Composite
12.1 / 100 percentile
Screener / 355034
A
TIOGA MEDICAL CENTER LTC
snfND
810 N WELO ST, TIOGA, ND 58852 · CCN 355034
Peer group
snf n = 14,684
Evidence depth
moderate
Certified beds
30
Model
v1.2
Reads as: riskier than 12.1% 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 model3Components9CHOW radar1Distress radar1Staffing16Penalties1Deficiencies16Licensure0Ownership23Related party0Transactions0Comps6Market rent32
Composite explanation
3| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 56.7 | 46.8 | 0.30 | 0.4286 | 24.30 | in index |
| chow risk | 25.2 | 25.0 | 0.15 | 0.2143 | 5.40 | in index |
| staffing risk | 4.1 | 4.2 | 0.25 | 0.3571 | 1.46 | 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
9| 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. |
| p adverse action 12m | 5.3 | — | 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 | 0.3 | — | 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 | 46.8 | C | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 4.2 | A | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| regulatory risk | 46.6 | 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 | 46.6 | 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 | 4.2 | 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 | 4.2 | 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)
0.3%
model v0.1 · computed 2026-07-29
Percentile among SNFs
48.1
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 | |
| Never sold on record | 1.00 | +0.62 | |
| Current owner tenure (years) | 25.00 | +0.57 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Occupancy | 0.84 | -0.40 | |
| Chain size (log) | 0.00 | -0.40 | |
| Total nurse staffing (HPRD) | 4.97 | -0.38 | |
| Contract staffing share | 0.30 | +0.37 |
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)
5.3%
model v0.1 · computed 2026-07-29
Percentile among SNFs
97.2
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 | 0.00 | +1.62 | |
| Deficiencies, last 12 months | 0.00 | +1.43 | |
| Chain size (log) | 0.00 | +1.20 | |
| Total nurse staffing (HPRD) | 4.97 | -0.74 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Occupancy | 0.84 | -0.37 | |
| Staffing trend, last 4 quarters | 0.75 | +0.32 | |
| Contract staffing share | 0.30 | +0.25 |
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 | ND median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 4.97 | 3.90 | 3.28 | 2.90–3.77 |
| RN | 0.51 | 0.59 | 0.39 | 0.25–0.58 |
| Weekend total | 4.79 | 3.55 | 3.11 | — |
| Weekday total | 5.04 | 4.01 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 25.1 | 4.97 | 0.51 | 0.64 | 3.82 | 4.79 | 29.9% |
| 2025Q3 | 92 | 24.7 | 5.57 | 0.57 | 0.69 | 4.31 | 5.00 | 18.8% |
| 2025Q2 | 91 | 26.1 | 5.47 | 0.54 | 0.57 | 4.37 | 4.94 | 22.3% |
| 2025Q1 | 90 | 27.2 | 4.52 | 0.45 | 0.57 | 3.50 | 4.19 | 50.3% |
| 2024Q4 | 92 | 26.9 | 4.22 | 0.70 | 0.37 | 3.14 | 4.00 | 50.5% |
| 2024Q3 | 92 | 27.5 | 4.30 | 0.71 | 0.32 | 3.28 | 4.03 | 27.4% |
| 2024Q2 | 91 | 26.8 | 4.02 | 0.61 | 0.50 | 2.90 | 3.85 | 30.7% |
| 2024Q1 | 91 | 25.7 | 4.22 | 0.80 | 0.36 | 3.06 | 4.05 | 17.0% |
| 2023Q4 | 92 | 25.5 | 4.34 | 0.68 | 0.48 | 3.18 | 4.06 | 25.7% |
| 2023Q3 | 92 | 27.0 | 4.33 | 0.86 | 0.42 | 3.06 | 4.28 | 33.3% |
| 2023Q2 | 91 | 29.2 | 3.81 | 0.80 | 0.17 | 2.83 | 3.56 | 32.2% |
| 2023Q1 | 90 | 26.2 | 4.23 | 1.01 | 0.21 | 3.02 | 4.02 | 19.0% |
| 2022Q4 | 92 | 26.1 | 4.42 | 0.78 | 0.39 | 3.25 | 4.16 | 29.2% |
| 2022Q3 | 92 | 27.8 | 3.84 | 0.83 | 0.24 | 2.77 | 3.67 | 29.7% |
| 2022Q2 | 91 | 27.7 | 3.85 | 0.79 | 0.20 | 2.87 | 3.64 | 30.9% |
| 2022Q1 | 90 | 27.9 | 3.73 | 0.67 | 0.37 | 2.69 | 3.35 | 28.2% |
