100 E Highland Dr, Oconto Falls, WI 54154 · CCN 525449
Composite
94.9 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
99
Model
v1.2
Reads as: riskier than 94.9% 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.
ML signals — parallel engine
5
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
+21.2 vs natl
PUKSHANSKY ROSTISLAV
6 facilities
connection
Owner spans multiple chains
6 chains
WIPFLI LLP
67 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.
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 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.
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.
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.
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.
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
3.50
3.60
3.28
2.90–3.77
RN
0.52
0.64
0.39
0.25–0.58
Weekend total
3.35
3.49
3.11
—
Weekday total
3.56
3.65
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
58.4
3.50
0.52
0.86
2.12
3.35
0.0%
2025Q3
92
52.1
3.74
0.56
0.86
2.31
3.62
0.0%
2025Q2
91
55.5
3.33
0.57
0.62
2.13
3.16
0.0%
2025Q1
90
57.2
3.23
0.65
0.56
2.02
3.08
0.0%
2024Q4
92
49.1
3.46
0.61
0.70
2.14
3.22
0.0%
2024Q3
92
49.1
3.31
0.50
0.78
2.03
3.02
0.0%
2024Q2
91
50.6
3.38
0.48
0.87
2.02
3.03
0.0%
2024Q1
91
56.3
3.29
0.61
0.74
1.94
2.96
0.0%
2023Q4
92
55.9
3.36
0.56
0.73
2.08
3.03
0.0%
2023Q3
92
61.2
3.35
0.45
0.78
2.12
3.04
0.0%
2023Q2
91
56.8
3.41
0.43
0.97
2.01
3.08
0.0%
2023Q1
90
65.0
2.75
0.42
0.77
1.56
2.52
0.0%
2022Q4
92
58.9
2.85
0.36
0.83
1.66
2.54
0.0%
2022Q3
92
56.4
2.96
0.33
0.69
1.94
2.63
0.0%
2022Q2
91
53.1
2.71
0.37
0.66
1.68
2.40
0.0%
2022Q1
90
53.7
2.85
0.33
0.84
1.67
2.54
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.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2026-04-03
2025-05-29
Health
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
2025-06-29
2025-05-29
Health
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2025-06-29
2025-05-29
Health
F0692
Provide enough food/fluids to maintain a resident's health.
D
2025-06-29
2025-05-29
Health
F0699
Provide care or services that was trauma informed and/or culturally competent.
D
2025-06-29
2025-05-29
Health
F0761
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
E
2025-06-29
2025-05-29
Health
F0880
Provide and implement an infection prevention and control program.
E
2025-06-29
2024-12-16
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.
E
2025-01-13
2024-12-16
Health · complaint
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
J
2025-01-13
2024-12-16
Health · complaint
F0609
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
2025-01-13
2024-12-16
Health · complaint
F0610
Respond appropriately to all alleged violations.
D
2025-01-13
2024-12-16
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2025-01-13
2024-10-14
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
2024-11-08
2024-10-14
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
2024-11-08
2024-05-21
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2024-06-17
2024-05-21
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
2024-06-17
2024-04-30
Health
F0552
Ensure that residents are fully informed and understand their health status, care and treatments.
E
2024-06-03
2024-04-30
Health
F0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
2024-06-03
2024-04-30
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
2024-06-03
2024-04-30
Health
F0695
Provide safe and appropriate respiratory care for a resident when needed.
D
2024-06-03
2024-04-30
Health
F0698
Provide safe, appropriate dialysis care/services for a resident who requires such services.
D
2024-06-03
2024-04-30
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2024-06-03
2024-04-30
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
2024-06-03
2024-04-30
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2024-06-03
2024-04-30
Health
F0880
Provide and implement an infection prevention and control program.
F
2024-06-03
2024-04-30
Health
F0883
Develop and implement policies and procedures for flu and pneumonia vaccinations.
E
2024-06-03
2024-04-30
Health
F0908
Keep all essential equipment working safely.
E
2024-06-03
2024-01-02
Health · complaint
F0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
E
2024-01-23
2023-03-16
Health
F0551
Give the resident's representative the ability to exercise the resident's rights.
D
2023-03-20
2023-03-16
Health
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.
E
2023-03-17
2023-03-16
Health
F0645
PASARR screening for Mental disorders or Intellectual Disabilities
D
2023-03-17
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
2023-03-31
2023-03-16
Health
F0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
2023-03-17
2023-03-16
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2023-03-17
2023-03-16
Health
F0685
Assist a resident in gaining access to vision and hearing services.
D
2023-04-05
2023-03-16
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.
F
2023-03-20
2023-03-16
Health
F0755
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
2023-04-05
2023-03-16
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2023-04-04
2023-03-16
Health
F0880
Provide and implement an infection prevention and control program.
E
2023-03-17
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
18
Owner
Role
Pct
From
Status
Source
BELL, CODY
OPERATIONAL/MANAGERIAL CONTROL
—
2024-10-15
current
pecos_ownership
GOEDTEL BIRR, STACEE
ADP OF THE SNF
—
2016-03-22
current
pecos_ownership
LINDEMANN, MITUL
CORPORATE OFFICER
—
2019-12-01
current
pecos_ownership
MASLOVSKY, BORIS
ADP OF THE SNF
—
2019-12-01
current
pecos_ownership
OCONTO FALLS NURSING REALTY LLC
ADP OF THE SNF
—
2022-06-28
current
pecos_ownership
PUKSHANSKY, ROSTISLAV
ADP OF THE SNF
—
2019-12-01
current
pecos_ownership
REINHART BOERNER VAN DEUREN S.C.
