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North Big Horn Hospital District, a Wyoming Special Hospital District
Nursing Home, Memory Care & Skilled Nursing · Casper, WY
CMS overall rating Info 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.
Modern healthcare facility building exterior Logo of North Big Horn Hospital District

North Big Horn Hospital District, a Wyoming Special Hospital District

Nursing Home, Memory Care & Skilled Nursing · Casper, WY
CMS overall rating Info 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.
60 Magnolia Street, Casper, WY 82604 View map Calculator: See prices in your area
North Big Horn Hospital District, a Wyoming Special Hospital District accepts Medicare, Medicaid, and private pay.
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North Big Horn Hospital District, a Wyoming Special Hospital District accepts Medicare, Medicaid, and private pay.

Overview of North Big Horn Hospital District, a Wyoming Special Hospital District

North Big Horn Hospital District, a Wyoming Special Hospital District, is located at the foot of the Big Horn Mountains in Lovell, Wyoming. The community offers nursing home care, memory care, and skilled nursing. Families can choose from Medicare, Medicaid, and private pay to cover both short-term recovery stays and longer-term care.

The facility is administered by Jessica Miller, and Whitney Barrett serves as Director of Nursing. Besides nursing home services, the district offers a notable range of clinical programs, including cardiac rehabilitation, diabetes education, home health, an infusion clinic, and other specialty clinics. That breadth reflects its roots as a hospital district rather than a stand-alone residential home. It’s a real advantage for residents managing ongoing medical needs.

It has 192 beds, making it one of the larger nursing communities in the state. It has an occupancy rate of 85%. Residents’ average stay is about 78 days, which is a mix of those recovering from a hospital stay or procedure and those settling in for longer-term nursing and memory care.

Nursing staffing averages 4 hours per resident daily, combining registered nurse, licensed practical nurse, and nurse aide time. State inspections of the facility have most often centered on documentation and medication-management practices. There were no findings of immediate jeopardy or harm to residents. Families touring the community may want to ask staff how those areas are handled daily.

The surrounding area has a walk score of 71 out of 100. It’s very walkable, so many everyday errands can be handled on foot.

Facility Direct Line (307) 234-9381
Facility Direct Line (307) 234-9381

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Overall rating Info 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.
▼ 66.0% Below WY avg. ▼ 66.0% Below WY avg.WY average: 2.9Click the badge to see the full State ranking.Click here to see the full State ranking.
Health Inspection Info 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.
▼ 65.3% Below WY avg. ▼ 65.3% Below WY avg.WY average: 2.9Click the badge to see the full State ranking.Click here to see the full State ranking.
Staffing Info 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.
▼ 14.3% Below WY avg. ▼ 14.3% Below WY avg.WY average: 3.5Click the badge to see the full State ranking.Click here to see the full State ranking.
Quality Measures Info 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.
▼ 36.5% Below WY avg. ▼ 36.5% Below WY avg.WY average: 3.2Click the badge to see the full State ranking.Click here to see the full State ranking.

Staffing hours Info 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.

Hours per resident per day vs Wyoming averages

Rank #8 / 13Nurse hours — State benchmarkedThis home is ranked 8th out of 13 homes we track in Wyoming for nurse hours. Shows adjusted nurse hours per resident per day benchmarked to the Wyoming average, with a ranking across 13 Wyoming facilities. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Wyoming that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

Total nursing care Info This home is ranked 8th out of 13 homes we track in Wyoming 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.

3h 44m

17% below state avg
Staff type
Hours / day / resident
vs state avg
Registered Nurse (RN) Info 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.
42m
−35% State avg: 1h 5m per day · National avg: 42m per day
LPN / LVN Info 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.
25m
−30% State avg: 36m per day · National avg: 52m per day
Nurse Aide Info 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.
2h 37m
−10% State avg: 2h 54m per day · National avg: 2h 24m per day
Weekend Total Nursing Info 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.
3h 3m
−22% State avg: 3h 53m per day · National avg: 3h 30m per day
Physical Therapist Info 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.
2m
−11% State avg: 3m per day · National avg: 4m per day
Weekend RN Info 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.
27m
−31% State avg: 39m per day · National avg: 29m per day

