Every person who worked here at any point in the quarter, employees and contractors. It is not how many are on site at once: that is the "on an average day" figure.
211
211 employees · 0 contractors · 82 on an average day North Big Horn Hospital District, a Wyoming Special Hospital District
Nursing Home, Memory Care & Skilled Nursing · Casper, WY
ALM Inspection Grade
D+
ALM's inspection grade is 67 / 100, a D+ — 17 points below the Wyoming average for CMS-certified facilities (84/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
ALM's inspection grade is 67 / 100, a D+ — 17 points below the Wyoming average for CMS-certified facilities (84/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
CMS overall rating
1/5
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.
1/5
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.
North Big Horn Hospital District, a Wyoming Special Hospital District
Nursing Home, Memory Care & Skilled Nursing · Casper, WY
ALM Inspection Grade
D+
ALM's inspection grade is 67 / 100, a D+ — 17 points below the Wyoming average for CMS-certified facilities (84/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
ALM's inspection grade is 67 / 100, a D+ — 17 points below the Wyoming average for CMS-certified facilities (84/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
CMS overall rating
1/5
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.
1/5
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.
North Big Horn Hospital District, a Wyoming Special Hospital District accepts Medicare, Medicaid, and private pay.
North Big Horn Hospital District, a Wyoming Special Hospital District, offers nursing home, memory care, and skilled nursing in Casper, Wyoming. Nursing home and skilled nursing care provide residential support with licensed nursing on site around the clock, while memory care offers a secured setting with supervision for someone at risk of wandering. Having all three care levels may suit a resident whose needs could grow over time without requiring a move to another community.
The home has 192 beds, so it is a larger community with many residents and staff. With 85% occupancy, most beds are in use and the setting is likely to feel active rather than small and private. Total nurse staffing is 3 hours and 48 minutes per resident each day, representing the daily hands-on nursing time allocated to each resident.
Medicare, Medicaid, and private pay are accepted, giving families several ways to cover care. Listed programs include Cardiac Rehabilitation, Diabetes Education, Home Health, Hospital Services, an Infusion Clinic, and Specialty Clinics, providing access to clinical services for cardiac, diabetes, infusion, and other specialized needs. Jessica Miller serves as the administrator. A Walk Score of 71 places the area in the very walkable band, meaning most errands can be completed on foot and a resident who no longer drives may still be able to get out independently.
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
Data period: Q4 2025 (October 1 – December 31, 2025).
Nursing care per resident per day and state rankings: CMS Provider Information.
Headcount, shifts and contractors: CMS Payroll-Based Journal (PBJ).
Resident count: CMS Long-Term Care Facility Characteristics (data as of Jun 2026).
Total nursing care per resident / day
This nursing home is ranked 7th out of 13 nursing 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 48m
This nursing home is ranked 7th out of 13 nursing 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 48m6 of 6 metrics below Wyoming average
Daily care time per resident, by role
Registered nurse (RN)
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. All 21 are the facility's own employees; no agency contractors work in this role.
21 staff · 9.8-hour shifts
56m
↓ 17% · WY 1h 7mThis facility: 56m per resident per day, 17% below the Wyoming average of 1h 7m (among Wyoming facilities reporting a recent figure).
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. All 21 are the facility's own employees; no agency contractors work in this role.
21 staff · 9.8-hour shiftsUS average: 43m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 43m
LPN / LVN
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. All 15 are the facility's own employees; no agency contractors work in this role.
15 staff · 10.1-hour shifts
26m
↓ 33% · WY 38mThis facility: 26m per resident per day, 33% below the Wyoming average of 38m (among Wyoming facilities reporting a recent figure).
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. All 15 are the facility's own employees; no agency contractors work in this role.
15 staff · 10.1-hour shiftsUS average: 52m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 52m
Certified nursing assistant
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. All 74 are the facility's own employees; no agency contractors work in this role.
74 staff · 9.9-hour shifts
2h 27m
↓ 18% · WY 3h 0mThis facility: 2h 27m per resident per day, 18% below the Wyoming average of 3h 0m (among Wyoming facilities reporting a recent figure).
