Awe Kualawaache Care Center

Location & what’s nearby

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Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Staffing

How full it usually is: this home is certified for 40 beds and averages 23.7 residents a day — about 59% occupied, or roughly 16 beds typically open. It often has substantial empty capacity — worth asking why, since low census can reflect either a new or shrinking home or one families are avoiding. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 4.08 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 1.41 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.453 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 3.41 hrs/resident/day on weekends vs 4.36 on weekdays — 22% thinner on weekends — a notable drop. RN hours go from 1.59 to 0.96 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 62% is well above the national median of 45%.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

Deficiencies are more than at the previous inspection — worsening. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

18 citations, most serious first. The 10 most serious are shown; the remaining 8 are one tap away and print in full.

• Potential for harm · D2026-06-04 · tag F0656 — failed to write and follow a full care plan — isolated
  Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and record review, the facility failed to implement a care plan intervention for foam heel protection intended to prevent skin breakdown for 1 (#3), which increased the risk for recurrence of pressure related skin breakdown for a resident with a history of pressure ulcers to both heels, and the facility staff failed to revise and implement a comprehensive, person-centered care plan to address the use of a high-risk anticoagulant medications, and interventions necessary to monitor for and minimize potential adverse consequences, which increased the risks for unrecognized adverse consequences, including bleeding complications associated with anticoagulant use, for 1 (#5) of 14 sampled residents. Findings include:1. During an observation on 6/1/26 at 4:34 p.m., resident #3 was observed lying in bed without foam heel protection boots on either foot.During a second observation on 6/3/26 at 1:25 p.m., resident #3 was again observed lying in bed without foam heel protection boots in place.During an interview on 6/3/26 at 12:58 p.m., staff member D said…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-06-04 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on the interview and record review, a facility staff member failed to notify nursing staff of a resident's initial fall for the immediate assessment to be completed by the nurse to determine the resident's clinical condition or if there were injuries after the fall, and the staff member failed to follow the fall program policies and procedures related to fall reporting, for 1 (#10) of 14 sampled residents. Findings include:Review of a facility-reported incident, submitted to the State Survey Agency on 4/23/26, showed resident #10 was found on the floor in his room by a nurse aide. Resident #10 stated he had a fall from his wheelchair. Nursing staff assessed resident #10 and transferred him via Hoyer lift to his wheelchair. The provider and director of nursing were notified, and the provider ordered that resident #10 be transported via ambulance to the local hospital's emergency room for evaluation. Review of the facility reported incident's investigative findings, dated 4/27/26, showed resident #10 was found on the floor after a fall in the morning on 4/22/26 at 9:02 a.m.…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-06-04 · tag F0692 — failed to prevent malnutrition and dehydration — isolated
  Provide enough food/fluids to maintain a resident's health.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and record review, the facility failed to ensure a fortified diet was implemented as ordered for a resident who was at risk for weight loss for 1 (#2) of 14 sampled residents. This failure increased the risk for the resident's continued weight loss and compromised nutritional status. Findings include:During an interview on 6/1/26 at 5:08 p.m., resident #2 reported she has lost weight since she was admitted to the facility. Resident #2 stated staff member D spoke to her regarding weight loss and encouraged her to eat foods she preferred.During an observation and interview on 6/3/26 at 8:14 a.m., resident #2's breakfast meal tray card did not identify the resident as requiring a fortified diet. Staff member H said he was unaware that resident #2 had experienced weight loss and was unaware of any interventions related to the resident's nutritional status.During an interview on 6/3/26 at 8:43 a.m., resident #2 said she was supposed to receive extra butter with meals due to her weight loss; however, staff frequently forgot to provide it.During an…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-06-04 · tag F0757 — failed to avoid unnecessary drugs — isolated
  Ensure each resident’s drug regimen must be free from unnecessary drugs.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interview and record review, the facility failed to ensure monitoring was in place for a resident for adverse consequences associated with the use of an anticoagulant medication that increased the risk of unrecognized adverse drug consequences and complications associated with anticoagulant therapy, for 1 (#5) of 14 residents sampled. Findings includeDuring an interview on 6/2/26 at 10:24 a.m., resident #5 said she was taking a blood thinner because staff suspected she had a blood clot.During an interview on 6/2/26 at 2:52 p.m., staff member P stated that when a resident received an anticoagulant medication, staff monitored for signs of bleeding and ensured the required laboratory work was completed. Staff member P stated that monitoring would be documented in the resident's medical record progress notes.During an interview on 6/2/26 at 2:55 p.m., staff member J said she was unsure what monitoring was required for a resident receiving an anticoagulant medication. After consulting staff member P, staff member J stated that staff should watch for signs such as bleeding gums…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2026-06-04 · tag F0880 — failed to prevent and control infections — isolated
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and record review, the facility failed to ensure staff kept a urinary catheter drainage bag off the floor for 1 (#35); and failed to ensure oxygen tubing was changed to prevent contamination of respiratory equipment for a resident who was dependent upon oxygen for 1 (#2) of 14 sampled residents. Findings include: 1. During an observation on 6/4/26 at 7:43 a.m., staff member N entered resident #35's room to administer morning medications. Resident #35 had urinary catheter tubing extending down from his bed ending in a covered bag, which was on the floor. Staff member N helped resident #35 adjust in bed to sit up for taking medications. Staff member N administered oral and ophthalmic medications. Staff member N was moving away from resident #35's bedside to exit the room when this surveyor pointed out the catheter bag on the floor, so the placement of the bag could be corrected. During an interview on 6/4/26 at 9:59 a.m., staff member M stated that nursing staff were to keep urinary catheter bags, used by residents, off the floor. Staff member M stated…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Fcited before2025-05-08 · tag F0880 — failed to prevent and control infections — widespread