ADP OF THE SNF
—
2019-12-01
current
pecos_ownership
ROTH & CO, LLP
ADP OF THE SNF
—
2019-12-01
current
pecos_ownership
SYNERGY SENIOR CARE LLC
ADP OF THE SNF
—
2025-04-03
current
pecos_ownership
SYNERGY SENIOR CARE LLC
OPERATIONAL/MANAGERIAL CONTROL
—
2019-12-01
current
pecos_ownership
VANDER VELDEN, BARBARA
CORPORATE DIRECTOR
—
2019-12-01
current
pecos_ownership
WIPFLI LLP
ADP OF THE SNF
—
2019-12-01
current
pecos_ownership
BARBARA VANDER VELDEN
CORPORATE DIRECTOR
100%
2019-12-01
ended 2026-05-18
pecos_ownership
MITUL LINDEMANN
CORPORATE OFFICER
100%
2019-12-01
ended 2026-05-18
pecos_ownership
BORIS MASLOVSKY
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
2019-12-01
ended 2026-05-18
pecos_ownership
ROSTISLAV PUKSHANSKY
5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
2019-12-01
ended 2026-05-18
pecos_ownership
CODY BELL
ADP OF THE SNF
—
2024-10-15
ended 2026-05-18
pecos_ownership
STACEE GOEDTEL BIRR
OPERATIONAL/MANAGERIAL CONTROL
—
2016-03-22
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
3
FY end
Total allowable
Rent
Home office
Therapy
Staffing
Counterparties
PropCo
2024-12-31
$1,156,036
—
—
—
—
0
—
2023-12-31
$1,061,384
—
—
—
—
0
—
2022-12-31
$625,707
—
—
—
—
0
—
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
Most recent same-state, same-setting trades. Most CHOW-derived trades carry no disclosed consideration, so price, $/bed, and cap rate show only where a sale price was resolved from a deed or filing — blanks are honest, not missing data.
Market rent context
33
Geo
Kind
BR
Amount
As of
Source
county 55083
acs median gross
0
$607
2024-12-31
CENSUS_ACS5
county 55083
fmr
0
$723
2025-10-01
HUD_USER_FMR
county 55083
acs median gross
1
$656
2024-12-31
CENSUS_ACS5
county 55083
fmr
1
$793
2025-10-01
HUD_USER_FMR
county 55083
acs median gross
2
$793
2024-12-31
CENSUS_ACS5
county 55083
fmr
2
$973
2025-10-01
HUD_USER_FMR
county 55083
acs median gross
3
$1,083
2024-12-31
CENSUS_ACS5
county 55083
fmr
3
$1,272
2025-10-01
HUD_USER_FMR
county 55083
acs median gross
4
$988
2024-12-31
CENSUS_ACS5
county 55083
fmr
4
$1,288
2025-10-01
HUD_USER_FMR
county 55083
acs median gross
5
$850
2024-12-31
CENSUS_ACS5
county 55083
acs median gross
$791
2024-12-31
CENSUS_ACS5
county 55083
acs recent mover gross
$970
2024-12-31
CENSUS_ACS5
zcta 54154
acs median gross
1
$662
2024-12-31
CENSUS_ACS5
zcta 54154
acs median gross
2
$702
2024-12-31
CENSUS_ACS5
zcta 54154
acs median gross
3
$1,026
2024-12-31
CENSUS_ACS5
zcta 54154
acs median gross
$692
2024-12-31
CENSUS_ACS5
zcta 54154
acs recent mover gross
$955
2024-12-31
CENSUS_ACS5
zip 54154
payment standard 110
0
$792
2025-10-01
HUD_USER_SAFMR
zip 54154
payment standard 90
0
$648
2025-10-01
HUD_USER_SAFMR
zip 54154
safmr
0
$720
2025-10-01
HUD_USER_SAFMR
zip 54154
payment standard 110
1
$869
2025-10-01
HUD_USER_SAFMR
zip 54154
payment standard 90
1
$711
2025-10-01
HUD_USER_SAFMR
zip 54154
safmr
1
$790
2025-10-01
HUD_USER_SAFMR
zip 54154
payment standard 110
2
$1,067
2025-10-01
HUD_USER_SAFMR
zip 54154
payment standard 90
2
$873
2025-10-01
HUD_USER_SAFMR
zip 54154
safmr
2
$970
2025-10-01
HUD_USER_SAFMR
zip 54154
payment standard 110
3
$1,397
2025-10-01
HUD_USER_SAFMR
zip 54154
payment standard 90
3
$1,143
2025-10-01
HUD_USER_SAFMR
zip 54154
safmr
3
$1,270
2025-10-01
HUD_USER_SAFMR
zip 54154
payment standard 110
4
$1,419
2025-10-01
HUD_USER_SAFMR
zip 54154
payment standard 90
4
$1,161
2025-10-01
HUD_USER_SAFMR
zip 54154
safmr
4
$1,290
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.