Whitefish Care And Rehabilitation

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

FORM CMS-2567 (02/99) Previous Versions Obsolete

the attitude. Resident #6 stated that many of the residents did not speak up about their concerns due to the concern for fear of getting kicked out of the facility, with nowhere to go or no family support.Review of the Facility's Grievances regarding concerns of staff customer service from 7/1/25 to 12/1/25 included: -7/17/25 - Resident #11 wrote: Additude. She passes dirty looks around like they are a gift, [sic]-9/17/25 - Staff member K wrote: (Resident #8) did not want her chicken sandwich for lunch and asked for a PB and J (peanut butter and jelly sandwich) in sub (substitution). Kitchen staff refused . Not offering to make it after trays were passed.,-11/12/25 - Resident #15 wrote: Resident expressed concern surrounding staff approach to patient cares, felt cares were lacking in customer service approach,-11/21/25 - Resident #11's grievance showed: (Resident #11) stated that a colored girl (staff name) is very loud at night and saying things to roommate like so sorry you have been with a grump. Also said to (resident #11) while kneeling, You white people think this is where we should be like this .,-12/1/25 - Resident #1's grievance showed: Resident used urinal and told CNAs that he was wet, they walked away without changing him or coming back with clean dry linen.

Event ID:

Facility ID:

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Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/22/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Whitefish Care and Rehabilitation

1305 E 7th St Whitefish, MT 59937

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

Based on observation, interview, and record review, the facility failed to ensure a clean room for 3 (#s 5, 7, and 9) of 12 sampled residents. Findings include:a. During an observation on 12/2/25 at 2:33 p.m., resident #5's floor was dirty with visible dirt near the area right by the bed. There were little pieces of paper underneath resident #5's bed.During an interview on 12/3/25 at 1:26 p.m., NF1 stated there was garbage

on the floor constantly in resident #5's room. NF1 stated they have never seen a staff member clean underneath the beds and stated they find garbage located there.b. During an observation and interview on 12/2/25 at 3:22 p.m., resident #7's floor had visible dirt where the resident and the wheelchair was located.

Resident #7 stated, They could do a better job (with cleaning). Resident #7 stated the cleaning depended

on the person and stated he often went outside and would drag dirt in so he felt bad for the cleaners and would never complain.During an interview on 12/3/25 at 5:40 p.m., staff member L stated some staff members were better at cleaning than others. They stated they would only clean something if it was needed and document it.c. During an observation on 12/3/25 at 8:00 a.m., resident #9 had two oxygen tubing ear protectors and a green piece of garbage located underneath his bed.During an observation on 12/4/25 at 8:15 a.m., resident #9's bed had two oxygen tubing ear protectors and a green piece of paper located underneath his bed.Review of a facility document, no title, dated 12/2/25 and 12/3/25, showed: resident #5 and resident #7's room was cleaned with a dry mop and wet mop on 12/3/25, but no records were shown for these residents on 12/2/25. The documentation was requested, and not received. Resident #9 had his room cleaned by a dry and wet mop on 12/3/25.

Event ID:

Facility ID:

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Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/22/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Whitefish Care and Rehabilitation

1305 E 7th St Whitefish, MT 59937

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0675

Honor each resident's preferences, choices, values and beliefs.

Level of Harm - Minimal harm or potential for actual harm

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

interview and record review, the facility failed to ensure scheduled showers were consistently completed and documented for 4 (#s 1, 5, 6, 7) residents of 12 sampled residents. Findings include:1. During an

interview on 12/3/25 at 1:26 p.m., NF1 stated the staff members did not take care of resident #5's overall hygienic needs including showering, shaving, hair trimming, and fingernail clipping frequently enough which resulted in NF1 doing these cares. NF1 stated resident #5 would refuse a shower sometimes and stated resident #5 refused a shower yesterday (12/2/25).Review of the [Facility Name] Shower Schedule, no date, showed resident #5 had showers scheduled for Tuesdays and Fridays.Review of resident #5's EHR showed nursing notes regarding showers from 11/11/25 to 12/2/25:-11/11/25 (Tuesday), a shower was documented,-11/19/25 (Wednesday), a shower was documented. Eight days later,-11/25/25 (Tuesday), a shower was documented. Six days later,-12/2/25 (Tuesday) no documentation of a given or refused shower.

