Montana ›Billings

Yellowstone River Nursing and Rehabilitation

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2115 Central Ave, Billings, MT 59102 (opens Google Maps) · Yellowstone County · (406) 656-6500· 160 certified beds · avg 116 residents/day · certified since Oct 1, 1969 · 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 →

Part of chain: EDURO HEALTHCARE (34 facilities, chain avg rating 2.4★)

1/5
Health inspection rating (on-site)
inspected Aug 28, 2025
6
Serious findings on record
most recent May 6, 2026
$142,698
Fines, last 3 years
3.55
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: ★☆☆☆☆1/5 · CMS overall rating: 1/5 · 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.

Most serious findings (actual harm or immediate jeopardy)

▲ Immediate jeopardy, isolated · Jun 5, 2025 · F-0689 · triggered by a complaint

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Jun 20, 2025 (Deficient, Provider has date of correction)

▲ Actual harm, isolated · May 6, 2026 · F-0689 · triggered by a complaint

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Mar 7, 2026 (Past Non-Compliance)

▲ Actual harm, isolated · May 6, 2026 · F-0760 · triggered by a complaint

The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication.

Why it matters: A serious medication error can cause real harm, hospitalization, or worse.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: May 22, 2026 (Deficient, Provider has date of correction)

▲ Actual harm, isolated · Aug 28, 2025 · F-0686

The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.

Why it matters: Bedsores are painful, can become deeply infected, and in serious cases can be life-threatening.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Sep 19, 2025 (Deficient, Provider has date of correction)

▲ Actual harm, isolated · Aug 28, 2025 · F-0692

The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration.

Why it matters: Malnutrition and dehydration can quickly weaken a resident and lead to serious complications.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Sep 19, 2025 (Deficient, Provider has date of correction)

▲ Actual harm, isolated · Jun 22, 2023 · F-0689

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Jul 21, 2023 (Deficient, Provider has date of correction)

Inspection findings in the public record

Showing the latest 3 of 58 inspection findings. Open the full record below to read every finding.

  1. G · Actual 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

  2. G · Actual harm, isolated

    The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · from a complaint F-0760

  3. D · Potential for more than minimal harm, isolated

    The facility did not reassess a resident after a significant change in their condition, such as a sudden decline in health. A full new assessment is required when a resident's condition changes in a major way. · from a complaint F-0637

View all 58 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.

