Just to add more information to anyone that searches for this later... I haven't seen any consistent pattern in the placement of the hole callout when giving it a placement position. Sometimes it is placed in the correct position (mostly on holes with no countersinks) while the rest of the time, the hole callout is placed in some arbitrary location; usually close to the center of the holes geometry intent. I've tried a few things to correct this, however, it seems like once the hole callout is placed, I am unable to move the location of the holecallout. The hole callout uses a line to define the leader line, so at this time, without redefining the leader line entirely, I don't see a way to fix the leader line coming in reversed. Also, whether the arrow is on the inside or the outside is another thing that doesn't seem to be consistent, and I don't see a property to change in the HoleThreadNote to change this.
I have not found a solution to this problem, as it doesn't take much to quickly fix the hole location. Haven't had a chance to test all the possibilities, as there are many different hole types/hole callouts in inventor.
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FYI I am working on drawing tools primarily to speed the creation of drawings; in case anyone is interested.
The code posted above is meant to search for a pattern in centermarks located on similar hole sizes, without querying the hole pattern features from the model. It will identify patterns of holes regardless of how they were created, so long as the spacing between 3 holes is similar.