Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before around December 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Glendive Medical Center N H during CMS and state inspections, most recent first.
Two residents were involved in an incident where one reported unwanted touching by a roommate to a nurse, but the nurse did not escalate the allegation to administration. As a result, the abuse allegation was not reported to the State Survey Agency within the required 24-hour period, only coming to light after a resident representative contacted social services.
The facility did not ensure that two residents received social services support or psychosocial assessments following allegations of abuse, such as harsh treatment and rough handling during care. Medical records lacked documentation of follow-up or evaluation by social services, despite staff acknowledging that such actions and notes were required.
The facility did not submit complete PBJ information to CMS for a quarter due to a missing job code (LPN2) in the file application. This resulted in the system failing to report hours worked by LPNs, despite timecards showing 24-hour coverage.
The facility failed to update care plans for several residents to include enhanced barrier precautions and other necessary interventions. A resident with a colostomy and urinary catheter, another with a urinary catheter, and a third on tube feeding did not have their care plans updated to reflect the need for enhanced barrier precautions. Additionally, a resident at risk for skin breakdown had a physician's order for a foot cradle that was not included in the care plan. Staff indicated that care plans were only updated quarterly, contributing to these deficiencies.
The facility failed to ensure timely medication regimen reviews by a registered pharmacist and that physicians addressed pharmacy recommendations promptly. For a resident, a six-week delay occurred in addressing a pharmacist's recommendation for a gradual dose reduction (GDR). Another resident experienced a ten-week delay in addressing medication change recommendations. Additionally, the facility lacked a comprehensive policy for monthly MRRs, contributing to these delays and inadequate documentation.
A facility failed to implement a comprehensive care plan for a resident with recurrent UTIs. Despite the resident's history and ongoing treatment with antibiotics, probiotics, and cranberry pills, the care plan lacked specific goals and interventions for UTI prevention. Staff interviews indicated care plans were updated quarterly, but real-time updates were being developed.
A facility failed to document the rationale for extending a PRN lorazepam order beyond 14 days for a resident. The resident, who had memory issues, had an active order for lorazepam for anxiety, despite responding well to non-pharmacological interventions. The staff member responsible for medication reviews was unaware of the regulation, and the medication review did not identify the issue. The facility's policy required prescriber documentation for extending PRN psychotropic medications, which was not followed.
Failure to Timely Report Resident-to-Resident Abuse Allegation
Penalty
Summary
The facility failed to report allegations of resident-to-resident abuse to the State Survey Agency within 24 hours as required. Specifically, a resident reported to a nurse that her roommate had engaged in unwanted touching of her thigh and groin area. This initial report was made by the resident to the nurse on 9/8/24, and the resident repeated her concerns an hour later. However, the nurse did not escalate the report to administration, resulting in a delay in notifying the appropriate authorities. The incident only came to the attention of facility administration when the resident's representative contacted social services several days later to request a room change due to the unwanted touching. Upon learning of the incident, the facility reported it to the State Survey Agency, but this was not within the required 24-hour timeframe from the initial event. The facility's own policy requires immediate reporting of such allegations, but this protocol was not followed due to the breakdown in communication between nursing staff and administration.
Failure to Provide Social Services Follow-Up After Alleged Abuse
Penalty
Summary
The facility failed to provide medically-related social services to assist two residents with emotional and psychosocial support following allegations of abuse. For one resident, after an incident where a staff member spoke harshly to her, there were no progress notes or social service documentation in the medical record from the date of the incident through several weeks later. Additionally, the resident exhibited behaviors such as frequent skin picking that resulted in open areas, but there was no evidence that social services assessed or addressed the potential psychosocial causes or connection to the alleged abuse. In a separate incident, another resident was reportedly handled roughly during a transfer. There were no progress notes or social service documentation indicating follow-up with the resident after the allegation. Staff interviews confirmed that social services follow-up and documentation should have occurred, including psychosocial assessments and notes in the medical record to reflect the residents' status after the events, but these were not completed.
Incomplete PBJ Submission Due to Missing Job Code
Penalty
Summary
The facility failed to submit complete and accurate Payroll Based Journal (PBJ) information to the Centers for Medicare and Medicaid Services (CMS) for the second quarter of the fiscal year 2024. The deficiency was identified when the PBJ Staffing Data Report indicated a failure to have licensed nursing coverage 24 hours each day. Upon review of the facility's timecards for specific dates within the quarter, it was confirmed that licensed nursing staff were present 24 hours each day. However, during an interview, a staff member revealed that a job code (LPN2) was missing from the file application, which led to the system not recognizing and reporting the hours worked by employees with this job code when the information was electronically transferred to the PBJ.
