Composite
66.5 / 100 percentile
Screener / 27A052
C
MONTANA MENTAL HEALTH NURSING HOME
snfMT
800 CASINO CREEK DR, LEWISTOWN, MT 59457 · CCN 27A052
Peer group
snf n = 14,684
Evidence depth
moderate
Certified beds
117
Model
v1.2
Reads as: riskier than 66.5% 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.
Score model2Components6CHOW radar1Distress radar1Staffing15Penalties2Deficiencies37Licensure0Ownership0Related party0Transactions0Comps12Market rent33
Composite explanation
2| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 69.3 | 63.9 | 0.30 | 0.6667 | 46.20 | in index |
| chow risk | 25.2 | 25.0 | 0.15 | 0.3333 | 8.40 | in index |
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.
Component scores and registry models
6| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| 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. |
| p adverse action 12m | 1.3 | — | 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 | 63.9 | C | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| regulatory risk | 63.7 | C | 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 | 63.7 | C | 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. |
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)
0.3%
model v0.1 · computed 2026-07-29
Percentile among SNFs
48.1
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 | |
| Total nurse staffing (HPRD) | 6.30 | -0.65 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Chain size (log) | 0.00 | -0.40 | |
| Occupancy | 0.59 | +0.31 | |
| Ownership changes, last 5 years | 0.00 | +0.20 |
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)
1.3%
model v0.1 · computed 2026-07-29
Percentile among SNFs
87.6
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) | 6.30 | -1.30 | |
| Chain size (log) | 0.00 | +1.20 | |
| Occupancy | 0.59 | +0.66 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Staffing trend, last 4 quarters | 0.83 | +0.36 | |
| Fine amount, 12m (log) | 0.00 | +0.18 | |
| Deficiencies, last 12 months | 7.00 | +0.13 |
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
15| 2025Q3 HPRD | This facility | MT median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 6.30 | 3.25 | 3.28 | 2.90–3.77 |
| RN | 1.35 | 0.62 | 0.39 | 0.25–0.58 |
| Weekend total | 5.97 | 3.12 | 3.11 | — |
| Weekday total | 6.43 | 3.34 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q3 | 92 | 69.1 | 6.30 | 1.35 | 0.00 | 4.94 | 5.97 | 0.0% |
| 2025Q2 | 91 | 69.9 | 5.95 | 1.37 | 0.00 | 4.58 | 5.54 | 0.0% |
| 2025Q1 | 90 | 66.3 | 5.56 | 1.45 | 0.00 | 4.11 | 5.17 | 0.0% |
| 2024Q4 | 92 | 64.4 | 5.45 | 1.42 | 0.00 | 4.02 | 5.05 | 0.0% |
| 2024Q3 | 92 | 66.2 | 5.47 | 1.41 | 0.00 | 4.06 | 5.06 | 0.0% |
| 2024Q2 | 91 | 63.7 | 5.51 | 1.54 | 0.00 | 3.97 | 4.95 | 0.0% |
| 2024Q1 | 91 | 61.9 | 5.54 | 1.48 | 0.00 | 4.05 | 5.18 | 0.0% |
| 2023Q4 | 92 | 65.1 | 4.82 | 1.23 | 0.00 | 3.58 | 4.35 | 0.0% |
| 2023Q3 | 92 | 65.7 | 4.62 | 1.37 | 0.00 | 3.25 | 4.16 | 0.0% |
| 2023Q2 | 91 | 66.9 | 4.58 | 1.28 | 0.00 | 3.30 | 3.85 | 0.0% |
| 2023Q1 | 90 | 65.2 | 5.00 | 1.18 | 0.14 | 3.68 | 4.26 | 27.3% |
| 2022Q4 | 92 | 66.8 | 4.72 | 1.11 | 0.17 | 3.44 | 4.07 | 27.4% |
| 2022Q3 | 92 | 67.6 | 4.79 | 1.16 | 0.19 | 3.44 | 4.25 | 31.6% |
| 2022Q2 | 91 | 67.3 | 4.71 | 1.43 | 0.04 | 3.24 | 4.11 | 22.9% |
| 2022Q1 | 90 | 73.2 | 4.60 | 1.36 | 0.01 | 3.23 | 4.03 | 10.6% |
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
2fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2024-10-23 | Payment Denial | — | CMS provider data |
| 2023-08-16 | Fine | $7,163 | CMS provider data |
Total fines on record: $7,163
Deficiencies
37D × 23E × 9F × 2G × 3
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-11-19 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | E | 2026-01-12 |
| 2025-11-19 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2026-01-12 |
| 2025-11-19 | Health · complaint | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | 2026-01-12 |