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. All 74 are the facility's own employees; no agency contractors work in this role.
74 staff · 9.9-hour shiftsUS average: 2h 26m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 2h 26m
Physical therapist
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. All 33 are the facility's own employees; no agency contractors work in this role.
33 staff · 7.2-hour shifts
2m
↓ 23% · WY 3mThis facility: 2m per resident per day, 23% below the Wyoming average of 3m (among Wyoming facilities reporting a recent figure).
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. All 33 are the facility's own employees; no agency contractors work in this role.
33 staff · 7.2-hour shiftsUS average: 4m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 4m
Total nursing, weekends
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.
RN + LPN + aide · Sat–Sun
3h 2m
↓ 23% · WY 3h 56mThis facility: 3h 2m per resident per day, 23% below the Wyoming average of 3h 56m (among Wyoming facilities reporting a recent figure).
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.
RN + LPN + aide · Sat–SunUS average: 3h 32m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 3h 32m
RN, weekends
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.
Sat–Sun
34m
↓ 10% · WY 38mThis facility: 34m per resident per day, 10% below the Wyoming average of 38m (among Wyoming facilities reporting a recent figure).
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.
Sat–SunUS average: 29m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 29m
Headcount
Every person who worked here at any point in the quarter, employees and contractors. It is not how many are on site at once: that is the "on an average day" figure.
211
211 employees · 0 contractors · 82 on an average day
211 total staff / 155 residents. Residents: CMS Long-Term Care Facility Characteristics (data as of Jun 2026); staff: CMS Payroll-Based Journal (Q4 2025).Residents and staff come from two different CMS releases, so the two counts can be a few months apart.
1.36 : 1
↓ 17% · WY 1.64This facility: 1.36 staff per resident, 17% below the Wyoming average of 1.64 (among Wyoming facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
211 staff ÷ 155 residents
See full Wyoming ranking →
Average hours one staff member works on a day they are on shift, across every role.
9 h
↑ 6% · WY 8.5 hThis facility: 9 h, 6% above the Wyoming average of 8.5 h (among Wyoming facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
67,979 staff hours this quarter
See full Wyoming ranking →100% of staff hours were worked by the facility's own employees
Wyoming average: 93.4% · No agency contractors this quarter
Why it matters: employees work here week after week and get to know each resident's routines and needs. Agency contractors often rotate between facilities, so a higher employee share usually means more consistent care.
By The Numbers
Community insights.
Bed count
A mid-sized community that may balance personal attention with shared amenities and social activities.
192
Rank #1 / 14Bed count — State benchmarked This nursing home is ranked 1st out of 14 nursing 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 compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
A mid-sized community that may balance personal attention with shared amenities and social activities.
192
Rank #1 / 14Bed count — State benchmarked This nursing home is ranked 1st out of 14 nursing 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 compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.Medium-capacity home · Offers a balance of services and community atmosphere.
Walk Score
Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
Rank #3 / 16Walk Score — State benchmarked This nursing home is ranked 3rd out of 16 nursing 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 compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
Rank #3 / 16Walk Score — State benchmarked This nursing home is ranked 3rd out of 16 nursing 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 compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
71
/ 100
Occupancy rate
Occupancy lower than 85% suggests more openings may be available.
Rank #1 / 14Occupancy rate — State benchmarked This nursing home is ranked 1st out of 14 nursing homes we track in Wyoming for occupancy. 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. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Occupancy lower than 85% suggests more openings may be available.
Rank #1 / 14Occupancy rate — State benchmarked This nursing home is ranked 1st out of 14 nursing homes we track in Wyoming for occupancy. 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. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
84.9%
This home usually has availability
Based on 163 residents and 192 beds. Source: state licensing agency resident count
Higher than the Wyoming average: 61.6%
Avg. Length of Stay
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.
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.
