Composite
75.1 / 100 percentile
Screener / 675879
C
Terrell Healthcare Center
snfTXSFF: SFF
204 W Nash, Terrell, TX 75160 · CCN 675879 · chain EASTLAND MEMORIAL HOSPITAL DISTRICT
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
0
Model
v1.2
Reads as: riskier than 75.1% 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 signals21Components20CHOW radar1Distress radar1Staffing16Penalties4Deficiencies93Licensure0Ownership18Related party0Transactions1Comps12Market rent35
Composite explanation
8| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 99.8 | 99.5 | 0.30 | 0.1714 | 17.11 | in index |
| state reg risk | 97.9 | 57.0 | 0.30 | 0.1714 | 16.78 | in index |
| financial risk | 50.4 | 45.7 | 0.30 | 0.1714 | 8.64 | in index |
| staffing risk | 55.7 | 55.7 | 0.25 | 0.1429 | 7.96 | in index |
| chow risk | 55.8 | 48.5 | 0.15 | 0.0857 | 4.78 | in index |
| billing conduct | 15.3 | 20.0 | 0.30 | 0.1714 | 2.62 | in index |
| lease risk | 3.6 | 23.4 | 0.15 | 0.0857 | 0.31 | in index |
| ownership opacity | 40.0 | 53.5 | 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
21| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +28.7 vs natl | WRIGHT LABAN | 12 facilities |
| connection | Owner fleet risk far above national | +27.5 vs natl | RINER MEERA | 46 facilities |
| connection | Owner fleet risk far above national | +26.4 vs natl | LEE BRIAN | 46 facilities |
| connection | Owner fleet risk far above national | +26.0 vs natl | FALLON JOHN | 20 facilities |
| connection | Owner fleet risk far above national | +24.3 vs natl | PIERCE DANIEL | 16 facilities |
| connection | Owner fleet risk far above national | +23.4 vs natl | KIRLEY FRANCIS | 50 facilities |
| connection | Owner fleet risk far above national | +23.1 vs natl | OSWALD JOHN | 13 facilities |
| connection | Owner fleet risk far above national | +21.3 vs natl | EASTLAND MEMORIAL HOSPITAL DISTRICT | 34 facilities |
| connection | Owner spans multiple chains | 10 chains | KIRLEY FRANCIS | 49 facilities |
| connection | Owner spans multiple chains | 8 chains | RINER MEERA | 46 facilities |
| connection | Owner spans multiple chains | 8 chains | FALLON JOHN | 20 facilities |
| connection | Owner spans multiple chains | 8 chains | PIERCE DANIEL | 16 facilities |
| connection | Owner spans multiple chains | 7 chains | LEE BRIAN | 46 facilities |
| connection | Owner spans multiple chains | 6 chains | OSWALD JOHN | 13 facilities |
| connection | Owner fleet enforcement cluster | 77% fined | OSWALD JOHN | 13 facilities |
| connection | Owner fleet enforcement cluster | 75% fined | PIERCE DANIEL | 16 facilities |
| connection | Owner fleet enforcement cluster | 50% fined | WRIGHT LABAN | 12 facilities |
| connection | Owner fleet enforcement cluster | 46% fined | RINER MEERA | 46 facilities |
| connection | Owner fleet enforcement cluster | 45% fined | FALLON JOHN | 20 facilities |
| connection | Owner fleet enforcement cluster | 44% fined | KIRLEY FRANCIS | 50 facilities |
| connection | Owner fleet enforcement cluster | 44% fined | LEE BRIAN | 46 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 | 20.0 | A | 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 | 33.3 | B | v0.1-txhhsc | default · in composite | Texas licence reissue timing as an ownership-transfer proxy. |
| chow risk | 56.8 | C | v0.6 | default · in composite | |
| financial risk | 45.7 | C | v0.5 | default · in composite | R18. |
| lease risk | 23.4 | A | v0.5 | default · in composite | |
| ownership opacity | 53.4 | 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 | 0.3 | — | 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 | 99.5 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 55.7 | C | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| state reg risk | 57.0 | C | v0.5 | default · in composite | |
| financial risk | 68.0 | 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 | 48.0 | 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 | 39.8 | 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 | 51.4 | C | 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 | 99.5 | 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 | 99.5 | 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 | 55.7 | C | 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 | 55.7 | C | 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)
