Based on interview and record review, the facility failed to provide a therapeutic diet to 1 (#21) of 2 sampled residents, and had incorrectly ordered food preparation cards for 2 (#s 21 and 24) of 2 sampled residents. This failure had the likelihood to cause physical harm from aspiration. Findings include: During an observation and interview, on 9/13/22 at 9:50 a.m., resident #21 was lying in his bed with a bedside table over his lap. He had several regular consistency drinks on the table with straws. Resident #21 had just tried to take a drink of milk and it was dripping down his chin. He grabbed the black waste basket and began to cough and spit the milk back out. Resident #21 stated, I thought I could get the milk down today, but I guess that's not happening. …
F805 citations in Montana
Food in a form residents can eat · Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2023
Montana cites F805 less often than its own record predicts
0.80 times the national share — cited less often here than elsewhere.
Of every deficiency written in Montana in 2023, this is the portion that was F805.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Montana surveyors wrote
F805 findings written in Montana, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on observation, interview, and record review, the facility failed to provide a physician ordered diet for 1 (#52) of 8 sampled residents, increasing the risk for weight loss. Findings include: During an observation on 8/15/23 at 9:00 a.m., resident #52 was sitting at a table in the dining room, with her breakfast tray in front of her. No peanut butter sandwich was on the tray, which was ordered to be given at each meal. Resident #52 appeared to be asleep. There was no attempt by the staff to wake resident #52. During an observation on 8/16/23 at 12:58 p.m., resident #52 was sitting at the dining room table, with her meal tray in front of her. On her tray was uncut, long fettucine noodles with light sauce, large sized broccoli florets, a full uncut bread stick, and a glass of water. …
What else Montana surveyors cite →
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