Reads as: riskier than 23.5% of the 14,684 facilities in the snf peer group. percentile within peer group, 100 = highest risk. Grade bands are fixed percentile cuts (F is the top 5% of peer risk), so a grade is a position, not an absolute level.
weighted_contribution sums to pre_rank_index over rows where counts_toward_index is true. The composite is the facility's percentile position of that index within its peer group, so contributions explain the input, and the rank explains the score.
Change-of-ownership footprint in the CMS Provider of Services file: control-family, legal-name and address deltas across quarterly snapshots, plus certification reset recency and Medicare tenure.
R23/W4-3. Deterministic logistic p(Medicare termination within 12m), SNF only. Label = first POS termination date (any code: voluntary closure, involuntary termination, merger exit); facilities already terminated by the panel date are excluded, not counted as safe. Trained on panels 2024-07/2024-10/2025-01 (n=46,466, 283 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.971, top-decile lift 9.5x, top-decile capture 95.4% of the 65 terminations that followed. Separability is high because closures announce themselves in the data: collapsing occupancy is the strongest signal, and the learned NEGATIVE weight on 12m deficiency counts is the surveys-stop signature of a facility winding down, not a claim that clean inspections are dangerous. Same 15 as-of-date features and anti-leakage chassis as p_chow_12m; SFF entry rejected as a label (only one month of SFF history exists, so as-of transitions cannot be reconstructed). Score = probability x 100; grade NULL. Not in any composite.
R22/W4-2. Deterministic logistic p(CHOW within 12m), SNF only. Trained on panels 2024-07/2024-10/2025-01 (n=50,700, 1,207 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.874, top-decile lift 5.0x (top 10% of predictions captured 49.6% of the CHOWs that actually closed in the next 12 months). Shipped coefficients are the evaluated ones; no post-holdout refit. Caveat: holdout positives (133) run below the training base rate because recent CHOWs surface in public records with a lag, so measured lift is conservative. Features are as-of-date public records: PBJ staffing level/trend/contract share (quarterly history to 2022Q1), deficiency and CMP counts (12m), ownership tenure and churn from CHOW-evidenced transactions, beds, occupancy, ownership type, chain size. Chain membership and ownership type are current-state (history not published). SFF and star ratings deliberately excluded (no as-of history). Notable learned direction: long ownership tenure RAISES sale odds and a recent prior CHOW lowers them. Score = probability x 100; grade is NULL because a probability is not a quality letter. Not in any composite.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Rows with counts_toward_composite false come from models that are addressable or retracted rather than default. They exist and may be informative, but they did not enter the published composite and must not be summed as though they had.
p_adverse_action_12m: probability the facility's Medicare participation terminates within 12 months (any POS termination code; already-terminated facilities are excluded, not scored safe). Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.971, top-decile lift 9.5x. Closures announce themselves: collapsing occupancy dominates, and fewer recent surveys is a winding-down signature. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models. | p_chow_12m: probability of a change of ownership within 12 months. Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.874, top-decile lift 5.0x. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models for full notes.
Probability the facility's Medicare participation ends within 12 months, from public records only. Red bars raise exit odds. A negative pull from deficiencies is the winding-down signature — surveys stop as a facility empties — not evidence that clean inspections are dangerous.
Staffing vs peers
16
2025Q4 HPRD
This facility
MN median
National median
National p25–p75
Total nurse
3.19
3.49
3.28
2.90–3.77
RN
0.35
0.65
0.39
0.25–0.58
Weekend total
3.20
3.32
3.11
—
Weekday total
3.19
3.59
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
27.1
3.19
0.35
0.65
2.20
3.20
16.4%
2025Q3
92
27.9
3.05
0.60
0.34
2.11
3.02
16.5%
2025Q2
91
29.2
2.86
0.35
0.54
1.97
2.84
13.4%
2025Q1
90
29.6
2.84
0.42
0.45
1.97
2.86
11.6%
2024Q4
92
29.6
2.85
0.46
0.45
1.94
2.83
14.0%
2024Q3
92
29.8
2.82
0.47
0.40
1.95
2.77
10.5%
2024Q2
91
29.7
2.78
0.29
0.57
1.92
2.75
3.3%
2024Q1
91
29.0
2.88
0.45
0.47
1.96
2.86
5.8%
2023Q4
92
29.3
2.85
0.40
0.51
1.94
2.88
5.8%
2023Q3
92
29.8
2.79
0.41
0.46
1.92
2.76
5.0%
2023Q2
91
29.8
2.78
0.38
0.50
1.90
2.83
5.1%
2023Q1
90
29.2
2.77
0.34
0.57
1.86
2.80
0.0%
2022Q4
92
29.1
2.82
0.28
0.63
1.91
2.84
0.0%
2022Q3
92
29.1
2.72
0.24
0.67
1.81
2.77
0.2%
2022Q2
91
28.1
2.86
0.23
0.70
1.92
2.88
0.0%
2022Q1
90
26.9
2.99
0.18
0.81
2.00
3.02
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
0
No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
14
D × 10E × 2F × 2
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2025-04-02
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
D
2025-05-12
2025-04-02
Health · complaint
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
D
2025-05-12
2025-04-02
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
2025-05-12
2025-04-02
Health
F0625
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
D
2025-05-12
2024-04-03
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
—
2024-04-03
Health
F0756
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
D
2024-05-01
2024-04-03
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
2024-05-01
2023-08-03
Health
F0644
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
2023-09-15
2023-08-03
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2023-09-15
2023-08-03
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2023-09-15
2023-08-03
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
2023-09-15
2023-08-03
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2023-09-15
2023-08-03
Health
F0881
Implement a program that monitors antibiotic use.
