500 S OHLMAN, MITCHELL, SD 57301 · CCN 435061 · chain AVERA HEALTH
Composite
39.2 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
84
Model
v1.2
Reads as: riskier than 39.2% of the 14,684 facilities in the snf peer group. percentile within peer group, 100 = highest risk. Grade bands are fixed percentile cuts (F is the top 5% of peer risk), so a grade is a position, not an absolute level.
weighted_contribution sums to pre_rank_index over rows where counts_toward_index is true. The composite is the facility's percentile position of that index within its peer group, so contributions explain the input, and the rank explains the score.
Change-of-ownership footprint in the CMS Provider of Services file: control-family, legal-name and address deltas across quarterly snapshots, plus certification reset recency and Medicare tenure.
R23/W4-3. Deterministic logistic p(Medicare termination within 12m), SNF only. Label = first POS termination date (any code: voluntary closure, involuntary termination, merger exit); facilities already terminated by the panel date are excluded, not counted as safe. Trained on panels 2024-07/2024-10/2025-01 (n=46,466, 283 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.971, top-decile lift 9.5x, top-decile capture 95.4% of the 65 terminations that followed. Separability is high because closures announce themselves in the data: collapsing occupancy is the strongest signal, and the learned NEGATIVE weight on 12m deficiency counts is the surveys-stop signature of a facility winding down, not a claim that clean inspections are dangerous. Same 15 as-of-date features and anti-leakage chassis as p_chow_12m; SFF entry rejected as a label (only one month of SFF history exists, so as-of transitions cannot be reconstructed). Score = probability x 100; grade NULL. Not in any composite.
R22/W4-2. Deterministic logistic p(CHOW within 12m), SNF only. Trained on panels 2024-07/2024-10/2025-01 (n=50,700, 1,207 positives), evaluated on the held-out later panel 2025-04 BEFORE shipping: AUC 0.874, top-decile lift 5.0x (top 10% of predictions captured 49.6% of the CHOWs that actually closed in the next 12 months). Shipped coefficients are the evaluated ones; no post-holdout refit. Caveat: holdout positives (133) run below the training base rate because recent CHOWs surface in public records with a lag, so measured lift is conservative. Features are as-of-date public records: PBJ staffing level/trend/contract share (quarterly history to 2022Q1), deficiency and CMP counts (12m), ownership tenure and churn from CHOW-evidenced transactions, beds, occupancy, ownership type, chain size. Chain membership and ownership type are current-state (history not published). SFF and star ratings deliberately excluded (no as-of history). Notable learned direction: long ownership tenure RAISES sale odds and a recent prior CHOW lowers them. Score = probability x 100; grade is NULL because a probability is not a quality letter. Not in any composite.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later regulatory_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Pre-registry model iteration, superseded by a later staffing_risk rebuild. Rows retained for audit per project convention (see regulatory_risk v0.4-pos); never consumed because v_cii_api_facility_score and the composite eligibility join both require status = default. Backfilled 2026-07-26 by alert triage on model_registry_integrity.
Rows with counts_toward_composite false come from models that are addressable or retracted rather than default. They exist and may be informative, but they did not enter the published composite and must not be summed as though they had.
p_adverse_action_12m: probability the facility's Medicare participation terminates within 12 months (any POS termination code; already-terminated facilities are excluded, not scored safe). Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.971, top-decile lift 9.5x. Closures announce themselves: collapsing occupancy dominates, and fewer recent surveys is a winding-down signature. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models. | p_chow_12m: probability of a change of ownership within 12 months. Deterministic logistic over as-of-date public records, SNF only. Holdout (2025-04 panel, evaluated before shipping): AUC 0.874, top-decile lift 5.0x. inputs.features holds raw feature values, inputs.contributions each feature's standardized pull on the log-odds. Predictions never enter the composite. See /v1/models for full notes.
Probability the facility's Medicare participation ends within 12 months, from public records only. Red bars raise exit odds. A negative pull from deficiencies is the winding-down signature — surveys stop as a facility empties — not evidence that clean inspections are dangerous.
