Federal inspection record · CMS data as of October 1, 2026
Awe Kualawaache Care Center
10131 S Heritage Rd, Crow Agency, MT · (406) 638-9111
- Certified beds
- 40
- Residents per day
- 26
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- June 9, 1998
1
How this home got 4 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Montana.
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Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★−1 star
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★4 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Montana homes
Awe Kualawaache Care Center carries 31 inspection points. That is fewer than 90% of Montana's 59 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Montana: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–31.5 pts
- 4★ 31.5–49.25 pts
- 3★ 49.25–84.75 pts
- 2★ 84.75–135.38 pts
- 1★ over 135.38 pts
Bars show every rated home in Montana by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
18 health citations on record since 2024. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Resident Assessment and Care Planning3D
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Quality of Life and Care3D
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide enough food/fluids to maintain a resident's health.
- D
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Administration3E
- E
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
- E
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
- B
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Pharmacy Service2D
- D
Ensure each resident’s drug regimen must be free from unnecessary drugs.
- D
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Infection Control2F
- D
Provide and implement an infection prevention and control program.
- F
Provide and implement an infection prevention and control program.
Freedom from Abuse, Neglect, and Exploitation2D
- D
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Nursing and Physician Services2D
- D
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
- D
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Resident Rights1D
- D
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Inspection history
2026-06-04
5 health deficiencies · 9 fire-safety deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
2025-05-08
5 health deficiencies · 4 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (1 deficiency)
2024-04-25
8 health deficiencies · 5 fire-safety deficiencies
Top issue: Administration (3 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 29 min of nursing staff time a day, 1 h 23 min of it from a registered nurse.
This home
3 h 29 min
Montana average
4 h 1 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 46% of nursing staff and 14% of registered nurses left in the past year.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine3.3 pts better | 100.0% | 96.7% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine6 pts better | 100.0% | 94.0% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury0.1 pts worse | 4.5% | 4.4% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms5 pts better | 1.3% | 6.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.6 pts worse | 8.0% | 6.4% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication13.1 pts better | 2.3% | 15.4% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication14.7 pts worse | 35.4% | 20.7% | 15.4% |
| Percentage of long-stay residents who were physically restrained7.3 pts worse | 7.9% | 0.6% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened26.9 pts worse | 43.0% | 16.1% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased17.7 pts worse | 36.2% | 18.5% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder1.4 pts better | 0.6% | 2.0% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.9 pts better | 1.1% | 3.0% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence6.7 pts better | 15.4% | 22.1% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1 pts better | 5.2% | 6.2% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine4.1 pts better | 88.2% | 84.1% | 82.3% |
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Who owns and runs it
3 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Crow Tribe Of Indians | 5% Or Greater Direct Ownership Interest · Organization | 100% | 1 facilities |
| Health Management Services, LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Little Light, Paul | W-2 Managing Employee · Individual | 0% | 1 facilities |
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Fire safety
18 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke7F
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Properly select, install, inspect, or maintain portable fire extinguishes.
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Provide properly protected cooking facilities.
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Properly select, install, inspect, or maintain portable fire extinguishes.
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Egress5F
- F
Install emergency lighting that can last at least 1 1/2 hours.
- D
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
- D
Have properly located and lighted "Exit" signs.
- F
Install emergency lighting that can last at least 1 1/2 hours.
- D
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Gas, Vacuum, and Electrical Systems4F
- F
Have generator or other power source capable of supplying service within 10 seconds.
- F
Ensure that testing and maintenance of electrical equipment is performed.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- E
Meet requirements for the installation and maintenance of electrical systems.
Miscellaneous2F
- F
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- F
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
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Other homes nearby
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River Ridge Rehabilitation And Nursing LLC
Billings, MT · The Charly Bello Family, The Maze Family, The Swain Family, & Walter Myers
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 10 min
- Fines
- $80,893
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Billings Rehabilitation And Nursing LLC
Billings, MT · The Charly Bello Family, The Maze Family, The Swain Family, & Walter Myers
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 2 h 58 min
- Fines
- $21,847
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Yellowstone River Nursing And Rehabilitation
Billings, MT · Eduro Healthcare
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 19 min
- Fines
- $127,566