All 6 underlying metrics fall below the state average

Capacity and availability

Residents per day
163
Avg. Length of Stay Info Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
78 days
Bed community size
192-bed community Rank #1 / 31Bed count — State benchmarkedThis home is ranked 1st out of 31 homes we track in Wyoming for bed count. Shows this facility's certified or reported bed count compared to other Wyoming facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Wyoming that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A large-scale community that may provide a wide range of amenities, services, and structured programs.
Walk Score
Walk Score: 71 / 100 Rank #6 / 51Walk Score — State benchmarkedThis home is ranked 6th out of 51 homes we track in Wyoming for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Wyoming facilities. Higher scores benefit residents, families, and staff.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Wyoming that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

About this community

Occupancy

Occupancy rate
85%
Rank #7 / 26Occupancy rate — State benchmarkedThis home is ranked 7th out of 26 homes we track in Wyoming for occupancy. Shows this facility's occupancy rate versus the Wyoming average, with its Statewide rank out of 26. Higher occupancy signals strong local demand and financial stability.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Wyoming that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Higher than the Wyoming average: 74.2%
Occupied beds
163 / 192
Average occupied beds in Wyoming homes 54 beds

License Details

Facility TypeNursing Home
StatusActive
CountyNatrona
License Number15452
CMS Certification Number535042

Ownership & Operating Entity

North Big Horn Hospital District, a Wyoming Special Hospital District is administered by Jessica Miller.

Staffing

Key information about the people who lead and staff this community.

Leadership

Director of NursingWhitney Barrett

Contact Information

Email legal@couvehealthcare.com
Fax307-472-3510

Additional Policies & Features

Pets not allowed

Amenities & Lifestyle

Specific ProgramsCardiac Rehabilitation, Diabetes Education, Home Health, Hospital Services, Infusion Clinic, Specialty Clinics

Contact North Big Horn Hospital District, a Wyoming Special Hospital District

Inspection History

In Wyoming, the Department of Health, Healthcare Licensing and Surveys is the regulatory authority that conducts unannounced inspections and manages quality reports for all licensed facilities.

Since 2025 · 1 year of data These figures come from state-published and/or federal inspection records. The period covered can vary depending on document availability. 0 deficiencies 1 inspection

Inspection Scorecard Info This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Wyoming state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Since 2025 vs. Wyoming state average
Overall vs. WY average 0 Worse No metrics in this bucket. 1 Better Metrics better than Wyoming average:
• Total deficiencies (100% below)

Deficiencies Info Deficiencies are formal regulatory issues recorded during state inspections.

This FacilityWY Averagevs. WY Avg
Total deficiencies Info Formal regulatory issues recorded by inspectors across all inspection types. 015 This facility has 100% fewer total deficiencies than a typical Wyoming nursing home (0 vs. WY avg 15).↓ 100% better

Inspections Info State inspections evaluate whether the facility meets health and safety standards.

This FacilityWY Averagevs. WY Avg
Total inspections Info Combined count of all inspections conducted at this facility. 1— —
Show Inspection Reports

CMS Health Inspection History

Federal inspection data published by CMS, covering this home's Medicare and/or Medicaid-certified skilled-nursing/nursing beds only.

Inspections Since 2022 · 4 years of data
Total health inspections 11

Wyoming average 5.6

Last Health inspection on May 2025

Total health citations
37 Rank #11 / 12Health citations — State benchmarkedThis home is ranked 11th out of 12 homes we track in Wyoming for health citations. Shows this facility's total health deficiency citations benchmarked to the Wyoming State average, with a ranking across all 12 WY facilities. Lower citation counts earn a better rank.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Wyoming that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

Wyoming average 18.9

Citations per inspection
3.36 Rank #7 / 12Citations per inspection — State benchmarkedThis home is ranked 7th out of 12 homes we track in Wyoming for citations per inspection. Shows average deficiency citations per CMS inspection for this facility versus the Wyoming mean across 12 facilities with citation data. Lower is better.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Wyoming that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

Wyoming average 3.4

Health citations are formal notices following inspections when they fail to comply with safety and care standards.

19 of 37 citations resulted from standard inspections; 12 of 37 resulted from complaint investigations; and 6 of 37 came from combined inspections (standard and complaint).

