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Complaint Investigation

Powder River Manor

September 10, 2025 · Broadus, MT · 104 N Trautman
Citations 2
CMS Rating 5/5
Beds 41
Provider ID 275087
Healthcare Facility
Powder River Manor
Broadus, MT  ·  View full profile →
Inspection Summary

POWDER RIVER MANOR in BROADUS, MT — inspection on September 10, 2025.

Found 2 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF0577
Resident Rights Deficiencies
Potential for More Than Minimal Harm

Based on observation and interview, the facility failed to ensure readily available results of surveys completed by the State Survey Agency were located in a publicly accessible area.

This failure would affect any person wishing to view the survey results.

Findings include:During an observation on 9/8/25 at 1:18 p.m., the facility had a wall-mounted file holder viewable upon entrance into the facility's building, located on the wall of the common area TV room.

The holder had a label with the words printed on it, SURVEY RESULTS.

The holder did not have any binder or documents to view.During an observation on 9/10/25 at 8:22 a.m., the facility did not have any binder or documents to view in the same entry area wall-mounted file holder.

During an interview on 9/10/25 at 10:12 a.m. staff member D stated she did not realize the binder with results from surveys was not available in the file holder.

Staff member D stated she would check to see where it might be.

During an interview on 9/10/25 at 10:51 a.m. staff member D stated she did not know why the binder had not been available in the file holder.

Staff member D stated it could have been pulled to the nurses station for something and just not returned.

Staff member D stated, It's one of those things, just in walking by it every day, you forget to think of that being there or not.

Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.

For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE

TITLE

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

09/10/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Powder River Manor

104 N Trautman Broadus, MT 59317

SUMMARY STATEMENT OF DEFICIENCIES

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to ensure a completed POLST form with physician signature was readily accessible in the hard chart and the electronic medical record for 1 (#5) of 5 sampled residents.

Findings include:During a record review of resident #5's POLST, dated [DATE], showed No CPR and selective treatment was selected, and the form was filled by the resident's responsible party.

The form was not signed by resident #5's responsible party.

The form was not signed by the provider, it was without a date, and there was not a printed name of the provider.

During an interview on [DATE] at 11:23 a.m., staff member F stated admission forms, including POLST forms, were reviewed by staff member F, the resident or responsible party, and or family member.

Staff member F stated some forms were given to the resident or responsible party to fill out ahead of time, before entering the facility.

Staff member F stated she was not sure why resident #5's POLST had not been completed and filled out with the responsible party signature, provider signature, and date.Review of a facility policy titled, Advance Directives, revised [DATE], showed: .

The facility defines the following in accordance with current OBRA definitions and guidelines:. a.

Advance care planning - a process of communication between individuals and their healthcare agents to understand, reflect on, discuss, and plan for future healthcare decisions for a time when individuals are not able to make their own healthcare decisions. h.

Physician Orders for Life-Sustaining Treatment (or POLST) . form - a form designed to improve patient care by creating a portable medical order form that records patients treatment wishes so that emergency personnel know what treatments the patient wants in the event of a medical emergency .Review of a document provided by the facility, Directions for Health Care Professionals, revised [DATE], showed: Completing POLST .

Provider signature must be a Montana licensed physician, advanced practice registered nurse or physician assistant.

Patient (or legal decision-maker, if patient unable to make medical decisions) must sign to be valid.

Facility ID:

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in BROADUS, MT, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from POWDER RIVER MANOR or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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