| 2025-11-19 | Health · complaint | F0835 | Administer the facility in a manner that enables it to use its resources effectively and efficiently. | E | 2026-01-12 |
| 2025-07-30 | Health · complaint | F0576 | Ensure residents have reasonable access to and privacy in their use of communication methods. | E | — |
| 2025-07-30 | Health · complaint | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | 2025-08-29 |
| 2025-07-30 | Health · complaint | F0692 | Provide enough food/fluids to maintain a resident's health. | G | 2025-08-29 |
| 2024-10-24 | 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. | E | 2024-11-29 |
| 2024-10-24 | Health | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | 2024-11-29 |
| 2024-10-24 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | E | 2024-11-29 |
| 2024-10-24 | Health | F0660 | Plan the resident's discharge to meet the resident's goals and needs. | D | 2024-11-29 |
| 2024-10-24 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2024-11-29 |
| 2024-10-24 | 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 | 2024-11-29 |
| 2024-10-24 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2024-11-29 |
| 2024-10-24 | Health | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | E | 2024-11-29 |
| 2024-04-09 | Health · complaint | F0583 | Keep residents' personal and medical records private and confidential. | D | 2024-06-20 |
| 2024-04-09 | Health · complaint | F0610 | Respond appropriately to all alleged violations. | D | 2024-06-20 |
| 2024-04-09 | Health · complaint | F0740 | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | D | 2024-06-20 |
| 2023-11-08 | 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 | 2024-01-05 |
| 2023-11-08 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2024-01-05 |
| 2023-11-08 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2024-01-05 |
| 2023-11-08 | Health | 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 | 2024-01-05 |
| 2023-11-08 | Health · complaint | F0791 | Provide or obtain dental services for each resident. | D | 2024-01-05 |
| 2023-11-08 | Health | F0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | D | 2024-01-05 |
| 2023-08-16 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2023-04-10 |
| 2023-08-16 | 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 | 2023-01-06 |
| 2023-08-16 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | G | 2023-01-06 |
| 2022-08-18 | Health | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | F | 2022-09-22 |
| 2022-08-18 | 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 | 2022-09-30 |
| 2022-08-18 | 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 | 2022-09-22 |
| 2022-08-18 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2022-09-22 |
| 2022-08-18 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2022-09-22 |
| 2022-08-18 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2022-09-22 |
| 2022-08-18 | Health | 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 | 2022-09-22 |
| 2022-08-18 | Health | F0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | 2022-09-22 |
| 2022-08-18 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2022-09-22 |
| 2022-08-18 | Health | F0888 | Ensure staff are vaccinated for COVID-19 | F | 2022-09-22 |
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
0No ownership edges on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
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 — MT snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2024-03-01 | NORTHERN MONTANA CARE CENTER | — | — | — | 135 | NORTHERN MONTANA CARE CENTER INC |
| 2023-10-01 | RIVER RIDGE REHABILITATION AND NURSING LLC | — | — | — | 129 | RIVER RIDGE REHABILITATION AND NURSING LLC |
| 2023-08-31 | ASPEN MEADOWS HEALTH AND REHABILITATION CENTER | — | — | — | 90 | ASPEN MEADOWS SNF OPERATIONS, LLC |
