4513 SOUTH PRINCE OF PEACE PLACE, SIOUX FALLS, SD 57103 · CCN 435066 · chain AVERA HEALTH
Composite
43.6 / 100 percentile
Peer group
snf n = 14,684
Evidence depth
deep
Certified beds
126
Model
v1.2
Reads as: riskier than 43.6% 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.
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
5.02
2.96
3.28
2.90–3.77
RN
0.93
0.52
0.39
0.25–0.58
Weekend total
5.14
2.75
3.11
—
Weekday total
4.97
3.06
3.35
—
Quarter
Days
Avg census
Total HPRD
RN
LPN
CNA
Weekend
Contract %
2025Q4
92
117.0
5.02
0.93
0.60
3.49
5.14
0.2%
2025Q3
92
115.3
4.90
0.89
0.57
3.43
4.94
0.2%
2025Q2
91
118.9
4.63
0.88
0.63
3.13
4.55
0.3%
2025Q1
90
118.5
4.74
0.93
0.63
3.17
4.86
0.3%
2024Q4
92
117.1
4.84
0.96
0.62
3.26
4.88
0.1%
2024Q3
92
113.0
4.96
0.95
0.61
3.40
4.98
0.5%
2024Q2
91
108.8
4.97
1.05
0.57
3.35
4.98
0.6%
2024Q1
91
106.6
4.86
1.09
0.56
3.21
5.04
0.0%
2023Q4
92
107.4
4.70
1.18
0.48
3.04
4.68
0.0%
2023Q3
92
107.0
4.36
1.11
0.37
2.88
4.32
0.1%
2023Q2
91
101.8
4.68
1.12
0.54
3.02
4.49
15.5%
2023Q1
90
96.8
4.46
1.20
0.43
2.83
4.35
0.0%
2022Q4
92
94.5
4.27
1.21
0.28
2.78
4.17
0.0%
2022Q3
92
97.5
4.21
1.06
0.34
2.81
4.19
0.0%
2022Q2
91
97.3
4.41
1.06
0.31
3.03
4.32
0.0%
2022Q1
90
94.1
4.36
1.10
0.41
2.84
4.32
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.
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
D
2026-01-22
2025-11-06
Health · complaint
F0628
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
D
2026-01-22
2025-08-21
Health
F0565
Honor the resident's right to organize and participate in resident/family groups in the facility.
E
2025-10-04
2025-08-21
Health
F0583
Keep residents' personal and medical records private and confidential.
E
2025-10-04
2025-08-21
Health
F0600
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
E
2025-10-04
2025-08-21
Health
F0605
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
D
2025-10-04
2025-08-21
Health
F0641
Ensure each resident receives an accurate assessment.
D
2025-10-04
2025-08-21
Health
F0759
Ensure medication error rates are not 5 percent or greater.
D
2025-10-04
2025-08-21
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
2025-10-04
2025-08-21
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2025-10-04
2025-08-21
Health
F0880
Provide and implement an infection prevention and control program.
E
2025-10-04
2025-07-03
Health · complaint
F0610
Respond appropriately to all alleged violations.
D
2025-08-05
2025-07-03
Health · complaint
F0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
2025-08-05
2024-03-14
Health
F0656
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
2024-04-28
2024-03-14
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
2024-04-28
2023-03-30
Health
F0812
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
2023-05-14
2023-03-30
Health
F0880
Provide and implement an infection prevention and control program.
