803 S UNIVERSITY AVE, BEAVER DAM, WI 53916 · CCN 525447 · chain SANFORD
Composite
59.9 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
115
Model
v1.2
Reads as: riskier than 59.9% 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
WI median
National median
National p25–p75
Total nurse
3.54
3.60
3.28
2.90–3.77
RN
0.79
0.64
0.39
0.25–0.58
Weekend total
3.40
3.49
3.11
—
Weekday total
3.60
3.65
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
55.7
3.54
0.79
0.23
2.52
3.40
46.6%
2025Q3
92
51.0
3.54
0.73
0.27
2.54
3.41
41.1%
2025Q2
91
54.4
3.34
0.90
0.24
2.20
3.30
28.1%
2025Q1
90
54.7
2.18
0.65
0.15
1.38
2.08
25.8%
2024Q4
92
53.7
3.59
1.01
0.26
2.32
3.42
17.8%
2024Q3
92
54.5
3.31
0.97
0.25
2.10
3.19
14.3%
2024Q2
91
54.5
1.09
0.32
0.09
0.68
1.22
0.8%
2024Q1
91
59.8
3.26
1.05
0.26
1.95
3.11
0.0%
2023Q4
92
58.0
3.52
1.06
0.31
2.14
3.34
0.4%
2023Q3
92
55.3
3.75
1.24
0.31
2.21
3.49
5.1%
2023Q2
91
55.3
4.04
1.33
0.37
2.34
3.73
8.4%
2023Q1
90
57.2
4.08
1.42
0.31
2.35
3.76
13.6%
2022Q4
92
57.2
4.07
1.53
0.36
2.18
3.76
12.5%
2022Q3
92
61.3
3.90
1.42
0.39
2.09
3.54
10.6%
2022Q2
91
62.4
4.09
1.48
0.33
2.28
3.65
15.8%
2022Q1
90
62.0
4.06
1.53
0.33
2.19
3.68
15.0%
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.
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
D
2026-04-04
2026-03-12
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2026-04-04
2026-03-12
Health
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
G
2026-04-04
2026-03-12
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2026-04-04
2026-03-12
Health
F0694
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
D
2026-04-04
2026-03-12
Health
F0759
Ensure medication error rates are not 5 percent or greater.
E
2026-04-04
2026-03-12
Health
F0804
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
D
2026-04-04
2026-03-12
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2026-04-04
2026-03-12
Health
F0880
Provide and implement an infection prevention and control program.
D
2026-04-04
2025-07-21
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
J
2025-07-22
2025-07-21
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2025-07-22
2025-07-21
Health · complaint
F0712
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
D
2025-07-24
2025-06-24
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.
D
2025-07-24
2025-06-24
Health · complaint
F0610
Respond appropriately to all alleged violations.
D
2025-07-24
2024-11-14
Health
F0557
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
D
2024-12-31
2024-11-14
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
2024-12-31
2024-11-14
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
2024-12-31
2024-11-14
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2024-12-31
2024-11-14
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
2024-12-31
2024-11-14
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
2024-12-31
2024-11-14
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2024-12-31
2024-11-14
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
2024-12-31
2024-11-14
Health
F0804
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
F
2024-12-31
2024-11-14
Health
F0806
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
D
2024-12-31
2024-11-14
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F
2024-12-31
2024-11-14
Health
F0851
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
F
2024-12-31
2023-09-07
Health
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2023-09-19
2023-09-07
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2023-09-28
2023-09-07
Health
F0880
Provide and implement an infection prevention and control program.