Failure to Update Resident Care Plans with Enhanced Barrier Precautions
Penalty
Summary
The facility failed to update care plans for four residents when changes in their care occurred. Resident #137, who had rectal cancer resulting in a colostomy and urinary retention necessitating a urinary catheter, was observed with an ostomy appliance and a urinary drainage bag. The care plan did not reflect the need for enhanced barrier precautions due to these conditions. Similarly, Resident #24, who had a urinary catheter, was not noted to be on enhanced barrier precautions in her care plan. Resident #14, who was on tube feeding, also had a care plan that failed to indicate the use of enhanced barrier precautions, despite the presence of a ladybug sticker indicating such precautions were necessary. Additionally, Resident #13, who was at risk for impaired skin integrity, had a physician's order for a foot cradle to prevent breakdown on the tops of her toes. However, this intervention was not included in the resident's care plan. Staff interviews revealed that care plans were only updated quarterly, which contributed to the failure to reflect current care needs. The facility's policy on Enhanced Barrier Precautions indicated that such precautions were necessary for residents with wounds or indwelling medical devices, yet this was not consistently documented in the care plans.
Failure to Conduct Timely Medication Regimen Reviews and Address Recommendations
Penalty
Summary
The facility failed to ensure that a registered pharmacist performed monthly medication regimen reviews (MRR) for residents, and that physicians addressed pharmacy recommendations and irregularities in a timely manner. Specifically, for one resident, the pharmacist recommended a gradual dose reduction (GDR) for certain medications, but the physician did not address these recommendations for six weeks. Additionally, there was no documentation indicating that a physician or pharmacist was present during the GDR discussion. Another resident's MRR showed recommendations for medication changes that were not addressed for ten weeks, and there was a lack of documentation of the pharmacist's presence during discussions. Furthermore, the facility did not maintain a comprehensive policy and procedure for monthly MRRs, which should have included documentation requirements and time frames for addressing identified irregularities. This lack of policy contributed to delays in addressing medication recommendations and irregularities, as evidenced by the absence of an MRR within 30 days of admission for another resident. The facility's policy also failed to outline steps for resolving disagreements between the pharmacist's recommendations and the attending provider's orders, as well as procedures for residents with an anticipated length of stay of less than 30 days.
Failure to Implement Comprehensive Care Plan for UTI Prevention
Penalty
Summary
The facility failed to implement a comprehensive, resident-centered care plan for a resident with a history of recurrent urinary tract infections (UTIs). The resident, who required assistance with toileting and perineal care, had been on antibiotics for UTIs and was also started on probiotics and cranberry pills for prevention. Despite these interventions, the resident's care plan did not include a focus area, goals, or interventions specifically related to the prevention of UTIs. This oversight was identified during a review of the resident's care plan dated late July 2024. Interviews with staff members revealed that care plans were typically updated on a quarterly basis, and the resident was due for her first quarterly care conference in late July 2024. However, the facility was in the process of developing a system for more real-time updates to care plans. The lack of a comprehensive care plan addressing the resident's recurrent UTIs was a deficiency noted by surveyors, as it failed to meet the resident's specific health needs.
Failure to Document Rationale for Extended Use of PRN Psychotropic Medication
Penalty
Summary
The facility failed to ensure that orders for as-needed psychotropic medications did not exceed 14 days without documented rationale from the provider for one of the sampled residents. During an observation, a resident was seen walking with a walker and expressed memory issues. The resident had an active order for lorazepam 0.5 mg every four hours as needed for anxiety, which had been in place since early July and was still active by the end of the month. Interviews with staff revealed that the resident responded well to non-pharmacological interventions such as redirection and distraction techniques when anxious. The staff member responsible for medication regimen reviews was new to the role and unaware of the regulations regarding the duration of as-needed psychotropic medication orders. The medication regimen review conducted after the survey began did not identify the issue of the prolonged as-needed order. Additionally, the resident's electronic health record lacked documentation from a medical provider justifying the continued use of lorazepam beyond the 14-day limit. The facility's policy on psychotropic drug use required prescriber documentation for extending as-needed psychotropic medications beyond 14 days, which was not adhered to in this case.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Glendive
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Eastern Montana Veterans Home | 0.9 mi | — | 2 | 0 |
| Wibaux County Nursing Home | 25.8 mi | — | 7 | 1 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.