Staffing vs peers
16
2025Q4 HPRD
This facility
SD median
National median
National p25–p75
Total nurse
3.58
2.96
3.28
2.90–3.77
RN
1.07
0.52
0.39
0.25–0.58
Weekend total
3.32
2.75
3.11
—
Weekday total
3.69
3.06
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
78.1
3.58
1.07
0.19
2.32
3.32
0.0%
2025Q3
92
73.8
3.69
1.06
0.20
2.42
3.46
0.0%
2025Q2
91
68.5
3.77
1.01
0.19
2.57
3.55
0.4%
2025Q1
90
70.7
3.66
1.09
0.13
2.44
3.61
0.1%
2024Q4
92
69.5
3.71
1.20
0.18
2.32
3.66
0.0%
2024Q3
92
73.2
3.47
0.99
0.21
2.28
3.43
0.0%
2024Q2
91
73.2
3.52
0.94
0.21
2.37
3.45
0.0%
2024Q1
91
71.8
3.67
0.99
0.23
2.46
3.52
0.0%
2023Q4
92
71.4
3.60
1.01
0.23
2.36
3.34
0.0%
2023Q3
92
74.6
3.44
0.92
0.24
2.27
3.14
0.0%
2023Q2
91
74.8
3.35
0.94
0.24
2.17
3.03
0.0%
2023Q1
90
71.6
3.50
1.00
0.19
2.31
3.22
0.3%
2022Q4
92
64.4
3.90
1.11
0.21
2.57
3.49
0.2%
2022Q3
92
62.8
3.55
1.06
0.17
2.33
3.13
0.0%
2022Q2
91
60.5
3.37
1.05
0.15
2.17
3.01
0.0%
2022Q1
90
58.4
3.53
1.10
0.18
2.25
3.08
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
0
No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
8
D × 6E × 2
deficiencies by survey year
Survey
Type
Tag
Deficiency
Scope
Corrected
2026-04-27
Health · complaint
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
2026-05-06
2026-04-27
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
2026-05-13
2026-02-26
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
2026-04-16
2024-12-12
Health
F0655
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
E
2025-01-08
2024-12-12
Health
F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
E
2025-01-08
2024-12-12
Health
F0760
Ensure that residents are free from significant medication errors.
D
2025-01-08
2023-08-17
Health
F0803
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
D
2023-09-15
2023-08-17
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
2023-09-15
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
44
Owner
Role
Pct
From
Status
Source
AVERA HEALTH
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
2009-07-01
current
pecos_ownership
BERGELEEN, DARLENE
MANAGING CONTROL - GOVERNING BODY
—
2023-07-01
current
pecos_ownership
BUCKMILLER, ANN
MANAGING CONTROL - GOVERNING BODY
—
2025-07-01
current
pecos_ownership
CLAUSSEN, JESSICA
MANAGING CONTROL - GOVERNING BODY
—
2023-07-01
current
pecos_ownership
DIERKS, TREVOR
MANAGING CONTROL - GOVERNING BODY
—
2023-07-01
current
pecos_ownership
DOVER, JAMES
CORPORATE OFFICER
—
2023-10-23
current
pecos_ownership
DOVER, JAMES
INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
—
2026-03-03
current
pecos_ownership
FETERAL, JOYCE
MANAGING CONTROL - GOVERNING BODY
—
2024-07-01
current
pecos_ownership
HUNHOFF, MARK
MANAGING CONTROL - GOVERNING BODY
—
2019-07-01
current
pecos_ownership
LARSON, VICKY
MANAGING CONTROL - GOVERNING BODY
—
2024-07-01
current
pecos_ownership
LAUTT, JULIE
CORPORATE OFFICER
—
2020-03-01
current
pecos_ownership
LONGE, KIMBERLY
OPERATIONAL/MANAGERIAL CONTROL
—