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 |
|---|---|---|---|
| 2025-02-11 | Fine | $11,408 | CMS provider data |
Total fines on record: $11,408
Deficiencies
16C × 1D × 13E × 1G × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-03-12 | Health | F0641 | Ensure each resident receives an accurate assessment. | E | 2025-04-11 |
| 2025-03-12 | Health | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2025-04-11 |
| 2025-03-12 | Health | F0732 | Post nurse staffing information every day. | C | 2025-04-11 |
| 2025-03-12 | 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 | 2025-04-11 |
| 2025-03-12 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2025-04-11 |
| 2025-02-11 | Health · complaint | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | 2025-03-07 |
| 2024-02-05 | Health | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-03-11 |
| 2024-02-05 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2024-03-11 |
| 2024-02-05 | Health | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2024-03-11 |
| 2024-02-05 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2024-03-11 |
| 2024-02-05 | 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. | D | 2024-03-11 |
| 2024-02-05 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2024-03-11 |
| 2023-01-12 | 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 | 2023-02-16 |
| 2023-01-12 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2023-02-16 |
| 2023-01-12 | Health | F0757 | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | 2023-02-16 |
| 2023-01-12 | 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 | 2023-02-16 |
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
23| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| BECKER, JEREMY | CORPORATE DIRECTOR | — | 2019-03-18 | current | pecos_ownership |
| BOOTH, JAMES | CORPORATE DIRECTOR | — | 2013-03-20 | current | pecos_ownership |
| BRYANT, HOLLY | CORPORATE OFFICER | — | 2023-02-21 | current | pecos_ownership |
| ERAAS, JAMIE | CORPORATE OFFICER | — | 2023-01-27 | current | pecos_ownership |
| GERMUNDSON, NATHAN | CORPORATE DIRECTOR | — | 2020-03-16 | current | pecos_ownership |
| JOYCE, PATRICK | CORPORATE DIRECTOR | — | 2023-03-20 | current | pecos_ownership |
| KUEHN, KRISTOPHER | CORPORATE DIRECTOR | — | 2023-03-20 | current | pecos_ownership |
| LENZEN, WENDY | CORPORATE DIRECTOR | — | 2023-03-20 | current | pecos_ownership |
| ODEGAARD, BRODIE | CORPORATE DIRECTOR | — | 2017-03-20 | current | pecos_ownership |
| OLSON, LEE | CORPORATE DIRECTOR | — | 2017-03-20 | current | pecos_ownership |
| TIOGA MEDICAL CENTER | OPERATIONAL/MANAGERIAL CONTROL | — | — | current | pecos_ownership |
| WISTHOFF, SETH | CORPORATE DIRECTOR | — | 2019-03-18 | current | pecos_ownership |
| BRODIE ODEGAARD | CORPORATE DIRECTOR | — | 2017-03-20 | ended 2026-05-18 | pecos_ownership |
| HOLLY BRYANT | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-02-21 | ended 2026-05-18 | pecos_ownership |
| JAMES BOOTH | CORPORATE DIRECTOR | — | 2013-03-20 | ended 2026-05-18 | pecos_ownership |
| JAMIE ERAAS | CORPORATE OFFICER | — | 2023-01-27 | ended 2026-05-18 | pecos_ownership |
| JEREMY BECKER | CORPORATE DIRECTOR | — | 2019-03-18 | ended 2026-05-18 | pecos_ownership |
| KRISTOPHER KUEHN | CORPORATE DIRECTOR | — | 2023-03-20 | ended 2026-05-18 | pecos_ownership |
| LEE OLSON | CORPORATE DIRECTOR | — | 2017-03-20 | ended 2026-05-18 | pecos_ownership |
| NATHAN GERMUNDSON | CORPORATE DIRECTOR | — | 2020-03-16 | ended 2026-05-18 | pecos_ownership |