D
2023-10-07
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
41
Owner
Role
Pct
From
Status
Source
MCHS HOSPITALS INC
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2019-05-01
current
pecos_ownership
BALTUS, JOHN
CORPORATE OFFICER
—
2023-09-08
current
pecos_ownership
BALTUS, JOHN
CORPORATE DIRECTOR
—
2016-02-04
current
pecos_ownership
BUSWELL CLEARY, LINDSEY
ADP OF THE SNF
—
2023-12-02
current
pecos_ownership
FERNANDEZ, EDWARD
CORPORATE DIRECTOR
—
2023-09-08
current
pecos_ownership
FERNANDEZ, EDWARD
CORPORATE OFFICER
—
2025-01-01
current
pecos_ownership
HOERNEMAN, BRIAN
CORPORATE OFFICER
—
2023-04-04
current
pecos_ownership
HOERNEMAN, BRIAN
CORPORATE DIRECTOR
—
2023-09-01
current
pecos_ownership
KLEBE, SAMANTHA
CORPORATE DIRECTOR
—
2023-09-08
current
pecos_ownership
KLEBE, SAMANTHA
CORPORATE OFFICER
—
2025-01-01
current
pecos_ownership
MARSHFIELD CLINIC HEALTH SYSTEM INC
5% OR GREATER INDIRECT OWNERSHIP INTEREST
—
2019-05-01
current
pecos_ownership
MATHISON, DOUGLAS
CORPORATE DIRECTOR
—
2020-12-15
current
pecos_ownership
MCKUEN, LAURIE
OPERATIONAL/MANAGERIAL CONTROL
—
2024-08-23
current
pecos_ownership
MORRISON, TONY
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
current
pecos_ownership
MUNSON, JOLYN
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
current
pecos_ownership
NEWCOMB, EVERETT
CORPORATE DIRECTOR
—
2024-09-13
current
pecos_ownership
OLSON, NICHOLAS
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
current
pecos_ownership
POPPEN, JEFFREY
ADP OF THE SNF
—
2025-06-12
current
pecos_ownership
PROCCI, LINDA
CORPORATE DIRECTOR
—
2025-01-14
current
pecos_ownership
SANFORD
5% OR GREATER INDIRECT OWNERSHIP INTEREST
—
2025-01-01
current
pecos_ownership
SMITH, DENNIS
CORPORATE DIRECTOR
—
2025-01-14
current
pecos_ownership
VENTLING-HERRMANN, MARNIE
TRUSTEE OF THE SNF
—
2025-01-01
current
pecos_ownership
BRIAN HOERNEMAN
CORPORATE OFFICER
0%
2023-04-04
ended 2026-05-18
pecos_ownership
BRIAN HOERNEMAN
CORPORATE DIRECTOR
0%
2023-09-01
ended 2026-05-18
pecos_ownership
DENNIS SMITH
CORPORATE DIRECTOR
0%
2025-01-14
ended 2026-05-18
pecos_ownership
EDWARD FERNANDEZ
CORPORATE DIRECTOR
0%
2023-09-08
ended 2026-05-18
pecos_ownership
EDWARD FERNANDEZ
CORPORATE OFFICER
0%
2025-01-01
ended 2026-05-18
pecos_ownership
EVERETT NEWCOMB
CORPORATE DIRECTOR
0%
2024-09-13
ended 2026-05-18
pecos_ownership
JEFFREY POPPEN
CORPORATE OFFICER
0%
2025-06-12
ended 2026-05-18
pecos_ownership
JOHN BALTUS
CORPORATE DIRECTOR
0%
2016-02-04
ended 2026-05-18
pecos_ownership
JOHN BALTUS
CORPORATE OFFICER
0%
2023-09-08
ended 2026-05-18
pecos_ownership
SAMANTHA KLEBE
CORPORATE OFFICER
0%
2025-01-01
ended 2026-05-18
pecos_ownership
SAMANTHA KLEBE
CORPORATE DIRECTOR
0%
2023-09-08
ended 2026-05-18
pecos_ownership
DOUGLAS MATHISON
