Federal inspection record · CMS data as of October 1, 2026
Livingston Health & Rehabilitation Center
510 S 14th St, Livingston, MT · (406) 222-0672
- Cited for abuse (CMS abuse icon)
- Special Focus Facility
- Certified beds
- 115
- Residents per day
- 57
- Ownership
- For-Profit
- Chain
- Evergreen Healthcare Group
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- August 1, 1974
1
How this home got 1 star
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.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Montana.
-
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.
-
Quality measures
★★★★★no change (already 1)
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
This home carries CMS's abuse icon, which caps its inspection rating at 2 stars and so its overall rating at 4.
2
Where it sits among Montana homes
Livingston Health & Rehabilitation Center carries 222 inspection points. That is fewer than 7% 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
45 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.
Harm and immediate-jeopardy citations (6)
-
G
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
-
G
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
-
G
Provide enough food/fluids to maintain a resident's health.
-
G
Provide and implement an infection prevention and control program.
-
G
Provide enough food/fluids to maintain a resident's health.
-
G
Provide safe, appropriate pain management for a resident who requires such services.
Everything else, by area of care
Freedom from Abuse, Neglect, and Exploitation9E
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- D
Respond appropriately to all alleged violations.
- E
Respond appropriately to all alleged violations.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- B
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- E
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- E
Respond appropriately to all alleged violations.
- E
Respond appropriately to all alleged violations.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Resident Rights6D
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
- D
Keep residents' personal and medical records private and confidential.
- D
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.
- D
Prepare residents for a safe transfer or discharge from the nursing home.
- D
Allow residents to self-administer drugs if determined clinically appropriate.
Resident Assessment and Care Planning6E
- D
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- D
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- B
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- E
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Nutrition and Dietary6F
- D
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- F
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
- D
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Quality of Life and Care4D
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Infection Control3F
- E
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
- F
Provide and implement an infection prevention and control program.
- D
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Pharmacy Service3E
- D
Ensure that residents are free from significant medication errors.
- E
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
- E
Ensure medication error rates are not 5 percent or greater.
Nursing and Physician Services2F
- E
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.
- F
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Inspection history
2026-06-29
21 health deficiencies · 11 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (6 deficiencies)
2025-06-05
16 health deficiencies · 13 fire-safety deficiencies
Top issue: Quality of Life and Care (4 deficiencies)
2024-07-03
8 health deficiencies · 12 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 26 min of nursing staff time a day, 49 min of it from a registered nurse.
This home
3 h 26 min
Montana average
4 h 1 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 75% of nursing staff and 70% 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
Fines and payment denials
$35,069 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2026-06-29 | Fine | $17,665 |
| 2024-12-31 | Fine | $17,404 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.7 pts worse | 2.1 | 1.4 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.9 pts worse | 3.0 | 2.1 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine1.7 pts better | 98.4% | 96.7% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine36 pts worse | 58.0% | 94.0% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury3.4 pts better | 1.0% | 4.4% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms46.3 pts worse | 52.6% | 6.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.7 pts better | 5.7% | 6.4% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication3.9 pts worse | 19.3% | 15.4% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication1.9 pts worse | 22.6% | 20.7% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.6 pts better | 0.0% | 0.6% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened9.5 pts worse | 25.6% | 16.1% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased10.3 pts worse | 28.8% | 18.5% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.3 pts better | 1.7% | 2.0% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.3 pts better | 1.7% | 3.0% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence4.1 pts worse | 26.2% | 22.1% | 18.3% |
| Percentage of long-stay residents with pressure ulcers3 pts worse | 9.2% | 6.2% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine0.3 pts worse | 83.8% | 84.1% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit0.9 pts worse | 14.0% | 13.1% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication3.4 pts worse | 4.6% | 1.2% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine5.2 pts better | 81.9% | 76.7% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission5.3 pts worse | 25.5% | 20.2% | 23.4% |
