Composite
97.5 / 100 percentile
Screener / 435039
F
AVANTARA NORTON
snfSDSFF: SFF
3600 SOUTH NORTON AVENUE, SIOUX FALLS, SD 57105 · CCN 435039 · chain CHAIM RAJCHENBACH DESCENDANTS TR UA 04282008
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
110
Model
v1.2
Reads as: riskier than 97.5% 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 model5ML signals9Components16CHOW radar1Distress radar1Staffing16Penalties6Deficiencies75Licensure0Ownership16Related party6Transactions1Comps12Market rent36
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 98.3 | 97.3 | 0.30 | 0.2308 | 22.68 | in index |
| billing conduct | 97.5 | 69.9 | 0.30 | 0.2308 | 22.50 | in index |
| staffing risk | 68.1 | 68.1 | 0.25 | 0.1923 | 13.10 | in index |
| financial risk | 51.6 | 46.5 | 0.30 | 0.2308 | 11.91 | in index |
| chow risk | 47.7 | 45.8 | 0.15 | 0.1154 | 5.50 | 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.
ML signals — parallel engine
9| Kind | Finding | Signal | Subject | First seen |
|---|---|---|---|---|
| connection | Owner fleet risk far above national | +32.9 vs natl | ROTH CO LLP | 40 facilities |
| connection | Owner fleet risk far above national | +31.4 vs natl | GPN FAMILY TRUST U A D 4 28 08 | 74 facilities |
| connection | Owner fleet risk far above national | +30.1 vs natl | DOROS GENERATION TRUST U A D 1 3 12 | 72 facilities |
| connection | Owner fleet risk far above national | +26.2 vs natl | LEGACY HEALTHCARE FINANCIAL SERVICES LLC | 79 facilities |
| connection | Owner fleet risk far above national | +25.1 vs natl | OAKWAY OPERATIONS LLC | 44 facilities |
| connection | Owner fleet risk far above national | +24.2 vs natl | SHABAT MENACHEM | 85 facilities |
| connection | Owner fleet risk far above national | +23.9 vs natl | BOKF NA | 13 facilities |
| connection | Owner spans multiple chains | 5 chains | ROTH CO LLP | 35 facilities |
| connection | Owner fleet enforcement cluster | 50% fined | ROTH CO LLP | 40 facilities |
Findings from the always-on scanning layer: anomalies on this facility, connections through its current owners and past buyers. Runs beside the deterministic composite, never inside it. Full board on the ML Lab page.
Component scores and registry models
16| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 69.9 | D | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| 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. |
| chow risk | 66.6 | D | v0.6 | default · in composite | |
| financial risk | 46.5 | C | v0.5 | default · in composite | R18. |
| p adverse action 12m | 0.0 | — | 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 | 0.2 | — | 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 | 97.3 | F | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 68.1 | D | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 96.1 | F | v0.1 | superseded | Pre-registry model iteration, superseded by a later financial_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. |
| financial risk | 76.1 | D | v0.2 | superseded | Pre-registry model iteration, superseded by a later financial_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. |
| financial risk | 61.4 | C | v0.3 | superseded | Pre-registry model iteration, superseded by a later financial_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. |
| financial risk | 48.0 | C | v0.4 | superseded | Pre-registry model iteration, superseded by a later financial_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 | 97.3 | F | 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 | 97.3 | F | 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 | 68.1 | D | 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 | 68.1 | D | 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)
0.2%
model v0.1 · computed 2026-07-29
Percentile among SNFs
41.3
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Never sold on record | 0.00 | -1.62 | |
| Current owner tenure (years) | 6.82 | -1.18 | |