D
2023-09-15
2023-08-03
Health
F0883
Develop and implement policies and procedures for flu and pneumonia vaccinations.
E
2023-09-15
scope_severity uses the CMS letter grid: A is least serious, L most. J, K and L are immediate jeopardy. Rows are the surveyor's findings of record, not the model's opinion.
Licensure actions
0
No licensure actions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Ownership
40
Owner
Role
Pct
From
Status
Source
AVERA HEALTH
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2016-03-01
current
pecos_ownership
AVERA MARSHALL
OPERATIONAL/MANAGERIAL CONTROL
—
2016-02-17
current
pecos_ownership
COUDRON, CHRISTY
CORPORATE OFFICER
—
2020-09-01
current
pecos_ownership
DOVER, JAMES
OPERATIONAL/MANAGERIAL CONTROL
—
2023-10-23
current
pecos_ownership
HENNEN, SHARON
CORPORATE DIRECTOR
—
2023-07-01
current
pecos_ownership
KOENEN, LAVONNE
CORPORATE DIRECTOR
—
2020-07-01
current
pecos_ownership
KOOIMAN, THOMAS
OPERATIONAL/MANAGERIAL CONTROL
—
2022-05-29
current
pecos_ownership
KOOIMAN, THOMAS
ADP OF THE SNF
—
2026-02-16
current
pecos_ownership
LAUTT, JULIE
CORPORATE OFFICER
—
2020-03-01
current
pecos_ownership
LORANG, THOMAS
CORPORATE DIRECTOR
—
2024-07-01
current
pecos_ownership
LOUWAGIE, CURTIS
CORPORATE DIRECTOR
—
2017-09-11
current
pecos_ownership
NOVAK, KARIE
CORPORATE DIRECTOR
—
2024-07-01
current
pecos_ownership
O'LEARY, TIM
CORPORATE DIRECTOR
—
2023-07-01
current
pecos_ownership
REYNOLDS, CHRISTOPHER
OPERATIONAL/MANAGERIAL CONTROL
—
2023-07-01
current
pecos_ownership
REYNOLDS, CHRISTOPHER
ADP OF THE SNF
—
2026-02-12
current
pecos_ownership
SIELING, AMANDA
CORPORATE DIRECTOR
—
2018-07-01
current
pecos_ownership
STREIER, DEBRA
CORPORATE OFFICER
—
2021-02-01
current
pecos_ownership
VROMAN, JILL
CORPORATE DIRECTOR
—
2023-07-01
current
pecos_ownership
ZIMMERMAN, JODELLE
CORPORATE DIRECTOR
—
2017-07-01
current
pecos_ownership
AMANDA SIELING
CORPORATE DIRECTOR
—
2018-07-01
ended 2026-05-18
pecos_ownership
AVERA MARSHALL
OPERATIONAL/MANAGERIAL CONTROL
—
2016-03-01
ended 2026-05-18
pecos_ownership
CHRISTOPHER REYNOLDS
W-2 MANAGING EMPLOYEE
—
2023-04-01
ended 2026-05-18
pecos_ownership
CHRISTY COUDRON
CORPORATE OFFICER
—
2020-09-01
ended 2026-05-18
pecos_ownership
CURTIS LOUWAGIE
CORPORATE DIRECTOR
—
2017-09-11
ended 2026-05-18
pecos_ownership
DEBRA STREIER
CORPORATE OFFICER
—
2021-02-01
ended 2026-05-18
pecos_ownership
GEORGE JORGENSON
CORPORATE DIRECTOR
—
2008-09-01
ended 2026-05-18
pecos_ownership
GREGORY GOEPFERICH
CORPORATE DIRECTOR
—
2020-07-01
ended 2026-05-18
pecos_ownership
JAMES DOVER
CORPORATE OFFICER
—
2023-10-23
ended 2026-05-18
pecos_ownership
JILL VROMAN
CORPORATE DIRECTOR
—
2023-07-01
ended 2026-05-18
pecos_ownership
JODELLE ZIMMERMAN
CORPORATE DIRECTOR
—
2017-09-11
ended 2026-05-18
pecos_ownership
JOYCE STROOTMAN
CORPORATE DIRECTOR
—
2017-09-11