| PATRICK JOYCE | CORPORATE DIRECTOR | — | 2023-03-20 | ended 2026-05-18 | pecos_ownership |
| SETH WISTHOFF | CORPORATE DIRECTOR | — | 2019-03-18 | ended 2026-05-18 | pecos_ownership |
| WENDY LENZEN | CORPORATE DIRECTOR | — | 2023-03-20 | 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 — ND snf
6| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2022-01-01 | GOLDEN ACRES MANOR | — | — | — | 64 | ALPHA INC |
| 2020-07-01 | GOOD SAMARITAN SOCIETY MILLER POINTE A PROSPERA CO | — | — | — | 120 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| 2020-07-01 | GOOD SAMARITAN SOCIETY AUGUSTA PLACE A PROSPERA CO | — | — | — | 48 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| 2020-07-01 | SUNSET DRIVE - A PROSPERA COMMUNITY | — | — | — | 128 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| 2020-07-01 | ST VINCENT'S - A PROSPERA COMMUNITY | — | — | — | 97 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| 2018-10-24 | THE MEADOWS ON UNIVERSITY | — | — | — | 95 | FARGO NURSING AND REHAB CENTER 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
32| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 38105 | acs median gross | 0 | $923 | 2024-12-31 | CENSUS_ACS5 |
| county 38105 | fmr | 0 | $1,042 | 2025-10-01 | HUD_USER_FMR |
| county 38105 | acs median gross | 1 | $930 | 2024-12-31 | CENSUS_ACS5 |
| county 38105 | fmr | 1 | $1,068 | 2025-10-01 | HUD_USER_FMR |
| county 38105 | acs median gross | 2 | $1,098 | 2024-12-31 | CENSUS_ACS5 |
| county 38105 | fmr | 2 | $1,196 | 2025-10-01 | HUD_USER_FMR |
| county 38105 | acs median gross | 3 | $1,342 | 2024-12-31 | CENSUS_ACS5 |
| county 38105 | fmr | 3 | $1,578 | 2025-10-01 | HUD_USER_FMR |
| county 38105 | acs median gross | 4 | $1,144 | 2024-12-31 | CENSUS_ACS5 |
| county 38105 | fmr | 4 | $1,745 | 2025-10-01 | HUD_USER_FMR |
| county 38105 | acs median gross | $1,123 | 2024-12-31 | CENSUS_ACS5 | |
| county 38105 | acs recent mover gross | $1,155 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 58852 | acs median gross | 0 | $1,211 | 2024-12-31 | CENSUS_ACS5 |
| zcta 58852 | acs median gross | 2 | $1,139 | 2024-12-31 | CENSUS_ACS5 |
| zcta 58852 | acs median gross | 3 | $1,412 | 2024-12-31 | CENSUS_ACS5 |
| zcta 58852 | acs median gross | $1,125 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 58852 | acs recent mover gross | $1,434 | 2024-12-31 | CENSUS_ACS5 | |
| zip 58852 | payment standard 110 | 0 | $1,056 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | payment standard 90 | 0 | $864 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | safmr | 0 | $960 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | payment standard 110 | 1 | $1,078 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | payment standard 90 | 1 | $882 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | safmr | 1 | $980 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | payment standard 110 | 2 | $1,221 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | payment standard 90 | 2 | $999 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | safmr | 2 | $1,110 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | payment standard 110 | 3 | $1,606 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | payment standard 90 | 3 | $1,314 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | safmr | 3 | $1,460 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | payment standard 110 | 4 | $1,925 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | payment standard 90 | 4 | $1,575 | 2025-10-01 | HUD_USER_SAFMR |
| zip 58852 | safmr | 4 | $1,750 | 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.