Composite
75.9 / 100 percentile
Screener / 435114
C
DIAMOND CARE CENTER
snfSD
901 N MAIN AVE, BRIDGEWATER, SD 57319 · CCN 435114 · chain CARING PROFESSIONALS INC
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
36
Model
v1.2
Reads as: riskier than 75.9% 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 model5Components16CHOW radar1Distress radar1Staffing12Penalties2Deficiencies25Licensure0Ownership5Related party0Transactions1Comps12Market rent31
Composite explanation
5| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 76.9 | 73.3 | 0.30 | 0.2308 | 17.75 | in index |
| staffing risk | 89.8 | 89.8 | 0.25 | 0.1923 | 17.27 | in index |
| financial risk | 54.6 | 48.5 | 0.30 | 0.2308 | 12.60 | in index |
| billing conduct | 30.7 | 31.9 | 0.30 | 0.2308 | 7.08 | in index |
| chow risk | 34.1 | 34.5 | 0.15 | 0.1154 | 3.93 | 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
16| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 31.9 | B | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 24.8 | A | 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 | 44.1 | B | v0.6 | default · in composite | |
| financial risk | 48.5 | 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 | 0.1 | — | 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 | 73.3 | D | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 89.8 | F | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| financial risk | 85.7 | 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 | 65.7 | 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 | 40.3 | B | 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 | 54.2 | 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 | 73.1 | D | 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 | 73.1 | D | 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 | 89.8 | F | 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 | 89.8 | F | 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)
0.1%
model v0.1 · computed 2026-07-29
Percentile among SNFs
25.3
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) | 6.83 | -1.18 | |
| For-profit ownership | 1.00 | +0.69 | |
| Occupancy | 0.87 | -0.51 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Contract staffing share | 0.14 | +0.13 | |
| Facility size (log beds) | 3.61 | +0.11 |
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
20.0
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| For-profit ownership | 1.00 | -0.69 | |
| Deficiencies, last 12 months | 11.00 | -0.61 | |
| Occupancy | 0.87 | -0.52 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Staffing trend, last 4 quarters | 0.71 | +0.31 | |
| Never sold on record | 0.00 | -0.28 | |
| Total nurse staffing (HPRD) | 2.54 | +0.28 | |
| Current owner tenure (years) | 6.83 | -0.19 |
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
12| 2025Q4 HPRD | This facility | SD median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 2.54 | 2.96 | 3.28 | 2.90–3.77 |
| RN | 0.22 | 0.52 | 0.39 | 0.25–0.58 |
| Weekend total | 2.44 | 2.75 | 3.11 | — |
| Weekday total | 2.58 | 3.06 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 31.4 | 2.54 | 0.22 | 0.28 | 2.05 | 2.44 | 14.4% |
| 2025Q3 | 92 | 33.3 | 2.59 | 0.20 | 0.30 | 2.08 | 2.53 | 17.1% |
| 2025Q2 | 91 | 34.1 | 2.41 | 0.19 | 0.38 | 1.84 | 2.23 | 12.0% |
| 2025Q1 | 90 | 35.7 | 1.84 | 0.20 | 0.41 | 1.23 | 1.92 | 0.0% |
| 2024Q4 | 92 | 31.1 | 1.83 | 0.20 | 0.40 | 1.23 | 1.93 | 0.0% |
| 2024Q3 | 92 | 32.3 | 1.86 | 0.22 | 0.37 | 1.27 | 1.65 | 0.0% |
| 2024Q1 | 91 | 33.5 | 2.68 | 0.17 | 0.65 | 1.86 | 2.23 | 4.4% |
| 2023Q4 | 92 | 34.9 | 1.45 | 0.00 | 0.39 | 1.06 | 1.46 | 0.0% |
| 2023Q2 | 91 | 34.1 | 1.68 | 0.00 | 0.51 | 1.18 | 1.51 | 0.0% |
| 2023Q1 | 90 | 35.0 | 1.60 | 0.00 | 0.47 | 1.14 | 1.48 | 0.0% |
| 2022Q2 | 91 | 27.3 | 2.46 | 0.16 | 0.75 | 1.56 | 2.01 | 0.0% |
| 2022Q1 | 90 | 27.2 | 2.70 | 0.00 | 0.71 | 1.99 | 2.35 | 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
2| Date | Type | Fine | Source |
|---|---|---|---|
| 2024-06-21 | Fine | $63,814 | CMS provider data |
| 2024-02-06 | Fine | $5,698 | CMS provider data |
Total fines on record: $69,512
Deficiencies
25D × 11E × 6F × 6G × 2
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-09-11 | Health | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | D | 2025-10-26 |
| 2025-09-11 | 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 | 2025-10-26 |
| 2025-09-11 | 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 | 2025-10-26 |
| 2025-09-11 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-10-26 |
| 2025-09-11 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-10-26 |
| 2025-09-11 | 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 | 2025-10-26 |
| 2025-09-11 | Health | 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 | 2025-10-26 |
| 2025-09-11 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2025-10-26 |
| 2025-09-11 | Health | F0813 | Have a policy regarding use and storage of foods brought to residents by family and other visitors. | E | 2025-10-26 |