0.4%
model v0.1 · computed 2026-07-29
Percentile among SNFs
48.5
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 | |
| Current owner tenure (years) | 8.33 | -1.04 | |
| Deficiencies, last 12 months | 39.00 | +0.78 | |
| For-profit ownership | 1.00 | +0.69 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Chain size (log) | 3.50 | +0.34 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Occupancy | 0.65 | +0.14 |
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 | 39.00 | -5.80 | |
| Chain size (log) | 3.50 | -0.83 | |
| For-profit ownership | 1.00 | -0.69 | |
| Occupancy | 0.65 | +0.42 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Never sold on record | 0.00 | -0.28 | |
| Staffing trend, last 4 quarters | 0.56 | +0.24 | |
| Fine amount, 12m (log) | 0.00 | +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 | 3.20 | 2.67 | 3.28 | 2.90–3.77 |
| RN | 0.40 | 0.24 | 0.39 | 0.25–0.58 |
| Weekend total | 3.38 | 2.56 | 3.11 | — |
| Weekday total | 3.12 | 2.72 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 61.0 | 3.20 | 0.40 | 0.72 | 2.08 | 3.38 | 0.0% |
| 2025Q3 | 92 | 61.3 | 3.36 | 0.48 | 0.67 | 2.22 | 3.44 | 0.0% |
| 2025Q2 | 91 | 67.0 | 2.67 | 0.58 | 0.48 | 1.60 | 2.53 | 0.0% |
| 2025Q1 | 90 | 71.0 | 2.44 | 0.47 | 0.54 | 1.44 | 2.28 | 0.0% |
| 2024Q4 | 92 | 63.3 | 2.63 | 0.48 | 0.57 | 1.58 | 2.56 | 0.0% |
| 2024Q3 | 92 | 62.0 | 2.46 | 0.50 | 0.52 | 1.43 | 2.31 | 0.0% |
| 2024Q2 | 91 | 54.4 | 2.62 | 0.52 | 0.62 | 1.48 | 2.56 | 0.0% |
| 2024Q1 | 91 | 58.6 | 2.60 | 0.45 | 0.64 | 1.50 | 2.46 | 0.0% |
| 2023Q4 | 92 | 61.4 | 2.37 | 0.35 | 0.66 | 1.36 | 2.50 | 0.0% |
| 2023Q3 | 92 | 60.9 | 2.37 | 0.35 | 0.70 | 1.31 | 2.24 | 0.0% |
| 2023Q2 | 91 | 62.5 | 2.18 | 0.30 | 0.69 | 1.19 | 1.93 | 0.0% |
| 2023Q1 | 90 | 57.8 | 2.30 | 0.29 | 0.70 | 1.31 | 2.07 | 0.0% |
| 2022Q4 | 92 | 53.6 | 2.41 | 0.24 | 0.76 | 1.41 | 2.24 | 0.0% |
| 2022Q3 | 92 | 50.4 | 2.42 | 0.26 | 0.69 | 1.47 | 2.12 | 0.0% |
| 2022Q2 | 91 | 42.8 | 2.33 | 0.26 | 0.76 | 1.30 | 2.06 | 0.0% |
| 2022Q1 | 90 | 40.3 | 2.84 | 0.25 | 0.90 | 1.69 | 2.48 | 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
4fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-03-29 | Fine | $91,910 | CMS provider data |
| 2024-03-20 | Fine | $103,109 | CMS provider data |
| 2024-03-20 | Payment Denial | — | CMS provider data |
| 2024-02-15 | Fine | $144,027 | CMS provider data |
Total fines on record: $339,046
Deficiencies
93D × 54E × 26F × 2G × 1J × 3K × 7
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-04-03 | Health | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2026-04-10 |
| 2026-04-03 | Health | F0552 | Ensure that residents are fully informed and understand their health status, care and treatments. | D | 2026-04-10 |
| 2026-04-03 | Health | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2026-04-10 |
| 2026-04-03 | Health | F0583 | Keep residents' personal and medical records private and confidential. | E | 2026-04-10 |
| 2026-04-03 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2026-04-10 |
| 2026-04-03 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | E | 2026-04-26 |
| 2026-04-03 | Health | F0659 | Provide care by qualified persons according to each resident's written plan of care. | D | 2026-04-10 |
| 2026-04-03 | Health | F0676 | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | 2026-04-10 |
| 2026-04-03 | 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 | 2026-04-10 |
| 2026-04-03 | Health | 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 | 2026-04-10 |
| 2026-04-03 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2026-04-10 |
| 2026-04-03 | Health | F0699 | Provide care or services that was trauma informed and/or culturally competent. | D | 2026-04-10 |
| 2026-04-03 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2026-04-10 |
| 2026-04-03 | 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 | 2026-04-10 |
