Yellowstone River Nursing: Care Plan Failures - MT
Yellowstone River Nursing and Rehabilitation hired staff member F about three months ago to fill the social services director position, despite the employee holding only a bachelor's degree in psychology. Federal inspectors found the facility violated staffing requirements during a November complaint investigation.
The nursing home is licensed for 160 beds, triggering federal regulations that mandate facilities with more than 120 beds employ a qualified social worker on a full-time basis. That social worker must hold a bachelor's degree in social work from an accredited institution and complete one year of supervised experience in a healthcare setting working directly with individuals.
Staff member F signed a job description on August 18 acknowledging these requirements. The document stated a "Bachelor's degree in Social Work from an accredited institution is required" and "Social Work license in the state employed is required."
Academic transcripts and the employee's resume showed staff member F earned a bachelor's degree in psychology, not social work. The resume contained no evidence of the required year of supervised social work experience in a healthcare setting.
During interviews, facility administrators revealed a pattern of employing unqualified staff in social services roles. The previous social services director "did not have a degree," according to staff member A. Another employee working in social services, staff member E, also lacked the required degree.
The facility's current census stands at 115 residents, causing administrators some concern. "They were getting a little nervous about that number," staff member A told inspectors on November 19.
Staff member A initially claimed the facility met social worker regulations because its census had "never reached 120 residents." The administrator argued that since the facility operated below 120 residents, it could use two unqualified staff members in social services roles instead of hiring a licensed social worker.
Federal regulations contain no such exception. The requirement to employ a qualified social worker applies to any facility licensed for more than 120 beds, regardless of current census levels.
The facility attempted to address the violation through corporate consultation. Staff member A told inspectors the nursing home's parent company employed a licensed social worker who "could oversee staff member F and act as a consultant as needed." This arrangement does not satisfy the federal requirement for on-site, full-time qualified social work services.
Inspectors linked the staffing violation to broader problems with resident care. The investigation referenced concerns about a resident not receiving necessary services for "mood, behavior, and psychosocial concerns." Federal citations for comprehensive care planning and behavioral services accompanied the social worker staffing violation.
The nursing home disputes the citation, according to inspection records. Facilities often challenge federal findings during the appeals process, which can delay enforcement actions.
Social work services in nursing homes address residents' emotional, behavioral, and psychosocial needs. Qualified social workers assess residents' mental health, coordinate family communications, and develop interventions for behavioral challenges. They also facilitate discharge planning and connect residents with community resources.
The distinction between psychology and social work education proves significant in healthcare settings. Social work programs emphasize direct practice skills, healthcare systems knowledge, and supervised fieldwork experience. Psychology degrees focus on research methods, theoretical frameworks, and may lack the practical healthcare training federal regulations require.
Montana's health department issued the facility's current license on May 2, 2024, authorizing 160 skilled nursing facility beds. The license specifications clearly identified the facility as a Title 18/19 SNF, subjecting it to federal Medicare and Medicaid participation requirements.
Staff member F has worked in the director role for approximately three months while lacking both the educational credentials and professional licensing the position demands. The employee's job description explicitly outlined requirements the facility knew were not met at the time of hiring.
The violation affects "some" residents according to inspection classifications, indicating the inadequate social services impacted multiple people receiving care. Without qualified social work assessment and intervention, residents may not receive appropriate mental health support, family mediation, or discharge planning services their conditions require.
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.
Federal inspectors found the facility violated staffing requirements during a November complaint investigation.
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.