTROL - GOVERNING BODY | — | 2021-08-10 | current | pecos_ownership |
| CSV RHEA MANAGEMENT HOLDCO, LLC | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| DEKOWSKI, DONOVAN | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| DWD TX HOLDINGS LLC | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| FROSCH, KEVIN | CORPORATE OFFICER | — | 2010-02-01 | current | pecos_ownership |
| GIBSON, PATRICIA | MANAGING CONTROL - GOVERNING BODY | — | 2021-08-01 | current | pecos_ownership |
| GONZALES, VERONICA | MANAGING CONTROL - GOVERNING BODY | — | 2024-05-16 | current | pecos_ownership |
| HARDT, TIMOTHY | CORPORATE OFFICER | — | 2020-01-27 | current | pecos_ownership |
| JACK AND NANCY DWYER WORKFORCE DEVELOPMENT CENTER INC | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| JOHNSON, TONY | CORPORATE OFFICER | — | 2012-11-26 | current | pecos_ownership |
| KAUFMAN, NICOLE | MANAGING CONTROL - GOVERNING BODY | — | 2021-08-10 | current | pecos_ownership |
| MANDELBAUM, ELLIOT | MANAGING CONTROL - GOVERNING BODY | — | 2025-01-01 | current | pecos_ownership |
| MANGOLD, MARY | CORPORATE OFFICER | — | 2023-08-31 | current | pecos_ownership |
| MARTINEZ, DELIA | ADP OF THE SNF | — | 2025-01-01 | current | pecos_ownership |
| MARTINEZ, THELMA | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-04-10 | current | pecos_ownership |
| MEDINA COUNTY HOSPITAL DISTRICT | — | — | 2024-06-01 | current | tx_hhsc_directory |
| REG BRIDGE OPCO LLC | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| REG HG OPCO LLC | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| REG OPERATOR HOLDCO LLC | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| REGENCY IHS CLINICAL CONSULTING, LLC | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| REGENCY IHS OF BOERNE LLC | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| REGENCY IHS OF BOERNE LLC | — | — | 2024-06-01 | current | tx_hhsc_directory |
| REGENCY IHS REHAB LLC | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| REGENCY INTEGRATED HEALTH SERVICES LLC | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| REGENCY TEXAS HOLDINGS LLC | ADP OF THE SNF | — | 2018-10-01 | current | pecos_ownership |
| WINDROW, ZACHARY | CORPORATE OFFICER | — | 2012-11-26 | current | pecos_ownership |
| WINKLER, JUDY | CORPORATE OFFICER | — | 2004-05-01 | current | pecos_ownership |
| YOUNG, CARLTON | CORPORATE OFFICER | — | 2006-05-01 | current | pecos_ownership |
| BILLIE BELL | CORPORATE OFFICER | 0% | 2023-06-03 | ended 2026-05-18 | pecos_ownership |
| CARLTON YOUNG | CORPORATE OFFICER | 0% | 2006-05-01 | ended 2026-05-18 | pecos_ownership |
| JUDY WINKLER | CORPORATE OFFICER | 0% | 2004-05-01 | ended 2026-05-18 | pecos_ownership |
| KEVIN FROSCH | CORPORATE OFFICER | 0% | 2010-02-01 | ended 2026-05-18 | pecos_ownership |
| MARY MANGOLD | CORPORATE OFFICER | 0% | 2023-08-31 | ended 2026-05-18 | pecos_ownership |
| TIMOTHY HARDT | CORPORATE OFFICER | 0% | 2020-01-27 | ended 2026-05-18 | pecos_ownership |
| TONY JOHNSON | CORPORATE OFFICER | 0% | 2012-11-26 | ended 2026-05-18 | pecos_ownership |
| WILLIAM BAIN | CORPORATE OFFICER | 0% | 2011-05-23 | ended 2026-05-18 | pecos_ownership |
| ZACHARY WINDROW | CORPORATE OFFICER | 0% | 2012-11-26 | ended 2026-05-18 | pecos_ownership |
| ANTONIO CARVAJAL | MANAGING CONTROL - GOVERNING BODY | — | 2024-05-16 | ended 2026-05-18 | pecos_ownership |
| BARBARA CLAPP | MANAGING CONTROL - GOVERNING BODY | — | 2021-06-01 | ended 2026-05-18 | pecos_ownership |
| DANIEL BAIRD | MANAGING CONTROL - GOVERNING BODY | — | 2021-04-13 | ended 2026-05-18 | pecos_ownership |
| DAREN CORTESE | MANAGING CONTROL - GOVERNING BODY | — | 2021-08-10 | ended 2026-05-18 | pecos_ownership |
| DELIA MARTINEZ | ADP OF THE SNF | — | 2025-01-01 | ended 2026-05-18 | pecos_ownership |
| DONOVAN DEKOWSKI | ADP OF THE SNF | — | 2018-10-01 | ended 2026-05-18 | pecos_ownership |
| ELLIOT MANDELBAUM | MANAGING CONTROL - GOVERNING BODY | — | 2025-01-01 | ended 2026-05-18 | pecos_ownership |
| JAIME BEAUMONT | ADP OF THE SNF | — | 2025-01-01 | ended 2026-05-18 | pecos_ownership |
| NICOLE KAUFMAN | MANAGING CONTROL - GOVERNING BODY | — | 2021-08-10 | ended 2026-05-18 | pecos_ownership |
| PATRICIA GIBSON | MANAGING CONTROL - GOVERNING BODY | — | 2021-08-01 | ended 2026-05-18 | pecos_ownership |
| THELMA MARTINEZ | ADP OF THE SNF | — | 2023-04-10 | ended 2026-05-18 | pecos_ownership |
| VERONICA GONZALES | MANAGING CONTROL - GOVERNING BODY | — | 2024-05-16 | ended 2026-05-18 | pecos_ownership |
| YASMEEN AGHA | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-01-01 | 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
0No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
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
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.