Powder River Manor
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.
Inspection Findings
agencies.
completed by the State Survey Agency were located in a publicly accessible area.
This failure would
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 TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE
275087 09/10/2025
Powder River Manor 104 N Trautman Broadus, MT 59317
to participate in experimental research, and to formulate an advance directive.
interview and record review, the facility failed to ensure a completed POLST form with physician
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.
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.