Big Horn County, Montana · Nursing home
Awe Kualawaache Care Center
4 of 5 overall from CMS
10131 S Heritage Rd, Crow Agency, MT 59022
At a glance
- Overall rating 4 of 5 Above the state average of 2.9
- Nurse time per resident, per day 4.08 hours Above the state average of 4.05
- Nursing staff who left in a year 61.5% Above the state average of 54.8%
- Health citations, last 3 inspection cycles 18 None at the harm level or above
- Fines in 3 years None None listed by CMS
- Certified beds in use 59.2% of 40 beds, on an average day
Arrows only show whether a figure is above or below the state average. They are not a judgment of the home.
Awe Kualawaache Care Center is a 40-bed nursing home in Crow Agency, Montana (Big Horn County). CMS rates it 4 of 5 stars overall as of Sep 2026. It reports 4.08 nurse staffing hours per resident per day, above the Montana average of 4.05. CMS lists no fines in the past three years.
- Certified beds
- 40
- Residents per day (average)
- 23.7
- Certified since
- 1998 (28 yrs)
For profit - Individual Participates in Medicare and Medicaid
Bed use is this site's calculation: average residents per day divided by certified beds. It is an average, so it does not show today's openings.
Terms used on this page
- CMS
- The Centers for Medicare & Medicaid Services, the federal agency that publishes the ratings, staffing figures, inspection results and penalties shown here.
- Certified beds
- The number of federally certified beds CMS lists for the home.
- Deficiency or citation
- A federal requirement that inspectors found the home did not meet. Each one gets a letter from A to L for how serious it was and how many residents were affected. What the letters mean
- Actual harm
- Letters G, H and I: actual harm to a resident that is not immediate jeopardy.
- Immediate jeopardy
- Letters J, K and L: the problem caused, or was likely to cause, serious injury, harm, impairment or death to a resident.
- Inspection cycle
- A standard inspection plus the complaint and infection-control citations CMS assigns to it. This page shows the three most recent cycles.
- Special Focus Facility (SFF)
- A home CMS has placed under closer oversight because of its inspection record. More about the program
Questions to ask Awe Kualawaache Care Center
Chosen from this home's public data.
- Nursing staff turnover is 61.5%, above the Montana average of 54.8%. How often would the same aides care for my relative?Turnover in CMS data
- Reported nurse staffing is 3.41 hours per resident on weekends against 4.08 overall. Who covers Saturdays and Sundays?Weekend staffing in CMS data
- About 59.2% of certified beds are in use on an average day. Are any units closed, or are admissions limited?Certified beds and average residents in CMS data
More in what to ask on a nursing home tour.
CMS star ratings
- Overall 4 of 5 Montana average 2.9
- Health inspections 5 of 5 Montana average 2.8
- Staffing 4 of 5 Montana average 3.6
- Quality measures 1 of 5 Montana average 3.0
The vertical line marks the Montana average. Ratings run from 1 to 5. How to read CMS star ratings
Nurse staffing
Hours of care per resident per day, as the home reported to CMS.
What these roles do
Nurse aides give most hands-on daily care, such as help with bathing, dressing and meals. Licensed practical nurses give medications and routine nursing care. Registered nurses assess residents and direct their care.
- All nursing staff 4.08 h Montana average 4.05
- Nurse aides 2.45 h Montana average 2.57
- Licensed practical nurses 0.22 h Montana average 0.50
- Registered nurses 1.41 h Montana average 0.98
- All staff, weekends 3.41 h Montana average 3.59
How much nurse staffing is enough? All bars share one scale, 0 to 8 hours. The vertical line marks the Montana average; the national average for all nursing staff is 3.86 hours.
- Nursing staff turnover61.5%
- Montana average54.8%
- Registered nurse turnover44.4%
- Montana average48.3%
Quality measures
CMS calculates these from residents' assessments and Medicare claims. They are shown as published, next to the Montana and national averages. marks the measures CMS uses in its quality star rating; for those, the rating gives more points for a lower rate.
