Show Inspection Reports
Total health inspections
11
Wyoming average 5.6
Last Health inspection on May 2025
Mostly short-term rehab stays
Most residents typically stay for a few weeks or months before returning home or moving on.
North Big Horn Hospital District, a Wyoming Special Hospital District
Nursing Home in Casper
CMS overall rating
The Overall CMS Rating is scored from 1 to 5 stars and 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.
The Overall CMS Rating is scored from 1 to 5 stars and 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.
North Big Horn Hospital District, a Wyoming Special Hospital District
Nursing Home in Casper
CMS overall rating
The Overall CMS Rating is scored from 1 to 5 stars and 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.
The Overall CMS Rating is scored from 1 to 5 stars and 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.
North Big Horn Hospital and New Horizons Care Center are located at the foot of the Big Horn Mountains in Lovell, Wyoming. They take pride in their facilities and their staff is fully trained and certified.
Quality ratings
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.
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.
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.
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.
Staffing hours breakdown
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.
Total nursing care / resident
This home is ranked 8th out of 14 homes in Wyoming.
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.
This home is ranked 8th out of 14 homes in Wyoming.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 57m per day
Rank #8 / 14Nurse hours — state benchmarkedThis home is ranked 8th out of 14 homes in Wyoming.Shows adjusted nurse hours per resident per day benchmarked to the Wyoming average, with a ranking across 14 Wyoming SNFs. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.
vs Wyoming avg
-14%
| Staff type | Hours / day | vs state avg |
|---|---|---|
|
Total Nursing (Weekend)
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.
| 2h 50m per day |
Capacity and availability
This home usually has availability
Occupancy lower than 85% suggests more openings may be available.
Occupancy rate
78.1%
Rank #5 / 14Occupancy rate — state benchmarkedThis home is ranked 5th out of 14 homes in Wyoming.Shows this facility's occupancy rate versus the Wyoming average, with its statewide rank out of 14. Higher occupancy signals strong local demand and financial stability.
Avg. Length of Stay
78 days
Occupancy rate
78.1%
Rank #5 / 14Occupancy rate — state benchmarkedThis home is ranked 5th out of 14 homes in Wyoming.Shows this facility's occupancy rate versus the Wyoming average, with its statewide rank out of 14. Higher occupancy signals strong local demand and financial stability.
Avg. Length of Stay
78 days
Who this home usually serves
Show admissions and discharges
TYPE OF STAY
Might be optimal for
Short stays
Recovery
Medicare-covered care
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
Finances and operations
Privately-owned community
Home revenue
$18.5M
Profit
$988.2K
Privately-owned community
Home revenue
$18.5M Rank #2 / 13Revenue — state benchmarkedThis home is ranked 2nd out of 13 homes in Wyoming.Shows this facility's annual revenue compared to the Wyoming SNF average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.
Profit
$988.2K
Payroll costs
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #5 / 13Payroll — state benchmarkedThis home is ranked 5th out of 13 homes in Wyoming.Shows total annual staff payroll benchmarked to the Wyoming average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.
$5.2M
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #5 / 13Payroll — state benchmarkedThis home is ranked 5th out of 13 homes in Wyoming.Shows total annual staff payroll benchmarked to the Wyoming average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.
Other operating costs
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
$12.2M
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Total costs
$17.5M
192-bed community
A large-scale community that may provide a wide range of amenities, services, and structured programs.
About this community
Facility TypeNh
StatusActive
CountyNatrona
License Number15452
CMS Certification Number535042
North Big Horn Hospital District, a Wyoming Special Hospital District is administrated by Jessica Miller.
Staffing
Key information about the people who lead and staff this community.
Director of NursingWhitney Barrett
Email
[email protected]
Fax307-472-3510
Specific ProgramsCardiac Rehabilitation, Diabetes Education, Home Health, Hospital Services, Infusion Clinic, Specialty Clinics
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.
