Composite
67.5 / 100 percentile
Screener / 165620
C
St Luke's Regional Medical Center SNF
snfIA
801 Fifth Street, Sioux City, IA 51102 · CCN 165620 · chain IOWA HEALTH SYSTEM
Peer group
snf n = 14,684
Evidence depth
moderate
Certified beds
20
Model
v1.2
Reads as: riskier than 67.5% 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 model3Components7CHOW radar1Distress radar1Staffing10Penalties0Deficiencies3Licensure0Ownership45Related party0Transactions1Comps12Market rent28
Composite explanation
3| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| billing conduct | 93.9 | 64.1 | 0.30 | 0.4000 | 37.56 | in index |
| chow risk | 80.5 | 27.2 | 0.15 | 0.2000 | 16.10 | in index |
| regulatory risk | 3.4 | 2.1 | 0.30 | 0.4000 | 1.36 | 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
7| Score type | Score | Grade | Model | Status | Registry model notes |
|---|---|---|---|---|---|
| billing conduct | 64.1 | C | v0.1-pacpuf-snf | default · in composite | R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup. |
| chow risk | 27.2 | 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 | 0.4 | — | 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 | 0.0 | — | 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 | 2.1 | A | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| regulatory risk | 2.1 | A | 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 | 2.1 | A | 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. |
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)
0.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
0.0
100 = most likely to sell
Holdout AUC
0.874
evaluated before shipping, never refit
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Current owner tenure (years) | 0.91 | -1.76 | |
| Never sold on record | 0.00 | -1.62 | |
| Total nurse staffing (HPRD) | 10.90 | -1.56 | |
| For-profit ownership | 0.00 | -1.24 | |
| Occupancy | 0.29 | +1.17 | |
| Ownership changes, last 5 years | 1.00 | -0.87 | |
| No PBJ staffing report | 0.00 | +0.42 | |
| Facility size (log beds) | 3.04 | +0.19 |
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)
0.4%
model v0.1 · computed 2026-07-29
Percentile among SNFs
71.9
100 = most likely to lose certification
Holdout AUC
0.971
top decile caught 95% of actual exits
| Driver | Value | Pull on odds | |
|---|---|---|---|
| Total nurse staffing (HPRD) | 10.90 | -3.23 | |
| Occupancy | 0.29 | +1.91 | |
| For-profit ownership | 0.00 | +1.62 | |
| Deficiencies, last 12 months | 0.00 | +1.43 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Current owner tenure (years) | 0.91 | -0.29 | |
| Never sold on record | 0.00 | -0.28 | |
| Facility size (log beds) | 3.04 | +0.27 |
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
10| 2024Q4 HPRD | This facility | IA median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 10.90 | 3.15 | 3.28 | 2.90–3.77 |
| RN | 3.14 | 0.46 | 0.39 | 0.25–0.58 |
| Weekend total | 11.16 | 2.96 | 3.11 | — |
| Weekday total | 10.80 | 3.20 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2024Q4 | 92 | 5.9 | 10.90 | 3.14 | 2.54 | 5.22 | 11.16 | 10.2% |
| 2024Q3 | 92 | 7.0 | 9.72 | 2.58 | 2.56 | 4.58 | 9.34 | 9.2% |
| 2024Q2 | 91 | 7.0 | 10.44 | 2.52 | 2.84 | 5.08 | 9.93 | 9.9% |
| 2023Q3 | 92 | 6.8 | 9.66 | 3.22 | 1.54 | 4.90 | 9.72 | 24.2% |
| 2023Q2 | 91 | 7.6 | 8.34 | 3.36 | 1.37 | 3.62 | 8.61 | 26.9% |
| 2023Q1 | 90 | 10.2 | 4.92 | 2.14 | 0.75 | 2.03 | 4.93 | 26.8% |
| 2022Q4 | 92 | 7.0 | 6.57 | 3.01 | 0.68 | 2.88 | 6.63 | 0.0% |
| 2022Q3 | 92 | 8.3 | 6.64 | 1.49 | 0.62 | 4.53 | 6.03 | 0.0% |
| 2022Q2 | 91 | 12.1 | 4.53 | 1.46 | 0.52 | 2.55 | 3.60 | 0.0% |
| 2022Q1 | 90 | 12.5 | 3.20 | 1.54 | 0.18 | 1.49 | 2.97 | 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
0No penalties on record for this facility. Absence of a record here means the sources CII ingests contain none, not that none exists anywhere.
