Pioneer Care and Rehabilitation
200 N Oregon St · Dillon, MT · 59725 · 4066835105
87 certified beds For profit - Limited Liability company Chain: Sweetwater Care
Why this verdict
- Inspection record is far worse than the national median (deficiency count and severity).
- Federal penalties on record: $87,203 in fines in the last 24 months.
- 5 citations involved actual harm to residents.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
$87,203 in federal fines in the last 24 months
4 fines — CMS fines are reserved for verified, serious non-compliance.
88% of nursing staff left within a year
High turnover disrupts continuity of care; the national median is 45%.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 1 of 5 Inspections: 1 of 5 Staffing: 2 of 5 Quality measures: 3 of 5
| Total nurse hours / resident-day | 3.64 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.53 | 0.55–0.75 |
| Weekend hours / resident-day | 3.13 | ≈ weekday level |
| Nursing turnover / year | 88% | median 45% |
| Fines (3-yr window) | 6 · $140,630 |
Inspection citations (53 in the current record)
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Potential for harm · D December 31, 2025 · found via complaint
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Corrected January 23, 2026 · Quality of Life and Care
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Actual harm · G May 8, 2025
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected May 30, 2025 · Quality of Life and Care
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Potential for harm · E May 8, 2025
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Corrected May 30, 2025 · Resident Rights
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Potential for harm · D May 8, 2025
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected May 30, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D May 8, 2025
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Corrected May 30, 2025 · Resident Rights
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Potential for harm · D May 8, 2025
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Corrected May 30, 2025 · Resident Rights
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Potential for harm · D May 8, 2025
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected May 30, 2025 · Resident Assessment and Care Planning
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Potential for harm · D May 8, 2025
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
Corrected May 30, 2025 · Quality of Life and Care
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Potential for harm · D May 8, 2025
Provide enough food/fluids to maintain a resident's health.
Corrected May 30, 2025 · Quality of Life and Care
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Potential for harm · D May 8, 2025
Provide safe and appropriate respiratory care for a resident when needed.
Corrected May 30, 2025 · Quality of Life and Care
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Potential for harm · D May 8, 2025
Provide safe, appropriate pain management for a resident who requires such services.
Corrected May 30, 2025 · Quality of Life and Care
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Potential for harm · E May 8, 2025
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Corrected May 30, 2025 · Pharmacy Service
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Potential for harm · D May 8, 2025
Ensure that residents are free from significant medication errors.
Corrected May 30, 2025 · Pharmacy Service
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Potential for harm · D May 8, 2025
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected May 30, 2025 · Pharmacy Service
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Potential for harm · F May 8, 2025
Designate a physician to serve as medical director responsible for implementation of resident care policies and coordination of medical care in the facility.
Corrected May 30, 2025 · Nursing and Physician Services
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Potential for harm · D May 8, 2025
Provide and implement an infection prevention and control program.
Corrected May 30, 2025 · Infection Control
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Potential for harm · E May 8, 2025
Implement a program that monitors antibiotic use.
Corrected May 30, 2025 · Infection Control
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Potential for harm · F May 8, 2025
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Corrected May 30, 2025 · Infection Control
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Potential for harm · D May 8, 2025
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Corrected May 30, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · F May 8, 2025 · found via complaint
Have a plan that describes the process for conducting QAPI and QAA activities.
Corrected May 30, 2025 · Administration
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Potential for harm · D February 27, 2025 · found via complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected April 4, 2025 · Pharmacy Service
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Potential for harm · E February 27, 2025 · found via complaint
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Corrected April 4, 2025 · Administration
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Actual harm · G December 5, 2024 · found via complaint
Ensure that residents are free from significant medication errors.
Corrected January 3, 2025 · Pharmacy Service
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Potential for harm · D December 5, 2024 · found via complaint
Provide and implement an infection prevention and control program.
Corrected January 3, 2025 · Infection Control
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Actual harm · G August 27, 2024 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected September 5, 2024 · Quality of Life and Care
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| February 19, 2026 | Fine | $7,360 |
| May 8, 2025 | Fine | $48,464 |
| December 5, 2024 | Fine | $12,529 |
| August 27, 2024 | Fine | $18,850 |
| May 21, 2024 | Fine | $40,641 |
| January 4, 2024 | Fine | $12,786 |
Better-scoring options nearby
No better-scoring facility within 25 miles in the current data. See the whole state.
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 275124 · certified since August 25, 1988. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.