Screener / 435062

Alcester Care And Rehab Center, Inc

snfSD

101 CHURCH STREET, ALCESTER, SD 57001 · CCN 435062 · chain CARING PROFESSIONALS INC

Composite

11.7 / 100 percentile

Peer group

snf n = 14,684

Evidence depth

deep

Certified beds

Model

v1.2

Reads as: riskier than 11.7% 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 model5 Components14 CHOW radar1 Distress radar1 Staffing16 Penalties0 Deficiencies11 Licensure0 Ownership8 Related party2 Transactions0 Comps12 Market rent33

Composite explanation

Component	Percentile	Raw	Weight	Weight share	Contribution	Counts
staffing risk	85.5	85.5	0.25	0.1923	16.44	in index
financial risk	47.4	43.9	0.30	0.2308	10.94	in index
regulatory risk	7.9	5.0	0.30	0.2308	1.82	in index
chow risk	14.6	18.8	0.15	0.1154	1.68	in index
billing conduct	0.0	0.0	0.30	0.2308	0.00	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

Score type	Score	Grade	Model	Status	Registry model notes
billing conduct	0.0	A	v0.1-pacpuf-snf	default · in composite	R22. PAC PUF SNF 2023. PDPM coding intensity vs acuity, stay length, charge markup.
chow risk	24.4	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.
chow risk	13.2	A	v0.6	default · in composite
financial risk	43.9	B	v0.5	default · in composite	R18.
p adverse action 12m	0.2	—	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	4.0	—	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	5.0	A	v0.3	default · in composite	Deficiency-based, SNF population. Runs alongside v0.5-pos.
staffing risk	85.5	F	v0.3	default · in composite	Cost-report staffing, SNF population. Runs alongside v0.4-pos, which covers ICF/IID from POS.
financial risk	62.6	C	v0.3	superseded	Pre-registry model iteration, superseded by a later financial_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.
financial risk	45.1	C	v0.4	superseded	Pre-registry model iteration, superseded by a later financial_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	4.9	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	4.9	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.
staffing risk	85.5	F	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	85.5	F	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)

4.0%

model v0.1 · computed 2026-07-29

Percentile among SNFs

84.5

100 = most likely to sell

Holdout AUC

0.874

evaluated before shipping, never refit

Driver	Value	Pull on odds
For-profit ownership	1.00	+0.69
Never sold on record	1.00	+0.62
Current owner tenure (years)	25.00	+0.57
Occupancy	0.86	-0.47
No PBJ staffing report	0.00	+0.42
Ownership changes, last 5 years	0.00	+0.20
Deficiencies, last 12 months	0.00	-0.17
Contract staffing share	0.12	+0.09

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)

0.2%

model v0.1 · computed 2026-07-29

Percentile among SNFs

59.2

100 = most likely to lose certification

Holdout AUC

0.971

top decile caught 95% of actual exits

Driver	Value	Pull on odds
Deficiencies, last 12 months	0.00	+1.43
For-profit ownership	1.00	-0.69
Occupancy	0.86	-0.47
No PBJ staffing report	0.00	+0.39
Total nurse staffing (HPRD)	2.67	+0.23
Fine amount, 12m (log)	0.00	+0.18
Chain size (log)	2.30	-0.14
Staffing trend, last 4 quarters	-0.22	-0.13

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

2025Q4 HPRD	This facility	SD median	National median	National p25–p75
Total nurse	2.67	2.96	3.28	2.90–3.77
RN	0.35	0.52	0.39	0.25–0.58
Weekend total	2.35	2.75	3.11	—
Weekday total	2.80	3.06	3.35	—