144
days
About This Community
Facility TypeNursing Home
StatusActive
CountyNatrona
License Number15452
CMS Certification Number535042
North Big Horn Hospital District, a Wyoming Special Hospital District is administered by Jessica Miller.
Resident Council
Director of NursingWhitney Barrett
Cardiac RehabilitationA supervised program that helps people regain strength and endurance after heart problems or procedures, often including exercise and risk-factor education.
Diabetes Education
Infusion Clinic
Fax307-472-3510
Pets not allowed
CMS Health Inspection History
ALM Inspection Grade
67 / 100
Calculated from CMS inspection data for this community's nursing-home beds
How it compares
17 points below the Wyoming average for CMS-certified facilities (84/100)
Category breakdown
Citations
Concern
180 severity-weighted points (39 deficiencies) · 2× higher than the typical CMS-certified WY facility (median: 84)
Enforcement
Concern
$97,031 in fines · 5 enforcement actions
Persistence
Typical
29 days to fix issues · faster than the typical CMS-certified WY facility (median: 32)
Total health inspections
12
↑ 107% · WY 5.8This facility: 12, 107% above the Wyoming average of 5.8 (among Wyoming facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Total health citations
39
Rank #11 / 13Health citations — State benchmarked This nursing home is ranked 11th out of 13 nursing 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 13 WY facilities. Lower citation counts earn a better rank. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.↑ 93% · WY 20.2This facility: 39, 93% above the Wyoming average of 20.2 (among Wyoming facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Citations per inspection
3.25
Rank #7 / 13Citations per inspection — State benchmarked This nursing home is ranked 7th out of 13 nursing homes we track in Wyoming for citations per inspection. Shows average deficiency citations per CMS inspection for this facility versus the Wyoming mean across 13 facilities with citation data. Lower is better. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.↓ 6% · WY 3.46This facility: 3.25, 6% below the Wyoming average of 3.46 (among Wyoming facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Citation severity
100% corrected
39 of 39 citations corrected
Critical
J–L
1
↑ 400% · WY 0.2This facility: 1, 400% above the Wyoming average of 0.2 (among Wyoming facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Immediate jeopardy
Serious
G–I
6
↑ 233% · WY 1.8This facility: 6, 233% above the Wyoming average of 1.8 (among Wyoming facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Actual harm
Moderate
D–F
32
↑ 82% · WY 17.6This facility: 32, 82% above the Wyoming average of 17.6 (among Wyoming facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
No harm, more than minimal risk
Minor
A–C
0
↓ 100% · WY 0.6This facility: 0, 100% below the Wyoming average of 0.6 (among Wyoming facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
No harm, minimal riskLatest inspection: Mar 13, 2026 · 3 citations, all corrected
Most cited category: Quality of Life & Care, 13 of 39 citations · 10 categories in total
Citations history
Most recent first
Mar 13, 2026
3 citations
Infection Control moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care critical citation
Corrected
Corrected
Jan 29, 2026
1 citation
Quality of Care moderate citation
Corrected
Corrected
May 22, 2025
1 citation
Abuse/Neglect serious citation
Corrected
Corrected
Mar 20, 2025
3 citations
Quality of Care serious citation
Corrected
Corrected
Quality of Care serious citation
Corrected
Corrected
Resident Rights serious citation
Corrected
Corrected
Oct 31, 2024
7 citations
Infection Control moderate citation
Corrected
Corrected
Nursing Services moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Sep 10, 2024
2 citations
Abuse/Neglect serious citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Aug 15, 2024
1 citation
Infection Control moderate citation
Corrected
Corrected
Mar 22, 2024
1 citation
Quality of Care serious citation
Corrected
Corrected
Feb 01, 2024
1 citation
Abuse/Neglect moderate citation
Corrected
Corrected
Nov 09, 2023
1 citation
Care Planning moderate citation
Corrected
Corrected
Aug 10, 2023
10 citations
Environmental moderate citation
Corrected
Corrected
Infection Control moderate citation
Corrected
Corrected
Nutrition moderate citation
Corrected
Corrected
Nutrition moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Aug 31, 2022
8 citations
Administration moderate citation
Corrected
Corrected
Infection Control moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Top deficiency categories
Share of 39 citations
Quality of Life & Care
13 deficiencies (33%)
Resident Assessment & Care Planning
8 deficiencies (21%)
Infection Control
5 deficiencies (13%)
Abuse, Neglect & Exploitation
3 deficiencies (8%)
Pharmacy Services
3 deficiencies (8%)
Resident Rights
2 deficiencies (5%)
Nutrition & Dietary
2 deficiencies (5%)
Administration
1 deficiency (3%)
Nursing & Physician Services
1 deficiency (3%)
Environmental
1 deficiency (3%)
How citations are counted
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
19 of 39 citations resulted from standard inspections; 14 of 39 resulted from complaint investigations; and 6 of 39 came from combined inspections (standard and complaint).