Breakdown of citation severity (last 4 years)
Critical health citations
0
100% better than Wyoming average

Wyoming average: 0.2

Serious health citations
7
289% worse than Wyoming average

Wyoming average: 1.8

0 critical citations Wyoming average: 0.2
7 serious citations Wyoming average: 1.8
30 moderate citations Wyoming average: 16.4
0 minor citations Wyoming average: 0.6
Citations history (last 4 years)
Abuse/Neglect serious citation May 22, 2025
Corrected
Quality of Care serious citation Mar 20, 2025
Corrected
Quality of Care serious citation Mar 20, 2025
Corrected
Resident Rights serious citation Mar 20, 2025
Corrected

Data sourced from CMS Health Deficiencies reports, which cover the Medicare and/or Medicaid-certified skilled-nursing and nursing beds and no other part of the community. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.

Staffing Data

Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.

Total staff 211
Employees 211
Contractors 0
Staff to resident ratio 1.36 : 1
17% fewer staff per resident than Wyoming average
Wyoming average ratio: 1.64 : 1 Wyoming average ratio: 1.64 : 1See full Wyoming ranking
Avg staff/day 82
Average shift 9 hours
7% better than Wyoming average
Wyoming average: 8.4 hours Wyoming average shift: 8.4 hoursSee full Wyoming ranking
Total staff hours (quarter) 67,979

Nursing staff breakdown

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Registered Nurse

Manages medical care and health needs.

RN Staff Info All 21 RN Staff are full-time employees. No contractors work on this role. 21
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.8 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info All 15 LPN Staff are full-time employees. No contractors work on this role. 15
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 10.1 hours
Certified Nursing Assistant

Helps with daily care and mobility.

CNA Staff Info All 74 CNA Staff are full-time employees. No contractors work on this role. 74
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.9 hours

Contractor staffing

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors 0% — all staff are direct employees this quarter

Staff by category

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Certified Nursing Assistant7407426,76292100%9.9
Physical Therapist330339,6237683%7.2
Registered Nurse210217,03892100%9.8
Medication Aide/Technician160166,84992100%10.2
Other Dietary Services Staff140144,00192100%7.4
Nurse Aide in Training170173,1958289%9.5
Licensed Practical Nurse150152,9469199%10.1
RN Director of Nursing6062,2058795%8.7
Clinical Nurse Specialist5051,8498289%7.6
Mental Health Service Worker3031,0956368%7.7
Occupational Therapy Aide2029576975%8.4
Nurse Practitioner1015046368%8
Administrator1014886166%8
Dietitian1013393942%8.7
Dental Services Staff2021281112%7.5
74 Certified Nursing Assistant
% of Days 100%
33 Physical Therapist
% of Days 83%
21 Registered Nurse
% of Days 100%
16 Medication Aide/Technician
% of Days 100%
View All Staffing Data in Casper

Penalties and fines

Includes penalties issued in 2024-2025

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 (Data as of Jan 2026)

Total fines amount $94K Rank #13 / 13Federal fines — State benchmarkedThis home is ranked 13th out of 13 homes we track in Wyoming for federal fines. Shows this facility's cumulative CMS federal fine dollars versus the Wyoming average among facilities with fines, and where it ranks among 13 facilities in the pool. Lower total dollars mean a better rank.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Wyoming that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
137% higher than Wyoming average

Wyoming average: $40K

Number of fines 5
87% more fines than Wyoming average

Wyoming average: 2.7

Payment Denials Info Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed. 0
100% fewer payment denials than Wyoming average

Wyoming average: 0.2

Fines amount comparison
Fines amount comparison
This facility $94K
Wyoming average $40K
Penalty History

Penalties are imposed by CMS for violations of federal nursing home regulations.

4 penalties in the past 3 years

Multiple penalties were reported in the last 3 years.

Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. May 22, 2025
$19K
Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Mar 20, 2025
$24K
Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Aug 15, 2024
$8K
Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Mar 22, 2024
$34K

Last updated: Jan 2026

Quality of care over time

These measures show how residents usually do over time at this home, based on health outcomes and preventive care.