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and record review, the facility failed to ensure the infection preventionist was properly trained; failed to ensure the safety measures were in place to prevent the growth of a waterborne illness (such as Legionella); failed to identify appropriate Transmission-Based Precautions for a resident with Clostridioides difficile (C. diff) for 1 (#178); and staff member D failed to adhere to proper infection control practices related to not performing hand hygiene between doffing and donning gloves, while performing wound care for 1 (#22) of 20 sampled residents. These deficient practices had the potential to affect all residents in the facility increasing the risk for infections overall. Findings include: 1. Infection Prevention During an interview on 5/7/25 at 2:29 p.m., staff member E stated they did not feel they had received the proper education that was required for their position. Staff member E stated hand hygiene audits were completed weekly, but they did not keep record of these audits. Staff member E stated PPE audits were completed weekly as…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-05-08 · tag F0628 — isolated
  Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interview and record review, the facility failed to notify the State Ombudsman Office when a resident was transferred to the hospital and failed to provide the resident with contact information for the State Ombudsmans Office for 3 (#s 13, 127, and 177) of 20 sampled residents. This deficient practice left the residents without an advocate related to the transfers in the event there were concerns. Findings include: During an interview on 5/5/25 at 2:56 p.m., NF1 stated, I am concerned the facility is not notifying the Ombudsman Office when they transfer someone to the hospital or when a resident is discharged . This is leaving them without an advocate during that time. During an interview on 5/7/25 at 1:25 p.m., staff member G stated we did not let the ombudsman know resident #177 was discharged because the facility was not aware the local hospital sent him to a larger hospital. During an interview on 5/8/25 at 8:07 a.m., NF1 stated, I am not notified when someone is transferred or discharged from the facility. During an interview on 5/8/25 at 8:45 a.m., staff member G…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2024-12-04 · tag F0604 — failed to not use physical restraints improperly — isolated
  Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interview and record review, a resident was acting out aggressively, and the staff restrained the resident for a Period of Imminent Danger to the Safety and Well being of others, and failed to ensure the required steps were taken to address the emergency restraint immediately after it occurred, or for future events in which a restraint may have been needed for this resident, for 1 (#2) of 1 sampled resident. Findings include: A review of a facility-reported incident, dated 11/11/24, revealed the following: On 11/13/24, at approximately 4:30 p.m., a personal care attendant (PCA) reported to the administrator-in-training that she had sustained an injury on 11/11/24, while assisting the charge nurse and other staff in physically restraining resident #2. During the investigation staff reported on 11/11/24, around 10:00 a.m., the charge nurse directed staff to physically restrain resident #2, due to the resident exhibiting physical aggression toward staff, and other residents. This restraint was implemented to allow the charge nurse to administer an intramuscular injection of an…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2024-12-04 · tag F0657 — failed to keep the care plan current — isolated
  Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and record review, the facility failed to update a resident's individualized care plan for personal preferences related to communication and the provision of ADL care from male staff who had the ability to speak the resident's native language. When male staff assisted the resident, and used the resident's native language when communicating, the resident would exhibit less agitation and aggression, for 1 (#2) of 7 sampled residents. Findings include: During an observation and interview on 12/3/24 at 2:45 p.m. resident #2 was observed sitting in his wheelchair speaking his native language with staff member H. Resident #2 appeared happy, smiling at times, and responsive during the interaction. Resident #2 stated he preferred male staff who spoke his Crow language to care for him stating, white people are okay. During an interview on 12/3/24 at 2:55 p.m., staff member H stated resident #2 preferred male staff to care for him who speak his native Crow language. Staff member H stated resident #2 was less aggressive and more compliant with daily care with…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2024-12-04 · tag F0726 — failed to have competent, trained nursing staff — isolated
  Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interview and record review, facility failed to ensure all nursing staff working with a resident who exhibited aggressive behaviors towards others, was educated to the extent necessary and competent to provide services for the resident's needs to be met for behaviors and use of restraints; and to ensure restraint use was utilized properly for resident safety, in the event of an emergency situation; and failed to ensure all staff working with the resident when a restraint was applied had necessary training for physicial restraint use, for 1 (#2) of 7 sampled residents. The deficient practice resulted in a resident being physically restrained for up to one hour without nursing oversight. Findings include: A review of a facility-reported incident, dated 11/11/24, showed the following information: On 11/13/24, at approximately 4:30 p.m., a personal care attendant (PCA) reported to the administrator-in-training that she had sustained an injury on 11/11/24, while assisting the charge nurse and other staff in physically restraining resident #2. During the facility's investigation,…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction

“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.

Fines & penalties

No federal fines in the current CMS record.

Who owns this facility

2 organizational owners listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.

What families pay in MT