Quarter	Days	Avg census	Total HPRD	RN	LPN	CNA	Weekend	Contract %
2025Q4	92	37.9	2.67	0.35	0.51	1.81	2.35	12.1%
2025Q3	92	38.3	2.82	0.35	0.51	1.96	2.46	13.9%
2025Q2	91	37.1	2.98	0.47	0.40	2.11	2.50	18.1%
2025Q1	90	36.4	2.80	0.47	0.44	1.89	2.25	25.5%
2024Q4	92	35.8	2.89	0.43	0.51	1.95	2.44	29.9%
2024Q3	92	35.3	2.81	0.42	0.50	1.88	2.45	22.8%
2024Q2	91	35.5	2.98	0.43	0.50	2.04	2.63	15.6%
2024Q1	91	38.2	2.73	0.42	0.46	1.85	2.55	13.8%
2023Q4	92	37.2	2.06	0.32	0.29	1.45	1.90	0.0%
2023Q3	92	36.8	2.53	0.39	0.37	1.77	2.26	23.4%
2023Q2	91	34.2	2.98	0.44	0.51	2.02	2.62	14.4%
2023Q1	90	34.1	2.92	0.42	0.54	1.95	2.67	14.3%
2022Q4	92	32.8	2.21	0.24	0.45	1.52	1.95	13.5%
2022Q3	92	35.0	3.01	0.41	0.58	2.03	2.78	5.9%
2022Q2	91	31.4	2.18	0.29	0.38	1.50	1.90	8.2%
2022Q1	90	33.0	2.69	0.42	0.48	1.79	2.49	5.8%

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

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

D × 8F × 2H × 1

deficiencies by survey year

Survey	Type	Tag	Deficiency	Scope	Corrected
2024-06-11	Health · complaint	F0689	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	D	2024-06-10
2024-04-30	Health	F0658	Ensure services provided by the nursing facility meet professional standards of quality.	D	2024-06-14
2023-09-26	Health · complaint	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	2023-11-10
2023-09-26	Health · complaint	F0658	Ensure services provided by the nursing facility meet professional standards of quality.	D	2023-11-10
2023-09-26	Health · complaint	F0698	Provide safe, appropriate dialysis care/services for a resident who requires such services.	D	2023-11-10
2023-06-06	Health · complaint	F0700	Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.	H	2023-06-23
2023-03-09	Health	F0578	Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.	D	2023-04-15
2023-03-09	Health	F0695	Provide safe and appropriate respiratory care for a resident when needed.	D	2023-04-15
2023-03-09	Health	F0700	Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.	D	2023-04-15
2023-03-09	Health	F0727	Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.	F	2023-04-15
2023-03-09	Health	F0880	Provide and implement an infection prevention and control program.	F	2023-04-15

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

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

Owner	Role	Pct	From	Status	Source
CARING PROFESSIONALS INC	TRUSTEE OF THE SNF	—	2015-02-01	current	pecos_ownership
MILLER, TIFFANY	MANAGING CONTROL - GOVERNING BODY	—	2020-12-30	current	pecos_ownership
ROHLFS, KARSTEN	ADP OF THE SNF	—	2024-10-01	current	pecos_ownership
STROSCHEIN PROPERTIES III LLC	5% OR GREATER DIRECT OWNERSHIP INTEREST	—	2015-02-01	current	pecos_ownership
STROSCHEIN, CHAD	5% OR GREATER DIRECT OWNERSHIP INTEREST	—	2015-02-01	current	pecos_ownership
CHAD STROSCHEIN	5% OR GREATER DIRECT OWNERSHIP INTEREST	100%	2015-02-01	ended 2026-05-18	pecos_ownership
TIFFANY MILLER	CORPORATE DIRECTOR	50%	2020-12-30	ended 2026-05-18	pecos_ownership
KARSTEN ROHLFS	ADP OF THE SNF	—	2024-10-01	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

FY end	Total allowable	Rent	Home office	Therapy	Staffing	Counterparties	PropCo
2024-12-31	$26,963	—	—	—	—	1	—
2023-12-31	$12,916	—	—	—	—	1	—

Cost-report related-party spend by fiscal year. has_propco flags real-estate counterparties.

