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4/5
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.
4/5
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.
St. John’s United operates a 104-bed nursing facility at 3940 Rimrock Road, Billings, Montana, administered by Karna Rhodes and owned by Gerald Pearsall. This voluntary non-profit church-affiliated community is car-dependent (Walk Score 6), 7.9 miles from downtown Billings with immediate access to Fuller Family Medicine. Current census: 26 residents (25% occupancy), average stay 129 days. Payer mix: 63% Medicare (28 days typical), 36% private pay (5–6 months), 1% Medicaid (18–19 years).
Staffing (Q4 2025): 262 total personnel including 29 RNs, 14 LPNs, and 164 CNAs. Total nursing delivers 5 hours 16 minutes per resident per day (35% above Montana average); weekend nursing reaches 4 hours 43 minutes (38% above state norm). Staff-to-resident ratio of 3.32:1 significantly exceeds benchmarks.
Care modalities include nursing home, independent and assisted living, memory care, home care, and hospice. Amenities: private rooms, aquatic center, fitness center, restaurant-style dining, housekeeping, and storage. 2023 financials: $34.4 million revenue, $19.6 million payroll, $984,311 net income. The facility ranks first statewide in payroll investment.
Quality outcomes show mixed results. Long-stay residents experience falls with major injury at 3.0% (31% better than state), pressure ulcers at 4.3% (32% better), and urinary tract infection at 2.0% (27% better). However, weight loss reaches 11.4% (85% worse), functional decline scores 23.4 (8% worse), and antipsychotic use stands at 20.8% (9% worse). No monetary penalties in three years.
The inspection record reveals significant compliance challenges. Over 34 months (August 2023–July 2025), four inspections yielded 33 deficiencies; 686% above Montana’s per-inspection average. July 2025 annual inspection cited 6 deficiencies: grievance policy gaps, medication errors exceeding 5%, incomplete care plans, expired food disposal, hand hygiene failures, and infection control breaches. A concurrent complaint investigation identified 2 deficiencies for delayed abuse/investigative findings reporting (2 days late).
August 2024 routine inspection documented 15 deficiencies spanning medication assessment, delayed abuse reporting, assessment accuracy, care planning, fall prevention, psychotropic medication governance, dietary and kitchen sanitation failures, and vaccination gaps. An August 2024 complaint investigation substantiated 2 deficiencies: delayed neglect reporting and 3-hour late insulin delivery. April 2024 complaint investigation found 1 deficiency: incorrect antiepileptic dosing for 27 days.
August 2023 routine inspection identified 7 deficiencies including unmet caregiver preferences, dementia care planning gaps, pressure ulcer management, missing equipment, absent nonpharmacological interventions, medication errors, and refrigerator temperature control failures. An August 2023 complaint investigation confirmed 1 deficiency for absent nonpharmacological documentation preceding antipsychotic initiation.
All violations carry moderate severity; no critical or serious citations exist. Deficiency patterns center on medication management, care planning, incident reporting timeliness, infection prevention, dietary operations, and failure to implement nonpharmacological approaches before chemical restraint, demonstrating compliance persistence without documented systemic resolution
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.
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.
This home is ranked 6th out of 34 homes in Montana for nurse hours. 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.
| 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 17m per day | ▲ 40% State avg: 55m per day · National avg: 41m 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.
| 34m per day | ▲ 15% State avg: 30m per day · National avg: 52m 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 6m per day | ▲ 22% State avg: 2h 32m per day · National avg: 2h 20m 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 28m per day | ▲ 26% State avg: 3h 33m per day · National avg: 3h 27m 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.
| 6m per day | ▲ 45% State avg: 4m per day · National avg: 4m 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 | ▲ 59% State avg: 41m per day · National avg: 29m per day |
Lower than the Montana average: 61.7%St. John‘s United is administrated by Karna Rhodes.
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.
This scorecard compares key inspection, citation, 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.