| 2025-09-11 | Health | F0851 | Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. | F | 2025-10-26 |
| 2025-09-11 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2025-10-26 |
| 2024-06-21 | Health | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | D | 2024-07-23 |
| 2024-06-21 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | 2024-06-22 |
| 2024-06-21 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2024-07-23 |
| 2024-06-21 | Health | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | E | 2024-08-12 |
| 2024-06-21 | Health | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | E | 2024-08-12 |
| 2024-06-21 | Health · complaint | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | 2024-07-23 |
| 2024-06-21 | Health | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | 2024-07-23 |
| 2024-06-21 | Health | F0700 | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | D | 2024-08-12 |
| 2024-06-21 | Health | 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 | 2024-07-23 |
| 2024-06-21 | 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 | 2024-07-23 |
| 2024-06-21 | Health | F0848 | Provide a neutral and fair arbitration process and agree to arbitrator and venue. | F | 2024-07-23 |
| 2024-06-21 | Health | F0851 | Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. | F | 2024-07-23 |
| 2024-06-21 | Health | F0880 | Provide and implement an infection prevention and control program. | E | 2024-07-23 |
| 2023-05-18 | Health | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | E | 2023-07-02 |
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
5| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| CARING PROFESSIONALS INC | OPERATIONAL/MANAGERIAL CONTROL | — | 2019-10-01 | current | pecos_ownership |
| HUBER, DAWN | W-2 MANAGING EMPLOYEE | — | 2019-10-01 | current | pecos_ownership |
| STROSCHEIN, CHAD | CORPORATE DIRECTOR | — | 2019-10-01 | current | pecos_ownership |
| CHAD STROSCHEIN | CORPORATE DIRECTOR | 100% | 2019-10-01 | ended 2026-05-18 | pecos_ownership |
| DAWN HUBER | W-2 MANAGING EMPLOYEE | 100% | 2019-10-01 | 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.
Transactions
1| Close date | Price | Buyer | Seller | Evidence |
|---|---|---|---|---|
| 2019-10-01 | — | BRIDGEWATER NURSING HOME CORPORATION | TCC HOLDINGS CORPORATION | 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 NORTON | — | — | — | 110 | NORTON SD SKILLED NURSING FACILITY LLC |
| 2019-10-02 | AVANTARA HURON | — | — | — | 119 | HURON SD SKILLED NURSING FACILITY, LLC |
| 2019-10-01 | DIAMOND CARE CENTERthis facility | — | — | — | 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
31| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 46087 | fmr | 0 | $865 | 2025-10-01 | HUD_USER_FMR |
| county 46087 | acs median gross | 1 | $636 | 2024-12-31 | CENSUS_ACS5 |
| county 46087 | fmr | 1 | $986 | 2025-10-01 | HUD_USER_FMR |
| county 46087 | acs median gross | 2 | $929 | 2024-12-31 | CENSUS_ACS5 |
| county 46087 | fmr | 2 | $1,156 | 2025-10-01 | HUD_USER_FMR |
| county 46087 | acs median gross | 3 | $1,173 | 2024-12-31 | CENSUS_ACS5 |
| county 46087 | fmr | 3 | $1,586 | 2025-10-01 | HUD_USER_FMR |
| county 46087 | acs median gross | 4 | $1,125 | 2024-12-31 | CENSUS_ACS5 |
| county 46087 | fmr | 4 | $1,939 | 2025-10-01 | HUD_USER_FMR |
| county 46087 | acs median gross | 5 | $1,010 | 2024-12-31 | CENSUS_ACS5 |
| county 46087 | acs median gross | $945 | 2024-12-31 | CENSUS_ACS5 | |
| county 46087 | acs recent mover gross | $1,067 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 57319 | acs median gross | 1 | $675 | 2024-12-31 | CENSUS_ACS5 |
| zcta 57319 | acs median gross | 2 | $737 | 2024-12-31 | CENSUS_ACS5 |
| zcta 57319 | acs median gross | 4 | $636 | 2024-12-31 | CENSUS_ACS5 |
| zcta 57319 | acs median gross | $729 | 2024-12-31 | CENSUS_ACS5 | |
| zip 57319 | payment standard 110 | 0 | $814 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | payment standard 90 | 0 | $666 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | safmr | 0 | $740 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | payment standard 110 | 1 | $924 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | payment standard 90 | 1 | $756 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | safmr | 1 | $840 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | payment standard 110 | 2 | $1,089 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | payment standard 90 | 2 | $891 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | safmr | 2 | $990 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | payment standard 110 | 3 | $1,496 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | payment standard 90 | 3 | $1,224 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | safmr | 3 | $1,360 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | payment standard 110 | 4 | $1,815 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | payment standard 90 | 4 | $1,485 | 2025-10-01 | HUD_USER_SAFMR |
| zip 57319 | safmr | 4 | $1,650 | 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.