| 2026-04-03 | Health | F0770 | Provide timely, quality laboratory services/tests to meet the needs of residents. | D | 2026-04-10 |
| 2026-04-03 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2026-04-10 |
| 2026-04-03 | Health | F0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | 2026-04-10 |
| 2026-04-03 | Health | F0808 | Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. | D | 2026-04-10 |
| 2026-04-03 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2026-04-10 |
| 2026-04-03 | 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 | 2026-04-10 |
| 2026-04-03 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2026-04-10 |
| 2026-04-03 | Health | F0882 | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | F | 2026-04-10 |
| 2026-03-05 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2026-03-06 |
| 2026-03-05 | 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. | E | 2026-03-06 |
| 2026-03-05 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2026-03-06 |
| 2025-12-03 | 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 | 2025-12-10 |
| 2025-12-03 | Health | F0679 | Provide activities to meet all resident's needs. | D | 2025-12-10 |
| 2025-12-03 | 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 | 2025-12-10 |
| 2025-12-03 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-12-10 |
| 2025-12-03 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2025-12-10 |
| 2025-12-03 | Health | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | E | 2025-12-10 |
| 2025-12-03 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2025-12-10 |
| 2025-12-03 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | E | 2025-12-10 |
| 2025-12-03 | 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 | 2025-12-10 |
| 2025-12-03 | Health | F0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | E | 2025-12-10 |
| 2025-12-03 | Health | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2025-12-19 |
| 2025-12-03 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2025-12-10 |
| 2025-12-03 | Health | F0926 | Have policies on smoking. | D | 2025-12-10 |
| 2025-11-19 | Health · complaint | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | E | 2025-11-20 |
| 2025-07-17 | Health · complaint | F0942 | Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents. | D | 2025-07-18 |
| 2025-07-17 | Health · complaint | F0944 | Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program. | D | 2025-07-18 |
| 2025-07-17 | Health · complaint | F0946 | Provide training in compliance and ethics. | D | 2025-07-18 |
| 2025-03-29 | Health | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2025-03-30 |
| 2025-03-29 | 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 | 2025-03-30 |
| 2025-03-29 | 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 | 2025-03-30 |
| 2025-03-29 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | K | 2025-03-30 |
| 2025-03-29 | Health · complaint | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | K | 2025-03-30 |
| 2025-03-29 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | J | 2025-03-30 |
| 2025-03-29 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | K | 2025-03-30 |
| 2025-03-29 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2025-03-30 |
| 2025-03-29 | Health | F0661 | Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | D | 2025-03-30 |
| 2025-03-29 | Health | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2025-03-30 |
| 2025-03-29 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | 2025-03-30 |
| 2025-03-29 | Health | 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 | 2025-03-30 |
| 2025-03-29 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2025-03-30 |
| 2025-03-29 | Health | F0694 | Provide for the safe, appropriate administration of IV fluids for a resident when needed. | D | 2025-03-30 |
| 2025-03-29 | Health | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | G | 2025-03-30 |
| 2025-03-29 | Health | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | 2025-03-30 |
| 2025-03-29 | Health | F0699 | Provide care or services that was trauma informed and/or culturally competent. | E | 2025-03-30 |