Deficiencies
| This Facility | MT Average | vs. MT Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 33 | 21 | This facility has 57% more total deficiencies than a typical Montana assisted living residence (33 vs. MT avg 21).↑ 57% worse |
|
Deficiencies per year
Average deficiencies per year since 2023.
| 11 | 7 | This facility has 57% more deficiencies per year than a typical Montana assisted living residence (11 vs. MT avg 7).↑ 57% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 33 | 4.2 | This facility has 686% more deficiencies per inspection than a typical Montana assisted living residence (33 vs. MT avg 4.2).↑ 686% worse |
Inspections
| This Facility | MT Average | vs. MT Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 1 | 5 | This facility has 80% fewer total inspections than a typical Montana assisted living residence (1 vs. MT avg 5).↓ 80% better |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
Montana average 5.1
Last Health inspection on Jul 2025
Montana average 29.7
Montana average 5.72
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
28 of 33 citations resulted from standard inspections; 2 of 33 resulted from complaint investigations; and 3 of 33 came from combined inspections (standard and complaint).
100% better than Montana averageMontana average: 0.3
100% better than Montana averageMontana average: 2.2
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
79% more staff per resident than Montana average
7% worse than Montana average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
29 total: 27 full-time employees and 2 contractors.
29
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10 hoursAssists with medical care and medications.
14 total: 11 full-time employees and 3 contractors.
14
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10 hoursHelps with daily care and mobility.
164 total: 91 full-time employees and 73 contractors.
164
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.1 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
7,897 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 91 | 73 | 164 | 20,672 | 92 | 100% | 8.1 |
| Registered Nurse | 27 | 2 | 29 | 6,453 | 92 | 100% | 10 |
| Licensed Practical Nurse | 11 | 3 | 14 | 3,964 | 92 | 100% | 10 |
| Clinical Nurse Specialist | 5 | 0 | 5 | 2,111 | 64 | 70% | 8 |
| Occupational Therapy Assistant | 6 | 0 | 6 | 1,765 | 85 | 92% | 6.1 |
| Mental Health Service Worker | 4 | 0 | 4 | 1,707 | 65 | 71% | 8.1 |
| Other Dietary Services Staff | 5 | 0 | 5 | 1,479 | 75 | 82% | 7.5 |
| Physical Therapy Assistant | 0 | 7 | 7 | 1,342 | 77 | 84% | 7 |
| Speech Language Pathologist | 0 | 5 | 5 | 928 | 69 | 75% | 6.6 |
| Nurse Aide in Training | 6 | 0 | 6 | 822 | 47 | 51% | 9.7 |
| Physical Therapy Aide | 0 | 3 | 3 | 694 | 67 | 73% | 7.1 |
| Respiratory Therapy Technician | 0 | 6 | 6 | 651 | 71 | 77% | 4.8 |
| Qualified Social Worker | 0 | 2 | 2 | 466 | 62 | 67% | 6.5 |
| Occupational Therapy Aide | 0 | 2 | 2 | 427 | 64 | 70% | 4.8 |
| Nurse Practitioner | 1 | 0 | 1 | 408 | 52 | 57% | 7.8 |
| Dietitian | 1 | 0 | 1 | 252 | 63 | 68% | 4 |
| Administrator | 1 | 0 | 1 | 220 | 55 | 60% | 4 |
| Medical Director | 0 | 1 | 1 | 37 | 16 | 17% | 2.3 |
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
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
11.5
In line with Montana averageMontana average: 11.2
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
23.4
8% worse than Montana averageMontana average: 21.8
Percent of long-stay residents whose need for help with daily activities has increased
18.7%
In line with Montana averageMontana average: 19.4%
Percent of long-stay residents whose ability to move independently worsened
20.0%
In line with Montana averageMontana average: 20.8%
Percent of low risk long-stay residents who lose control of their bowels or bladder
31.6%
26% worse than Montana averageMontana average: 25.2%
Percent of long-stay residents experiencing one or more falls with major injury
3.0%
31% better than Montana averageMontana average: 4.3%
Percent of long-stay high risk residents with pressure ulcers
4.3%
32% better than Montana averageMontana average: 6.3%
Percent of long-stay residents with a urinary tract infection
2.0%
27% better than Montana averageMontana average: 2.8%
Percent of long-stay residents who lose too much weight
11.4%
85% worse than Montana averageMontana average: 6.1%
Percent of long-stay residents who have depressive symptoms
2.6%
44% better than Montana averageMontana average: 4.7%
Percent of long-stay residents who received an antipsychotic medication
20.8%
9% worse than Montana averageMontana average: 19.1%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
91.5%
In line with Montana averageMontana average: 93.8%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
7% better than Montana averageMontana average: 93.7%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
97.3%
27% better than Montana averageMontana average: 76.4%
Percent of short-stay residents who newly received an antipsychotic medication
1.2%
32% better than Montana averageMontana average: 1.8%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
82.1%
11% better than Montana averageMontana average: 73.8%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
63% of new residents, usually for short-term rehab.