Long-stay residents
| Measure | This home | Montana | U.S. |
|---|---|---|---|
| ★ Percentage of long-stay residents whose need for help with daily activities has increased | 31.4% | 18.7% | 13.9% |
| Percentage of long-stay residents who lose too much weight | 8.1% | 6.2% | 5.2% |
| ★ Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.6% | 2.1% | 0.8% |
| ★ Percentage of long-stay residents with a urinary tract infection | 1.1% | 2.9% | 1.6% |
| Percentage of long-stay residents who have depressive symptoms | 0.0% | 5.6% | 12.8% |
| Percentage of long-stay residents who were physically restrained | 6.9% | 0.6% | 0.1% |
| ★ Percentage of long-stay residents experiencing one or more falls with major injury | 2.3% | 4.4% | 3.2% |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% | 96.5% | 93.6% |
| ★ Percentage of long-stay residents whose ability to walk independently worsened | 43.0% | 17.2% | 14.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 3.5% | 15.8% | 19.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% | 93.6% | 95.5% |
| ★ Percentage of long-stay residents with pressure ulcers | 9.2% | 6.3% | 4.6% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 21.4% | 24.1% | 19.0% |
| ★ Percentage of long-stay residents who received an antipsychotic medication | 32.2% | 20.4% | 15.4% |
| ★ Number of hospitalizations per 1000 long-stay resident days | Too few residents or stays to report | 1.38 | 1.90 |
| ★ Number of outpatient emergency department visits per 1000 long-stay resident days | Too few residents or stays to report | 2.16 | 1.78 |
Short-stay residents
| Measure | This home | Montana | U.S. |
|---|---|---|---|
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 83.3% | 81.2% | 82.0% |
| ★ Percentage of short-stay residents who newly received an antipsychotic medication | Too few residents or stays to report | 1.2% | 1.6% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Too few residents or stays to report | 73.8% | 79.8% |
| ★ Percentage of short-stay residents who were rehospitalized after a nursing home admission | Too few residents or stays to report | 19.2% | 23.8% |
| ★ Percentage of short-stay residents who had an outpatient emergency department visit | Too few residents or stays to report | 14.5% | 12.0% |
Measure periods: April 2025 to March 2026 for most measures; July 2024 to June 2025 for the flu vaccine measures; January to December 2025 for the hospital and emergency department measures, which CMS risk-adjusts. See the measures on Medicare.gov
Inspection history
Inspectors cited 18 health deficiencies in the three most recent inspection cycles. None was graded as actual harm or immediate jeopardy. 10 were cited in connection with a complaint investigation.
| Standard inspection | Health | Fire safety |
|---|---|---|
| Jun 4, 2026 | 5 | 9 |
| May 8, 2025 | 5 | 4 |
| Apr 25, 2024 | 8 | 5 |
Montana homes averaged 11.2 health deficiencies in the latest cycle; the national average is 9.2. Each cycle's health count covers the standard inspection on that date plus the complaint and infection-control citations CMS assigns to that cycle.
Health citations, three most recent inspection cycles (18)
-
DPotential for more than minimal harm, isolated
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Jun 26, 2026)
-
DPotential for more than minimal harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Jun 26, 2026)
-
DPotential for more than minimal harm, isolated
Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care · Deficient, Provider has date of correction (Jun 26, 2026)
-
DPotential for more than minimal harm, isolated
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Pharmacy Service · Deficient, Provider has date of correction (Jun 26, 2026)
-
DPotential for more than minimal harm, isolated
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Jun 26, 2026)
Show 13 more
-
FPotential for more than minimal harm, widespread
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (May 30, 2025)
-
DPotential for more than minimal harm, isolated
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Resident Rights · Deficient, Provider has date of correction (May 30, 2025)
-
DPotential for more than minimal harm, isolated
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Dec 30, 2024)
-
DPotential for more than minimal harm, isolated
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Dec 30, 2024)
-
DPotential for more than minimal harm, isolated
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.
