Composite
12.1 / 100 percentile
Screener / 355115
A
GARRISON MEM HOSP NSG FAC
snfND
407 3RD AVE SE, GARRISON, ND 58540 · CCN 355115 · chain COMMONSPIRIT HEALTH
Peer group
snf n = 14,684
Evidence depth
moderate
Certified beds
26
Model
v1.2
Reads as: riskier than 12.1% 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 model3Components9CHOW radar1Distress radar1Staffing15Penalties0Deficiencies24Licensure0Ownership28Related party0Transactions0Comps6Market rent30
Composite explanation
3| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 44.0 | 32.8 | 0.30 | 0.4286 | 18.86 | in index |
| staffing risk | 19.3 | 19.4 | 0.25 | 0.3571 | 6.89 | in index |
| chow risk | 25.2 | 25.0 | 0.15 | 0.2143 | 5.40 | 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
9| 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 | 0.2 | — | 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 | 4.4 | — | 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 | 32.8 | B | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 19.4 | A | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| regulatory risk | 32.7 | B | 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 | 32.7 | B | 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 | 19.4 | A | 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 | 19.4 | A | 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)
4.4%
model v0.1 · computed 2026-07-29
Percentile among SNFs
86.4
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 | |
| Contract staffing share | 0.70 | +0.99 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| Chain size (log) | 4.47 | +0.55 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Total nurse staffing (HPRD) | 3.93 | -0.18 |
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)
0.2%
model v0.1 · computed 2026-07-29
Percentile among SNFs
61.0
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 | |
| Chain size (log) | 4.47 | -1.40 | |
| Contract staffing share | 0.70 | +0.67 | |
| Staffing trend, last 4 quarters | -0.87 | -0.43 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Occupancy | 0.66 | +0.38 | |
| Total nurse staffing (HPRD) | 3.93 | -0.30 | |
| Deficiencies, last 12 months | 9.00 | -0.24 |
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| 2025Q4 HPRD | This facility | ND median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 3.93 | 3.90 | 3.28 | 2.90–3.77 |
| RN | 2.06 | 0.59 | 0.39 | 0.25–0.58 |
| Weekend total | 3.45 | 3.55 | 3.11 | — |
| Weekday total | 4.13 | 4.01 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 17.1 | 3.93 | 2.06 | 0.07 | 1.81 | 3.45 | 70.2% |
| 2025Q3 | 92 | 17.3 | 5.32 | 1.90 | 0.26 | 3.17 | 4.75 | 66.0% |
| 2025Q2 | 91 | 15.4 | 6.49 | 2.50 | 0.37 | 3.62 | 5.86 | 64.7% |
| 2025Q1 | 90 | 16.8 | 5.57 | 1.69 | 0.44 | 3.44 | 5.13 | 63.9% |
| 2024Q4 | 92 | 18.5 | 4.81 | 1.56 | 0.43 | 2.81 | 4.36 | 54.7% |
| 2024Q2 | 91 | 17.8 | 5.14 | 1.18 | 0.73 | 3.23 | 4.66 | 55.4% |
| 2024Q1 | 91 | 18.6 | 1.82 | 0.57 | 0.33 | 0.92 | 1.51 | 34.5% |
| 2023Q4 | 92 | 20.4 | 3.30 | 0.75 | 0.67 | 1.88 | 2.56 | 24.9% |
| 2023Q3 | 92 | 21.1 | 3.89 | 0.81 | 0.64 | 2.44 | 3.31 | 28.3% |
| 2023Q2 | 91 | 22.5 | 3.78 | 1.02 | 0.68 | 2.09 | 3.45 | 38.2% |
| 2023Q1 | 90 | 21.6 | 4.02 | 1.18 | 1.02 | 1.82 | 3.51 | 40.1% |
| 2022Q4 | 92 | 21.4 | 3.34 | 1.13 | 0.55 | 1.66 | 2.94 | 29.3% |
| 2022Q3 | 92 | 23.7 | 3.36 | 1.09 | 0.49 | 1.78 | 3.37 | 34.6% |
| 2022Q2 | 91 | 23.2 | 3.78 | 1.40 | 0.19 | 2.19 | 3.61 | 43.3% |
| 2022Q1 | 90 | 20.2 | 5.01 | 1.11 | 0.58 | 3.32 | 4.74 | 69.5% |
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
0No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
24D × 17E × 5F × 2
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-04-08 | Health | F0552 | Ensure that residents are fully informed and understand their health status, care and treatments. | E | 2026-05-05 |
| 2026-04-08 | 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 | 2026-05-05 |