Documentation showed resident #5 did not receive a shower and was potentially not offered a shower for seven days.2. Review of the [Facility Name] Shower Schedule, no date, showed resident #7 had showers scheduled for Sundays and Thursdays.Review of resident #7's EHR showed one documentation of a shower refusal on 9/30/25. No other documentation of any showers completed or refused was documented

in the EHR since his admission on [DATE REDACTED].During an interview on 12/4/25 at 10:06 a.m., staff member C stated resident #7 showered independent with minimal assistance.During an interview on 12/4/25 at 11:01 a.m., staff member B stated it was the facility's policy to document on paper only. Staff member B stated the facility had problems in the past with documented showers.Review of many paper charting shower sheets of resident #7's showed: inconsistencies in regularly scheduled shower dates (12/2/25 (Tuesday); 11/25/25 (Tuesday); 11/21/25 (Friday)).3. During an interview with residents #6 and #1 on 12/3/25 at 4:21 p.m., resident #6 stated getting the scheduled showers were a concern. Resident #6 pointed to his roommate (resident #1) and stated resident #1 went two months without getting a shower. Resident #6 stated he kept

a record of all of the incidents that happened to him and on November 10th he was left in the shower room for 45 minutes. Resident #6 stated there was no pull cord for him in the shower room and he was wheelchair bound. Please see F-F689 for further details regarding safety in the shower. Resident #1 stated showers were important to him because he was a big guy and sweat was an issue. Resident #1 also stated

the facility did not always get the correct size of a fitted bed sheet so the sheet would move leaving his skin

on the rubber mattress, and he got a rash one time.Review of the [Facility Name] Shower Schedule, no date, showed resident #1 had showers scheduled for Tuesdays and Saturdays.Review of resident #1's EHR showed nursing notes regarding showers from 10/21/25 to 11/18/25:-10/21/25 (Tuesday), a shower was documented,-11/4/25 (Tuesday), a shower was documented. 14 days from the prior shower documentation,-11/18/25 (Tuesday), shower was documented. 14 days from the prior shower documentation,During an interview on 12/4/25 at 8:20 a.m., staff member C stated showers were double documented, once on paper which was filled out by the CNAs and once as a task in PCC (Point Click Care).Review of a facility policy titled, Resident Showers, not dated, showed:- .1. Residents will be provided showers/baths as per request or as per facility schedule protocols.,- 18. Complete paper documentation indicating completion of shower and other related questions. Provide completed shower sheet to Nurse for signature and progress note entry.- 19. Nurse to enter progress note that shower was completed and if any skin conditions/concerns .,- 20. Ensure shower completion is documented in electronic POC under PRN tasks,- 21. If bathing was refused by resident please follow process on paper documentation. Resident is to be approached and shower request is to be made 2 times by CNA at least 2 hours apart.

Residents Affected - Some

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/22/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Whitefish Care and Rehabilitation

1305 E 7th St Whitefish, MT 59937

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0677

Provide care and assistance to perform activities of daily living for any resident who is unable.

Level of Harm - Minimal harm or potential for actual harm

Based on observation, interview, and record review, the facility failed to ensure the basic ADL (activities of daily living) of teeth brushing was completed and documented for 1 (#9) of 12 sampled residents. Findings include:During an interview and observation on 12/3/25 at 8:00 a.m., resident #9 stated he had not brushed his teeth yet for the day, but wanted to wait until he was done eating breakfast. There was a piece of paper hanging off of resident #9's light shade on the wall. This piece of paper showed: . Complete/assist w/ oral care . Thank you, Speech TherapyDuring an interview on 12/3/25 at 12:48 p.m., resident #9 stated no staff member had helped him brush his teeth yet. He stated one staff member talked about doing it but because of an interruption with physical therapy, the task was not completed. Resident #9 stated interruptions in care were not a new issue. He stated he felt he had no consistent schedule in the day and stated physical therapy had never offered to help him brush his teeth.During an interview on 12/3/25 at 4:38 p.m., resident #9 stated he had not brushed his teeth for the day. NF3 stated they were unaware resident #9 had not brushed his teeth for the day and said NF3 could help him today.During an interview on 12/4/25 at 8:30 a.m., staff member D stated, I'm not surprised, when asked if any residents complained about their teeth not getting brushed. Staff member D stated some of the CNAs are great and will do all of the ADLs without having to ask them and some of CNAs do not.Review of a facility policy titled, Activities of Daily Living (ADLs), not dated, showed: . 3. A resident who is unable to carry out activities of daily living will receive the necessary services to maintain good nutrition, grooming, and personal and oral hygiene.

Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/22/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Whitefish Care and Rehabilitation

1305 E 7th St Whitefish, MT 59937

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0686

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Level of Harm - Minimal harm or potential for actual harm

Based on observation, interview, and record review, the facility failed to ensure physician wound orders were followed correctly for 1 (#1) of 12 sampled residents. Findings include:During an observation and

interview on 12/3/25 at 11:49 a.m., staff member M removed resident #1's old wound dressing. Observation of the old wound dressing showed a yellow substance similar to xeroform, along with the old gauze and tape dressing supplies. Staff member M stated the substance was calcium alginate. Staff member M stated

they added this to resident #1's wounds, as the wound had not been healing, and staff member M felt the calcium alginate would help. Staff member M stated they were not wound certified, and this was not what

the wound certified PT had ordered for resident #1's wound treatment. Staff member M stated resident #1 had been at the facility for several months, with no wound improvement, and thought this addition would help with the drainage from the wound. Additionally, during the dressing change, staff member M did not perform proper hand hygiene after the old dressing had been removed, before placing the new clean dressing.Review of resident #1's physician order, with a start date of 10/29/25, showed: . Cleanse with wound cleanser . apply collagen pad to the base of the wound, secure with a dry dressing .Review of a facility policy titled, Wound Treatment Management, no date, showed: . 1. Wound treatments will be provided in accordance with physician orders .

Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/22/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Whitefish Care and Rehabilitation

1305 E 7th St Whitefish, MT 59937

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0689 Level of Harm - Minimal harm or potential for actual harm

Scheduled ambulation or toileting assistance .,6. Each resident's risk factors and environmental hazards will be evaluated when developing the resident's comprehensive plan of care: a. Interventions will be monitored for effectiveness .Reference:1Mayo Clinic. (2022, May 26). Orthostatic hypotension (postural hypotension). Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/orthostatic-hypotension/symptoms-causes/syc-20352548?cjdata=MXxOfDB

Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/22/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Whitefish Care and Rehabilitation

1305 E 7th St Whitefish, MT 59937

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0692 Level of Harm - Actual harm Residents Affected - Few Note: The nursing home is disputing this citation.

FORM CMS-2567 (02/99) Previous Versions Obsolete

said she would supply residents' drinks as needed or requested. Staff member K said during rounds or when providing care, she encouraged residents to drink. Staff member K would not usually report difficulty with a resident's intake unless she had serious concerns or noted a change in a resident's status. During an

interview on 10/22/25 at 10:47 a.m., staff member O said that when doing the chart review for the requested surveyor documentation, it was noted that the intake and output for the residents were deleted from the charting system. Staff member O said, Monitoring was not required by the state, but we see now it is important and are in the process of reactivating it. Staff member O said only a few residents within the facility had hydration monitoring, and resident #3 was not one of the residents. During an interview on 10/22/25 at 11:28 a.m., staff member B said the registered dietitian had been removing the hydration tracking for each resident when she placed the order for documentation of a resident's intake. Staff member B stated the facility has not been documenting the fluid intake. Staff member B said, We now have identified hydration as a problem. We need to provide training for the staff on tracking hydration.Review of a facility policy, Hydration, with an implementation date of 7/1/2025, showed: Policy:The facility offers each resident sufficient fluid, including water and other liquids, consistent with resident needs and preferences to maintain proper hydration and health.Sufficient fluid means the amount of fluid needed to prevent dehydration . and maintain health. The amount needed is specific to each resident and fluctuates as the resident's condition fluctuates.1. The facility will utilize a systematic approach to optimize the resident's hydration status:a.

Identifying and assessing each resident's hydration status and risk factorsb. Evaluating/analyzing the assessment informationc. Developing and consistently implementing pertinent approaches.2.

Identification/assessment:a. Nursing staff shall assess hydration status upon admission and throughout the resident's stay in accordance with assessment protocols.

Event ID:

Facility ID:

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Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/22/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Whitefish Care and Rehabilitation

1305 E 7th St Whitefish, MT 59937

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0726 Level of Harm - Actual harm Residents Affected - Few Note: The nursing home is disputing this citation.

