Skyline Heights Nursing and Rehabilitation

1807 24th St W · Billings, MT · 59102 · 4066565010

150 certified beds For profit - Limited Liability company Chain: Eduro Healthcare

Why this verdict

  • Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (1 citation).
  • Inspection record is far worse than the national median (deficiency count and severity).
  • Federal penalties on record: $400,228 in fines in the last 24 months.
  • 6 citations involved actual harm to residents.
  • Inspection results have improved across recent cycles.

Red flags

Special Focus Facility candidate

CMS lists this facility as a candidate for its Special Focus program for persistently poor inspection performance.

1 immediate-jeopardy citation in the most recent inspection cycle

Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.

1 abuse-related citation at the actual-harm level

Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.

2 actual-harm citations in the most recent cycle

Inspectors found deficiencies that caused real harm to residents, beyond potential-harm paperwork findings.

$400,228 in federal fines in the last 24 months

3 fines — CMS fines are reserved for verified, serious non-compliance.

84% of nursing staff left within a year

High turnover disrupts continuity of care; the national median is 45%.

Score breakdown

Inspection record 30% of score 18
Serious harm & abuse 20% 30
Staffing 20% 53
Federal penalties 15% 0
Trend 10% 83
Context 5% 35

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: 2 of 5

Total nurse hours / resident-day3.163.48 min · 4.1 strong
RN hours / resident-day0.580.55–0.75
Weekend hours / resident-day2.83≈ weekday level
Nursing turnover / year84%median 45%
Fines (3-yr window)6 · $418,996

Inspection citations (63 in the current record)

  • Potential for harm · D April 23, 2026 · found via complaint

    Ensure each resident’s drug regimen must be free from unnecessary drugs.

    Deficient, Provider has no plan of correction · Pharmacy Service

  • Potential for harm · D March 12, 2026

    Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.

    Corrected April 3, 2026 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D March 12, 2026

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Corrected April 2, 2026 · Resident Assessment and Care Planning

  • Potential for harm · E March 12, 2026

    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 April 3, 2026 · Pharmacy Service

  • Potential for harm · F March 12, 2026

    Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

    Deficient, Provider has plan of correction · Nutrition and Dietary

  • Potential for harm · F March 12, 2026

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Corrected April 3, 2026 · Nutrition and Dietary

  • Potential for harm · F March 12, 2026

    Provide and implement an infection prevention and control program.

    Corrected April 3, 2026 · Infection Control

  • Potential for harm · E March 12, 2026 · found via complaint

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Corrected April 3, 2026 · Quality of Life and Care

  • No harm found · B March 12, 2026

    Post nurse staffing information every day.

    Corrected April 3, 2026 · Nursing and Physician Services

  • Potential for harm · D December 31, 2025 · found via complaint

    Ensure that residents are fully informed and understand their health status, care and treatments.

    Corrected January 20, 2026 · Resident Rights

  • Potential for harm · D December 31, 2025 · found via complaint

    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

    Corrected January 20, 2026 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D December 31, 2025 · found via complaint

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Corrected January 20, 2026 · Resident Assessment and Care Planning

  • Immediate jeopardy · J November 19, 2025 · found via complaint

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Corrected November 27, 2025 · Quality of Life and Care

  • Actual harm · G November 19, 2025 · found via complaint

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

    Corrected November 27, 2025 · Resident Assessment and Care Planning

  • Actual harm · G November 19, 2025 · found via complaint

    Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

    Corrected November 27, 2025 · Nursing and Physician Services

  • Actual harm · G March 27, 2025 · found via complaint

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Corrected April 28, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Actual harm · G March 27, 2025 · found via complaint

    Ensure that residents are free from significant medication errors.

    Corrected April 19, 2025 · Pharmacy Service

  • Potential for harm · D March 27, 2025 · found via complaint

    Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

    Corrected April 19, 2025 · Nursing and Physician Services

  • Potential for harm · E March 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 June 25, 2025 · Pharmacy Service

  • Potential for harm · E March 27, 2025 · found via complaint

    Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

    Corrected April 19, 2025 · Nutrition and Dietary

  • Actual harm · G January 30, 2025

    Provide appropriate pressure ulcer care and prevent new ulcers from developing.

    Corrected February 21, 2025 · Quality of Life and Care

  • Potential for harm · D January 30, 2025

    Allow residents to self-administer drugs if determined clinically appropriate.

    Corrected March 26, 2025 · Resident Rights

  • Potential for harm · D January 30, 2025

    Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

    Corrected February 21, 2025 · Resident Assessment and Care Planning

  • Potential for harm · E January 30, 2025

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Corrected March 25, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D January 30, 2025

    Provide care and assistance to perform activities of daily living for any resident who is unable.

    Corrected June 25, 2025 · Quality of Life and Care

Showing the 25 most recent. The Safety Report includes every citation with full findings.

Federal penalties

DateTypeAmount / length
November 19, 2025Fine$77,103
August 28, 2025Fine$72,768
January 30, 2025Fine$250,357
January 30, 2025Payment Denial56 days
February 20, 2024Fine$4,893
December 26, 2023Fine$8,631
July 17, 2023Fine$5,244

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 275020 · certified since January 1, 1967. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.