Total health inspections
5
State average N/A
Last Health inspection on Apr 2025
Sapphire Lutheran Homes
Nursing Home, Assisted Living, Independent Living & Memory Care · Hamilton, MT
CMS overall rating
3/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
3/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Sapphire Lutheran Homes
Nursing Home, Assisted Living, Independent Living & Memory Care · Hamilton, MT
CMS overall rating
3/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
3/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Sapphire Lutheran Homes is a 40-bed independent living facility and memory care community operated by a nonprofit Christian organization at 501 N 10th, Hamilton, Ravalli County, Montana, offering independent living and memory support services with 24-hour staffing, respite care, housekeeping and maintenance services, physical social and spiritual wellness activities, community gathering areas, library, and game rooms. The campus features views of the Bitterroot Mountains and comprises 64 individual homes with one- and two-bedroom apartments offering meals and scheduled activities in a secure environment. The facility does not accept Medicaid or Medicare and does not offer rehabilitation services.
Hamilton is the county seat of Ravalli County in the Bitterroot Valley of western Montana. Marcus Daly Memorial Hospital is the primary nearby acute-care resource.
Inspection records span a single documented visit on November 6, 2015, yielding 2 deficiencies, 66 percent better than Montana average of 5.8. The November 6, 2015, renewal inspection identified 2 deficiencies: no documentation that policies and procedures had been reviewed annually by administrator or medical director; food storage violations with cans and boxes on floors of walk-in freezer, refrigerator, and dry storage room, and uncovered food in baking sheet and plate in refrigerator. No complaint investigations or enforcement actions appear in the available record.
Documentation of annual policy review and food storage practices require verification.
Families should ask administrators directly about current annual policy review procedures and food safety protocols before enrollment.
Quality ratings
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Staffing hours breakdown
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
Total nursing care / resident
Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
7h 20m per day
Rank #2 / 38Nurse hours — State benchmarkedThis home is ranked 2nd out of 38 homes in Montana. Shows adjusted nurse hours per resident per day benchmarked to the Montana average, with a ranking across 38 Montana facilities. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Rankings are based only on facilities in Montana that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
vs avg
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 1h 24m per day | |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 9m per day | |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 3h 54m per day | |
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 4h 51m per day | |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 0m per day | |
|
Weekend RN
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 1h 5m per day |
40-bed community Rank #70 / 106Bed count — State benchmarkedThis home is ranked 70th out of 106 homes in Montana. Shows this facility's certified or reported bed count compared to other Montana facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families.Rankings are based only on facilities in Montana that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A moderately sized community that may balance personal attention with shared amenities and social activities.
2 years in operation Rank #33 / 89Years in operation — State benchmarkedThis home is ranked 33rd out of 89 homes in Montana. Shows how long this facility has been in operation compared to other Montana facilities. Longer operating histories may benefit residents, families, and staff.Rankings are based only on facilities in Montana that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A newer community that may feature more recent facilities and programs.
Walk Score: 82 / 100 Rank #13 / 159Walk Score — State benchmarkedThis home is ranked 13th out of 159 homes in Montana. Shows how walkable this facility's neighborhood is compared to the average Walk Score across Montana facilities. Higher scores benefit residents, families, and staff.Rankings are based only on facilities in Montana that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
About this community
Facility TypeRetirement Homes
StatusCurrent
IssuanceDecember 12, 2023
ExpirationDecember 11, 2026
License Number13294
Sapphire Lutheran Homes is administered by Cole Harden.
Licensed Nurses/CNAs
24-Hour Staffing
Housekeeping And Maintenance Services
Physical
Social
And Spiritual Wellness Activities
Community Gathering Areas
A Library
And Game Rooms
Activitiesregular exercise sessions
Inspection History
In Montana, the Department of Public Health and Human Services, Quality Assurance Division is the state body responsible for inspecting and licensing all senior residential care facilities.
Since 2015 · 11 years of data
2 deficiencies
4 inspections
Inspection Scorecard
This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Montana state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Since 2015 vs. Montana state average
Overall vs. MT average
0 Worse
No metrics in this bucket.
