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.

Inspection Report

Yellowstone River Nursing: Mouse Droppings in Kitchen - MT

June 4, 2026

Billings, MT

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Yellowstone River Nursing: Mouse Droppings in Kitchen - MT

Healthcare Facility

Yellowstone River Nursing And Rehabilitation

Billings, MT · 1/5 stars

The dietary manager had never met the contract dietitian despite working there for three months. The dietitian, hired just months earlier, had never set foot in the kitchen or spoken with the person running daily food operations.

Kitchen staff served residents lunch without beard coverings over their facial hair. When one cook asked about the required protective equipment during hiring, administrators promised to get him some but never did. He eventually cut his bushy beard because he "felt uncomfortable."

Two gallons of chunky, curdled milk sat in the cook's refrigerator next to the serving area. The dietary manager told inspectors the fridge "should not be used since it freezes everything" and admitted staff didn't check it "as often as we should."

Inspectors documented extensive sanitation failures throughout the kitchen during their July 15-18 visit. Unlabeled bags of sliced onions, diced ham, and peeled cucumbers filled the walk-in cooler. A pitcher containing an unidentified yellow substance sat uncovered and unmarked. Bags of pancakes and waffles in the freezer bore no dates or labels.

The hand-washing sinks outside the kitchen had no soap or paper towels. Food debris accumulated in and under the microwave. Grease and dirt coated the stove handles and juice machine vents. Black drip marks stained the wall beneath a storage area vent.

Staff member E, the dietary manager, acknowledged the mouse problem during questioning. "We have had mice in the kitchen, but I haven't seen one in a while," she said. "They are usually seen in the dish room. We were aware that there was an issue with mice; that's why we put our dry goods in the plastic totes."

Despite the precautions, mouse droppings appeared throughout dry storage and chemical storage areas along the walls. Cleaning logs showed staff cleaned the storeroom just 15 times over a 98-day period from April through July.

Open food containers violated basic safety protocols. A 25-pound bag of breadcrumbs sat unsealed without a date. Bags of white cake mix stored in plastic totes included one with a hole that spilled powder. Tortilla chips remained open with no dating. Bags of powdered Jello were covered in an unidentified powdery substance.

The dietary manager said she held "multiple meetings about labeling and dating foods that are open or not in the original packaging." Kitchen policy required all refrigerated and frozen foods to be "covered, labeled, and dated," but staff routinely ignored the rules.

Staff member S, observed preparing food without a beard covering, explained the basic food safety rule to inspectors: "When we open any food in the kitchen, it should be labeled with the date that it was open, and then after three days it should be thrown out."

Yet the kitchen operated without the protective equipment staff knew they needed. The dietary manager admitted responsibility when questioned on the final day of inspection. "I do not have any beard coverings available for staff," she said. "I know they should be wearing them, and it's my bad, I haven't ordered any."

Staff member R described his unsuccessful attempt to follow safety protocols. "I asked when I was hired if I should be wearing a covering over my beard and was told they would get me one," he said. "I have not seen any or seen anyone wearing one."

The facility's administrative failures extended beyond equipment shortages. The dietary manager, promoted from within when administrators "couldn't find anyone else to hire," was enrolled in a certification program but hadn't completed it due to working in the kitchen constantly.

The contract dietitian visited every two weeks but had established no working relationship with the person managing daily food operations. "The dietician has not worked with the dietary manager directly," an administrator explained. "We have been trying to work on a schedule for me to meet with the dietary manager, but we haven't met yet."

Staff member F, the dietitian, confirmed the disconnect. "I have not spent time in the kitchen, and I haven't had a chance to meet the dietary manager," she said during her July interview. She primarily attended team meetings to discuss nutrition concerns rather than providing hands-on kitchen oversight.

The dietary manager worked largely in isolation. "I have never met her," she said of the dietitian. "She is available for me to call if I have questions. I have only been in this position for about three months."

Facility policy required dry storage areas to be "temperature and humidity controlled, free of insects and rodents and kept clean." The reality inspectors documented included mouse waste, leaking vents, and sporadic cleaning that left the storeroom uncleaned for days at a time.

Grease buildup under and around the grill created additional sanitation hazards. The sink behind the serving area filled with debris and standing water. These conditions persisted despite the dietary manager's awareness of cleaning schedules staff "should be following."

The inspection found systematic failures that put every resident at risk for foodborne illness. From the missing soap at hand-washing stations to the rodent-contaminated storage areas, basic food safety measures had broken down across the kitchen operation.

Federal inspectors classified the violations as having "minimal harm or potential for actual harm" but affecting "many" residents who received meals from the compromised kitchen daily.

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

Editorial Standards

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

Quick Answer

YELLOWSTONE RIVER NURSING AND REHABILITATION in BILLINGS, MT was cited for violations during a health inspection on July 18, 2024.

The dietary manager had never met the contract dietitian despite working there for three months.

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?: The dietary manager had never met the contract dietitian despite working there for three months.
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.