Awe Kualawaache Care Center

10131 S Heritage Rd, Crow Agency, MT 59022 (opens Google Maps) · Big Horn County · (406) 638-9111· 40 certified beds · avg 24 residents/day · certified since Jun 9, 1998 · Medicare and Medicaid certified

Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →

5/5

Health inspection rating (on-site)

inspected Jun 4, 2026

Serious findings on record

Fines, last 3 years

4.78

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

New to these records? How to read an inspection report →

Health inspection rating: ★★★★★5/5 · CMS overall rating: 4/5 · how star ratings work →

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and quality measures from resident assessments and claims.

Inspection findings in the public record

Showing the latest 3 of 18 inspection findings. Open the full record below to read every finding.

Jun 4, 2026D · Potential for more than minimal harm, isolated
The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. F-0656
Jun 4, 2026D · Potential for more than minimal harm, isolated
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint F-0689
Jun 4, 2026D · Potential for more than minimal harm, isolated
The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. F-0692

View all 18 inspection findingsShow only the latest 3 findings

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.

Date	Severity	What the facility was cited for
Jun 4, 2026	D · Potential for more than minimal harm, isolated	The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · F-0656
Jun 4, 2026	D · Potential for more than minimal harm, isolated	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Jun 4, 2026	D · Potential for more than minimal harm, isolated	The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. · F-0692
Jun 4, 2026	D · Potential for more than minimal harm, isolated	The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason. · F-0757
Jun 4, 2026	D · Potential for more than minimal harm, isolated	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880
May 8, 2025	F · Potential for more than minimal harm, widespread	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880
May 8, 2025	D · Potential for more than minimal harm, isolated	The facility did not provide required paperwork or notices about a resident's needs, their right to appeal a transfer or discharge, or the facility's bed-hold policy (how long a bed is saved during a hospital stay). · F-0628
Dec 4, 2024	D · Potential for more than minimal harm, isolated	The facility used physical restraints — devices that limit a resident's movement — when they weren't needed for medical treatment. · from a complaint · F-0604
Dec 4, 2024	D · Potential for more than minimal harm, isolated	The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · from a complaint · F-0657
Dec 4, 2024	D · Potential for more than minimal harm, isolated	The facility did not make sure its nurses and nurse aides had the skills and training needed to properly care for every resident. · from a complaint · F-0726
Jul 30, 2024	E · Potential for more than minimal harm, pattern	The facility did not conduct and document a facility-wide assessment of what staff, supplies, and resources it needs to care for its residents properly — during everyday operations, nights, weekends, and emergencies. · from a complaint · F-0838
Jul 30, 2024	E · Potential for more than minimal harm, pattern	The facility did not provide its staff with required training on behavioral health — caring for residents with conditions like dementia, depression, or other mental health needs. · from a complaint · F-0949
Jul 30, 2024	D · Potential for more than minimal harm, isolated	The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint · F-0600
Jul 30, 2024	D · Potential for more than minimal harm, isolated	The facility did not provide necessary behavioral health care and services — support for residents' mental and emotional wellbeing, including conditions like depression and anxiety. · from a complaint · F-0740
Jul 30, 2024	D · Potential for more than minimal harm, isolated	The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits. · from a complaint · F-0758
Apr 25, 2024	D · Potential for more than minimal harm, isolated	The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · F-0657
Apr 25, 2024	D · Potential for more than minimal harm, isolated	The facility did not make sure its nurses and nurse aides had the skills and training needed to properly care for every resident. · from a complaint · F-0726
Apr 25, 2024	B · Potential for minimal harm, pattern	The facility did not electronically submit complete and accurate staffing information to the government, based on payroll and other verifiable records. · F-0851

Inspection trend by year

Citations from standard inspections increased between the last two inspection cycles (2 → 5).

Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01

All citationsSerious citations (G–L)

2024

2025

2026

All bars start at zero. Exact values and supporting details remain below.

Year	Citations	Worst severity that year
2024	11	E
2025	2	F
2026	5	D

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

How to file a complaint about care →

No fines or payment denials in the published 3-year window.

Nurse staffing (from payroll records, adjusted for how much care residents need)

What these staffing numbers mean →

Nurse time, in contextAdjusted hours per resident per day · Source: CMS, 2026-08-01

This facilityMontana averageU.S. average

Total nurse staffing (hours per resident per day)

4.78

4.82

3.95

Registered Nurse hours

1.65

1.17

0.69

Weekend total nurse staffing

3.99

4.26

3.50

All bars start at zero. Exact values and supporting details remain below.