| For-profit ownership | 1.00 | +0.69 | |
| Occupancy | 0.90 | -0.59 | |
| Chain size (log) | 4.49 | +0.55 | |
| High-severity deficiencies, 12m | 8.00 | +0.42 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Deficiencies, last 12 months | 21.00 | +0.34 |
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)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
0.0
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Deficiencies, last 12 months | 21.00 | -2.47 | |
| Chain size (log) | 4.49 | -1.41 | |
| For-profit ownership | 1.00 | -0.69 | |
| Occupancy | 0.90 | -0.64 | |
| High-severity deficiencies, 12m | 8.00 | -0.60 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Never sold on record | 0.00 | -0.28 | |
| Staffing trend, last 4 quarters | -0.38 | -0.20 |
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 | SD median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 3.01 | 2.96 | 3.28 | 2.90–3.77 |
| RN | 0.31 | 0.52 | 0.39 | 0.25–0.58 |
| Weekend total | 2.83 | 2.75 | 3.11 | — |
| Weekday total | 3.08 | 3.06 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 99.0 | 3.01 | 0.31 | 0.68 | 2.02 | 2.83 | 7.0% |
| 2025Q3 | 92 | 96.6 | 3.15 | 0.35 | 0.63 | 2.17 | 3.02 | 5.9% |
| 2025Q2 | 91 | 94.7 | 3.22 | 0.42 | 0.59 | 2.21 | 3.03 | 3.2% |
| 2025Q1 | 90 | 94.7 | 3.15 | 0.48 | 0.66 | 2.01 | 3.04 | 6.9% |
| 2024Q4 | 92 | 89.2 | 3.39 | 0.43 | 0.67 | 2.28 | 3.29 | 14.5% |
| 2024Q3 | 92 | 97.3 | 3.08 | 0.33 | 0.68 | 2.07 | 2.90 | 18.1% |
| 2024Q2 | 91 | 92.8 | 3.30 | 0.29 | 0.73 | 2.28 | 3.06 | 32.3% |
| 2024Q1 | 91 | 87.7 | 3.29 | 0.24 | 0.81 | 2.23 | 3.14 | 26.2% |
| 2023Q4 | 92 | 88.4 | 3.39 | 0.25 | 0.86 | 2.28 | 3.30 | 36.2% |
| 2023Q3 | 92 | 90.2 | 3.16 | 0.25 | 0.86 | 2.06 | 3.04 | 31.9% |
| 2023Q2 | 91 | 87.6 | 3.15 | 0.34 | 0.67 | 2.15 | 2.96 | 45.8% |
| 2023Q1 | 90 | 92.2 | 3.00 | 0.41 | 0.57 | 2.03 | 2.90 | 62.8% |
| 2022Q4 | 92 | 78.4 | 3.07 | 0.52 | 0.52 | 2.03 | 2.85 | 61.6% |
| 2022Q3 | 92 | 73.0 | 3.34 | 0.44 | 0.73 | 2.17 | 3.04 | 45.4% |
| 2022Q2 | 91 | 68.2 | 3.50 | 0.44 | 0.74 | 2.33 | 2.96 | 17.1% |
| 2022Q1 | 90 | 55.8 | 4.08 | 0.50 | 0.79 | 2.80 | 3.54 | 27.6% |
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
6fines by year
| Date | Type | Fine | Source |
|---|---|---|---|
| 2025-03-05 | Fine | $51,376 | CMS provider data |
| 2024-09-26 | Fine | $12,035 | CMS provider data |
| 2024-07-17 | Fine | $12,035 | CMS provider data |
| 2024-06-20 | Fine | $12,035 | CMS provider data |
| 2024-03-13 | Fine | $37,557 | CMS provider data |
| 2023-10-04 | Fine | $28,600 | CMS provider data |
Total fines on record: $153,638
Deficiencies
75D × 28E × 25F × 3G × 14H × 4K × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-03-31 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2026-05-08 |
| 2026-03-31 | Health · complaint | F0561 | Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | E | 2026-05-08 |
| 2026-03-31 | 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. | D | 2026-05-08 |
| 2026-03-31 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2026-05-08 |
| 2026-03-31 | Health | F0641 | Ensure each resident receives an accurate assessment. | E | 2026-05-08 |
| 2026-03-31 | Health | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | E | 2026-05-08 |
| 2026-03-31 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | G | 2026-05-08 |
| 2026-03-31 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | 2026-05-08 |
| 2026-03-31 | Health · complaint | F0688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | E | 2026-05-08 |
| 2026-03-31 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2026-05-08 |
| 2026-03-31 | Health | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | G | 2026-05-08 |
| 2026-03-31 | Health · complaint | F0740 | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | D | 2025-12-10 |
| 2026-03-31 | Health | F0760 | Ensure that residents are free from significant medication errors. | G | 2026-05-08 |
| 2026-03-31 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2026-05-08 |