DateSeverityWhat the facility was cited for
May 6, 2026▲ G · Actual harm, isolatedThe 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
May 6, 2026▲ G · Actual harm, isolatedThe facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · from a complaint · F-0760
May 6, 2026D · Potential for more than minimal harm, isolatedThe facility did not reassess a resident after a significant change in their condition, such as a sudden decline in health. A full new assessment is required when a resident's condition changes in a major way. · from a complaint · F-0637
May 6, 2026D · Potential for more than minimal harm, isolatedThe facility did not properly complete the required screening (called PASARR) that identifies whether a person entering a nursing home has a mental illness or intellectual disability and needs specialized services. · from a complaint · F-0645
May 6, 2026D · Potential for more than minimal harm, isolatedThe facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. · from a complaint · F-0692
May 6, 2026D · Potential for more than minimal harm, isolatedThe facility did not provide safe, appropriate care for residents who need dialysis — the treatment that filters the blood when kidneys fail. · from a complaint · F-0698
Dec 31, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · from a complaint · F-0677
Nov 19, 2025E · Potential for more than minimal harm, patternThe facility has more than 120 beds but did not hire a qualified full-time social worker as required. · from a complaint · F-0850
Nov 19, 2025D · Potential for more than minimal harm, isolatedThe 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. · from a complaint · F-0656
Nov 19, 2025D · Potential for more than minimal harm, isolatedThe facility did not make sure the resident's doctor reviewed their care and wrote, signed, and dated progress notes and orders at each required visit. · from a complaint · F-0711
Nov 19, 2025D · Potential for more than minimal harm, isolatedThe 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
Nov 19, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide the social services residents need — such as counseling, help with adjustment, or connecting to outside resources — to achieve the best possible quality of life. · from a complaint · F-0745
Aug 28, 2025▲ G · Actual harm, isolatedThe facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · F-0686
Aug 28, 2025▲ G · Actual harm, isolatedThe facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. · F-0692
Aug 28, 2025E · Potential for more than minimal harm, patternThe facility did not honor residents' right to voice complaints without discrimination or retaliation, or did not have a working complaint process that resolves issues promptly. · F-0585
Aug 28, 2025E · Potential for more than minimal harm, patternThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812
Aug 28, 2025D · Potential for more than minimal harm, isolatedThe facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · F-0550
Aug 28, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · F-0684
Aug 28, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. · F-0695
Jun 5, 2025▲ J · Immediate jeopardy, isolatedThe 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 5, 2025E · Potential for more than minimal harm, patternThe 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
Jun 5, 2025D · Potential for more than minimal harm, isolatedThe facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint · F-0610
Jun 5, 2025D · Potential for more than minimal harm, isolatedThe 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
Mar 27, 2025E · Potential for more than minimal harm, patternThe facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. · from a complaint · F-0804
Mar 27, 2025D · Potential for more than minimal harm, isolatedThe facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint · F-0550
Mar 27, 2025D · Potential for more than minimal harm, isolatedThe facility did not honor residents' right to share a room with their spouse or a roommate of their choosing, or moved residents to a different room without written notice beforehand. · from a complaint · F-0559
Mar 27, 2025D · Potential for more than minimal harm, isolatedThe facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint · F-0580
Mar 27, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide a bathroom in or near each resident's room. · from a complaint · F-0918
Mar 27, 2025D · Potential for more than minimal harm, isolatedThe facility did not have a working call system — the button or cord residents use to summon help — in each resident's bathroom and bathing area. · from a complaint · F-0919
Dec 17, 2024D · Potential for more than minimal harm, isolatedThe 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
Jul 18, 2024F · Potential for more than minimal harm, widespreadThe facility did not employ enough qualified food and nutrition staff, including a qualified dietician, to properly run its food service. · F-0801
Jul 18, 2024F · Potential for more than minimal harm, widespreadThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812
Jul 18, 2024F · Potential for more than minimal harm, widespreadThe facility did not run an ongoing quality assurance committee that reviews care problems and creates plans to fix them. · F-0867
Jul 18, 2024F · Potential for more than minimal harm, widespreadThe facility did not maintain an effective pest control program to prevent or deal with mice, insects, or other pests. · F-0925
Jul 18, 2024E · Potential for more than minimal harm, patternThe facility did not let a resident help develop and carry out their own plan of care — the written roadmap of the services and support they'll receive, built around their personal goals and preferences. · F-0553
Jul 18, 2024E · Potential for more than minimal harm, patternThe facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · F-0584
Jul 18, 2024E · Potential for more than minimal harm, patternThe facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · F-0755
Jul 18, 2024E · Potential for more than minimal harm, patternThe facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time. · F-0759
Jul 18, 2024D · Potential for more than minimal harm, isolatedThe facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. · F-0558
Jul 18, 2024D · Potential for more than minimal harm, isolatedThe 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 18, 2024D · Potential for more than minimal harm, isolatedThe facility used physical restraints — devices that limit a resident's movement — when they weren't needed for medical treatment. · F-0604
Jul 18, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide proper foot care for residents. Foot care includes routine care like nail trimming and attention to foot problems, which matter greatly for older adults. · F-0687
Jul 18, 2024D · Potential for more than minimal harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689
Jul 18, 2024D · Potential for more than minimal harm, isolatedThe facility was not managed in a way that uses its money, staff, and resources effectively and efficiently to care for residents. · F-0835
Jul 18, 2024D · Potential for more than minimal harm, isolatedThe 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
Jul 18, 2024D · Potential for more than minimal harm, isolatedThe facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices. · F-0908
Oct 26, 2023E · Potential for more than minimal harm, patternThe 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. · from a complaint · F-0880
Oct 26, 2023D · Potential for more than minimal harm, isolatedThe facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint · F-0550
Oct 26, 2023D · Potential for more than minimal harm, isolatedThe facility did not make sure residents were fully informed about their own health, care, and treatments in a way they could understand. · from a complaint · F-0552
Oct 26, 2023D · Potential for more than minimal harm, isolatedThe facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. · from a complaint · F-0558
Oct 26, 2023D · Potential for more than minimal harm, isolatedThe facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint · F-0610
Oct 26, 2023D · Potential for more than minimal harm, isolatedThe 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
Jun 22, 2023▲ G · Actual harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689
Jun 22, 2023E · Potential for more than minimal harm, patternThe facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · F-0584
Jun 22, 2023E · Potential for more than minimal harm, patternThe facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. · F-0725
Jun 22, 2023E · Potential for more than minimal harm, patternThe 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
Jun 22, 2023D · Potential for more than minimal harm, isolatedThe facility did not reassess a resident after a significant change in their condition, such as a sudden decline in health. A full new assessment is required when a resident's condition changes in a major way. · F-0637
Jun 22, 2023D · Potential for more than minimal harm, isolatedThe facility did not make sure its nurses and nurse aides had the skills and training needed to properly care for every resident. · F-0726

Inspection trend by year

Citations from standard inspections decreased between the last two inspection cycles (16 → 7).

Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01
All citationsSerious citations (G–L)
2023
All citations: 12
Serious citations (G–L): 1
2024
All citations: 17
Serious citations (G–L): 0
2025
All citations: 23
Serious citations (G–L): 3
2026
All citations: 6
Serious citations (G–L): 2

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

YearCitationsSerious (G–L)Worst severity that year
2023121G ▲
2024170F
2025233J ▲
202662G ▲

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 →

4 fines totaling $142,698, plus 1 Medicare payment denial period.

Every penalty CMS publishes for this facility in the 3-year window is listed —none excluded. The count and the dollar total come from two different CMS datasets and agree for this facility. Penalties older than the window are dropped by CMS before publication, not by us.

DateTypeAmount / length
May 6, 2026Fine$19,635
May 6, 2026Fine$23,600
Aug 28, 2025Fine$87,019
Aug 28, 2025Payment Denial47 days from Oct 2, 2025
Jun 4, 2025Fine$12,444

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)
This facility: 3.55
Montana average: 4.82
U.S. average: 3.95
Registered Nurse hours
This facility: 0.77
Montana average: 1.17
U.S. average: 0.69
Weekend total nurse staffing
This facility: 3.15
Montana average: 4.26
U.S. average: 3.50

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

MeasureThis facilityMontana avgU.S. avgWhere it stands
Total nurse staffing (hours per resident per day)3.554.823.95bottom 12% in Montana; bottom 39% in the U.S.
Registered Nurse hours0.771.170.69bottom 24% in Montana; top 30% in the U.S.
Weekend total nurse staffing3.154.263.50bottom 17% in Montana; bottom 39% in the U.S.
Weekend RN hours (not acuity-adjusted)0.670.710.48top 45% in Montana; top 18% in the U.S.
Total nursing staff turnover (%)71.854.845.8bottom 17% in Montana; bottom 5% in the U.S.
RN turnover (%)75.848.342.9bottom 6% in Montana; bottom 7% 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 3.15, RN 0.68, weekend 2.80.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.15 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 2/5.

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: 2/5 · long-stay residents: 2/5 · short-stay residents: 2/5

Costs & payment

Price evidence · separate from quality

No verified facility-specific private-pay price is available in our data for Yellowstone River Nursing and Rehabilitation. CMS inspection and staffing records do not tell us what this home will charge you.

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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 / managerTypeRoleStakeSince
Bewsey, MichaelIndividualCorporate OfficerNOT APPLICABLE06/01/2023
Caldwell, SarahIndividualW-2 Managing EmployeeNOT APPLICABLE06/01/2023
Monroe, DustinIndividualCorporate OfficerNOT APPLICABLE06/01/2023

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

Other facilities in the same chain

CMS lists this facility under the chain Eduro Healthcare — 34 facilities in the current records. Chain membership says who operates these homes. It says nothing about how any individual one of them was inspected; each has its own record.

Listed by state, then facility name — not a ranking. Showing 8 of the 33 others, continuing from this facility's own place in that list.

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.

  • "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
  • "What systems do you use to prevent medication errors, and what happens when one occurs?"
  • "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
  • "How do you monitor residents' weight and eating, and what happens when someone starts losing weight?"
  • "If my family member's health suddenly changes, how quickly do you reassess them and update their care?"
  • "How do you screen new residents for mental health and disability-related needs, and how do you provide the specialized services they require?"
  • "How do you coordinate and monitor care for residents who receive dialysis?"
  • "How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"

Also worth asking anywhere

  • "Your weekend nurse staffing is reported below the Montana midpoint — how does the weekend schedule differ from a weekday?"
  • "Can I see the plan of correction for the findings in your most recent state inspection?"
  • "CMS reports 72% 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 (within 20 miles)

FacilityDistanceCityOverallInspectionFlags
Skyline Heights Nursing and Rehabilitation1.4 miBillings, MT★☆☆☆☆1/5SFF
Aspen Meadows Health and Rehabilitation Center1.5 miBillings, MT★★☆☆☆3/5
St John's Lutheran Home3.1 miBillings, MT★★★★☆3/5
Billings Rehabilitation and Nursing LLC3.4 miBillings, MT★★☆☆☆2/5
River Ridge Rehabilitation and Nursing LLC6.7 miBillings, MT★★☆☆☆2/5
Laurel Health & Rehabilitation Center11.6 miLaurel, MT★☆☆☆☆1/5

Compare this facility with the 3 closest →

All facilities in Billings →

Facility data as of CMS processing date 2026-08-01. CCN 275029.

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