Yellowstone River Nursing: Mouse Droppings in Food - MT
Federal inspectors discovered the contaminated food during a July inspection of the facility's kitchen, which serves meals to 43 residents. The mouse droppings formed "a thick layer of black dirt" along the floor where walls meet throughout the storage areas.
Staff member E, the dietary manager, told inspectors she was aware of mice in the kitchen but hadn't seen one recently. She said the facility used covered plastic containers for food storage specifically because of the known mouse problem, but couldn't explain how rodents got inside the sealed container with the cake mix.
The kitchen violations extended far beyond pest control. Inspectors found grease buildup on stove handles and under the grill, debris inside and underneath the microwave, and a puddle of water on the floor without warning signs. A staff member served lunch without wearing a beard covering.
Multiple pieces of essential kitchen equipment weren't working. The ice machine was warm with no ice, the dessert refrigerator was warm, and two ovens below the gas stove were broken and used for storage instead. Kitchen staff stored gloves and a long lighter inside the nonfunctional ovens.
"Nothing should be in that fridge. It doesn't work; it freezes everything," staff member E told inspectors about the cook's refrigerator, which contained two gallons of chunky-looking milk. "The dessert fridge hasn't been working for quite a while. The ice machine is down as well."
The facility's pest control contract with Orkin had lapsed months before the inspection. Records showed the last professional pest control service occurred in March 2024, despite facility policy requiring ongoing pest control to keep the building free of insects and rodents.
Bugs weren't limited to the kitchen. Inspectors observed ants crawling among crumbs on the floor near a resident's recliner, dead insects scattered across hallway floors, and beetles crawling near exit doors. Staff member J acknowledged the problem directly: "We have a bug problem. Most of our problems are ants."
Several staff members confirmed the pest issues. Staff member L said bugs flew through residents' screenless windows, though she didn't know what the facility had done about it. Staff member K reported seeing ants throughout the facility.
The facility's quality assurance program had failed to identify or correct these problems despite claiming to monitor kitchen conditions. Administrator staff member A said they had been working on kitchen issues since April through their quality improvement process, with the most recent inspection in June finding only minor problems like a dirty cart and unlabeled juice.
But when federal inspectors arrived weeks later, they found extensive contamination the internal monitoring had missed.
The infection control violations extended to resident care. Staff member H was observed treating a resident's pressure ulcer without wearing a protective gown, despite facility policy requiring enhanced barrier precautions for wound care. When the same nurse later administered medication through a feeding tube, she again failed to wear required protective equipment.
"I should have worn a gown," staff member H admitted after being questioned about the feeding tube procedure.
The facility had hired a new infection control specialist who had begun conducting observational audits, but the training hadn't prevented basic protocol violations. Staff members B and Q confirmed that gowns were required for wound care and feeding tube procedures, and said education on enhanced barrier precautions had started in April with ongoing training.
Equipment problems plagued resident rooms as well. A recliner in resident #65's room had tears and scratches with material flaking onto the floor, creating surfaces that couldn't be properly cleaned. Staff member N said the damaged furniture needed to be thrown away, but no maintenance requests had been filed by the end of the inspection.
The dietary manager position had been filled by promoting from within after the facility couldn't find qualified external candidates. Staff member E had been in the role for only three months and was enrolled in a certification program but hadn't completed it due to spending so much time working in the kitchen.
"I have never met her," staff member E said about the contract dietitian who was supposed to visit every other week.
The facility's maintenance logs from January through July failed to document which kitchen equipment was broken or show any repairs during that period, despite multiple pieces of essential equipment being nonfunctional for extended periods.
A grievance filed in December 2023 complained about bugs in the food. Staff member A signed off on the complaint as complete the same day it was filed.
The inspection found violations affecting infection control, food safety, equipment maintenance, and quality assurance across multiple departments. Residents continued receiving meals from the contaminated kitchen and care from staff who weren't following basic infection prevention protocols while administrators claimed their internal monitoring systems were working effectively.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Yellowstone River Nursing and Rehabilitation from 2024-07-18 including all violations, facility responses, and corrective action plans.
Additional Resources
- View all inspection reports for Yellowstone River Nursing and Rehabilitation
- Browse all MT nursing home inspections
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 16, 2026 · Our methodology
YELLOWSTONE RIVER NURSING AND REHABILITATION in BILLINGS, MT was cited for violations during a health inspection on July 18, 2024.
Federal inspectors discovered the contaminated food during a July inspection of the facility's kitchen, which serves meals to 43 residents.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.
Frequently Asked Questions
- What happened at YELLOWSTONE RIVER NURSING AND REHABILITATION?
- Federal inspectors discovered the contaminated food during a July inspection of the facility's kitchen, which serves meals to 43 residents.
- How serious are these violations?
- Violation severity varies from minor documentation issues to serious safety concerns. Review the inspection report for specific deficiency codes and scope. All violations must be corrected within required timeframes and are subject to follow-up verification inspections.
- What should families do?
- Families should: (1) Ask facility administration about specific corrective actions taken, (2) Request to see the follow-up inspection report verifying corrections, (3) Check if this represents a pattern by reviewing prior inspection reports, (4) Compare this facility's ratings with other nursing homes in BILLINGS, MT, (5) Report any new concerns directly to state authorities.
- Where can I see the full inspection report?
- The complete inspection report is available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request a copy directly from YELLOWSTONE RIVER NURSING AND REHABILITATION or from the state Department of Health. The report includes specific deficiency codes, facility responses, and correction timelines. This facility's federal provider number is 275029.
- Has this facility had violations before?
- To check YELLOWSTONE RIVER NURSING AND REHABILITATION's history, visit Medicare.gov's Care Compare and review their inspection history, quality ratings, and staffing levels. Look for patterns of repeated violations, especially in critical areas like abuse prevention, medication management, infection control, and resident safety.