| 2026-03-31 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2026-05-08 |
| 2026-02-04 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | G | 2026-01-16 |
| 2026-02-04 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | 2026-03-06 |
| 2026-02-04 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2026-03-06 |
| 2025-12-30 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | — |
| 2025-12-30 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | D | — |
| 2025-11-14 | Health · complaint | F0880 | Provide and implement an infection prevention and control program. | E | 2025-12-12 |
| 2025-07-10 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2025-05-28 |
| 2025-07-10 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-08-04 |
| 2025-07-10 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | 2025-05-01 |
| 2025-07-10 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-06-07 |
| 2025-04-10 | Health · complaint | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | D | 2025-04-09 |
| 2025-04-10 | Health · complaint | F0624 | Prepare residents for a safe transfer or discharge from the nursing home. | D | — |
| 2025-04-10 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | E | — |
| 2025-03-05 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | E | 2025-04-04 |
| 2025-03-05 | 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 | 2025-04-04 |
| 2025-03-05 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-04-04 |
| 2025-03-05 | Health · complaint | F0675 | Honor each resident's preferences, choices, values and beliefs. | H | 2025-04-04 |
| 2025-03-05 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | 2025-04-04 |
| 2025-03-05 | Health | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2025-04-04 |
| 2025-03-05 | Health | F0835 | Administer the facility in a manner that enables it to use its resources effectively and efficiently. | E | 2025-04-04 |
| 2025-03-05 | Health | F0837 | Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. | E | 2025-04-04 |
| 2025-03-05 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2025-04-04 |
| 2024-12-27 | Health · complaint | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-02-10 |
| 2024-11-14 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2024-12-11 |
| 2024-10-29 | 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. | D | 2024-11-27 |
| 2024-10-29 | 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. | G | 2024-11-27 |
| 2024-09-26 | Health · complaint | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | 2024-11-10 |
| 2024-08-21 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | 2024-09-20 |
| 2024-08-21 | Health · complaint | F0760 | Ensure that residents are free from significant medication errors. | E | 2024-09-20 |
| 2024-08-21 | Health · complaint | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2024-09-20 |
| 2024-07-17 | Health · complaint | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2024-08-26 |
| 2024-06-20 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | G | 2024-05-30 |
| 2024-06-20 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-05-30 |
| 2024-04-16 | 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 | 2024-04-14 |
| 2024-03-13 | Health · complaint | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2024-04-08 |
| 2024-03-13 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2024-04-08 |
| 2024-03-13 | Health · complaint | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | G | 2024-04-08 |
| 2023-12-14 | Health · complaint | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2024-01-11 |
| 2023-12-14 | 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 | 2024-01-11 |
| 2023-11-09 | Health | F0561 | Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | E | 2023-12-14 |
| 2023-11-09 | Health | F0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | 2023-12-14 |
| 2023-11-09 | Health | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | E | 2023-12-14 |