High-risk clinical events score Info A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline. 12.8
17% worse than Wyoming average

Wyoming average: 10.9

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 23.1
11% worse than Wyoming average

Wyoming average: 20.8

Long-stay resident measures
Average Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 21.7%
8% worse than Wyoming average

Wyoming average: 20.0%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 29.7%
55% worse than Wyoming average

Wyoming average: 19.1%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 17.9%
23% better than Wyoming average

Wyoming average: 23.2%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 5.4%
9% worse than Wyoming average

Wyoming average: 4.9%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 1.5%
69% better than Wyoming average

Wyoming average: 5.0%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 0.8%
76% better than Wyoming average

Wyoming average: 3.1%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 5.4%
17% better than Wyoming average

Wyoming average: 6.5%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 9.5%
47% worse than Wyoming average

Wyoming average: 6.4%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 30.1%
32% worse than Wyoming average

Wyoming average: 22.7%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 96.4%
In line with Wyoming average

Wyoming average: 94.1%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 90.9%
In line with Wyoming average

Wyoming average: 94.3%

Short-stay resident measures
Significantly below average Info CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 77.4%
In line with Wyoming average

Wyoming average: 74.6%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 1.8%
19% better than Wyoming average

Wyoming average: 2.3%

Influenza Vaccine Info Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine 63.0%
18% worse than Wyoming average

Wyoming average: 77.0%

Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.

Breakdown by payment type

Medicare

56% of new residents, usually for short-term rehab.

Typical stay 1 months

Private pay

25% of new residents, often for short stays.

Typical stay 6 - 7 months

Medicaid

19% of new residents, often for long-term daily care.

Typical stay 1 - 2 years

Facility Characteristics

Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)

Total residents 155
Medicare
15
9.7% of residents
Medicaid
104
67.1% of residents
Private pay or other
36
23.2% of residents
Programs & Services
Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Active Resident Council

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.

Finances and operations

Based on the home's most recent complete CMS SNF Cost Report — fiscal year ending in 08/2022. This is an older period than most facilities report, so compare with that in mind.

For-profit
Corporation
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$17.4M
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
$825.9K
For-profit Corporation
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$17.4M
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
$825.9K
Payroll costs Info Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs.
$8.6M 49.2% of net patient revenue Info Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay.
Other operating costs Info Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
$8.0M
Total costs Info The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
$16.6M
How we calculate these figures

This home is administered by Jessica Miller.

Certified by the Centers for Medicare & Medicaid Services authority — CMS Certification Number: 535042

Show certification details

Who this home usually serves

TYPE OF STAY

Mostly short-term rehab stays

Most residents typically stay for a few weeks or months before returning home or moving on.

Most new residents arrive under Medicare (56% of admissions), and a typical Medicare stay runs around 1 months.

Admissions
236 total

Coverage residents most often arrive under.

Medicare 56%
Private pay 25%
Medicaid 19%
Discharges
519 total

Coverage residents most often leave under.

Medicare 16%
Private pay 44%
Medicaid 40%

Admissions and discharges reflect care patterns over time — they are not used to rate this facility.

How we assess these insights

Places of interest near North Big Horn Hospital District, a Wyoming Special Hospital District

Address 0.0 miles from city center Info Estimated distance in miles from Casper's city center to North Big Horn Hospital District, a Wyoming Special Hospital District's address, calculated via Google Maps.

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Address

Compare Nursing Homes around Casper

Info below is compiled from CMS reports & the WY Dept. of Health (WDH), senior community websites & trusted data sources such as Walk Score & BBB.

Communities are listed from highest to lowest based on our ranking methodology.