Deficiencies
3D × 1F × 2
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2024-01-18 | Health | F0847 | Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse. | F | 2024-02-13 |
| 2024-01-18 | Health | F0848 | Provide a neutral and fair arbitration process and agree to arbitrator and venue. | F | 2024-02-13 |
| 2024-01-18 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2024-02-13 |
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
45| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| ARNOLD, JANE | CORPORATE OFFICER | — | 2015-12-01 | current | pecos_ownership |
| ARNOLD, JANE | OPERATIONAL/MANAGERIAL CONTROL | — | 2000-06-19 | current | pecos_ownership |
| ARNOLD, JANE | ADP OF THE SNF | — | 2025-07-01 | current | pecos_ownership |
| BEAULIEU, RENEE | CORPORATE DIRECTOR | — | 2020-01-01 | current | pecos_ownership |
| BULLOCK, DENNIS | CORPORATE DIRECTOR | — | 2019-01-01 | current | pecos_ownership |
| CHOQUETTE, HOLLY | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-09-01 | current | pecos_ownership |
| CRONE, MICHAEL | CORPORATE DIRECTOR | — | 2018-01-01 | current | pecos_ownership |
| DEWALD, HANNAH | CORPORATE DIRECTOR | — | 2021-01-01 | current | pecos_ownership |
| DREW, CARA | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-09-01 | current | pecos_ownership |
| IOWA HEALTH SYSTEM | OPERATIONAL/MANAGERIAL CONTROL | — | 1996-08-01 | current | pecos_ownership |
| JAMES, ANGELO | CORPORATE DIRECTOR | — | 2022-01-01 | current | pecos_ownership |
| KIZER, SCOTT | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | — | 2025-08-24 | current | pecos_ownership |
| KNAPP, LEAH | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-09-10 | current | pecos_ownership |
| KNAPP, LEAH | ADP OF THE SNF | — | 2025-09-01 | current | pecos_ownership |
| LINDLEY, WENDY | OPERATIONAL/MANAGERIAL CONTROL | — | 2017-04-16 | current | pecos_ownership |
| LINDLEY, WENDY | ADP OF THE SNF | — | 2025-09-01 | current | pecos_ownership |
| PALMER, JAMES | CORPORATE OFFICER | — | 2019-01-01 | current | pecos_ownership |
| PALMER, JAMES | CORPORATE DIRECTOR | — | 2017-01-01 | current | pecos_ownership |
| SAYLER, ROBERT | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-09-01 | current | pecos_ownership |
| SMITH, GARRETT | CORPORATE DIRECTOR | — | 2008-01-01 | current | pecos_ownership |
| ST. LUKE'S HEALTH SYSTEM, INC. | OPERATIONAL/MANAGERIAL CONTROL | — | 2015-05-05 | current | pecos_ownership |
| TREJO, BETH | CORPORATE DIRECTOR | — | 2021-01-01 | current | pecos_ownership |
| TRINITY CONTINUING CARE SERVICES | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-09-01 | current | pecos_ownership |
| TRINITY CONTINUING CARE SERVICES | ADP OF THE SNF | — | 2025-09-24 | current | pecos_ownership |
| WOLFE, CHARLES | CORPORATE DIRECTOR | — | 2022-01-01 | current | pecos_ownership |
| ANGELO JAMES | CORPORATE DIRECTOR | — | 2022-01-01 | ended 2026-05-18 | pecos_ownership |
| BETH TREJO | CORPORATE DIRECTOR | — | 2021-01-01 | ended 2026-05-18 | pecos_ownership |
| CARA DREW | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-09-01 | ended 2026-05-18 | pecos_ownership |
| CHARLES WOLFE | CORPORATE DIRECTOR | — | 2022-01-01 | ended 2026-05-18 | pecos_ownership |
| DENNIS BULLOCK | CORPORATE DIRECTOR | — | 2019-01-01 | ended 2026-05-18 | pecos_ownership |
| GARRETT SMITH | CORPORATE DIRECTOR | — | 2008-01-01 | ended 2026-05-18 | pecos_ownership |
| HANNAH DEWALD | CORPORATE DIRECTOR | — | 2021-01-01 | ended 2026-05-18 | pecos_ownership |
| HOLLY CHOQUETTE | ADP OF THE SNF | — | 2025-09-01 | ended 2026-05-18 | pecos_ownership |
| JAMES PALMER | CORPORATE DIRECTOR | — | 2017-01-01 | ended 2026-05-18 | pecos_ownership |
| JAMES PALMER | CORPORATE OFFICER | — | 2019-01-01 | ended 2026-05-18 | pecos_ownership |
| JANE ARNOLD | CORPORATE OFFICER | — | 2015-12-01 | ended 2026-05-18 | pecos_ownership |
| JANE ARNOLD | ADP OF THE SNF | — | 2025-07-01 | ended 2026-05-18 | pecos_ownership |
| JANE ARNOLD | OPERATIONAL/MANAGERIAL CONTROL | — | 2000-06-19 | ended 2026-05-18 | pecos_ownership |
| LEAH KNAPP | CORPORATE OFFICER | — | 2023-09-10 | ended 2026-05-18 | pecos_ownership |