| 2023-11-09 | 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. | E | 2023-12-14 |
| 2023-11-09 | 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 | 2023-12-14 |
| 2023-11-09 | 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 | 2023-12-14 |
| 2023-11-09 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2023-12-14 |
| 2023-11-09 | Health | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | H | 2023-12-14 |
| 2023-11-09 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | K | 2023-12-07 |
| 2023-11-09 | Health | F0692 | Provide enough food/fluids to maintain a resident's health. | E | 2023-12-14 |
| 2023-11-09 | Health | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | H | 2023-12-07 |
| 2023-11-09 | 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. | H | 2023-12-07 |
| 2023-11-09 | 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. | E | 2023-12-14 |
| 2023-11-09 | 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. | E | 2023-12-14 |
| 2023-11-09 | Health | F0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | E | 2023-12-14 |
| 2023-11-09 | Health | F0809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | E | 2023-12-14 |
| 2023-11-09 | Health | F0835 | Administer the facility in a manner that enables it to use its resources effectively and efficiently. | F | 2023-12-14 |
| 2023-11-09 | Health | F0837 | Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. | F | 2023-12-14 |
| 2023-11-09 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2023-12-14 |
| 2023-10-04 | Health · complaint | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | 2023-12-14 |
| 2023-10-04 | Health · complaint | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2023-12-14 |
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
16| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| DOROS GENERATION TRUST U/A/D 1/3/12 | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 43% | 2019-10-02 | current | pecos_ownership |
| GPN FAMILY TRUST U/A/D 4/28/08 | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 43% | 2019-10-02 | current | pecos_ownership |
| OAKWAY OPERATIONS LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 15% | 2019-10-02 | current | pecos_ownership |
| BOKF,NA | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-03-04 | current | pecos_ownership |
| LEGACY HEALTHCARE FINANCIAL SERVICES LLC | OPERATIONAL/MANAGERIAL CONTROL | — | 2019-10-02 | current | pecos_ownership |
| LEGACY HEALTHCARE FINANCIAL SERVICES LLC | ADP OF THE SNF | — | 2025-11-24 | current | pecos_ownership |
| NICKEL, ASHLEY | ADP OF THE SNF | — | 2022-08-28 | current | pecos_ownership |
| NORTON SD PROPERTY HOLDINGS, LLC | 5% OR GREATER SECURITY INTEREST | — | 2019-10-02 | current | pecos_ownership |
| REES, JOSEPH | ADP OF THE SNF | — | 2019-10-02 | current | pecos_ownership |
| ROTH & CO, LLP | ADP OF THE SNF | — | 2024-01-01 | current | pecos_ownership |
| SHABAT, MENACHEM | OPERATIONAL/MANAGERIAL CONTROL | — | 2019-10-02 | current | pecos_ownership |
| CHAIM RAJCHENBACH DESCENDANTS TR UA 04282008 | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 43% | 2019-10-02 | ended 2026-05-18 | pecos_ownership |
| GPN FAM TR UA 04282008 | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 43% | 2019-10-02 | ended 2026-04-01 | pecos_ownership |
| ASHLEY NICKEL | ADP OF THE SNF | — | 2022-08-28 | ended 2026-05-18 | pecos_ownership |
| JOSEPH REES | ADP OF THE SNF | — | 2019-10-02 | ended 2026-05-18 | pecos_ownership |
| MENACHEM SHABAT | OPERATIONAL/MANAGERIAL CONTROL | — | 2019-10-02 | 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
1| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2019-10-02 | — | NORTON SD SKILLED NURSING FACILITY LLC | HEALTH QUEST INC | chow |
Comparable trades — SD snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2023-08-31 | RIVERVIEW HEALTHCARE CENTER | — | — | — | 63 | RIVERVIEW SNF OPERATIONS, LLC |