The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
CMS (Centers for Medicare & Medicaid Services, the federal agency that regulates nursing homes) Overall 5-star rating — a composite of Health Inspection, Staffing, and Quality Measures scores. 5 stars = top 10% nationally. 1 star = bottom 10%. The single most important number to start with when comparing facilities.
Care Types in This Table NH (Nursing Home): 24/7 skilled nursing care for residents with complex, ongoing medical needs. SNF (Skilled Nursing Facility): Round-the-clock nursing care, often for recovery after surgery, injury, or illness. MC (Memory Care): Secured, specialized care for people living with Alzheimer's or dementia.
Neighborhood or city area where the facility is located. Proximity to family, hospitals, and green space matters for both quality of life and ease of visitation. Consider drive time and transit access when evaluating location.
Licensed bed capacity. Larger facilities (300+ beds) often have more specialized programs but can feel institutional. Smaller homes (under 150 beds) tend to deliver more personalized care. Compare with Avg Res/Day to understand how full the facility typically runs.
Percentage of licensed beds filled on an average day. Color indicates financial health: green (90%+) = operationally strong, typically profitable. Amber (80–89%) = stable but leaving revenue on the table. Orange (70–79%) = financial strain likely, may struggle with fixed costs. Red (<70%) = significant distress, closure or ownership change risk increases sharply.
This facility's occupancy rate compared to the statewide average for similar facilities. A positive number means above-average demand. Facilities running 5%+ above the state average are typically the most sought-after in their market — a strong proxy for reputation.
CMS-adjusted total nurse hours per resident per day (RN + LPN + CNA combined). The national average is approximately 3.5 hrs. Higher is better — more direct care time per resident. Below 3.0 is a red flag. CMS weights RN hours more heavily because RNs handle complex clinical decisions that CNAs cannot.
CMS Health Inspection star rating (1–5 stars), based on the 3 most recent annual state surveys plus any complaint investigations. This is the hardest rating to manipulate — it reflects real surveyor findings on-site. 5 stars = fewest deficiencies found. 1 star = most. It carries the heaviest weight in the Overall CMS rating.
CMS Staffing star rating (1–5 stars), based on daily nurse staffing hours submitted to CMS via verified payroll data. Compares RN, LPN, and CNA coverage relative to resident acuity level. 5 stars = well above expected staffing. Weekend staffing is evaluated separately, as that's where many facilities quietly reduce coverage.
CMS Quality Measures star rating (1–5 stars), based on 15 clinical outcome metrics including fall rates, pressure ulcers, antipsychotic drug use, and hospital readmissions. Captures actual resident health outcomes, not just compliance. High QM combined with low Health Inspection scores can indicate a facility with strong care but weak documentation practices.
Registered Nurse hours per resident/day compared to the statewide average. RNs are the highest-skilled nursing staff — they assess residents, manage medications, and respond to emergencies. A value of +50% means RN coverage is 50% above the state norm. Negative values are a concern for residents with complex or acute medical needs.
Total nursing staff hours (RN + LPN + CNA combined) per resident/day vs. the statewide average. A broader measure than RN vs State — it captures the entire care team. A facility can have high total staffing but low RN hours, meaning more aides and fewer nurses. Read both columns together for the full picture.
Total dollar amount of federal monetary fines (civil money penalties) issued by CMS in the past 3 years. Fines are only levied for serious violations — typically actual harm to residents, repeated uncorrected deficiencies, or systemic non-compliance. Even a single fine is noteworthy. Multiple fines strongly suggest a pattern, not isolated incidents.
Total health deficiency citations from the most recent standard inspection cycle. Minor citations (scope A–C) are common and often administrative in nature. Higher counts aren't always disqualifying, but should be read alongside Severe Citations to understand actual harm levels. Under 10 is strong for a large facility; 30+ warrants a closer look.
Average deficiency citations per CMS inspection (survey) in the reporting window — total citations divided by the number of inspections. Lower is better; compare alongside total Citations and Severe Citations for context.
Citations at CMS scope/severity level G or higher — G–I means actual harm occurred; J–L means residents were placed in immediate jeopardy. (D–F is potential for harm only). Examples include unaddressed falls, medication errors causing injury, neglect, or abuse.
Average number of residents in the building on any given day, derived from annual census data. Reflects true operating scale — a 400-bed facility running 200 residents/day operates very differently from one at 390. Higher resident counts generally mean more funded staffing hours.
Better Business Bureau rating (A+ to F). Reflects complaint history, business transparency, and how family disputes were resolved. A+ means no significant unresolved complaints. A blank (—) means the facility isn't BBB-accredited, which is common for healthcare providers and not necessarily a negative signal.
Walk Score® (0–100). Measures walkability of the surrounding area. 90–100 = Walker's Paradise. 70–89 = Very Walkable. 50–69 = Somewhat Walkable. Below 50 = Car-Dependent. Higher scores benefit family visitors, resident outings, and staff commuting.
The licensed owner or operator of record filed with CMS — the individual or organization legally accountable for the facility. Searching the operator name across other facilities can reveal chain or multi-site ownership, which matters: chain-operated homes tend to have more variable quality outcomes than independently run facilities.
What the home actually collects for resident care, after contractual allowances, bad debt and discounts — not gross billings. Taken from the latest complete annual cost report, so it is comparable across homes reporting the same period. Revenue alone doesn't indicate care quality, but it funds staffing and capital reinvestment. Pair with Payroll %. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Staff salaries plus wage-related benefits from the latest complete annual cost report. Contract and agency labour is counted separately, under other operating costs, so a home leaning on agency staff can show a low figure here. Payroll is the cost most directly tied to care quality — compare with Payroll % for full context. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Payroll as a share of NET PATIENT REVENUE (not gross revenue). Both figures come from the same cost-report year. A higher figure means more of each revenue dollar goes to staff pay. Read with the Staffing star rating to judge whether spend translates into coverage — and note that homes whose patient revenue covers only part of their operation can read implausibly high. The Wyoming average is: 60.5% Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
CMS Certification Number: the unique federal identifier for this skilled nursing provider.
Life Care Center of Casper – Nursing Home ★ ★ ★ ★ ★
NH
SNF
Casper
120
Facility 120
WY AVG 82
Rank #5 / 31
61.8%
Facility 61.8%
WY AVG 68.2%
Rank #17 / 26
-9%
4.28
Facility 4.28
WY AVG 4.53
Rank #4 / 13
 ★ ★ ★ ☆ ☆ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ +34%-5%
$0
Facility $0
WY AVG $42.4k
Rank #1 / 13
15
Facility 15
WY AVG 18.9
Rank #5 / 12
3.0
Facility 3.0
WY AVG 3.4
Rank #4 / 12
-74-
45
Facility 45
WY AVG 47
Rank #30 / 51
Ainsley Huber
$11.1MFiscal year ending 06/2024
Facility $11.1MFiscal year ending 06/2024
WY AVG $8.9M
Rank #2 / 9
$7.5MFiscal year ending 06/2024
Facility $7.5MFiscal year ending 06/2024
WY AVG $5.4M
Rank #2 / 9
67.4%Fiscal year ending 06/2024
Facility 67.4%Fiscal year ending 06/2024
WY AVG 60.5%
Rank #2 / 9
535049
North Big Horn Hospital District, a Wyoming Special Hospital District ★ ☆ ☆ ☆ ☆
NH
MC
SNF
Casper
192
Facility 192
WY AVG 82
Rank #1 / 31
84.9%
Facility 84.9%
WY AVG 68.2%
Rank #7 / 26
+24%
3.74
Facility 3.74
WY AVG 4.53
Rank #8 / 13
 ★ ☆ ☆ ☆ ☆ ★ ★ ★ ☆ ☆ ★ ★ ☆ ☆ ☆ -32%-17%
$105.2k
Facility $105.2k
WY AVG $42.4k
Rank #13 / 13
37
Facility 37
WY AVG 18.9
Rank #11 / 12
3.4
Facility 3.4
WY AVG 3.4
Rank #7 / 12
7163-
71
Facility 71
WY AVG 47
Rank #6 / 51
-$17.4M*Fiscal year ending 08/2022These figures are from this home's most recent complete cost report — an older period than most facilities report. Compare with that in mind.$8.6M*Fiscal year ending 08/2022These figures are from this home's most recent complete cost report — an older period than most facilities report. Compare with that in mind.49.2%*Fiscal year ending 08/2022These figures are from this home's most recent complete cost report — an older period than most facilities report. Compare with that in mind.535042
Nursing Home Explorer

