Yellowstone River Nursing: Behavioral Health Gaps - MT
Yellowstone River Nursing and Rehabilitation employed staff member F in the social services director role despite federal regulations requiring facilities with more than 120 beds to hire qualified social workers. The facility is licensed for 160 beds.
Staff member A told inspectors on November 18 that staff member F had held the position for about three months and had a degree in psychology. The previous social services staff member also lacked the required degree, according to staff member A. A second employee working in social services, staff member E, similarly had no degree.
The facility's own job description for the social worker position clearly outlined the requirements: "Bachelor's degree in Social Work from an accredited institution is required" and "Social Work license in the state employed is required." Staff member F signed this job description on August 18.
Yet staff member F's academic transcripts and resume showed only a bachelor's degree in psychology. The resume contained no evidence of the required year of supervised social work experience in a healthcare setting working directly with individuals.
Staff member A initially defended the hiring during a November 19 interview, claiming the facility's census had never reached 120 residents. "Since the census had never reached or went over 120, the facility met the social worker regulation," staff member A stated.
The administrator added that the current census was 115, so "they were getting a little nervous about that number."
This interpretation contradicts federal regulations. The requirement for a qualified social worker applies to any facility licensed for more than 120 beds, regardless of current occupancy levels. Yellowstone River's state license, dated May 2, 2024, clearly shows authorization for 160 beds.
Staff member A also mentioned that the facility's corporate company employed a licensed social worker who could "oversee staff member F and act as a consultant as needed." However, federal regulations require facilities to employ qualified social workers directly, not rely on corporate consultants.
The regulatory violation extends beyond paperwork. Federal inspectors referenced related concerns in comprehensive care planning and behavioral services, indicating residents may not have received necessary care for mood, behavioral, and psychosocial issues due to the unqualified staffing.
The facility is disputing the citation.
Long-term care facilities depend on qualified social workers to address complex psychosocial needs of elderly residents, many of whom struggle with depression, anxiety, and adjustment to institutional care. These professionals assess residents' emotional well-being, coordinate family meetings, and develop intervention plans for behavioral issues.
Psychology degrees, while valuable, do not provide the specific training in healthcare social work practice, medical terminology, and interdisciplinary care planning that licensed social workers receive. The supervised healthcare experience requirement ensures social workers understand the unique challenges of institutional care settings.
The distinction matters for resident care. Social workers in nursing homes navigate complex family dynamics, coordinate discharge planning, and advocate for residents' psychosocial needs within medical treatment teams. They also handle sensitive situations involving end-of-life decisions, financial concerns, and resident rights issues.
Federal regulations establish minimum staffing standards because research demonstrates the correlation between qualified staff and resident outcomes. Facilities that employ unqualified personnel in key positions risk compromising care quality, particularly for vulnerable elderly residents with multiple chronic conditions and cognitive impairments.
The three-month duration of the improper employment suggests systematic non-compliance rather than an oversight. During this period, residents requiring social work interventions may have received services from someone lacking the professional training and supervised experience designed to protect their welfare.
Staff member A's admission about being "nervous" as the census approached 120 residents reveals awareness of the regulatory threshold, making the facility's interpretation of the requirements more difficult to justify as an innocent misunderstanding.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Yellowstone River Nursing and Rehabilitation from 2025-11-19 including all violations, facility responses, and corrective action plans.
Additional Resources
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 20, 2026 · Our methodology
YELLOWSTONE RIVER NURSING AND REHABILITATION in BILLINGS, MT was cited for violations during a health inspection on November 19, 2025.
The facility is licensed for 160 beds.
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.