D
2023-04-28
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
47
Owner
Role
Pct
From
Status
Source
AVERA HEALTH
5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
1992-06-15
current
pecos_ownership
BIEGLER, JOSEPH
CORPORATE DIRECTOR
—
2016-07-01
current
pecos_ownership
BUNKERS, JENNIFER
CORPORATE DIRECTOR
—
2021-07-01
current
pecos_ownership
CHRYSTAL, CANDYCE
CORPORATE DIRECTOR
—
2023-07-01
current
pecos_ownership
COSTELLO, JOSEPH
CORPORATE DIRECTOR
—
2017-07-01
current
pecos_ownership
CURRAN, MARY
CORPORATE DIRECTOR
—
2015-07-01
current
pecos_ownership
FISHBACK, VAN
CORPORATE DIRECTOR
—
2018-07-01
current
pecos_ownership
GORDON, JEFFREY
CORPORATE DIRECTOR
—
2023-07-01
current
pecos_ownership
HILL JENSEN, CRISTINA
CORPORATE DIRECTOR
—
2018-07-01
current
pecos_ownership
HINKER, JUSTIN
W-2 MANAGING EMPLOYEE
—
2008-07-21
current
pecos_ownership
KALLEMEYN, BRENDA
CORPORATE DIRECTOR
—
2023-07-01
current
pecos_ownership
KIRBY, JENNIFER
CORPORATE DIRECTOR
—
2020-07-01
current
pecos_ownership
KNECHT, RANDY
CORPORATE DIRECTOR
—
2018-07-01
current
pecos_ownership
KNUTSON, LAURIE
CORPORATE DIRECTOR
—
2017-07-01
current
pecos_ownership
LAUTT, JULIE
CORPORATE OFFICER
—
2020-03-01
current
pecos_ownership
NAZIR, JAWAD
CORPORATE DIRECTOR
—
2020-07-01
current
pecos_ownership
PLACE, RONALD
CORPORATE OFFICER
—
2023-06-05
current
pecos_ownership
RAMIREZ, ALEJANDRO
CORPORATE DIRECTOR
—
2016-07-01
current
pecos_ownership
REINDL, ALISA
CORPORATE DIRECTOR
—
2021-07-01
current
pecos_ownership
SEIFERT, ROXANNE
CORPORATE DIRECTOR
—
2022-07-01
current
pecos_ownership
SOLOMON, BENJAMIN
CORPORATE DIRECTOR
—
2022-07-01
current
pecos_ownership
SUTTON, BOBBY
CORPORATE OFFICER
—
2018-06-18
current
pecos_ownership
WELBIG, LUCILLE
CORPORATE DIRECTOR
—
2014-07-01
current
pecos_ownership
YOCUM, HARRIET
CORPORATE DIRECTOR
—
2021-07-01
current
pecos_ownership
ALEJANDRO RAMIREZ
CORPORATE DIRECTOR
—
2016-07-01
ended 2026-05-18
pecos_ownership
ALISA REINDL
CORPORATE DIRECTOR
—
2021-07-01
ended 2026-05-18
pecos_ownership
BENJAMIN SOLOMON
CORPORATE DIRECTOR
—
2022-07-01
ended 2026-05-18
pecos_ownership
BOBBY SUTTON
CORPORATE OFFICER
—
2018-06-18
ended 2026-05-18
pecos_ownership
BRENDA KALLEMEYN
CORPORATE DIRECTOR
—
2023-07-01
ended 2026-05-18
pecos_ownership
CANDYCE CHRYSTAL
CORPORATE DIRECTOR
—
2023-07-01
ended 2026-05-18
pecos_ownership
CRISTINA HILL JENSEN
CORPORATE DIRECTOR
—
2018-07-01
ended 2026-05-18
pecos_ownership
HARRIET YOCUM
CORPORATE DIRECTOR
—
2021-07-01
ended 2026-05-18
pecos_ownership
JAWAD NAZIR
CORPORATE DIRECTOR
—
2020-07-01
ended 2026-05-18
pecos_ownership
JEFFREY GORDON
CORPORATE DIRECTOR
—
2023-07-01
ended 2026-05-18
pecos_ownership
JENNIFER BUNKERS
CORPORATE DIRECTOR
—
2021-07-01
ended 2026-05-18
pecos_ownership
JENNIFER KIRBY
CORPORATE DIRECTOR
—
2020-07-01
ended 2026-05-18
pecos_ownership
JOSEPH BIEGLER
CORPORATE DIRECTOR
—
2016-07-01
ended 2026-05-18
pecos_ownership
