Composite
24.6 / 100 percentile
Screener / 245512
A
First Care Living Center
snfMN
900 HILLIGOSS BOULEVARD SOUTHEAST, FOSSTON, MN 56542 · CCN 245512 · chain ESSENTIA HEALTH
Peer group
snf n = 14,684
Evidence depth
moderate
Certified beds
50
Model
v1.2
Reads as: riskier than 24.6% 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 radar1Staffing16Penalties1Deficiencies14Licensure0Ownership34Related party0Transactions0Comps12Market rent34
Composite explanation
3| Component | Percentile | Raw | Weight | Weight share | Contribution | Counts |
|---|---|---|---|---|---|---|
| regulatory risk | 65.4 | 58.1 | 0.30 | 0.4286 | 28.03 | in index |
| staffing risk | 17.2 | 17.3 | 0.25 | 0.3571 | 6.14 | in index |
| chow risk | 19.5 | 24.7 | 0.15 | 0.2143 | 4.18 | 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 | 24.7 | 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. |
| p adverse action 12m | 1.0 | — | 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 | 1.0 | — | 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 | 58.1 | C | v0.3 | default · in composite | Deficiency-based, SNF population. Runs alongside v0.5-pos. |
| staffing risk | 17.3 | A | v0.3 | default · in composite | Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS. |
| regulatory risk | 57.9 | 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 | 57.9 | 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 | 17.3 | 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 | 17.3 | 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)
1.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
60.5
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 | 0.56 | +0.39 | |
| Ownership changes, last 5 years | 0.00 | +0.20 | |
| Total nurse staffing (HPRD) | 4.00 | -0.19 | |
| Chain size (log) | 2.40 | +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)
1.0%
model v0.1 · computed 2026-07-29
Percentile among SNFs
85.8
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 | |
| Occupancy | 0.56 | +0.79 | |
| No PBJ staffing report | 0.00 | +0.39 | |
| Total nurse staffing (HPRD) | 4.00 | -0.33 | |
| Deficiencies, last 12 months | 6.00 | +0.32 | |
| Chain size (log) | 2.40 | -0.19 | |
| Fine amount, 12m (log) | 0.00 | +0.18 | |
| Never sold on record | 1.00 | +0.12 |
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 | MN median | National median | National p25–p75 |
|---|---|---|---|---|
| Total nurse | 4.00 | 3.49 | 3.28 | 2.90–3.77 |
| RN | 0.84 | 0.65 | 0.39 | 0.25–0.58 |
| Weekend total | 3.27 | 3.32 | 3.11 | — |
| Weekday total | 4.28 | 3.59 | 3.35 | — |
| Quarter | Days | Avg census | Total HPRD | RN | LPN | CNA | Weekend | Contract % |
|---|---|---|---|---|---|---|---|---|
| 2025Q4 | 92 | 28.1 | 4.00 | 0.84 | 0.78 | 2.38 | 3.27 | 0.0% |
| 2025Q3 | 92 | 26.0 | 4.33 | 0.94 | 0.81 | 2.59 | 3.36 | 0.0% |
| 2025Q2 | 91 | 24.5 | 4.36 | 0.95 | 0.69 | 2.72 | 3.65 | 0.0% |
| 2025Q1 | 90 | 27.6 | 4.17 | 0.83 | 0.70 | 2.64 | 3.48 | 0.0% |
| 2024Q4 | 92 | 27.6 | 3.94 | 0.70 | 0.68 | 2.56 | 3.13 | 0.0% |
| 2024Q3 | 92 | 28.8 | 3.84 | 0.52 | 0.77 | 2.56 | 3.16 | 0.0% |
| 2024Q2 | 91 | 30.8 | 4.17 | 0.43 | 1.10 | 2.64 | 3.47 | 0.0% |
| 2024Q1 | 91 | 32.6 | 3.80 | 0.46 | 1.07 | 2.27 | 3.15 | 0.0% |
| 2023Q4 | 92 | 31.1 | 4.04 | 0.40 | 1.04 | 2.60 | 3.50 | 0.0% |
| 2023Q3 | 92 | 34.3 | 3.68 | 0.33 | 1.07 | 2.27 | 3.14 | 0.0% |
| 2023Q2 | 91 | 33.6 | 3.75 | 0.40 | 1.03 | 2.33 | 3.01 | 0.0% |
| 2023Q1 | 90 | 28.3 | 4.57 | 0.48 | 1.19 | 2.90 | 4.17 | 0.0% |
| 2022Q4 | 92 | 29.9 | 4.59 | 0.66 | 1.16 | 2.77 | 3.97 | 0.0% |
| 2022Q3 | 92 | 31.3 | 4.41 | 0.68 | 1.21 | 2.52 | 3.73 | 0.0% |
| 2022Q2 | 91 | 32.3 | 4.21 | 0.60 | 1.04 | 2.56 | 3.52 | 0.0% |
| 2022Q1 | 90 | 29.1 | 4.53 | 0.53 | 1.31 | 2.70 | 3.94 | 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
1| Date | Type | Fine | Source |
|---|---|---|---|
| 2024-04-26 | Fine | $14,433 | CMS provider data |
Total fines on record: $14,433
Deficiencies
14D × 12E × 1J × 1
deficiencies by survey year
| Survey | Type | Tag | Deficiency | Scope | Corrected |
|---|---|---|---|---|---|
| 2025-07-30 | Health | F0637 | Assess the resident when there is a significant change in condition | D | 2025-08-10 |