1 visit/inspection
Inspections are mandatory, regular evaluations conducted by state health departments or regulatory agencies. They ensure the community provides safe, compliant care, covering areas like resident health, staff and management.
Latest inspection
Date
October 20, 2025
Complaint InvestigationInspection Report Summary for North Big Horn Hospital District, a Wyoming Special Hospital District
The most recent inspection on October 20, 2025, found no deficiencies. Earlier inspections also showed no deficiencies, indicating a consistent compliance record. A complaint investigation prompted by intake 2637234 was unsubstantiated, with no issues identified. Enforcement actions such as fines or license suspensions were not listed in the available reports. The facility’s inspection history suggests stable adherence to regulatory standards.
Health Inspection History
Inspections
Total health citations
37
Rank #12 / 14Health citations — state benchmarkedThis home is ranked 12th out of 14 homes in Wyoming.Shows this facility's total health deficiency citations benchmarked to the Wyoming state average, with a ranking across all 14 WY SNFs. Lower citation counts earn a better rank.
Wyoming average 18.9
Citations per inspection
3.36
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 3 years)
Critical Health citations
0
Rank #8 / 8Severe citations — state benchmarkedThis home is ranked 8th out of 8 homes in Wyoming.Shows citations where actual resident harm occurred, compared to the Wyoming average and ranked across 8 SNFs statewide. Even a single severe citation is significant — lower is always better.
100% better than Wyoming averageWyoming average: 0.2
Serious Health citations
7
7
289% worse than Wyoming averageWyoming average: 1.8
0 critical citations
7 serious citations
30 moderate citations
0 minor citations
Citations history (last 3 years)
Abuse/Neglect serious citation
Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment.
May 22, 2025
Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment.
May 22, 2025
Corrected
Quality of Care serious citation
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Mar 20, 2025
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Mar 20, 2025
Corrected
Quality of Care serious citation
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Mar 20, 2025
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Mar 20, 2025
Corrected
Resident Rights serious citation
Issues related to resident's rights, including dignity, privacy, and the ability to make decisions about their care.
Mar 20, 2025
Issues related to resident's rights, including dignity, privacy, and the ability to make decisions about their care.
Mar 20, 2025
Corrected
Data sourced from CMS Health Deficiencies reports. 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.
Compare Nursing Homes around Casper The information below is reported by the Wyoming Department of Health, Healthcare Licensing and Surveys.
Filter by care type
| North Big Horn Hospital District, a Wyoming Special Hospital District |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Casper | 192 | 78.1% | +13% | 3.95 | -13% | -13% | 5 | 37 | 3.4 | 7 | 157 | - | - | - | $18.5M | $5.2M | 28.3% | 535042 | ||||
| Elkhorn Valley Rehabilitation Hospital LLC | - |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Casper | 41 | - | - | - | - | - | - | - | - | 0 | 0 | 0.0 | 0 | - | - | - | - | - | - | - | - |
Financial Assistance for
Nursing Home in Wyoming
Get Financial aid guidance
Places of interest near North Big Horn Hospital District, a Wyoming Special Hospital District
0.0 miles from city center
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.
Calculate Travel Distance to North Big Horn Hospital District, a Wyoming Special Hospital District
Add your location
Staffing Data (Q2 2025)
This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
Total staff
215
Employees
215
Contractors
0
Staff to resident ratio
1.39:1
13% worse than Wyoming averageWyoming average ratio: 1.60:1
Avg staff/day
80
Average shift
9 hours
7% better than Wyoming averageWyoming average: 8.4 hours
Total staff hours (quarter)
65,735
Nursing staff breakdown
Registered Nurse
Manages medical care and health needs.
Total count
27
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.8 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.8 hoursNo contractors work on this role.
Licensed Practical Nurse
Assists with medical care and medications.
Total count
15
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.6 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.6 hoursNo contractors work on this role.
Certified Nursing Assistant
Helps with daily care and mobility.
Total count
68
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.2 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.2 hoursNo contractors work on this role.