| 2023-08-31 | Wheatcrest Hills Healthcare Center | — | — | — | 60 | WHEATCREST HILLS SNF OPERATIONS, LLC |
| 2023-08-31 | PALISADE HEALTHCARE CENTER | — | — | — | 55 | PALISADE SNF OPERATIONS, LLC |
| 2023-08-31 | PRAIRIE VIEW HEALTHCARE CENTER | — | — | — | 42 | PRAIRIE VIEW SNF OPERATIONS, LLC |
| 2023-08-31 | FIRESTEEL HEALTHCARE CENTER | — | — | — | 125 | FIRESTEEL SNF OPERATIONS, LLC |
| 2023-08-31 | Fountain Springs Healthcare | — | — | — | 90 | FOUNTAIN SPRINGS SNF OPERATIONS, LLC |
| 2019-10-02 | AVANTARA NORTONthis facility | — | — | — | 110 | NORTON SD SKILLED NURSING FACILITY LLC |
| 2019-10-02 | AVANTARA HURON | — | — | — | 119 | HURON SD SKILLED NURSING FACILITY, LLC |
| 2019-10-01 | DIAMOND CARE CENTER | — | — | — | 36 | BRIDGEWATER NURSING HOME CORPORATION |
| 2019-07-01 | AVANTARA SAINT CLOUD | — | — | — | 78 | SAINT CLOUD SD SKILLED NURSING FACILITY, LLC |
| 2019-07-01 | AVANTARA WATERTOWN | — | — | — | 51 | WATERTOWN SD SKILLED NURSING FACILITY, LLC |
| 2019-07-01 | AVANTARA CLARK CITY | — | — | — | 35 | CLARK CITY SD SKILLED NURSING FACILITY 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
36| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 46099 | acs median gross | 0 | $840 | 2024-12-31 | CENSUS_ACS5 |
| county 46099 | fmr | 0 | $865 | 2025-10-01 | HUD_USER_FMR |
| county 46099 | acs median gross | 1 | $854 | 2024-12-31 | CENSUS_ACS5 |
| county 46099 | fmr | 1 | $986 | 2025-10-01 | HUD_USER_FMR |
| county 46099 | acs median gross | 2 | $995 | 2024-12-31 | CENSUS_ACS5 |
| county 46099 | fmr | 2 | $1,156 | 2025-10-01 | HUD_USER_FMR |
| county 46099 | acs median gross | 3 | $1,291 | 2024-12-31 | CENSUS_ACS5 |
| county 46099 | fmr | 3 | $1,586 | 2025-10-01 | HUD_USER_FMR |
| county 46099 | acs median gross | 4 | $1,755 | 2024-12-31 | CENSUS_ACS5 |
| county 46099 | fmr | 4 | $1,939 | 2025-10-01 | HUD_USER_FMR |
| county 46099 | acs median gross | 5 | $1,368 | 2024-12-31 | CENSUS_ACS5 |
| county 46099 | acs median gross | $978 | 2024-12-31 | CENSUS_ACS5 | |
| county 46099 | acs recent mover gross | $1,149 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 57105 | acs median gross | 0 | $779 | 2024-12-31 | CENSUS_ACS5 |
| zcta 57105 | acs median gross | 1 | $784 | 2024-12-31 | CENSUS_ACS5 |
| zcta 57105 | acs median gross | 2 | $960 | 2024-12-31 | CENSUS_ACS5 |
| zcta 57105 | acs median gross | 3 | $1,361 | 2024-12-31 | CENSUS_ACS5 |
| zcta 57105 | acs median gross | 4 | $1,859 | 2024-12-31 | CENSUS_ACS5 |
| zcta 57105 | acs median gross | 5 | $1,109 | 2024-12-31 | CENSUS_ACS5 |
| zcta 57105 | acs median gross | $953 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 57105 | acs recent mover gross | $996 | 2024-12-31 | CENSUS_ACS5 | |
| zip 57105 | payment standard 110 | 0 | $913 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | payment standard 90 | 0 | $747 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | safmr | 0 | $830 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | payment standard 110 | 1 | $1,045 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | payment standard 90 | 1 | $855 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | safmr | 1 | $950 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | payment standard 110 | 2 | $1,221 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | payment standard 90 | 2 | $999 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | safmr | 2 | $1,110 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | payment standard 110 | 3 | $1,672 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | payment standard 90 | 3 | $1,368 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | safmr | 3 | $1,520 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | payment standard 110 | 4 | $2,046 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | payment standard 90 | 4 | $1,674 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57105 | safmr | 4 | $1,860 | 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.