| 2025-07-30 | 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 | 2025-08-10 |
| 2025-07-30 | Health | F0676 | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | 2025-08-01 |
| 2025-07-30 | Health | F0688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | 2025-08-01 |
| 2025-07-30 | Health | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2025-08-05 |
| 2025-07-30 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2025-07-30 |
| 2024-06-06 | Health | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | 2024-06-30 |
| 2024-06-06 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2024-06-30 |
| 2024-04-26 | Health · complaint | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | 2024-05-13 |
| 2023-08-17 | Health | F0641 | Ensure each resident receives an accurate assessment. | D | 2023-09-20 |
| 2023-08-17 | Health | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2023-09-15 |
| 2023-08-17 | Health | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2023-09-12 |
| 2023-08-17 | Health | F0880 | Provide and implement an infection prevention and control program. | D | 2023-09-15 |
| 2023-08-17 | Health | F0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | E | 2023-09-20 |
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
34| Owner | Role | Pct | From | Status | Source |
|---|---|---|---|---|---|
| ARVIN, DOUGLAS | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-05-08 | current | pecos_ownership |
| ARVIN, DOUGLAS | ADP OF THE SNF | — | 2023-05-18 | current | pecos_ownership |
| CHRISTENSEN, JAMES | CORPORATE DIRECTOR | — | 2020-01-01 | current | pecos_ownership |
| CURTIS, MICHAEL | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-07-08 | current | pecos_ownership |
| ESSENTIA HEALTH | ADP OF THE SNF | — | 2025-01-29 | current | pecos_ownership |
| GEFROH ELLISON, STEFANIE | CORPORATE OFFICER | — | 2024-08-12 | current | pecos_ownership |
| GUPTA, PARUL | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-09-02 | current | pecos_ownership |
| HAUGEN, JOEL | CORPORATE DIRECTOR | — | 2017-01-01 | current | pecos_ownership |
| HEILMAN, TIM | CORPORATE DIRECTOR | — | 2020-01-01 | current | pecos_ownership |
| HORN, BEVERLY | CORPORATE DIRECTOR | — | 2017-01-01 | current | pecos_ownership |
| HURLEY, ALAN | CORPORATE OFFICER | — | 2023-05-18 | current | pecos_ownership |
| INNOVIS HEALTH LLC | OPERATIONAL/MANAGERIAL CONTROL | — | 2017-01-01 | current | pecos_ownership |
| INNOVIS HEALTH LLC | ADP OF THE SNF | — | 2025-01-29 | current | pecos_ownership |
| JACKSON, AARICK | CORPORATE DIRECTOR | — | 2020-01-01 | current | pecos_ownership |
| LEWANDOWSKI, LAURIE | CORPORATE DIRECTOR | — | 2017-01-01 | current | pecos_ownership |
| MERTZ, TAYLOR | CORPORATE DIRECTOR | — | 2022-05-17 | current | pecos_ownership |
| SMITH, BENJAMIN | CORPORATE DIRECTOR | — | 2022-05-17 | current | pecos_ownership |
| WATTERS, MICHAEL | CORPORATE OFFICER | — | 2023-07-01 | current | pecos_ownership |
| ESSENTIA HEALTH | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% | 2017-01-01 | ended 2026-05-18 | pecos_ownership |
| AARICK JACKSON | CORPORATE DIRECTOR | 0% | 2020-01-01 | ended 2026-05-18 | pecos_ownership |
| JAMES CHRISTENSEN | CORPORATE DIRECTOR | 0% | 2020-01-01 | ended 2026-05-18 | pecos_ownership |
| TIM HEILMAN | CORPORATE DIRECTOR | 0% | 2020-01-01 | ended 2026-05-18 | pecos_ownership |
| ALAN HURLEY | ADP OF THE SNF | — | 2023-05-18 | ended 2026-05-18 | pecos_ownership |
| BENJAMIN SMITH | CORPORATE DIRECTOR | — | 2022-05-17 | ended 2026-05-18 | pecos_ownership |
| BEVERLY HORN | CORPORATE DIRECTOR | — | 2017-01-01 | ended 2026-05-18 | pecos_ownership |
| DOUGLAS ARVIN | ADP OF THE SNF | — | 2023-05-18 | ended 2026-05-18 | pecos_ownership |
| DOUGLAS ARVIN | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-05-08 | ended 2026-05-18 | pecos_ownership |
| JOEL HAUGEN | CORPORATE DIRECTOR | — | 2017-01-01 | ended 2026-05-18 | pecos_ownership |
| LAURIE LEWANDOWSKI | CORPORATE DIRECTOR | — | 2017-01-01 | ended 2026-05-18 | pecos_ownership |
| MICHAEL CURTIS | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-07-08 | ended 2026-05-18 | pecos_ownership |
| MICHAEL WATTERS | CORPORATE OFFICER | — | 2023-07-01 | ended 2026-05-18 | pecos_ownership |