ended 2026-05-18
pecos_ownership
JULIE LAUTT
CORPORATE OFFICER
—
2020-03-01
ended 2026-05-18
pecos_ownership
LAURIE JOHANSEN
CORPORATE DIRECTOR
—
2011-04-01
ended 2026-05-18
pecos_ownership
LAVONNE KOENEN
CORPORATE DIRECTOR
—
2020-07-01
ended 2026-05-18
pecos_ownership
MARK VORTHERMS
CORPORATE OFFICER
—
2020-09-29
ended 2026-05-18
pecos_ownership
QUENTIN FIXEN
CORPORATE DIRECTOR
—
2017-09-11
ended 2026-05-18
pecos_ownership
SHARON HENNEN
CORPORATE DIRECTOR
—
2023-07-01
ended 2026-05-18
pecos_ownership
STEPHEN CRIM
CORPORATE DIRECTOR
—
2019-07-01
ended 2026-05-18
pecos_ownership
THOMAS KOOIMAN
OPERATIONAL/MANAGERIAL CONTROL
—
2022-05-29
ended 2026-05-18
pecos_ownership
TIM O'LEARY
CORPORATE DIRECTOR
—
2023-07-01
ended 2026-05-18
pecos_ownership
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.
Related-party costs
0
No related-party cost years on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
Transactions
0
No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
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
30
Geo
Kind
BR
Amount
As of
Source
county 27081
fmr
0
$671
2025-10-01
HUD_USER_FMR
county 27081
acs median gross
1
$505
2024-12-31
CENSUS_ACS5
county 27081
fmr
1
$742
2025-10-01
HUD_USER_FMR
county 27081
acs median gross
2
$631
2024-12-31
CENSUS_ACS5
county 27081
fmr
2
$973
2025-10-01
HUD_USER_FMR
county 27081
acs median gross
3
$919
2024-12-31
CENSUS_ACS5
county 27081
fmr
3
$1,283
2025-10-01
HUD_USER_FMR
county 27081
acs median gross
4
$783
2024-12-31
CENSUS_ACS5
county 27081
fmr
4
$1,288
2025-10-01
HUD_USER_FMR
county 27081
acs median gross
$674
2024-12-31
CENSUS_ACS5
county 27081
acs recent mover gross
$678
2024-12-31
CENSUS_ACS5
zcta 56178
acs median gross
2
$736
2024-12-31
CENSUS_ACS5
zcta 56178
acs median gross
3
$941
2024-12-31
CENSUS_ACS5
zcta 56178
acs median gross
$750
2024-12-31
CENSUS_ACS5
zcta 56178
acs recent mover gross
$725
2024-12-31
CENSUS_ACS5
zip 56178
payment standard 110
0
$770
2025-10-01
HUD_USER_SAFMR
zip 56178
payment standard 90
0
$630
2025-10-01
HUD_USER_SAFMR
zip 56178
safmr
0
$700
2025-10-01
HUD_USER_SAFMR
zip 56178
payment standard 110
1
$858
2025-10-01
HUD_USER_SAFMR
zip 56178
payment standard 90
1
$702
2025-10-01
HUD_USER_SAFMR
zip 56178
safmr
1
$780
2025-10-01
HUD_USER_SAFMR
zip 56178
payment standard 110
2
$1,111
2025-10-01
HUD_USER_SAFMR
zip 56178
payment standard 90
2
$909
2025-10-01
HUD_USER_SAFMR
zip 56178
safmr
2
$1,010
2025-10-01
HUD_USER_SAFMR
zip 56178
payment standard 110
3
$1,474
2025-10-01
HUD_USER_SAFMR
zip 56178
payment standard 90
3
$1,206
2025-10-01
HUD_USER_SAFMR
zip 56178
safmr
3
$1,340
2025-10-01
HUD_USER_SAFMR
zip 56178
payment standard 110
4
$1,562
2025-10-01
HUD_USER_SAFMR
zip 56178
payment standard 90
4
$1,278
2025-10-01
HUD_USER_SAFMR
zip 56178
safmr
4
$1,420
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.