| 2023-08-31 | LIVINGSTON HEALTH & REHABILITATION CENTER | — | — | — | 115 | LIVINGSTON SNF OPERATIONS LLC |
| 2023-08-31 | POLSON HEALTH & REHABILITATION CENTER | — | — | — | 70 | POLSON SNF OPERATIONS LLC |
| 2023-08-31 | MISSOULA HEALTH & REHABILITATION CENTER | — | — | — | 53 | MISSOULA SNF OPERATIONS LLC |
| 2023-08-31 | LAUREL HEALTH & REHABILITATION CENTER | — | — | — | 79 | LAUREL SNF OPERATIONS LLC |
| 2023-08-31 | HOT SPRINGS HEALTH & REHABILITATION CENTER | — | — | — | 40 | HOT SPRINGS SNF OPERATIONS LLC |
| 2023-07-01 | KALISPELL REHABILITATION AND NURSING LLC | — | — | — | 140 | KALISPELL REHABILITATION AND NURSING LLC |
| 2023-07-01 | NORTHERN PINES REHABILITATION AND NURSING | — | — | — | 41 | NORTHERN PINES REHABILITATION AND NURSING |
| 2023-07-01 | BILLINGS REHABILITATION AND NURSING LLC | — | — | — | 100 | BILLINGS REHABILITATION AND NURSING LLC |
| 2023-07-01 | VALLE VISTA REHABILITATION AND NURSING LLC | — | — | — | 101 | VALLE VISTA REHABILITATION AND NURSING LLC |
Most recent same-state, same-setting trades. Most CHOW-derived trades carry no disclosed consideration, so price, $/bed, and cap rate show only where a sale price was resolved from a deed or filing — blanks are honest, not missing data.
Market rent context
33| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 30027 | acs median gross | 0 | $995 | 2024-12-31 | CENSUS_ACS5 |
| county 30027 | fmr | 0 | $1,084 | 2025-10-01 | HUD_USER_FMR |
| county 30027 | acs median gross | 1 | $531 | 2024-12-31 | CENSUS_ACS5 |
| county 30027 | fmr | 1 | $1,102 | 2025-10-01 | HUD_USER_FMR |
| county 30027 | acs median gross | 2 | $930 | 2024-12-31 | CENSUS_ACS5 |
| county 30027 | fmr | 2 | $1,446 | 2025-10-01 | HUD_USER_FMR |
| county 30027 | acs median gross | 3 | $1,215 | 2024-12-31 | CENSUS_ACS5 |
| county 30027 | fmr | 3 | $1,991 | 2025-10-01 | HUD_USER_FMR |
| county 30027 | fmr | 4 | $2,338 | 2025-10-01 | HUD_USER_FMR |
| county 30027 | acs median gross | 5 | $521 | 2024-12-31 | CENSUS_ACS5 |
| county 30027 | acs median gross | $954 | 2024-12-31 | CENSUS_ACS5 | |
| county 30027 | acs recent mover gross | $1,166 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 59457 | acs median gross | 0 | $995 | 2024-12-31 | CENSUS_ACS5 |
| zcta 59457 | acs median gross | 1 | $523 | 2024-12-31 | CENSUS_ACS5 |
| zcta 59457 | acs median gross | 2 | $938 | 2024-12-31 | CENSUS_ACS5 |
| zcta 59457 | acs median gross | 3 | $1,281 | 2024-12-31 | CENSUS_ACS5 |
| zcta 59457 | acs median gross | $970 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 59457 | acs recent mover gross | $1,165 | 2024-12-31 | CENSUS_ACS5 | |
| zip 59457 | payment standard 110 | 0 | $1,188 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | payment standard 90 | 0 | $972 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | safmr | 0 | $1,080 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | payment standard 110 | 1 | $1,210 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | payment standard 90 | 1 | $990 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | safmr | 1 | $1,100 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | payment standard 110 | 2 | $1,584 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | payment standard 90 | 2 | $1,296 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | safmr | 2 | $1,440 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | payment standard 110 | 3 | $2,178 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | payment standard 90 | 3 | $1,782 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | safmr | 3 | $1,980 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | payment standard 110 | 4 | $2,563 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | payment standard 90 | 4 | $2,097 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59457 | safmr | 4 | $2,330 | 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.