4 Better
Metrics better than Montana average:
• Total deficiencies (90% below)
• Deficiencies per year (89% below)
• Deficiencies per inspection (88% below)
• Total inspections (20% below)
• Total deficiencies (90% below)
• Deficiencies per year (89% below)
• Deficiencies per inspection (88% below)
• Total inspections (20% below)
Latest Inspection
November 6, 2015
Renewal
Deficiencies
| This Facility | MT Average | vs. MT Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 2 | 21 | This facility has 90% fewer total deficiencies than a typical Montana assisted living residence (2 vs. MT avg 21).↓ 90% better |
|
Deficiencies per year
Average deficiencies per year since 2015.
| 0.2 | 1.9 | This facility has 89% fewer deficiencies per year than a typical Montana assisted living residence (0.2 vs. MT avg 1.9).↓ 89% better |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 0.5 | 4.2 | This facility has 88% fewer deficiencies per inspection than a typical Montana assisted living residence (0.5 vs. MT avg 4.2).↓ 88% better |
Inspections
| This Facility | MT Average | vs. MT Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 4 | 5 | This facility has 20% fewer total inspections than a typical Montana assisted living residence (4 vs. MT avg 5).↓ 20% better |
Inspection Reports Summary
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
- November 6, 2015 inspection found 2 deficiencies, including missing annual policy review documentation and multiple food safety violations in storage areas.
- Food safety issues involved uncovered food and items stored on the floor in walk-in freezer, refrigerator, and dry storage rooms.
- No complaints were reported or substantiated during the November 6, 2015 renewal inspection.
Health Inspection History
Inspections
Total health citations
24
Rank #14 / 39Health citations — State benchmarkedThis home is ranked 14th out of 39 homes in Montana. Shows this facility's total health deficiency citations benchmarked to the Montana State average, with a ranking across all 39 MT facilities. Lower citation counts earn a better rank.Rankings are based only on facilities in Montana that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
State average N/A
Citations per inspection
4.8
Rank #11 / 39Citations per inspection — State benchmarkedThis home is ranked 11th out of 39 homes in Montana. Shows average deficiency citations per CMS inspection for this facility versus the Montana mean across 39 facilities with citation data. Lower is better.Rankings are based only on facilities in Montana that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
State average N/A
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
16 of 24 citations resulted from standard inspections; 7 of 24 resulted from complaint investigations; and 1 of 24 came from combined inspections (standard and complaint).
Breakdown of citation severity (last 3 years)
Critical health citations
0
In line with State averageState average: N/A
Serious health citations
1
In line with State averageState average: N/A
Citations history (last 3 years)
Infection Control moderate citation
Apr 23, 2025
Corrected
Infection Control moderate citation
Apr 23, 2025
Corrected
Nutrition moderate citation
Apr 23, 2025
Corrected
Nutrition moderate citation
Apr 23, 2025
Corrected
Staffing Data
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
Total staff
67
Employees
67
Contractors
0
Staff to resident ratio
1.63 : 1
0% compared with State averageState average ratio: 0 : 0
Avg staff/day
27
Average shift
8.8 hours
0% compared with State averageState average: 0 hours
Total staff hours (quarter)
21,890
Nursing staff breakdown
Q4 2025 · Oct 1 – Dec 31
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Registered Nurse
Manages medical care and health needs.
RN Staff
All 8 RN Staff are full-time employees. No contractors work on this role.
8
All 8 RN Staff are full-time employees. No contractors work on this role.
8
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.7 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.7 hoursLicensed Practical Nurse
Assists with medical care and medications.
LPN Staff
All 2 LPN Staff are full-time employees. No contractors work on this role.
2
All 2 LPN Staff are full-time employees. No contractors work on this role.
2
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.5 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.5 hoursCertified Nursing Assistant
Helps with daily care and mobility.
CNA Staff
All 37 CNA Staff are full-time employees. No contractors work on this role.
37
All 37 CNA Staff are full-time employees. No contractors work on this role.
37
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.3 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.3 hoursContractor staffing
Q4 2025 · Oct 1 – Dec 31
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
0% — all staff are direct employees this quarter
Staff by category
Q4 2025 · Oct 1 – Dec 31
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 37 | 0 | 37 | 11,617 | 92 | 100% | 9.3 |
| Registered Nurse | 8 | 0 | 8 | 4,576 | 92 | 100% | 10.7 |
| Nurse Aide in Training | 13 | 0 | 13 | 2,667 | 91 | 99% | 7 |
| Other Dietary Services Staff | 3 | 0 | 3 | 845 | 65 | 71% | 8.1 |
| Administrator | 2 | 0 | 2 | 673 | 66 | 72% | 5.5 |
| Licensed Practical Nurse | 2 | 0 | 2 | 535 | 54 | 59% | 9.5 |
| Nurse Practitioner | 1 | 0 | 1 | 528 | 66 | 72% | 8 |
| Dental Services Staff | 1 | 0 | 1 | 450 | 60 | 65% | 7.5 |
37 Certified Nursing Assistant
% of Days
100%
8 Registered Nurse
% of Days
100%
13 Nurse Aide in Training
% of Days
99%
3 Other Dietary Services Staff
% of Days
71%
2 Administrator
% of Days
72%
2 Licensed Practical Nurse
% of Days
59%
1 Nurse Practitioner
% of Days
72%
1 Dental Services Staff
% of Days
65%
Penalties and fines
Includes penalties issued in 2024
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database (Data as of Jan 2026)
Total fines amount
$23K Rank #17 / 39Federal fines — State benchmarkedThis home is ranked 17th out of 39 homes in Montana. Shows this facility's cumulative CMS federal fine dollars versus the Montana average among facilities with fines, and where it ranks among 39 facilities in the pool. Lower total dollars mean a better rank.Rankings are based only on facilities in Montana that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
74% lower than State averageState average: $87K
Number of fines
1
57% fewer fines than State averageState average: 2.3
Payment Denials
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
100% fewer payment denials than State averageState average: 0.2
Fines amount comparison
Fines amount comparison
This facility
$23K
State average
$87K
Penalty History
Penalties are imposed by CMS for violations of federal nursing home regulations.