2024-06-01
current
pecos_ownership
LONGE, KIMBERLY
ADP OF THE SNF
—
2026-02-12
current
pecos_ownership
MARGALLO, LUCIO
CORPORATE DIRECTOR
—
2020-07-01
current
pecos_ownership
MARGALLO, LUCIO
ADP OF THE SNF
—
2026-02-12
current
pecos_ownership
PUETZ, MARK
MANAGING CONTROL - GOVERNING BODY
—
2023-07-01
current
pecos_ownership
ROCKWELL, HILARY
OPERATIONAL/MANAGERIAL CONTROL
—
2023-07-01
current
pecos_ownership
SANDHOFF, DIANE
MANAGING CONTROL - GOVERNING BODY
—
2023-07-01
current
pecos_ownership
STAHLE, NICOLE
MANAGING CONTROL - GOVERNING BODY
—
2023-07-01
current
pecos_ownership
TEGETHOFF, JENNIFER
MANAGING CONTROL - GOVERNING BODY
—
2021-07-01
current
pecos_ownership
THOMAS, FREDEL
MANAGING CONTROL - GOVERNING BODY
—
2024-07-01
current
pecos_ownership
THOMPSON, RYAN
MANAGING CONTROL - GOVERNING BODY
—
2018-07-01
current
pecos_ownership
ZOMER, BRAD
MANAGING CONTROL - GOVERNING BODY
—
2018-07-01
current
pecos_ownership
ANN BUCKMILLER
MANAGING CONTROL - GOVERNING BODY
—
2025-07-01
ended 2026-05-18
pecos_ownership
BRAD ZOMER
MANAGING CONTROL - GOVERNING BODY
—
2018-07-01
ended 2026-05-18
pecos_ownership
DARLENE BERGELEEN
MANAGING CONTROL - GOVERNING BODY
—
2023-07-01
ended 2026-05-18
pecos_ownership
DIANE SANDHOFF
MANAGING CONTROL - GOVERNING BODY
—
2023-07-01
ended 2026-05-18
pecos_ownership
FREDEL THOMAS
MANAGING CONTROL - GOVERNING BODY
—
2024-07-01
ended 2026-05-18
pecos_ownership
HILARY ROCKWELL
OPERATIONAL/MANAGERIAL CONTROL
—
2023-07-01
ended 2026-05-18
pecos_ownership
JAMES DOVER
CORPORATE OFFICER
—
2023-10-23
ended 2026-05-18
pecos_ownership
JENNIFER TEGETHOFF
MANAGING CONTROL - GOVERNING BODY
—
2021-07-01
ended 2026-05-18
pecos_ownership
JESSICA CLAUSSEN
MANAGING CONTROL - GOVERNING BODY
—
2023-07-01
ended 2026-05-18
pecos_ownership
JOYCE FETERAL
MANAGING CONTROL - GOVERNING BODY
—
2024-07-01
ended 2026-05-18
pecos_ownership
JULIE LAUTT
CORPORATE OFFICER
—
2020-03-01
ended 2026-05-18
pecos_ownership
KIMBERLY LONGE
OPERATIONAL/MANAGERIAL CONTROL
—
2024-06-01
ended 2026-05-18
pecos_ownership
KIMBERLY LONGE
ADP OF THE SNF
—
2026-02-12
ended 2026-05-18
pecos_ownership
LUCIO MARGALLO
ADP OF THE SNF
—
2026-02-12
ended 2026-05-18
pecos_ownership
LUCIO MARGALLO
OPERATIONAL/MANAGERIAL CONTROL
—
2020-07-01
ended 2026-05-18
pecos_ownership
MARK HUNHOFF
MANAGING CONTROL - GOVERNING BODY
—
2019-07-01
ended 2026-05-18
pecos_ownership
MARK PUETZ
MANAGING CONTROL - GOVERNING BODY
—
2023-07-01
ended 2026-05-18
pecos_ownership
NICOLE STAHLE
MANAGING CONTROL - GOVERNING BODY
—
2023-07-01
ended 2026-05-18
pecos_ownership
RYAN THOMPSON
MANAGING CONTROL - GOVERNING BODY
—
2018-07-01
ended 2026-05-18
pecos_ownership
TREVOR DIERKS
MANAGING CONTROL - GOVERNING BODY
—
2023-07-01
ended 2026-05-18
pecos_ownership
VICKY LARSON
MANAGING CONTROL - GOVERNING BODY
—
2024-07-01
ended 2026-05-18
pecos_ownership
PECOS ownership and managing-control associations. Current edges have no end date in the source; historical edges are retained.
