Composite
16.9 / 100 percentile
Screener / 275147
A
TOBACCO ROOT MOUNTAINS CARE CENTER
snfMT
326 MADISON ST, SHERIDAN, MT 59749 · CCN 275147
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
39
Model
v1.2
Reads as: riskier than 16.9% 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.
Score model4Components15CHOW radar1Distress radar1Staffing16Penalties1Deficiencies19Licensure0Ownership13Related party0Transactions0Comps12Market rent29
Composite explanation
4| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 65.5 | 58.2 | 0.30 | 0.3000 | 19.65 | in index |
| financial risk | 29.5 | 33.5 | 0.30 | 0.3000 | 8.85 | in index |
| chow risk | 37.3 | 35.8 | 0.15 | 0.1500 | 5.60 | in index |
| staffing risk | 0.7 | 0.8 | 0.25 | 0.2500 | 0.18 | 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
15| 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. |
| chow risk | 46.6 | C | v0.6 | default · in composite | |
| financial risk | 33.5 | B | v0.5 | default · in composite | R18. |
| p adverse action 12m | 4.0 | — | 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 | 1.6 | — | 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 | 58.2 | C | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 0.8 | A | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 78.3 | D | 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 | 58.3 | C | 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 | 21.7 | A | 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 | 35.0 | B | 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 | 58.1 | 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 | 58.1 | 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. |
| staffing risk | 0.8 | 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 | 0.8 | 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)
1.6%
model v0.1 · computed 2026-07-29
Percentile among SNFs
65.9
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 | |
| Occupancy | 0.34 | +1.04 | |
| Total nurse staffing (HPRD) | 7.08 | -0.80 | |
| Never sold on record | 1.00 | +0.62 | |
| Contract staffing share | 0.46 | +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 |
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)
4.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
96.1
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Occupancy | 0.34 | +1.73 | |
| Total nurse staffing (HPRD) | 7.08 | -1.63 | |
| For-profit ownership | 0.00 | +1.62 | |
| Chain size (log) | 0.00 | +1.20 | |
| Staffing trend, last 4 quarters | 1.46 | +0.65 | |
| Fine amount, 12m (log) | 10.01 | -0.55 | |
| Deficiencies, last 12 months | 5.00 | +0.50 | |
| Contract staffing share | 0.46 | +0.42 |
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 | MT median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 7.08 | 3.25 | 3.28 | 2.90–3.77 |
| RN | 1.32 | 0.62 | 0.39 | 0.25–0.58 |
| Weekend total | 6.73 | 3.12 | 3.11 | — |
| Weekday total | 7.22 | 3.34 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 13.2 | 7.08 | 1.32 | 0.77 | 4.99 | 6.73 | 46.1% |
| 2025Q3 | 92 | 16.2 | 6.36 | 1.01 | 0.93 | 4.41 | 5.92 | 8.9% |
| 2025Q2 | 91 | 18.7 | 5.50 | 0.67 | 0.91 | 3.92 | 4.91 | 0.1% |
| 2025Q1 | 90 | 19.9 | 5.32 | 0.66 | 0.88 | 3.77 | 4.79 | 0.0% |
| 2024Q4 | 92 | 20.4 | 5.62 | 0.52 | 0.91 | 4.20 | 4.86 | 63.2% |
| 2024Q3 | 92 | 19.0 | 5.83 | 0.31 | 1.09 | 4.42 | 5.14 | 58.4% |
| 2024Q2 | 91 | 20.5 | 5.68 | 0.48 | 0.97 | 4.23 | 5.00 | 47.4% |
| 2024Q1 | 91 | 19.7 | 5.69 | 0.94 | 0.43 | 4.32 | 4.97 | 49.4% |
| 2023Q4 | 92 | 23.4 | 4.74 | 0.77 | 0.48 | 3.49 | 4.17 | 0.0% |
| 2023Q3 | 92 | 26.8 | 3.89 | 0.47 | 0.58 | 2.84 | 3.57 | 0.0% |
| 2023Q2 | 91 | 24.5 | 4.28 | 0.46 | 0.68 | 3.15 | 3.82 | 0.0% |
| 2023Q1 | 90 | 24.8 | 4.07 | 0.22 | 0.90 | 2.96 | 3.69 | 0.0% |
| 2022Q4 | 92 | 23.7 | 3.83 | 0.41 | 0.65 | 2.77 | 3.79 | 0.0% |
| 2022Q3 | 92 | 22.8 | 4.25 | 0.57 | 0.58 | 3.09 | 3.98 | 0.0% |
| 2022Q2 | 91 | 24.1 | 3.87 | 0.70 | 0.47 | 2.71 | 3.48 | 0.0% |
| 2022Q1 | 90 | 25.0 | 3.79 | 0.80 | 0.21 | 2.78 | 3.53 | 0.0% |
HPRD is census-weighted: total hours over the quarter divided by total resident-days, not an average of daily ratios. Source is CMS Payroll-Based Journal daily records; only SNFs report PBJ, so other settings legitimately return zero rows.