| 2025-03-29 | Health | F0740 | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | K | 2025-03-30 |
| 2025-03-29 | 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 | 2025-03-30 |
| 2025-03-29 | 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 | 2025-03-30 |
| 2025-03-29 | Health | F0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | D | 2025-03-30 |
| 2025-03-29 | Health | F0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | 2025-03-30 |
| 2025-03-29 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2025-03-30 |
| 2025-03-29 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2025-03-30 |
| 2025-03-29 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2025-03-30 |
| 2024-03-20 | Health · complaint | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | 2024-04-23 |
| 2024-03-20 | Health · complaint | F0660 | Plan the resident's discharge to meet the resident's goals and needs. | J | 2024-03-21 |
| 2024-03-20 | Health · complaint | F0661 | Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | E | 2024-04-23 |
| 2024-02-15 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2024-02-16 |
| 2024-02-15 | Health · complaint | F0576 | Ensure residents have reasonable access to and privacy in their use of communication methods. | E | 2024-02-16 |
| 2024-02-15 | Health · complaint | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2024-02-16 |
| 2024-02-15 | Health · complaint | 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 | 2024-02-16 |
| 2024-02-15 | 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 | 2024-02-16 |
| 2024-02-15 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | K | 2024-02-16 |
| 2024-02-15 | Health · complaint | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | K | 2024-02-16 |
| 2024-02-15 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2024-02-16 |
| 2024-02-15 | Health · complaint | F0679 | Provide activities to meet all resident's needs. | D | 2024-02-16 |
| 2024-02-15 | Health · complaint | F0680 | Ensure the activities program is directed by a qualified professional. | D | 2024-02-16 |
| 2024-02-15 | 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 | 2024-02-16 |
| 2024-02-15 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2024-02-16 |
| 2024-02-15 | 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. | E | 2024-02-16 |
| 2024-02-15 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2024-02-16 |
| 2024-02-15 | 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. | E | 2024-02-16 |
| 2024-02-15 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2024-02-16 |
| 2024-02-15 | Health · complaint | F0926 | Have policies on smoking. | K | 2024-02-16 |
| 2023-12-04 | Health · complaint | 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 | 2023-12-21 |
| 2023-12-04 | Health · complaint | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2023-12-21 |
| 2023-12-04 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2023-12-21 |
| 2023-12-04 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2023-12-21 |
| 2023-12-04 | Health · complaint | F0791 | Provide or obtain dental services for each resident. | D | 2023-12-21 |
| 2023-12-04 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2023-12-21 |
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
18| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| EASTLAND MEMORIAL HOSPITAL DISTRICT | 5% OR GREATER DIRECT OWNERSHIP INTEREST | — | 2018-04-01 | current | pecos_ownership |
| EASTLAND MEMORIAL HOSPITAL DISTRICT | — | — | 2024-04-01 | current | tx_hhsc_directory |
| FALLON, JOHN | OPERATIONAL/MANAGERIAL CONTROL | — | 2018-04-01 | current | pecos_ownership |
| KIRLEY, FRANCIS | OPERATIONAL/MANAGERIAL CONTROL | — | 2018-04-01 | current | pecos_ownership |
| LEE, BRIAN | OPERATIONAL/MANAGERIAL CONTROL | — | 2018-04-01 | current | pecos_ownership |
| NEXION HEALTH AT TERRELL, INC | — | — | 2024-04-01 | current | tx_hhsc_directory |
| NEXION HEALTH AT TERRELL, INC. | OPERATIONAL/MANAGERIAL CONTROL | — | 2018-04-01 | current | pecos_ownership |