Contractor staffing
Total hours from contractors
0%
0 contractor hours this quarter
No contractor roles were reported this quarter.
Staff by category
| Certified Nursing Assistant | 68 | 0 | 68 | 23,971 | 91 | 100% | 10.2 |
| Physical Therapist | 30 | 0 | 30 | 10,867 | 91 | 100% | 7.3 |
| Registered Nurse | 27 | 0 | 27 | 7,154 | 91 | 100% | 9.8 |
| Medication Aide/Technician | 15 | 0 | 15 | 4,401 | 90 | 99% | 9.6 |
| Clinical Nurse Specialist | 8 | 0 | 8 | 4,033 | 91 | 100% | 9 |
| Licensed Practical Nurse | 15 | 0 | 15 | 3,583 | 91 | 100% | 10.6 |
| Nurse Aide in Training | 29 | 0 | 29 | 3,417 | 88 | 97% | 9.4 |
| Other Dietary Services Staff | 10 | 0 | 10 | 2,641 | 90 | 99% | 7 |
| RN Director of Nursing | 4 | 0 | 4 | 1,789 | 71 | 78% | 8.2 |
| Mental Health Service Worker | 3 | 0 | 3 | 1,191 | 70 | 77% | 7.4 |
| Occupational Therapy Aide | 2 | 0 | 2 | 1,066 | 69 | 76% | 8.3 |
| Nurse Practitioner | 2 | 0 | 2 | 624 | 61 | 67% | 8 |
| Administrator | 1 | 0 | 1 | 504 | 63 | 69% | 8 |
| Dietitian | 1 | 0 | 1 | 496 | 62 | 68% | 8 |
68 Certified Nursing Assistant
% of Days
100%
30 Physical Therapist
% of Days
100%
27 Registered Nurse
% of Days
100%
15 Medication Aide/Technician
% of Days
99%
8 Clinical Nurse Specialist
% of Days
100%
15 Licensed Practical Nurse
% of Days
100%
29 Nurse Aide in Training
% of Days
97%
10 Other Dietary Services Staff
% of Days
99%
4 RN Director of Nursing
% of Days
78%
3 Mental Health Service Worker
% of Days
77%
2 Occupational Therapy Aide
% of Days
76%
2 Nurse Practitioner
% of Days
67%
1 Administrator
% of Days
69%
1 Dietitian
% of Days
68%
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.
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
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
12.8
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 averageWyoming average: 10.9
Functional decline score
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
23.1
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
23.1
11% worse than Wyoming averageWyoming average: 20.8
Long-stay resident measures
Need for Help with Daily Activities Increased
Percent of long-stay residents whose need for help with daily activities has increased
21.7%
Percent of long-stay residents whose need for help with daily activities has increased
21.7%
8% worse than Wyoming averageWyoming average: 20.0%
Walking Ability Worsened
Percent of long-stay residents whose ability to move independently worsened
29.7%
Percent of long-stay residents whose ability to move independently worsened
29.7%
55% worse than Wyoming averageWyoming average: 19.1%
Low Risk Residents with Bowel/Bladder Incontinence
Percent of low risk long-stay residents who lose control of their bowels or bladder
17.9%
Percent of low risk long-stay residents who lose control of their bowels or bladder
17.9%
23% better than Wyoming averageWyoming average: 23.2%
Falls with Major Injury
Percent of long-stay residents experiencing one or more falls with major injury
5.4%
Percent of long-stay residents experiencing one or more falls with major injury
5.4%
9% worse than Wyoming averageWyoming average: 4.9%
High Risk Residents with Pressure Ulcers
Percent of long-stay high risk residents with pressure ulcers
1.5%
Percent of long-stay high risk residents with pressure ulcers
1.5%
69% better than Wyoming averageWyoming average: 5.0%
Urinary Tract Infection
Percent of long-stay residents with a urinary tract infection
0.8%
Percent of long-stay residents with a urinary tract infection
0.8%
76% better than Wyoming averageWyoming average: 3.1%
Lost Too Much Weight
Percent of long-stay residents who lose too much weight
5.4%
Percent of long-stay residents who lose too much weight
5.4%
17% better than Wyoming averageWyoming average: 6.5%
Depressive Symptoms
Percent of long-stay residents who have depressive symptoms
9.5%
Percent of long-stay residents who have depressive symptoms
9.5%
47% worse than Wyoming averageWyoming average: 6.4%
Antipsychotic Use
Percent of long-stay residents who received an antipsychotic medication
30.1%
Percent of long-stay residents who received an antipsychotic medication
30.1%