FORM CMS-2567 (02/99) Previous Versions Obsolete

of shift, it was reported that resident #3 was not eating or drinking, and there was no report of nausea or vomiting. Staff member L said she was aware that resident #3 was admitted with a tooth infection, and she was on antibiotics and was taking a diuretic for her congestive heart failure. Staff member L said hydration was not documented and recorded in the medical record for each resident. During an interview on 10/22/25 at 10:47 a.m., staff member O said when doing the chart review for the requested documentation, it was noted that the intake and output for most facility residents had been deleted from the charting system. Due to this, the resident's intake and output were not reflected in the EHR. The failure of the staff to competently ensure the resident's intake and or hydration was documented, preventing the facility and staff from identifying concerns or trends timely.During an interview on 10/22/25 at 11:28 a.m., staff member B said

the registered dietitian had been disabling the hydration tracking for each resident when she placed the order for meal consumption, although tracking the hydration assists with maintaining a resident's health and is used for identifying concerns or trends related to hydration. Review of resident #3's medical record weight documentation showed resident #3 weighed 129.8 pounds on admission. Resident #3's medical

record showed no documentation of a weight for three weeks; and then it was identified that the resident had a 14-pound weight loss, which was a severe loss at 10.4%, and this was 26 days after her admission.

Review of resident #3's physician order summary showed an order on 9/5/2025, Obtain weekly weights; reweigh if >5# difference from previous week in the morning every Mon [Monday]. This was not completed as ordered by the nursing staff. Review of a facility policy, Hydration, with an implementation date of 7/1/2025, showed: Policy:The facility offers each resident sufficient fluid, including water and other liquids, consistent with resident needs and preferences to maintain proper hydration and health.Sufficient fluid means the amount of fluid needed to prevent dehydration . and maintain health. The amount needed is specific to each resident and fluctuates as the resident's condition fluctuates.1. The facility will utilize a systematic approach to optimize the resident's hydration status:a. Identifying and assessing each resident's hydration status and risk factorsb. Evaluating/analyzing the assessment informationc. Developing and consistently implementing pertinent approaches.2. Identification/assessment:a. Nursing staff shall assess hydration status upon admission and throughout the resident's stay in accordance with assessment protocols.

Event ID:

Facility ID:

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Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/22/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Whitefish Care and Rehabilitation

1305 E 7th St Whitefish, MT 59937

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0791 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

payment for the procedure. Resident #3 expressed she could not afford the amount and agreed to cancel

the appointment.Record review of resident #3's Nutritional Services IDT Note, which was a late entry dated 9/25/25, showed resident #3 was admitted post-hospitalization with antibiotic therapy for urinary tract infection and tooth/jaw infection. Resident #3 had poor dentition with a dental infection present. Resident #3 was having difficulty with chewing.Record review of resident #3's Nutritional Services IDT Note, dated 10/1/25 showed: . WTS: (9/30) 115.8# (9/8) 125.6# (9/4) 129.8#Noted significant wt [weight] loss of -14# (10.8%) x 1mo [month] since admission . Reported decrease in appetite with intakes averaging 40-60% of meals. Noted dental infection but no plan for surgery as resident cannot afford to pay for out of pocket expenses. [sic]Review of resident #3's care plan, initiated 9/17/25, showed a focus for dental and an intervention to coordinate arrangements for dental care and transportation as needed/as ordered.

Event ID:

Facility ID:

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Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/22/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Whitefish Care and Rehabilitation

1305 E 7th St Whitefish, MT 59937

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0887

Guidance. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/covid/hcp/vaccine-considerations/routine-guidance.html#heading-od-jmebm1w

Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/22/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Whitefish Care and Rehabilitation

1305 E 7th St Whitefish, MT 59937

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0919 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

FORM CMS-2567 (02/99) Previous Versions Obsolete

but they would sometimes not work outside of the rooms. Staff member C stated they always worked on the call system status board, so you'd have to walk back to the nursing station to know exactly who was calling.Review of a facility document titled Work Orders, dated 11/1/25 to 11/30/25, showed: 13 call lights had issues and were fixed.During an interview with staff members A, B, and F on 12/4/25 at 11:01 a.m., staff member A did not see a concern with the number of call lights fixed for November 2028, but staff member F stated he felt this was a lot of call lights being fixed in a month, and that might mean there is something ultimately wrong with the system. Staff member F stated that call lights not working could lead to

a lot of unhappy residents, so the facility should look into the inconsistencies.4. Review of the facility's grievances regarding call lights from 8/18/25 to 11/2/25 showed:-8/18/25 - Resident #13 wrote: 300 hallway light - for call lights does not work .-10/13/25 - NF2 wrote: Nurse stated He's been here before he knows how to use the call light, light was out of reach and sister had to get it off of curtain. States residents not being heard/needs met. [sic]-11/2/25 - Resident #14 wrote: Stated his aid . took a long time to respond to needs. On night of 11/1, aid answered call light but did not resolve his issue. He had to put call light on again and a different aid was able to resolve his need. [sic]

Event ID:

Facility ID:

If continuation sheet