| OSWALD, JOHN | OPERATIONAL/MANAGERIAL CONTROL | — | 2022-03-22 | current | pecos_ownership |
| PIERCE, DANIEL | OPERATIONAL/MANAGERIAL CONTROL | — | 2021-03-16 | current | pecos_ownership |
| RINER, MEERA | OPERATIONAL/MANAGERIAL CONTROL | — | 2018-04-01 | current | pecos_ownership |
| WRIGHT, LABAN | W-2 MANAGING EMPLOYEE | — | 2021-11-10 | current | pecos_ownership |
| BRIAN LEE | OPERATIONAL/MANAGERIAL CONTROL | — | 2018-04-01 | ended 2026-05-18 | pecos_ownership |
| DANIEL PIERCE | OPERATIONAL/MANAGERIAL CONTROL | — | 2021-03-16 | ended 2026-05-18 | pecos_ownership |
| FRANCIS KIRLEY | OPERATIONAL/MANAGERIAL CONTROL | — | 2018-04-01 | ended 2026-05-18 | pecos_ownership |
| JOHN FALLON | OPERATIONAL/MANAGERIAL CONTROL | — | 2018-04-01 | ended 2026-05-18 | pecos_ownership |
| JOHN OSWALD | OPERATIONAL/MANAGERIAL CONTROL | — | 2022-03-22 | ended 2026-05-18 | pecos_ownership |
| LABAN WRIGHT | W-2 MANAGING EMPLOYEE | — | 2021-11-10 | ended 2026-05-18 | pecos_ownership |
| MEERA RINER | OPERATIONAL/MANAGERIAL CONTROL | — | 2018-04-01 | 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 |
|---|---|---|---|---|
| 2018-04-01 | — | EASTLAND MEMORIAL HOSPITAL DISTRICT | NEXION HEALTH AT TERRELL, INC. | 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
35| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 48257 | acs median gross | 0 | $1,182 | 2024-12-31 | CENSUS_ACS5 |
| county 48257 | fmr | 0 | $1,582 | 2025-10-01 | HUD_USER_FMR |
| county 48257 | acs median gross | 1 | $1,314 | 2024-12-31 | CENSUS_ACS5 |
| county 48257 | fmr | 1 | $1,648 | 2025-10-01 | HUD_USER_FMR |
| county 48257 | acs median gross | 2 | $1,263 | 2024-12-31 | CENSUS_ACS5 |
| county 48257 | fmr | 2 | $1,931 | 2025-10-01 | HUD_USER_FMR |
| county 48257 | acs median gross | 3 | $1,916 | 2024-12-31 | CENSUS_ACS5 |
| county 48257 | fmr | 3 | $2,431 | 2025-10-01 | HUD_USER_FMR |
| county 48257 | acs median gross | 4 | $2,283 | 2024-12-31 | CENSUS_ACS5 |
| county 48257 | fmr | 4 | $3,091 | 2025-10-01 | HUD_USER_FMR |
| county 48257 | acs median gross | 5 | $2,456 | 2024-12-31 | CENSUS_ACS5 |
| county 48257 | acs median gross | $1,554 | 2024-12-31 | CENSUS_ACS5 | |
| county 48257 | acs recent mover gross | $1,894 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 75160 | acs median gross | 0 | $672 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75160 | acs median gross | 1 | $1,096 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75160 | acs median gross | 2 | $1,205 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75160 | acs median gross | 3 | $1,505 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75160 | acs median gross | 4 | $2,000 | 2024-12-31 | CENSUS_ACS5 |
| zcta 75160 | acs median gross | $1,257 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 75160 | acs recent mover gross | $1,696 | 2024-12-31 | CENSUS_ACS5 | |
| zip 75160 | payment standard 110 | 0 | $1,375 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | payment standard 90 | 0 | $1,125 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | safmr | 0 | $1,250 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | payment standard 110 | 1 | $1,430 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | payment standard 90 | 1 | $1,170 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | safmr | 1 | $1,300 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | payment standard 110 | 2 | $1,672 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | payment standard 90 | 2 | $1,368 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | safmr | 2 | $1,520 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | payment standard 110 | 3 | $2,101 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | payment standard 90 | 3 | $1,719 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | safmr | 3 | $1,910 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | payment standard 110 | 4 | $2,673 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | payment standard 90 | 4 | $2,187 | 2025-10-01 | HUD_USER_SAFMR |
| zip 75160 | safmr | 4 | $2,430 | 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.