Measure	This facility	Montana avg	U.S. avg	Where it stands
Total nurse staffing (hours per resident per day)	4.78	4.82	3.95	top 43% in Montana; top 17% in the U.S.
Registered Nurse hours	1.65	1.17	0.69	top 19% in Montana; top 3% in the U.S.
Weekend total nurse staffing	3.99	4.26	3.50	top 48% in Montana; top 23% in the U.S.
Weekend RN hours (not acuity-adjusted)	0.96	0.71	0.48	top 19% in Montana; top 7% in the U.S.
Total nursing staff turnover (%)	61.5	54.8	45.8	bottom 26% in Montana; bottom 14% in the U.S.
RN turnover (%)	44.4	48.3	42.9	top 45% in Montana; bottom 45% in the U.S.

Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 4.08, RN 1.41, weekend 3.41.Comparing with Medicare Care Compare? Care Compare shows the raw figure (4.08 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 4/5.

Quality measures: assessments & claims

Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.

Quality measures rating: 1/5 · long-stay residents: 1/5 · short-stay residents: —/5

Costs & payment

Price evidence · separate from quality

No verified facility-specific private-pay price is available in our data for Awe Kualawaache Care Center. CMS inspection and staffing records do not tell us what this home will charge you.

Calculate a stay from a quote you receive

Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.

Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.

Before you compare prices

Request the room type, effective date and itemized daily rate in writing.
Ask about therapy, medicines, supplies, care-level charges, deposits, refunds and annual increases.
Confirm insurance or Medicaid eligibility and bed availability directly; certification alone does not guarantee either.

Understand who pays for care · How we handle price evidence · Report an incorrect price

Who owns this facility

How to read ownership records →

Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →

For profit - Individual

Owner / manager	Type	Role	Stake	Since
Crow Tribe of Indians	Organization	5% or Greater Direct Ownership Interest	100%	04/01/1998
Health Management Services, LLC	Organization	Operational/Managerial Control	NOT APPLICABLE	03/10/2010
Little Light, Paul	Individual	W-2 Managing Employee	NOT APPLICABLE	05/15/2015

All 3 owning or managing parties CMS has on file are shown — none excluded.

Questions to ask on your visit

Full visit checklist →

Print visit checklist

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

"Can you show me an example care plan, and how are families included when it's created and updated?"
"What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
"How do you monitor residents' weight and eating, and what happens when someone starts losing weight?"
"How often is each resident's medication list reviewed, and who decides when a drug can be reduced or stopped?"
"Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
"What written notices do we get before any transfer or discharge, and what is your bed-hold policy?"
"What is your policy on physical restraints, and what alternatives do you try first?"
"Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"

Also worth asking anywhere

"What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
"Can I see the plan of correction for the findings in your most recent state inspection?"
"CMS reports 62% total nursing staff turnover here — who on the care team has been with you longest?"
"Can I visit again unannounced, at a mealtime or on a weekend?"

Nearby facilities

This is the only Medicare-certified nursing home within 40 miles. The nearest other one is River Ridge Rehabilitation and Nursing LLC in Billings, MT — 51 miles away in a straight line.

Straight-line distance is not travel distance. The road route is longer, and in some regions there is no road. Check the actual journey before ruling this option in or out.

All facilities in Crow Agency →

Facility data as of CMS processing date 2026-08-01. CCN 275153.

This page is the printable visit checklist. If your browser did not open the print dialog automatically, use File → Print (Ctrl/⌘-P).

The Care File

Visit checklist — Awe Kualawaache Care Center

10131 S Heritage Rd, Crow Agency, MT 59022 · (406) 638-9111

Health inspection rating 5/5 · CMS overall 4/5· Fines (3y): $0

Questions for the administrator:

☐ "Can you show me an example care plan, and how are families included when it's created and updated?"
☐ "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
☐ "How do you monitor residents' weight and eating, and what happens when someone starts losing weight?"
☐ "How often is each resident's medication list reviewed, and who decides when a drug can be reduced or stopped?"
☐ "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
☐ "What written notices do we get before any transfer or discharge, and what is your bed-hold policy?"
☐ "What is your policy on physical restraints, and what alternatives do you try first?"
☐ "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
☐ "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
☐ "Can I see the plan of correction for the findings in your most recent state inspection?"
☐ "CMS reports 62% total nursing staff turnover here — who on the care team has been with you longest?"
☐ "Can I visit again unannounced, at a mealtime or on a weekend?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 275153 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)