Complaint investigation · Nursing and Physician Services · Deficient, Provider has date of correction (Dec 30, 2024)
-
EPotential for more than minimal harm, pattern
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.
Complaint investigation · Administration · Deficient, Provider has date of correction (Aug 23, 2024)
-
EPotential for more than minimal harm, pattern
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Complaint investigation · Administration · Deficient, Provider has date of correction (Aug 23, 2024)
-
DPotential for more than minimal harm, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Aug 23, 2024)
-
DPotential for more than minimal harm, isolated
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Aug 23, 2024)
-
DPotential for more than minimal harm, isolated
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.
Complaint investigation · Pharmacy Service · Deficient, Provider has date of correction (Aug 23, 2024)
-
DPotential for more than minimal harm, isolated
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (May 16, 2024)
-
DPotential for more than minimal harm, isolated
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.
Complaint investigation · Nursing and Physician Services · Deficient, Provider has date of correction (May 16, 2024)
-
BPotential for minimal harm, pattern
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Administration · Deficient, Provider has date of correction (May 16, 2024)
What severity letters A to L mean
Each sentence above is the requirement that was not met, in CMS's wording. For the inspection results as Medicare publishes them, open this home's page on Medicare.gov and look under "Health inspections".
Penalties, past three years
CMS lists no fines or payment denials for this home in the past three years.
Montana homes averaged 1.5 fines and $55,610 in fine amounts; the national averages are 0.9 and $30,972.
Cost
Not in the public data. CMS does not publish what a nursing home charges.
Ask the home for its daily private-pay rate and whether a bed is open for your coverage. See what Medicare covers and how Medicaid pays for a nursing home.
Compared within Montana
- Size53 of 59 by certified beds
- Montana average residents per day56.7
- ChainNone listed
- Resident or family councilResident
- Homes in Big Horn County1
Common questions
What is the CMS star rating for Awe Kualawaache Care Center?
Awe Kualawaache Care Center has an overall rating of 4 of 5 stars from CMS as of Sep 2026. Its health inspection rating is 5, staffing is 4 and quality measures is 1.
How many beds does Awe Kualawaache Care Center have?
Awe Kualawaache Care Center has 40 certified beds. It averages 23.7 residents per day, about 59.2% of its certified beds.
How much nursing care do residents get at Awe Kualawaache Care Center?
The home reports 4.08 hours of nurse staffing per resident per day, including 1.41 hours from registered nurses. The Montana average is 4.05 hours and 0.98 hours from registered nurses.
Has Awe Kualawaache Care Center been fined?
CMS lists no fines for this home in the past three years.
Does Awe Kualawaache Care Center accept Medicare or Medicaid?
CMS lists its participation as "Medicare and Medicaid". Ask the home whether a bed is open for your coverage.
Guides for families looking at this home
- Understanding the recordWhat to ask on a nursing home tourQuestions that turn a home's public record into a useful conversation when you tour, plus what to look for yourself.
- Understanding the recordInspection severity letters A to LHow inspectors grade each deficiency by harm and by how many residents were affected.
- Understanding the recordHow to read CMS star ratingsWhat the overall, health inspection, staffing and quality measure ratings cover, and what they leave out.
Nearest nursing homes
- 2 of 5 River Ridge Rehabilitation and Nursing LLC 129beds 66.0%in use 3.23nurse hours a day
- 2 of 5 Billings Rehabilitation and Nursing LLC 100beds 77.0%in use 3.34nurse hours a day
- 1 of 5 Yellowstone River Nursing and Rehabilitation 160beds 72.5%in use 3.15nurse hours a day
Sorted by straight-line distance. This is not a ranking or a recommendation. Compare all homes in Big Horn County
Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026. CMS Certification Number 275153. See this home's official record on Medicare.gov
See something shown incorrectly? Tell us. This site shows each record as CMS publishes it and cannot change the underlying record.