Related-party costs
0
No related-party cost years on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.
Transactions
0
No transactions on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Most recent same-state, same-setting trades. Most CHOW-derived trades carry no disclosed consideration, so price, $/bed, and cap rate show only where a sale price was resolved from a deed or filing — blanks are honest, not missing data.
Market rent context
34
Geo
Kind
BR
Amount
As of
Source
county 46035
acs median gross
0
$1,048
2024-12-31
CENSUS_ACS5
county 46035
fmr
0
$645
2025-10-01
HUD_USER_FMR
county 46035
acs median gross
1
$615
2024-12-31
CENSUS_ACS5
county 46035
fmr
1
$713
2025-10-01
HUD_USER_FMR
county 46035
acs median gross
2
$884
2024-12-31
CENSUS_ACS5
county 46035
fmr
2
$936
2025-10-01
HUD_USER_FMR
county 46035
acs median gross
3
$1,229
2024-12-31
CENSUS_ACS5
county 46035
fmr
3
$1,302
2025-10-01
HUD_USER_FMR
county 46035
acs median gross
4
$1,354
2024-12-31
CENSUS_ACS5
county 46035
fmr
4
$1,570
2025-10-01
HUD_USER_FMR
county 46035
acs median gross
5
$1,329
2024-12-31
CENSUS_ACS5
county 46035
acs median gross
$847
2024-12-31
CENSUS_ACS5
county 46035
acs recent mover gross
$1,129
2024-12-31
CENSUS_ACS5
zcta 57301
acs median gross
0
$1,048
2024-12-31
CENSUS_ACS5
zcta 57301
acs median gross
1
$621
2024-12-31
CENSUS_ACS5
zcta 57301
acs median gross
2
$894
2024-12-31
CENSUS_ACS5
zcta 57301
acs median gross
3
$1,282
2024-12-31
CENSUS_ACS5
zcta 57301
acs median gross
$857
2024-12-31
CENSUS_ACS5
zcta 57301
acs recent mover gross
$1,149
2024-12-31
CENSUS_ACS5
zip 57301
payment standard 110
0
$704
2025-10-01
HUD_USER_SAFMR
zip 57301
payment standard 90
0
$576
2025-10-01
HUD_USER_SAFMR
zip 57301
safmr
0
$640
2025-10-01
HUD_USER_SAFMR
zip 57301
payment standard 110
1
$781
2025-10-01
HUD_USER_SAFMR
zip 57301
payment standard 90
1
$639
2025-10-01
HUD_USER_SAFMR
zip 57301
safmr
1
$710
2025-10-01
HUD_USER_SAFMR
zip 57301
payment standard 110
2
$1,023
2025-10-01
HUD_USER_SAFMR
zip 57301
payment standard 90
2
$837
2025-10-01
HUD_USER_SAFMR
zip 57301
safmr
2
$930
2025-10-01
HUD_USER_SAFMR
zip 57301
payment standard 110
3
$1,419
2025-10-01
HUD_USER_SAFMR
zip 57301
payment standard 90
3
$1,161
2025-10-01
HUD_USER_SAFMR
zip 57301
safmr
3
$1,290
2025-10-01
HUD_USER_SAFMR
zip 57301
payment standard 110
4
$1,716
2025-10-01
HUD_USER_SAFMR
zip 57301
payment standard 90
4
$1,404
2025-10-01
HUD_USER_SAFMR
zip 57301
safmr
4
$1,560
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.