·
Who owns and runs it
35 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 |
|---|---|---|---|
| Ch Pacific Northwest Holdings LLC | Indirect Ownership Interest · Organization | 0% | 22 facilities |
| Ch Pacific Northwest Holdings LLC | Adp Of The SNF · Organization | 0% | 22 facilities |
| Cheeks, Donald | Managing Control - Governing Body · Individual | 0% | 7 facilities |
| Cheeks, Donald | Operational/Managerial Control · Individual | 0% | 7 facilities |
| Cheeks, Donald | Adp Of The SNF · Individual | 0% | 7 facilities |
| Couve Financial Services LLC | Operational/Managerial Control · Organization | 0% | 41 facilities |
| Couve Financial Services LLC | Adp Of The SNF · Organization | 0% | 41 facilities |
| Couve Healthcare Consulting LLC | Operational/Managerial Control · Organization | 0% | 50 facilities |
| Couve Healthcare Consulting LLC | Adp Of The SNF · Organization | 0% | 50 facilities |
| Herzka, Yisroel | Indirect Ownership Interest · Individual | 0% | 75 facilities |
| Herzka, Yisroel | Adp Of The SNF · Individual | 0% | 75 facilities |
| Johnson, Rebecca | Managing Control - Governing Body · Individual | 0% | 5 facilities |
| Johnson, Rebecca | Operational/Managerial Control · Individual | 0% | 5 facilities |
| Johnson, Rebecca | Adp Of The SNF · Individual | 0% | 5 facilities |
| Livingston SNF Operations LLC | Direct Ownership Interest · Organization | 0% | 1 facilities |
| Livingston SNF Operations LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Livingston SNF Operations LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Mitchell, Lauren | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Mitchell, Lauren | Adp Of The SNF · Individual | 0% | 1 facilities |
| Montana SNF Consulting LLC | Operational/Managerial Control · Organization | 0% | 4 facilities |
| Montana SNF Consulting LLC | Adp Of The SNF · Organization | 0% | 4 facilities |
| Pacific Northwest Opco Management LLC | Operational/Managerial Control · Organization | 0% | 29 facilities |
| Pacific Northwest Opco Management LLC | Adp Of The SNF · Organization | 0% | 29 facilities |
| Pacific Northwest SNF Operations Holdings (Mt) LLC | Direct Ownership Interest · Organization | 0% | 4 facilities |
| Pacific Northwest SNF Operations Holdings LLC | Indirect Ownership Interest · Organization | 0% | 16 facilities |
| Rich, Karrie | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Rich, Karrie | Adp Of The SNF · Individual | 0% | 2 facilities |
| Spielman, Shimon | Corporate Officer · Individual | 0% | 48 facilities |
| Spielman, Shimon | Operational/Managerial Control · Individual | 0% | 48 facilities |
| Spielman, Shimon | Adp Of The SNF · Individual | 0% | 48 facilities |
| Witzcorp Global LLC | Indirect Ownership Interest · Organization | 0% | 21 facilities |
| Witzcorp Global LLC | Adp Of The SNF · Organization | 0% | 21 facilities |
| Yenowitz, Yitzchok | Indirect Ownership Interest · Individual | 0% | 50 facilities |
| Yenowitz, Yitzchok | Operational/Managerial Control · Individual | 0% | 50 facilities |
| Yenowitz, Yitzchok | Adp Of The SNF · Individual | 0% | 50 facilities |
·
Fire safety
36 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke14F
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D
Properly select, install, inspect, or maintain portable fire extinguishes.
- D
Install corridor and hallway doors that block smoke.
- F
Provide properly protected cooking facilities.
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Properly select, install, inspect, or maintain portable fire extinguishes.
- D
Install corridor and hallway doors that block smoke.
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- F
Inspect, test, and maintain automatic sprinkler systems.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D
Properly select, install, inspect, or maintain portable fire extinguishes.
- D
Install corridor and hallway doors that block smoke.
Gas, Vacuum, and Electrical Systems8F
- 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.
- 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.
- D
Ensure proper usage of power strips and extension cords.
- 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.
- D
Ensure proper usage of power strips and extension cords.
Egress7F
- F
Install emergency lighting that can last at least 1 1/2 hours.
- D
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- D
Have stairways and smokeproof enclosures used as exits that meet safety requirements.
- D
Have exits that are accessible at all times.
- D
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- D
Have stairways and smokeproof enclosures used as exits that meet safety requirements.
Miscellaneous5F
- F
Have simulated fire drills held at unexpected times.
- F
Have simulated fire drills held at unexpected times.
- E
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F
Have simulated fire drills held at unexpected times.
- F
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Emergency Preparedness2F
- F
Conduct testing and exercise requirements.
- F
Include a process for Emergency Preparedness collaboration.
·
Other homes nearby
-
Gallatin Rest Home
Bozeman, MT
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 5 h 54 min
- Fines
- $55,413
-
Madison Valley Manor
Ennis, MT
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- —
- Fines
- $0
-
Beartooth Rehabilitation And Nursing LLC
Columbus, MT · The Charly Bello Family, The Maze Family, The Swain Family, & Walter Myers · Special Focus · Abuse icon
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 2 h 51 min
- Fines
- $50,592