Nursing homeActive
Tobacco Root Mountains Care Center
326 Madison St, Sheridan, MT 59749406842560039 certified beds · 15 residentsGovernment - CountyMedicare and Medicaid
Surveys on file
4
since 2024
Deficiencies
11
● 0● 9● 2
Penalties · 3 yrs
$22,205
1 fine · 1 action
Last survey
2026-05-21
Standard
CMS overall
1 / 5
stars as published by CMS
CMS overall 1/5
Health 2
Staffing 4
Quality 1
Star ratings as published by CMS · CMS’s caveats
Survey history
Source: CMS · Montana DPHHS · data as of 2026-08-01| Date | Kind | Deficiencies | Official record | Archived PDF |
|---|---|---|---|---|
| 2026-05-21 | Standard | 020 | CMS-2567 (Care Compare) | — |
| 2026-04-01 | Complaint | 032 | CMS-2567 (Care Compare) | — |
| 2025-04-09 | Complaint | 010 | CMS-2567 (Care Compare) | — |
| 2024-04-10 | Standard | 030 | CMS-2567 (Care Compare) | — |
Counts by class: paperwork · standard · harm.
Deficiencies
CMS · Montana DPHHS publishes each citation’s tag, official description and scope/severity letter. The surveyor’s written findings are in the Statement of Deficiencies (CMS-2567) for each survey, linked above.
F605Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-06-22Record 275147-20260521-F605
F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Scope/severity FStandard
Food & nutrition
Widespread; no actual harm, potential for more than minimal harm.Corrected 2026-06-22Record 275147-20260521-F812
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity GHarm
Care planningFalls
Isolated; actual harm that is not immediate jeopardy.Corrected 2026-04-22Record 275147-20260401-F689
F697Provide safe, appropriate pain management for a resident who requires such services.Scope/severity GHarm
Care planning
Isolated; actual harm that is not immediate jeopardy.Corrected 2026-04-30Record 275147-20260401-F697
F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-04-30Record 275147-20260401-F600
F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-04-30Record 275147-20260401-F609
F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Scope/severity DStandard
Staffing
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-04-30Record 275147-20260401-F726
F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-01-28Record 275147-20250409-F600
F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-05-16Record 275147-20240410-F657
F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-05-16Record 275147-20240410-F755
F880Provide and implement an infection prevention and control program.Scope/severity DStandard
Infection control
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-05-16Record 275147-20240410-F880
Penalties & enforcement
| Date | Action | Amount | Source |
|---|---|---|---|
| 2026-04-01 | Civil money penalty | $22,205 | CMS · Penalties |
| 2026-04-01 | Denial of payment for new admissions Payment denial for 49 days, from 2026-05-05 | — | CMS · Penalties |
Staffing
CMS Payroll-Based Journal · PBJ, as published Aug 2026 · explainerRN hours per resident day1.74
Facility
Montana
National
Montana 0.98 · National 0.69
Total nurse hours per resident day7.05
Facility
Montana
National
Montana 4.05 · National 3.86
Weekend total nurse hours6.37
Facility
Montana
National
Montana 3.59 · National 3.42
Total nursing staff turnover73%
Facility
Montana
National
Montana 55% · National 46%
Registered nurse turnover43%
Facility
Montana
National
Montana 48% · National 43%
Quality measures
CMS MDS quality measures · 2025Q2-2026Q1 · definitions| Measure | Facility | Montana | National |
|---|---|---|---|
| Percentage of long-stay residents with pressure ulcers lower is better | 7.7% | 6.3% | 4.6% |
| Percentage of long-stay residents experiencing one or more falls with major injury lower is better | 12.7% | 4.4% | 3.2% |
| Percentage of long-stay residents who received an antipsychotic medication lower is better | 18.9% | 20.4% | 15.4% |
| Percentage of long-stay residents with a urinary tract infection lower is better | 0.0% | 2.9% | 1.6% |
| Percentage of long-stay residents who were physically restrained lower is better | 7.9% | 0.6% | 0.1% |
| Percentage of long-stay residents whose need for help with daily activities has increased lower is better | 17.1% | 18.7% | 13.9% |
| Percentage of long-stay residents who lose too much weight lower is better | 8.0% | 6.2% | 5.2% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication lower is better | 11.8% | 15.8% | 19.5% |
Figures verbatim from CMS, with the state and national figures from the same release. The direction that counts as better is CMS’s own and is stated on every row.
Ownership
As reported to CMS (Provider Enrollment)| Entity | Role | Interest | Since | Registry |
|---|---|---|---|---|
| Madison County Finance Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | — | — |
| Allhands, Daniel Individual | W-2 MANAGING EMPLOYEE | NOT APPLICABLE | — | — |
| Allhands, Daniel Individual | CORPORATE OFFICER | NOT APPLICABLE | — | — |
| Forsythe, Jayne Individual | W-2 MANAGING EMPLOYEE | NOT APPLICABLE | — | — |
| Hart, James Individual | CORPORATE OFFICER | NOT APPLICABLE | — | — |
| Hart, James Individual | W-2 MANAGING EMPLOYEE | NOT APPLICABLE | — | — |
| Nye, Ronald Individual | CORPORATE OFFICER | NOT APPLICABLE | — | — |
| Nye, Ronald Individual | W-2 MANAGING EMPLOYEE | NOT APPLICABLE | — | — |
| Oneill, Bonnie Individual | W-2 MANAGING EMPLOYEE | NOT APPLICABLE | — | — |
Ownership as reported to CMS/state. CMS ownership data has known gaps; merges between entities are published only after human review.
Cost context
County figures from public surveys. Not this facility’s price. Nursing-home rates are not published by CMS or Montana.
No county cost figures on file for Madison.
Nearby nursing homes
| Facility | Distance | Last survey | Deficiencies · 3 yrs |
|---|---|---|---|
| Madison Valley Manor Ennis | 23.5 mi | 2026-05-20 | 0140 |
| Pioneer Care And Rehabilitation Dillon | 26.7 mi | 2026-06-04 | 0464 |
| Southwest Montana Veterans Home Butte | 37.6 mi | 2025-06-19 | 0120 |
| Crest Nursing Home Butte | 39.6 mi | 2026-05-07 | 1100 |
| Continental Care And Rehabilitation Butte | 39.8 mi | 2026-06-04 | 1301 |
Watch this facility
One email when a new survey, harm-class deficiency, penalty, Special Focus change or ownership change is recorded. Nothing else, ever.
Sources & provenance
| Section | Agency · dataset | Retrieved |
|---|---|---|
| Facility, ratings | CMS Provider Data · Nursing Home Provider Information | 2026-08-01 |
| Surveys | CMS · Survey Summary | 2026-08-01 |
| Deficiencies | CMS · Health Deficiencies (CMS-2567 findings via Care Compare) | 2026-08-01 |
| Penalties | CMS · Penalties | 2026-08-01 |
| Staffing | CMS · Payroll-Based Journal (PBJ, as published Aug 2026) | 2026-08-01 |
| Quality measures | CMS · MDS Quality Measures | 2026-08-01 |
| Ownership | CMS · Ownership | 2026-08-01 |