| PARUL GUPTA | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-09-02 | ended 2026-05-18 | pecos_ownership |
| STEFANIE GEFROH ELLISON | CORPORATE OFFICER | — | 2024-08-12 | ended 2026-05-18 | pecos_ownership |
| TAYLOR MERTZ | CORPORATE DIRECTOR | — | 2022-05-17 | 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 — MN snf
12| Close | Facility | Price | $/bed | Cap rate | Beds | Buyer |
|---|---|---|---|---|---|---|
| 2025-07-22 | CURA OF ONAMIA | — | — | — | 57 | CURA OF ONAMIA LLC |
| 2024-12-01 | SHAKOPEE FRIENDSHIP MANOR | — | — | — | 60 | SHAKOPEE CARE LLC |
| 2024-12-01 | EDENBROOK ROCHESTER WEST | — | — | — | 48 | EDENBROOK ROCHESTER WEST LLC |
| 2024-10-29 | Cura of Sauk Centre | — | — | — | 60 | CURA OF SAUK CENTRE LLC |
| 2024-10-15 | Heartwood | — | — | — | 54 | CROSBY SENIOR SERVICES CARE CENTER |
| 2024-02-13 | Cura of Monticello | — | — | — | 67 | CURA OF MONTICELLO LLC |
| 2023-12-31 | MAPLEWOOD REHABILITATION CENTER | — | — | — | 115 | MAPLEWOOD REHABILITATION CENTER LLC |
| 2023-12-31 | SLEEPY EYE REHABILITATI CENTER | — | — | — | 61 | SLEEPY EYE REHABILITATION CENTER LLC |
| 2023-12-15 | ST BENEDICTS CARE CENTER | — | — | — | 75 | ECUMEN SBC ST CLOUD PROPERTIES LLC |
| 2023-12-01 | Frazee Care Center | — | — | — | 42 | LEGACY SENIOR SERVICES |
| 2023-06-05 | CURA OF LE SUEUR | — | — | — | 50 | CURA OF LE SUEUR LLC |
| 2023-05-01 | LAKEHOUSE HEALTHCARE & REHABILITATION CENTER | — | — | — | 260 | LAKE HARRIET OPERATOR 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
34| Geo | Kind | BR | Amount | As of | Source |
|---|---|---|---|---|---|
| county 27119 | acs median gross | 0 | $424 | 2024-12-31 | CENSUS_ACS5 |
| county 27119 | fmr | 0 | $863 | 2025-10-01 | HUD_USER_FMR |
| county 27119 | acs median gross | 1 | $659 | 2024-12-31 | CENSUS_ACS5 |
| county 27119 | fmr | 1 | $868 | 2025-10-01 | HUD_USER_FMR |
| county 27119 | acs median gross | 2 | $836 | 2024-12-31 | CENSUS_ACS5 |
| county 27119 | fmr | 2 | $1,089 | 2025-10-01 | HUD_USER_FMR |
| county 27119 | acs median gross | 3 | $1,097 | 2024-12-31 | CENSUS_ACS5 |
| county 27119 | fmr | 3 | $1,515 | 2025-10-01 | HUD_USER_FMR |
| county 27119 | acs median gross | 4 | $1,408 | 2024-12-31 | CENSUS_ACS5 |
| county 27119 | fmr | 4 | $1,827 | 2025-10-01 | HUD_USER_FMR |
| county 27119 | acs median gross | 5 | $708 | 2024-12-31 | CENSUS_ACS5 |
| county 27119 | acs median gross | $855 | 2024-12-31 | CENSUS_ACS5 | |
| county 27119 | acs recent mover gross | $796 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 56542 | acs median gross | 1 | $663 | 2024-12-31 | CENSUS_ACS5 |
| zcta 56542 | acs median gross | 2 | $795 | 2024-12-31 | CENSUS_ACS5 |
| zcta 56542 | acs median gross | 3 | $950 | 2024-12-31 | CENSUS_ACS5 |
| zcta 56542 | acs median gross | 4 | $1,338 | 2024-12-31 | CENSUS_ACS5 |
| zcta 56542 | acs median gross | $788 | 2024-12-31 | CENSUS_ACS5 | |
| zcta 56542 | acs recent mover gross | $714 | 2024-12-31 | CENSUS_ACS5 | |
| zip 56542 | payment standard 110 | 0 | $880 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | payment standard 90 | 0 | $720 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | safmr | 0 | $800 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | payment standard 110 | 1 | $891 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | payment standard 90 | 1 | $729 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | safmr | 1 | $810 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | payment standard 110 | 2 | $1,111 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | payment standard 90 | 2 | $909 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | safmr | 2 | $1,010 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | payment standard 110 | 3 | $1,540 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | payment standard 90 | 3 | $1,260 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | safmr | 3 | $1,400 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | payment standard 110 | 4 | $1,859 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | payment standard 90 | 4 | $1,521 | 2025-10-01 | HUD_USER_SAFMR |
| zip 56542 | safmr | 4 | $1,690 | 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.