JOSEPH COSTELLO
CORPORATE DIRECTOR
—
2017-07-01
ended 2026-05-18
pecos_ownership
JULIE LAUTT
CORPORATE OFFICER
—
2020-03-01
ended 2026-05-18
pecos_ownership
JUSTIN HINKER
W-2 MANAGING EMPLOYEE
—
2008-07-21
ended 2026-05-18
pecos_ownership
LAURIE KNUTSON
CORPORATE DIRECTOR
—
2017-07-01
ended 2026-05-18
pecos_ownership
LUCILLE WELBIG
CORPORATE DIRECTOR
—
2014-07-01
ended 2026-05-18
pecos_ownership
MARY CURRAN
CORPORATE DIRECTOR
—
2015-07-01
ended 2026-05-18
pecos_ownership
RANDY KNECHT
CORPORATE DIRECTOR
—
2018-07-01
ended 2026-05-18
pecos_ownership
RONALD PLACE
CORPORATE OFFICER
—
2023-06-05
ended 2026-05-18
pecos_ownership
ROXANNE SEIFERT
CORPORATE DIRECTOR
—
2022-07-01
ended 2026-05-18
pecos_ownership
VAN FISHBACK
CORPORATE DIRECTOR
—
2018-07-01
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
35
Geo
Kind
BR
Amount
As of
Source
county 46099
acs median gross
0
$840
2024-12-31
CENSUS_ACS5
county 46099
fmr
0
$865
2025-10-01
HUD_USER_FMR
county 46099
acs median gross
1
$854
2024-12-31
CENSUS_ACS5
county 46099
fmr
1
$986
2025-10-01
HUD_USER_FMR
county 46099
acs median gross
2
$995
2024-12-31
CENSUS_ACS5
county 46099
fmr
2
$1,156
2025-10-01
HUD_USER_FMR
county 46099
acs median gross
3
$1,291
2024-12-31
CENSUS_ACS5
county 46099
fmr
3
$1,586
2025-10-01
HUD_USER_FMR
county 46099
acs median gross
4
$1,755
2024-12-31
CENSUS_ACS5
county 46099
fmr
4
$1,939
2025-10-01
HUD_USER_FMR
county 46099
acs median gross
5
$1,368
2024-12-31
CENSUS_ACS5
county 46099
acs median gross
$978
2024-12-31
CENSUS_ACS5
county 46099
acs recent mover gross
$1,149
2024-12-31
CENSUS_ACS5
zcta 57103
acs median gross
0
$812
2024-12-31
CENSUS_ACS5
zcta 57103
acs median gross
1
$819
2024-12-31
CENSUS_ACS5
zcta 57103
acs median gross
2
$968
2024-12-31
CENSUS_ACS5
zcta 57103
acs median gross
3
$1,293
2024-12-31
CENSUS_ACS5
zcta 57103
acs median gross
4
$1,808
2024-12-31
CENSUS_ACS5
zcta 57103
acs median gross
$942
2024-12-31
CENSUS_ACS5
zcta 57103
acs recent mover gross
$1,236
2024-12-31
CENSUS_ACS5
zip 57103
payment standard 110
0
$902
2025-10-01
HUD_USER_SAFMR
zip 57103
payment standard 90
0
$738
2025-10-01
HUD_USER_SAFMR
zip 57103
safmr
0
$820
2025-10-01
HUD_USER_SAFMR
zip 57103
payment standard 110
1
$1,034
2025-10-01
HUD_USER_SAFMR
zip 57103
payment standard 90
1
$846
2025-10-01
HUD_USER_SAFMR
zip 57103
safmr
1
$940
2025-10-01
HUD_USER_SAFMR
zip 57103
payment standard 110
2
$1,210
2025-10-01
HUD_USER_SAFMR
zip 57103
payment standard 90
2
$990
2025-10-01
HUD_USER_SAFMR
zip 57103
safmr
2
$1,100
2025-10-01
HUD_USER_SAFMR
zip 57103
payment standard 110
3
$1,661
2025-10-01
HUD_USER_SAFMR
zip 57103
payment standard 90
3
$1,359
2025-10-01
HUD_USER_SAFMR
zip 57103
safmr
3
$1,510
2025-10-01
HUD_USER_SAFMR
zip 57103
payment standard 110
4
$2,035
2025-10-01
HUD_USER_SAFMR
zip 57103
payment standard 90
4
$1,665
2025-10-01
HUD_USER_SAFMR
zip 57103
safmr
4
$1,850
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.