36% of new residents, often for short stays.
1% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
79Residents meet regularly to discuss policies, care quality, and activities
Part of a Continuing Care Retirement Community offering multiple care levels
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.
Historical financial and operational data for St. John‘s United from 2011–2023, based on CMS SNF Cost Reports.
Based on the 2023 CMS SNF Cost Report.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #1 / 31Payroll — State benchmarkedThis home is ranked 1st out of 31 homes in Montana. Shows total annual staff payroll benchmarked to the Montana average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Housing Options: Private Rooms
Building Type: Single-story
Transportation Services
Fitness and Recreation
Most residents typically stay for a few weeks or months before returning home or moving on.
Most new residents arrive under Medicare (63% of admissions), and a typical Medicare stay runs around 28 days.
Coverage residents most often arrive under.
Coverage residents most often leave under.
7.9 miles from city center
Estimated distance in miles from Billings's city center to St. John‘s United's address, calculated via Google Maps.
— 1.34 miles to nearest hospital (Linde LLC)
Add your location
St. John‘s United is located in Billings, Montana.
Here are the financial assistance programs available to residents in Montana.
The information below is reported by the Montana Department of Public Health and Human Services, Quality Assurance Division.
| St. John‘s United |
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
HC Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
HC Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk.
NC Nursing Care
RC Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision.
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care). | Billings | - | 104
Facility
104
MT AVG
70
Rank
#21 / 106 | - |
6
Facility
6
MT AVG
43
Rank
#144 / 159 | Private Rooms |
| Billings Nursing and Rehab |
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
HC Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
NC Nursing Care
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
RC Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision.
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care). | Billings (South Side) | - | 100
Facility
100
MT AVG
70
Rank
#26 / 106 | - |
56
Facility
56
MT AVG
43
Rank
#57 / 159 | Private Rooms |
| Eagle Cliff Healthcare Community |
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care). | Billings (Heights) | - | 129
Facility
129
MT AVG
70
Rank
#10 / 106 | - |
3
Facility
3
MT AVG
43
Rank
#148 / 159 | Private Rooms |
| Yellowstone River Nursing and Rehabilitation |
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care). | Billings (East Central) | - | 160
Facility
160
MT AVG
70
Rank
#6 / 106 | - |
67
Facility
67
MT AVG
43
Rank
#33 / 159 | Private Rooms |
| Skyline Heights Nursing and Rehabilitation |
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
HC Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care). | Billings (Colton Heights Apartments) | - | 150
Facility
150
MT AVG
70
Rank
#7 / 106 | - |
57
Facility
57
MT AVG
43
Rank
#51 / 159 | Private Rooms |
St. John‘s United has a walk score of 6. Car-dependent. Most errands require a car, with limited nearby walkable options.
According to MT state health department records, St. John‘s United's license number is 12420.
According to MT state health department records, St. John‘s United's license expires on August 19, 2027.
St. John‘s United's occupancy is 25%.
Karna Rhodes is the administrator of St. John‘s United.
St. John‘s United has 104 beds.
Yes — there are 3 photos of St. John‘s United in the photo gallery on this page.
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