CORPORATE DIRECTOR
—
2020-12-15
ended 2026-05-18
pecos_ownership
JOLYN MUNSON
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
ended 2026-05-18
pecos_ownership
LAURIE MCKUEN
ADP OF THE SNF
—
2024-08-23
ended 2026-05-18
pecos_ownership
LINDA PROCCI
CORPORATE DIRECTOR
—
2025-01-14
ended 2026-05-18
pecos_ownership
LINDSEY BUSWELL CLEARY
OPERATIONAL/MANAGERIAL CONTROL
—
2023-12-02
ended 2026-05-18
pecos_ownership
MARNIE VENTLING-HERRMANN
TRUSTEE OF THE SNF
—
2025-01-01
ended 2026-05-18
pecos_ownership
NICHOLAS OLSON
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
ended 2026-05-18
pecos_ownership
TONY MORRISON
OPERATIONAL/MANAGERIAL CONTROL
—
2025-01-01
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
34
Geo
Kind
BR
Amount
As of
Source
county 55027
acs median gross
0
$743
2024-12-31
CENSUS_ACS5
county 55027
fmr
0
$745
2025-10-01
HUD_USER_FMR
county 55027
acs median gross
1
$761
2024-12-31
CENSUS_ACS5
county 55027
fmr
1
$873
2025-10-01
HUD_USER_FMR
county 55027
acs median gross
2
$992
2024-12-31
CENSUS_ACS5
county 55027
fmr
2
$1,080
2025-10-01
HUD_USER_FMR
county 55027
acs median gross
3
$1,200
2024-12-31
CENSUS_ACS5
county 55027
fmr
3
$1,454
2025-10-01
HUD_USER_FMR
county 55027
acs median gross
4
$1,229
2024-12-31
CENSUS_ACS5
county 55027
fmr
4
$1,485
2025-10-01
HUD_USER_FMR
county 55027
acs median gross
5
$1,339
2024-12-31
CENSUS_ACS5
county 55027
acs median gross
$988
2024-12-31
CENSUS_ACS5
county 55027
acs recent mover gross
$1,103
2024-12-31
CENSUS_ACS5
zcta 53916
acs median gross
0
$647
2024-12-31
CENSUS_ACS5
zcta 53916
acs median gross
1
$831
2024-12-31
CENSUS_ACS5
zcta 53916
acs median gross
2
$994
2024-12-31
CENSUS_ACS5
zcta 53916
acs median gross
3
$1,152
2024-12-31
CENSUS_ACS5
zcta 53916
acs median gross
4
$1,118
2024-12-31
CENSUS_ACS5
zcta 53916
acs median gross
$959
2024-12-31
CENSUS_ACS5
zip 53916
payment standard 110
0
$847
2025-10-01
HUD_USER_SAFMR
zip 53916
payment standard 90
0
$693
2025-10-01
HUD_USER_SAFMR
zip 53916
safmr
0
$770
2025-10-01
HUD_USER_SAFMR
zip 53916
payment standard 110
1
$990
2025-10-01
HUD_USER_SAFMR
zip 53916
payment standard 90
1
$810
2025-10-01
HUD_USER_SAFMR
zip 53916
safmr
1
$900
2025-10-01
HUD_USER_SAFMR
zip 53916
payment standard 110
2
$1,221
2025-10-01
HUD_USER_SAFMR
zip 53916
payment standard 90
2
$999
2025-10-01
HUD_USER_SAFMR
zip 53916
safmr
2
$1,110
2025-10-01
HUD_USER_SAFMR
zip 53916
payment standard 110
3
$1,639
2025-10-01
HUD_USER_SAFMR
zip 53916
payment standard 90
3
$1,341
2025-10-01
HUD_USER_SAFMR
zip 53916
safmr
3
$1,490
2025-10-01
HUD_USER_SAFMR
zip 53916
payment standard 110
4
$1,683
2025-10-01
HUD_USER_SAFMR
zip 53916
payment standard 90
4
$1,377
2025-10-01
HUD_USER_SAFMR
zip 53916
safmr
4
$1,530
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.