| 2026-04-08 | Health | F0605 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | D | 2026-05-05 |
| 2026-04-08 | 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. | E | 2026-05-05 |
| 2026-04-08 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2026-05-05 |
| 2026-04-08 | 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. | D | 2026-05-05 |
| 2026-04-08 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2026-05-05 |
| 2026-04-08 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2026-05-05 |
| 2026-04-08 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2026-05-05 |
| 2025-02-27 | 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. | E | 2025-03-28 |
| 2025-02-27 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-03-28 |
| 2025-02-27 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-03-28 |
| 2025-02-27 | Health · complaint | F0692 | Provide enough food/fluids to maintain a resident's health. | D | 2025-03-28 |
| 2025-02-27 | 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 | 2025-03-28 |
| 2025-02-27 | Health · complaint | F0865 | Have a plan that describes the process for conducting QAPI and QAA activities. | E | 2025-03-28 |
| 2025-02-27 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | D | 2025-03-28 |
| 2023-12-20 | Health | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | D | 2024-01-29 |
| 2023-12-20 | Health · complaint | F0583 | Keep residents' personal and medical records private and confidential. | D | 2024-01-29 |
| 2023-12-20 | 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 | 2024-01-29 |
| 2023-12-20 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-01-29 |
| 2023-12-20 | Health · complaint | 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 | 2024-01-29 |
| 2023-12-20 | Health | F0759 | Ensure medication error rates are not 5 percent or greater. | D | 2024-01-29 |
| 2023-12-20 | Health | F0801 | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | F | 2024-01-29 |
| 2023-12-20 | 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 | 2024-01-29 |
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
28| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| COMMONSPIRIT HEALTH | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2019-02-01 | current | pecos_ownership |
| BOPP, TIMOTHY | CORPORATE DIRECTOR | — | 2018-07-01 | current | pecos_ownership |
| DAHMEN, KEVIN | CORPORATE DIRECTOR | — | 2018-07-01 | current | pecos_ownership |
| GARRISON MEMORIAL HOSPITAL | 5% OR GREATER DIRECT OWNERSHIP INTEREST | — | 1998-06-22 | current | pecos_ownership |
| GIESE, JOHN | CORPORATE DIRECTOR | — | 2007-12-01 | current | pecos_ownership |
| HYDER, SYED SHIRAZ | CORPORATE DIRECTOR | — | 2019-07-01 | current | pecos_ownership |
| KUIPER, EVERT | CORPORATE DIRECTOR | — | 2022-01-17 | current | pecos_ownership |
| KUNZE, NICOLE | CORPORATE DIRECTOR | — | 2020-08-01 | current | pecos_ownership |
| LEFOR, MICHAEL | CORPORATE OFFICER | — | 2016-04-20 | current | pecos_ownership |
| MILLER, NANCY | CORPORATE DIRECTOR | — | 2008-05-01 | current | pecos_ownership |
| MONGEON, JOHN | CORPORATE DIRECTOR | — | 2018-10-01 | current | pecos_ownership |
| PRESZLER, TODD | CORPORATE DIRECTOR | — | 2016-10-26 | current | pecos_ownership |
| REYMAN, REED | CORPORATE OFFICER | — | 2022-12-19 | current | pecos_ownership |
| ST ALEXIUS MEDICAL CENTER | 5% OR GREATER DIRECT OWNERSHIP INTEREST | — | 1998-06-22 | current | pecos_ownership |
| WEISBECK, MIKE | CORPORATE DIRECTOR | — | 2019-07-01 | current | pecos_ownership |
| JOHN GIESE | CORPORATE DIRECTOR | 100% | 2007-12-01 | ended 2026-05-18 | pecos_ownership |
| JOHN MONGEON | CORPORATE DIRECTOR | 100% | 2018-10-01 | ended 2026-05-18 | pecos_ownership |
| KEVIN DAHMEN | CORPORATE DIRECTOR | 100% | 2018-07-01 | ended 2026-05-18 | pecos_ownership |
| MICHAEL LEFOR | CORPORATE OFFICER | 100% | 2016-04-20 | ended 2026-05-18 | pecos_ownership |
| MIKE WEISBECK | CORPORATE DIRECTOR | 100% | 2019-07-01 | ended 2026-05-18 | pecos_ownership |