Penalties
1| Date | Type | Fine | Source |
|---|---|---|---|
| 2026-04-01 | Fine | $22,205 | CMS provider data |
Total fines on record: $22,205
Deficiencies
19D × 16F × 1G × 1J × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2026-04-01 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2026-04-30 |
| 2026-04-01 | Health · complaint | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2026-04-30 |
| 2026-04-01 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | 2026-04-22 |
| 2026-04-01 | Health · complaint | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | G | 2026-04-30 |
| 2026-04-01 | 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 | 2026-04-30 |
| 2025-04-09 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | 2025-01-28 |
| 2024-04-10 | 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 | 2024-05-16 |
| 2024-04-10 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2024-05-16 |
| 2024-04-10 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2024-05-16 |
| 2023-03-16 | Health | F0552 | Ensure that residents are fully informed and understand their health status, care and treatments. | D | 2023-04-26 |
| 2023-03-16 | 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 | 2023-04-26 |
| 2023-03-16 | 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 | 2023-04-26 |
| 2023-03-16 | 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 | 2023-04-26 |
| 2023-03-16 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2023-04-26 |
| 2023-03-16 | Health | F0699 | Provide care or services that was trauma informed and/or culturally competent. | D | 2023-04-26 |
| 2023-03-16 | Health | F0740 | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | D | 2023-04-26 |
| 2023-03-16 | Health | F0745 | Provide medically-related social services to help each resident achieve the highest possible quality of life. | D | 2023-04-26 |
| 2023-03-16 | Health | F0880 | Provide and implement an infection prevention and control program. | F | 2023-04-26 |
| 2023-03-16 | Health | F0881 | Implement a program that monitors antibiotic use. | D | 2023-04-26 |
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
13| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| MADISON COUNTY FINANCE | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | — | current | pecos_ownership |
| ALLHANDS, DANIEL | CORPORATE OFFICER | — | 2017-01-01 | current | pecos_ownership |
| FORSYTHE, JAYNE | W-2 MANAGING EMPLOYEE | — | 2020-02-06 | current | pecos_ownership |
| HART, JAMES | CORPORATE OFFICER | — | 2007-01-01 | current | pecos_ownership |
| HART, JAMES | W-2 MANAGING EMPLOYEE | — | 2015-01-01 | current | pecos_ownership |
| NYE, RONALD | CORPORATE OFFICER | — | 2015-01-01 | current | pecos_ownership |
| ONEILL, BONNIE | W-2 MANAGING EMPLOYEE | — | 2020-02-06 | current | pecos_ownership |
| DANIEL ALLHANDS | CORPORATE OFFICER | 33% | 2017-01-01 | ended 2026-05-18 | pecos_ownership |
| JAMES HART | W-2 MANAGING EMPLOYEE | 33% | 2015-01-01 | ended 2026-05-18 | pecos_ownership |
| RONALD NYE | CORPORATE OFFICER | 33% | 2015-01-01 | ended 2026-05-18 | pecos_ownership |
| JAMES HART | CORPORATE OFFICER | 33% | 2007-01-01 | ended 2026-05-18 | pecos_ownership |
| BONNIE ONEILL | W-2 MANAGING EMPLOYEE | — | 2020-02-06 | ended 2026-05-18 | pecos_ownership |
| JAYNE FORSYTHE | W-2 MANAGING EMPLOYEE | — | 2020-02-06 | 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 — 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
29| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 30057 | fmr | 0 | $1,154 | 2025-10-01 | HUD_USER_FMR |
| county 30057 | acs median gross | 1 | $850 | 2024-12-31 | CENSUS_ACS5 |
| county 30057 | fmr | 1 | $1,202 | 2025-10-01 | HUD_USER_FMR |
| county 30057 | acs median gross | 2 | $850 | 2024-12-31 | CENSUS_ACS5 |
| county 30057 | fmr | 2 | $1,540 | 2025-10-01 | HUD_USER_FMR |
| county 30057 | acs median gross | 3 | $1,583 | 2024-12-31 | CENSUS_ACS5 |
| county 30057 | fmr | 3 | $2,073 | 2025-10-01 | HUD_USER_FMR |
| county 30057 | acs median gross | 4 | $2,094 | 2024-12-31 | CENSUS_ACS5 |
| county 30057 | fmr | 4 | $2,583 | 2025-10-01 | HUD_USER_FMR |
| county 30057 | acs median gross | 5 | $936 | 2024-12-31 | CENSUS_ACS5 |
| county 30057 | acs median gross | $1,000 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 59749 | acs median gross | 2 | $1,250 | 2024-12-31 | CENSUS_ACS5 |
| zcta 59749 | acs median gross | 3 | $1,100 | 2024-12-31 | CENSUS_ACS5 |
| zcta 59749 | acs median gross | $942 | 2024-12-31 | CENSUS_ACS5 | |
| zip 59749 | payment standard 110 | 0 | $1,133 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | payment standard 90 | 0 | $927 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | safmr | 0 | $1,030 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | payment standard 110 | 1 | $1,144 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | payment standard 90 | 1 | $936 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | safmr | 1 | $1,040 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | payment standard 110 | 2 | $1,485 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | payment standard 90 | 2 | $1,215 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | safmr | 2 | $1,350 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | payment standard 110 | 3 | $1,958 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | payment standard 90 | 3 | $1,602 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | safmr | 3 | $1,780 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | payment standard 110 | 4 | $2,486 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | payment standard 90 | 4 | $2,034 | 2025-10-01 | HUD_USER_SAFMR |
| zip 59749 | safmr | 4 | $2,260 | 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.