Financial Assistance for
Nursing Home in Wyoming

North Big Horn Hospital District, a Wyoming Special Hospital District is located in Casper, Wyoming.
Here are the financial assistance programs available to residents in Wyoming.

Get Financial aid guidance

Community Choices Waiver

WY Medicaid CCW

Age 65+ or disabled
General Wyoming resident, Medicaid-eligible, nursing home-level care need.
Income Limits (2025) ~$2,829/month 300% FBR, individual
Asset Limits $2,000 (individual), $3,000 (couple).
WY

Sparse population; rural access focus.

Benefits
Personal care (5-7 hours/day) Respite (240 hours/year) Adult day care ($60/day) Home modifications ($1,500 avg.)

Wyoming Home Services

WY Home Services

Age 60+
General Wyoming resident, at risk of nursing home.
Income Limits ~$2,000/month individual, varies
Asset Limits $5,000 individual
WY

Limited funding; rural emphasis.

Benefits
In-home care (3-5 hours/week) Respite (up to 10 days/year) Transportation (~5 trips/month)

Older Americans Act (OAA) Services

Wyoming OAA Services

Age 60+
General WY resident; no income/asset limits.
Income Limits (2025) None; donations encouraged.
Asset Limits Not assessed.
WY

Includes Meals on Wheels; serves ~10,000 annually; rural emphasis.