| LEAH KNAPP | ADP OF THE SNF | — | 2025-09-01 | ended 2026-05-18 | pecos_ownership |
| MICHAEL CRONE | CORPORATE DIRECTOR | — | 2018-01-01 | ended 2026-05-18 | pecos_ownership |
| RENEE BEAULIEU | CORPORATE DIRECTOR | — | 2020-01-01 | ended 2026-05-18 | pecos_ownership |
| ROBERT SAYLER | ADP OF THE SNF | — | 2025-09-01 | ended 2026-05-18 | pecos_ownership |
| WENDY LINDLEY | ADP OF THE SNF | — | 2025-09-01 | ended 2026-05-18 | pecos_ownership |
| WENDY LINDLEY | OPERATIONAL/MANAGERIAL CONTROL | — | 2017-04-16 | 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 |
|---|---|---|---|---|
| 2025-09-01 | — | NORTHWEST IOWA HOSPITAL CORPORATION | MERCY HEALTH SERVICES-IOWA CORP | chow |
Comparable trades — IA snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-09-01 | St Luke's Regional Medical Center SNFthis facility | — | — | — | 20 | NORTHWEST IOWA HOSPITAL CORPORATION |
| 2025-08-01 | Crystal Heights Care Center | — | — | — | 72 | CANFIELD RIVER HEALTHCARE LLC |
| 2025-06-01 | AMS Memorial-Greene | — | — | — | 31 | AMS MEMORIAL-GREENE LLC |
| 2025-02-05 | Chapters Living of Council Bluffs | — | — | — | 102 | CHAPTERS COUNCIL BLUFFS OPCO LLC |
| 2025-02-01 | Osage Rehab and Health Care Center | — | — | — | 46 | OPCO OSAGE IA LLC |
| 2025-02-01 | Iowa City Rehab & Health Care | — | — | — | 89 | OPCO IOWA CITY IA LLC |
| 2025-02-01 | Accura Healthcare of Creston | — | — | — | 31 | ACCURA HEALTHCARE OF CRESTON LLC |
| 2025-02-01 | Casa De Paz Health Care Center | — | — | — | 71 | OPCO 19TH ST SIOUX CITY IA LLC |
| 2025-02-01 | Pleasant Acres Care Center | — | — | — | 46 | OPCO HULL IA LLC |
| 2025-02-01 | Cedar Falls Health Care Center | — | — | — | 70 | OPCO CEDAR FALLS IA LLC |
| 2025-02-01 | Accura Healthcare of Onawa | — | — | — | 46 | ACCURA HEALTHCARE OF ONAWA LLC |
| 2025-02-01 | Grundy Care Center | — | — | — | 40 | OPCO GRUNDY CENTER IA 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
28| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 19193 | acs median gross | 0 | $758 | 2024-12-31 | CENSUS_ACS5 |
| county 19193 | fmr | 0 | $796 | 2025-10-01 | HUD_USER_FMR |
| county 19193 | acs median gross | 1 | $817 | 2024-12-31 | CENSUS_ACS5 |
| county 19193 | fmr | 1 | $925 | 2025-10-01 | HUD_USER_FMR |
| county 19193 | acs median gross | 2 | $1,005 | 2024-12-31 | CENSUS_ACS5 |
| county 19193 | fmr | 2 | $1,154 | 2025-10-01 | HUD_USER_FMR |
| county 19193 | acs median gross | 3 | $1,137 | 2024-12-31 | CENSUS_ACS5 |
| county 19193 | fmr | 3 | $1,386 | 2025-10-01 | HUD_USER_FMR |
| county 19193 | acs median gross | 4 | $1,317 | 2024-12-31 | CENSUS_ACS5 |
| county 19193 | fmr | 4 | $1,528 | 2025-10-01 | HUD_USER_FMR |
| county 19193 | acs median gross | 5 | $1,217 | 2024-12-31 | CENSUS_ACS5 |
| county 19193 | acs median gross | $981 | 2024-12-31 | CENSUS_ACS5 | |
| county 19193 | acs recent mover gross | $1,215 | 2024-12-31 | CENSUS_ACS5 | |
| zip 51102 | payment standard 110 | 0 | $858 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | payment standard 90 | 0 | $702 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | safmr | 0 | $780 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | payment standard 110 | 1 | $1,001 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | payment standard 90 | 1 | $819 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | safmr | 1 | $910 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | payment standard 110 | 2 | $1,243 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | payment standard 90 | 2 | $1,017 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | safmr | 2 | $1,130 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | payment standard 110 | 3 | $1,496 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | payment standard 90 | 3 | $1,224 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | safmr | 3 | $1,360 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | payment standard 110 | 4 | $1,650 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | payment standard 90 | 4 | $1,350 | 2025-10-01 | HUD_USER_SAFMR |
| zip 51102 | safmr | 4 | $1,500 | 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.