| NANCY MILLER | CORPORATE DIRECTOR | 100% | 2008-05-01 | ended 2026-05-18 | pecos_ownership |
| SYED SHIRAZ HYDER | CORPORATE DIRECTOR | 100% | 2019-07-01 | ended 2026-05-18 | pecos_ownership |
| TIMOTHY BOPP | CORPORATE DIRECTOR | 100% | 2018-07-01 | ended 2026-05-18 | pecos_ownership |
| TODD PRESZLER | CORPORATE DIRECTOR | 100% | 2016-10-26 | ended 2026-05-18 | pecos_ownership |
| EVERT KUIPER | CORPORATE DIRECTOR | 0% | 2022-01-17 | ended 2026-05-18 | pecos_ownership |
| MARVIN O'QUINN | OTHER | 0% | 2022-08-01 | ended 2026-05-18 | pecos_ownership |
| NICOLE KUNZE | CORPORATE DIRECTOR | 0% | 2020-08-01 | ended 2026-05-18 | pecos_ownership |
| REED REYMAN | OPERATIONAL/MANAGERIAL CONTROL | 0% | 2022-12-19 | 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 — ND snf
6| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2022-01-01 | GOLDEN ACRES MANOR | — | — | — | 64 | ALPHA INC |
| 2020-07-01 | GOOD SAMARITAN SOCIETY MILLER POINTE A PROSPERA CO | — | — | — | 120 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| 2020-07-01 | GOOD SAMARITAN SOCIETY AUGUSTA PLACE A PROSPERA CO | — | — | — | 48 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| 2020-07-01 | SUNSET DRIVE - A PROSPERA COMMUNITY | — | — | — | 128 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| 2020-07-01 | ST VINCENT'S - A PROSPERA COMMUNITY | — | — | — | 97 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| 2018-10-24 | THE MEADOWS ON UNIVERSITY | — | — | — | 95 | FARGO NURSING AND REHAB CENTER 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
30| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 38055 | acs median gross | 0 | $813 | 2024-12-31 | CENSUS_ACS5 |
| county 38055 | fmr | 0 | $760 | 2025-10-01 | HUD_USER_FMR |
| county 38055 | acs median gross | 1 | $475 | 2024-12-31 | CENSUS_ACS5 |
| county 38055 | fmr | 1 | $796 | 2025-10-01 | HUD_USER_FMR |
| county 38055 | acs median gross | 2 | $691 | 2024-12-31 | CENSUS_ACS5 |
| county 38055 | fmr | 2 | $873 | 2025-10-01 | HUD_USER_FMR |
| county 38055 | acs median gross | 3 | $1,005 | 2024-12-31 | CENSUS_ACS5 |
| county 38055 | fmr | 3 | $1,214 | 2025-10-01 | HUD_USER_FMR |
| county 38055 | acs median gross | 4 | $1,025 | 2024-12-31 | CENSUS_ACS5 |
| county 38055 | fmr | 4 | $1,464 | 2025-10-01 | HUD_USER_FMR |
| county 38055 | acs median gross | $784 | 2024-12-31 | CENSUS_ACS5 | |
| county 38055 | acs recent mover gross | $643 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 58540 | acs median gross | 2 | $683 | 2024-12-31 | CENSUS_ACS5 |
| zcta 58540 | acs median gross | 3 | $1,056 | 2024-12-31 | CENSUS_ACS5 |
| zcta 58540 | acs median gross | $643 | 2024-12-31 | CENSUS_ACS5 | |
| zip 58540 | payment standard 110 | 0 | $836 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | payment standard 90 | 0 | $684 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | safmr | 0 | $760 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | payment standard 110 | 1 | $880 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | payment standard 90 | 1 | $720 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | safmr | 1 | $800 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | payment standard 110 | 2 | $957 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | payment standard 90 | 2 | $783 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | safmr | 2 | $870 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | payment standard 110 | 3 | $1,331 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | payment standard 90 | 3 | $1,089 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | safmr | 3 | $1,210 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | payment standard 110 | 4 | $1,617 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | payment standard 90 | 4 | $1,323 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58540 | safmr | 4 | $1,470 | 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.