Benefits
Meals (~$5-$7/meal) Transportation Homemaker services (~4 hours/week) Respite (~5 days/year) Legal aid

Medicare Savings Program (MSP)

Wyoming Medicare Savings Program

Age 65+ or disabled
General WY resident, Medicare Part A/B.
Income Limits (2025) ~$2,510/month (QMB), ~$3,380/month (SLMB), ~$3,598/month (QI)—individual.
Asset Limits $9,430 (individual), $14,130 (couple).
WY

Includes Extra Help for Part D; no waitlist.

Benefits
Covers Part B premiums ($174.70/month) Deductibles ($240/year) Copays (~20%)

Low-Income Energy Assistance Program (LIEAP)

Wyoming LIEAP

Age 60+ prioritized
General WY resident, low-income household.
Income Limits (2025) ~$3,970/month 185% FPL
Asset Limits Not assessed.
WY

Covers gas, electric, wood; emergency aid available; serves ~15,000 households.

Benefits
Heating aid ($300-$1,000/season) Emergency aid ($500 max)

Family Caregiver Support Program (FCSP)

Wyoming National Family Caregiver Support Program

Age —
General Caregivers of 60+ needing care or 55+ caregivers of others; WY resident; 2+ ADLs.
Income Limits (2025) No strict cap; prioritizes low-income ~$24,980/year
Asset Limits Not assessed.
WY

Covers Big Horn, Carbon, Converse, Fremont, Goshen, Hot Springs, Laramie, Natrona, Washakie; serves ~1,000 annually.

Benefits
Respite (4-6 hours/week or 5 days/year) Adult day care ($60/day) Training Supplies (~$500/year)

VA Aid and Attendance (A&A) and Housebound Benefits

Wyoming VA Aid and Attendance/Housebound

Age 65+ or disabled veteran/spouse
General WY resident, wartime service, ADL help (A&A) or homebound.
Income Limits (2025) Net income < ~$1,984/month (veteran with dependent, A&A); pension offsets income.
Asset Limits ~$155,356 net worth
WY

High rural veteran use; supports care costs.

Benefits
Cash (~$1,433-$2,642/month veteran, ~$951-$1,318 spouse) for care costs

Property Tax Refund Program

Wyoming Property Tax Refund Program

Age 65+ or disabled
General WY resident 5+ years, homeowner/renter, paid property taxes/rent.
Income Limits (2025) ~$22,500/year (individual in high-cost counties), ~$18,000 (low-cost); $36,000/$28,800 (couples).
Asset Limits Not assessed beyond income.
WY

Refunds up to $900 (homeowners) or 50% rent paid; serves ~5,000 annually.

Benefits
Tax refund (~$200-$900/year avg.)

Senior Farmers’ Market Nutrition Program (SFMNP)

Wyoming SFMNP

Age 60+
General WY resident, low-income.
Income Limits (2025) ~$2,322/month 185% FPL
Asset Limits Not assessed.
WY

Vouchers (~$50/season); serves ~5,000 annually.

Benefits
Vouchers (~$50/season) for produce at farmers’ markets

Frequently Asked Questions about North Big Horn Hospital District, a Wyoming Special Hospital District

Who is the Director of Nursing at North Big Horn Hospital District, a Wyoming Special Hospital District?

Whitney Barrett is the Director of Nursing at North Big Horn Hospital District, a Wyoming Special Hospital District.

Is North Big Horn Hospital District, a Wyoming Special Hospital District in a walkable area?

North Big Horn Hospital District, a Wyoming Special Hospital District has a walk score of 71. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

What is the license number of North Big Horn Hospital District, a Wyoming Special Hospital District?

According to WY state health department records, North Big Horn Hospital District, a Wyoming Special Hospital District's license number is 15452.

What is the occupancy rate at North Big Horn Hospital District, a Wyoming Special Hospital District?

North Big Horn Hospital District, a Wyoming Special Hospital District's occupancy is 85%.

Are pets allowed at North Big Horn Hospital District, a Wyoming Special Hospital District?

No, North Big Horn Hospital District, a Wyoming Special Hospital District has a no-pet policy.

What is the best email address for North Big Horn Hospital District, a Wyoming Special Hospital District?

The team at North Big Horn Hospital District, a Wyoming Special Hospital District can be reached at legal@couvehealthcare.com.

Does North Big Horn Hospital District, a Wyoming Special Hospital District operate as a for-profit or non-profit?

North Big Horn Hospital District, a Wyoming Special Hospital District is registered as a for-profit in WY.

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