Transactions

No 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 — SD snf

Close	Facility	Price	$/bed	Cap rate	Beds	Buyer
2023-08-31	RIVERVIEW HEALTHCARE CENTER	—	—	—	63	RIVERVIEW SNF OPERATIONS, LLC
2023-08-31	Wheatcrest Hills Healthcare Center	—	—	—	60	WHEATCREST HILLS SNF OPERATIONS, LLC
2023-08-31	PALISADE HEALTHCARE CENTER	—	—	—	55	PALISADE SNF OPERATIONS, LLC
2023-08-31	PRAIRIE VIEW HEALTHCARE CENTER	—	—	—	42	PRAIRIE VIEW SNF OPERATIONS, LLC
2023-08-31	FIRESTEEL HEALTHCARE CENTER	—	—	—	125	FIRESTEEL SNF OPERATIONS, LLC
2023-08-31	Fountain Springs Healthcare	—	—	—	90	FOUNTAIN SPRINGS SNF OPERATIONS, LLC
2019-10-02	AVANTARA NORTON	—	—	—	110	NORTON SD SKILLED NURSING FACILITY LLC
2019-10-02	AVANTARA HURON	—	—	—	119	HURON SD SKILLED NURSING FACILITY, LLC
2019-10-01	DIAMOND CARE CENTER	—	—	—	36	BRIDGEWATER NURSING HOME CORPORATION
2019-07-01	AVANTARA SAINT CLOUD	—	—	—	78	SAINT CLOUD SD SKILLED NURSING FACILITY, LLC
2019-07-01	AVANTARA WATERTOWN	—	—	—	51	WATERTOWN SD SKILLED NURSING FACILITY, LLC
2019-07-01	AVANTARA CLARK CITY	—	—	—	35	CLARK CITY SD SKILLED NURSING FACILITY 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

Geo	Kind	BR	Amount	As of	Source
county 46127	fmr	0	$796	2025-10-01	HUD_USER_FMR
county 46127	acs median gross	1	$963	2024-12-31	CENSUS_ACS5
county 46127	fmr	1	$925	2025-10-01	HUD_USER_FMR
county 46127	acs median gross	2	$1,123	2024-12-31	CENSUS_ACS5
county 46127	fmr	2	$1,154	2025-10-01	HUD_USER_FMR
county 46127	acs median gross	3	$1,119	2024-12-31	CENSUS_ACS5
county 46127	fmr	3	$1,386	2025-10-01	HUD_USER_FMR
county 46127	acs median gross	4	$1,417	2024-12-31	CENSUS_ACS5
county 46127	fmr	4	$1,528	2025-10-01	HUD_USER_FMR
county 46127	acs median gross	5	$1,275	2024-12-31	CENSUS_ACS5
county 46127	acs median gross		$1,069	2024-12-31	CENSUS_ACS5
county 46127	acs recent mover gross		$1,089	2024-12-31	CENSUS_ACS5
zcta 57001	acs median gross	1	$608	2024-12-31	CENSUS_ACS5
zcta 57001	acs median gross	2	$679	2024-12-31	CENSUS_ACS5
zcta 57001	acs median gross	3	$938	2024-12-31	CENSUS_ACS5
zcta 57001	acs median gross	4	$1,693	2024-12-31	CENSUS_ACS5
zcta 57001	acs median gross		$839	2024-12-31	CENSUS_ACS5
zcta 57001	acs recent mover gross		$694	2024-12-31	CENSUS_ACS5
zip 57001	payment standard 110	0	$748	2025-10-01	HUD_USER_SAFMR
zip 57001	payment standard 90	0	$612	2025-10-01	HUD_USER_SAFMR
zip 57001	safmr	0	$680	2025-10-01	HUD_USER_SAFMR
zip 57001	payment standard 110	1	$880	2025-10-01	HUD_USER_SAFMR
zip 57001	payment standard 90	1	$720	2025-10-01	HUD_USER_SAFMR
zip 57001	safmr	1	$800	2025-10-01	HUD_USER_SAFMR
zip 57001	payment standard 110	2	$1,078	2025-10-01	HUD_USER_SAFMR
zip 57001	payment standard 90	2	$882	2025-10-01	HUD_USER_SAFMR
zip 57001	safmr	2	$980	2025-10-01	HUD_USER_SAFMR
zip 57001	payment standard 110	3	$1,408	2025-10-01	HUD_USER_SAFMR
zip 57001	payment standard 90	3	$1,152	2025-10-01	HUD_USER_SAFMR
zip 57001	safmr	3	$1,280	2025-10-01	HUD_USER_SAFMR
zip 57001	payment standard 110	4	$1,716	2025-10-01	HUD_USER_SAFMR
zip 57001	payment standard 90	4	$1,404	2025-10-01	HUD_USER_SAFMR
zip 57001	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.