1 penalty in the past 3 years
May 8, 2024 · $23K
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
May 8, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
May 8, 2024
$23K
Last updated: Jan 2026
Quality of care over time
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
High-risk clinical events score
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
6.8
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
6.8
39% better than State averageState average: 11.2
Functional decline score
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
10.3
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
10.3
53% better than State averageState average: 21.8
Long-stay resident measures
Need for Help with Daily Activities Increased
Percent of long-stay residents whose need for help with daily activities has increased
9.8%
Percent of long-stay residents whose need for help with daily activities has increased
9.8%
49% better than State averageState average: 19.4%
Walking Ability Worsened
Percent of long-stay residents whose ability to move independently worsened
5.2%
Percent of long-stay residents whose ability to move independently worsened
5.2%
75% better than State averageState average: 20.8%
Low Risk Residents with Bowel/Bladder Incontinence
Percent of low risk long-stay residents who lose control of their bowels or bladder
15.7%
Percent of low risk long-stay residents who lose control of their bowels or bladder
15.7%
37% better than State averageState average: 25.2%
Falls with Major Injury
Percent of long-stay residents experiencing one or more falls with major injury
0.0%
Percent of long-stay residents experiencing one or more falls with major injury
0.0%
100% better than State averageState average: 4.3%
High Risk Residents with Pressure Ulcers
Percent of long-stay high risk residents with pressure ulcers
8.9%
Percent of long-stay high risk residents with pressure ulcers
8.9%
41% worse than State averageState average: 6.3%
Urinary Tract Infection
Percent of long-stay residents with a urinary tract infection
15.1%
Percent of long-stay residents with a urinary tract infection
15.1%
449% worse than State averageState average: 2.8%
Lost Too Much Weight
Percent of long-stay residents who lose too much weight
10.1%
Percent of long-stay residents who lose too much weight
10.1%
65% worse than State averageState average: 6.1%
Depressive Symptoms
Percent of long-stay residents who have depressive symptoms
8.5%
Percent of long-stay residents who have depressive symptoms
8.5%
80% worse than State averageState average: 4.7%
Antipsychotic Use
Percent of long-stay residents who received an antipsychotic medication
6.6%
Percent of long-stay residents who received an antipsychotic medication
6.6%
65% better than State averageState average: 19.1%
Pneumococcal Vaccine
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
98.3%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
98.3%
5% better than State averageState average: 93.8%
Influenza Vaccine
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
97.8%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
97.8%
In line with State averageState average: 93.7%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
Facility Characteristics
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
41
Medicaid
31
75.6% of residents
Private pay or other
10
24.4% of residents
Programs & Services
Residents Group
Residents meet regularly to discuss policies, care quality, and activities
Nurse Aide Training
State-approved Nurse Aide Training and Competency Evaluation Program on-site
Active Resident Council
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Places of interest near Sapphire Lutheran Homes
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Estimated distance in miles from Hamilton's city center to Sapphire Lutheran Homes's address, calculated via Google Maps.
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Frequently Asked Questions about Sapphire Lutheran Homes
Is Sapphire Lutheran Homes in a walkable area?
Sapphire Lutheran Homes has a walk score of 82. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
What is the license number of Sapphire Lutheran Homes?
According to MT state health department records, Sapphire Lutheran Homes's license number is 13294.
When does Sapphire Lutheran Homes's license expire?
According to MT state health department records, Sapphire Lutheran Homes's license expires on December 11, 2026.
Does Sapphire Lutheran Homes operate as a for-profit or non-profit?
Sapphire Lutheran Homes is registered as a for-profit in MT.
Who is the administrator of Sapphire Lutheran Homes?
Cole Harden is the administrator of Sapphire Lutheran Homes.
How many beds does Sapphire Lutheran Homes have?
Sapphire Lutheran Homes has 40 beds.
Are there photos of Sapphire Lutheran Homes?
Yes — there are 6 photos of Sapphire Lutheran Homes in the photo gallery on this page.
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