32% worse than Wyoming averageWyoming average: 22.7%
Pneumococcal Vaccine
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
96.4%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
96.4%
In line with Wyoming averageWyoming average: 94.1%
Influenza Vaccine
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
90.9%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
90.9%
In line with Wyoming averageWyoming average: 94.3%
Short-stay resident measures
Pneumococcal Vaccine
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
77.4%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
77.4%
In line with Wyoming averageWyoming average: 74.6%
Antipsychotic medication increase
Percent of short-stay residents who newly received an antipsychotic medication
1.8%
Percent of short-stay residents who newly received an antipsychotic medication
1.8%
19% better than Wyoming averageWyoming average: 2.3%
Influenza Vaccine
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
63.0%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
63.0%
18% worse than Wyoming averageWyoming average: 77.0%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
Penalties and fines
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
137% higher than Wyoming averageWyoming average: $40K
Number of fines
5 Rank #8 / 8Federal fines — state benchmarkedThis home is ranked 8th out of 8 homes in Wyoming.Shows this facility's CMS fine count alongside the Wyoming average, and where it ranks among all 8 skilled nursing facilities in the state. Fewer fines mean a better rank.
87% more fines than Wyoming averageWyoming average: 2.7
Payment Denials
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
100% fewer payment denials than Wyoming averageWyoming 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.
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
May 22, 2025
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
May 22, 2025
$19K
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Mar 20, 2025
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Mar 20, 2025
$24K
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Aug 15, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Aug 15, 2024
$8K
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Mar 22, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Mar 22, 2024
$34K
Last updated: Jan 2026
Financial Trends
Historical financial and operational data for North Big Horn Hospital District, a Wyoming Special Hospital District based on CMS SNF Cost Reports.
Occupancy Rate
78.1%
↑ 10.2pp vs 2022
Net Income
$988.2K
↑ ~$50.3K vs 2022
Total Payroll
$7.1M
↓ ~$3.1M vs 2022
Profit Margin
5.4%
↑ 1.6pp vs 2022
Loading trend charts...
Guides for Better Senior Living
Care Cost Calculator: See Prices in Your Area
Nursing Home Data Explorer
Don’t Wait Too Long: 7 Red Flag Signs Your Parent Needs Assisted Living Now
The True Cost of Assisted Living in 2025 – And How Families Are Paying For It
Understanding Senior Living Costs: Pricing Models, Discounts & Financial Assistance
Contact Us
Planning a tour? Check our touring checklist.
Thinking of living here? We can help you speak to a current resident
Thinking about senior living? Use our bidding system to get competitive quotes from the best homes in your area.
Touring Checklist for Senior Living
Touring a community? Use this expert-backed checklist to stay organized, ask the right questions, and find the perfect fit.
Location
Community Spaces and Overall Environment
Services
Staffing
Accommodations
Finances
Other Notes
0/250
Send Checklist to Your Email
We'll send you a PDF version of the touring checklist.
Feedback
Write a review for North Big Horn Hospital District, a Wyoming Special Hospital District
Rate your overall experience with this community
Explore Open Rooms
1
Contact details
2
What type of senior care service are you looking for?
3
What budget do you have in mind for senior care?
4
How soon do you need to find care?
5
Additional details
Thank you for your interest!
Our team will be in touch shortly to help with next steps.
Need Help?
Let us help you or a loved one find the perfect senior home.