Includes all CMS health inspection records for this property, which could include management/ownership changes.
Source
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.
Show Inspection Reports
Enforcement
Penalties and fines
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 Aug 2026
5 penalties in the past 3 years
Latest: Mar 13, 2026 · $26,685 civil money penalty
Mar 13, 2026 · $26,685 civil money penalty
May 22, 2025 · $12,438 civil money penalty
Mar 20, 2025 · $15,857 civil money penalty
Aug 15, 2024 · $7,718 civil money penalty
Mar 22, 2024 · $34,333 civil money penalty
Total fines
$97,031
↑ 166% · WY $36KThis facility: $97,031, 166% above the Wyoming average of $36,463. Average among the 25 Wyoming facilities with a penalty on record.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.US avg $67KUS average: $67,417, among the 6,775 US facilities with a penalty on record.Rank #12 / 13Federal fines — State benchmarked This nursing home is ranked 12th out of 13 nursing 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 compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Number of fines
5
↑ 221% · WY 1.56This facility: 5, 221% above the Wyoming average of 1.56. Average among the 25 Wyoming facilities with a penalty on record.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.US avg 1.96US average: 1.96, among the 6,775 US facilities with a penalty on record.
Payment denials
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
WY avg 0.36Wyoming average: 0.36. Average among the 25 Wyoming facilities with a penalty on record.US avg 0.36US average: 0.36, among the 6,775 US facilities with a penalty on record.
Penalty history · past 3 years
Mar 13, 2026
Civil money penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$26,685
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$26,685
May 22, 2025
Civil money penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$12,438
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$12,438
Mar 20, 2025
Civil money penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$15,857
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$15,857
Aug 15, 2024
Civil money penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$7,718
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$7,718
Mar 22, 2024
Civil money penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$34,333
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$34,333Fine amount comparison
This facility
$97,031
Wyoming average
$36,463
US average
$67,417
Totals count every penalty on record; the history lists the past 3 years. Wyoming and US averages are among facilities with a penalty on record.
A civil money penalty is a fine for noncompliance, per day or per instance. A payment denial stops Medicare/Medicaid payments for new residents until issues are fixed.
Health Outcomes
Quality of care over time
How residents at this home fare on health outcomes and preventive care, compared with the Wyoming average.
CMS star rating for the care of long-stay residents, who live at the home for 100 days or more. It is built from the long-stay quality measures below. 5 stars is the best.
3
/ 5
Average
CMS star rating for the care of short-stay residents, mostly people recovering after a hospital stay for under 100 days. It is built from the short-stay quality measures below. 5 stars is the best.
3
/ 5
Average
Average of five long-stay measures: pressure ulcers, falls with major injury, unplanned weight loss, worsening ability to walk, and needing more help with daily activities. Each is the % of residents affected, so lower is better.
9.9
Score · lower is better
↑ 5% · WY 9.5This facility: 9.9, 5% above the WY average of 9.5 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Average of three long-stay measures: needing more help with daily activities, worsening ability to walk, and loss of bowel or bladder control. Each is the % of residents affected, so lower is better.
17.8
Score · lower is better
↓ 3% · WY 18.3This facility: 17.8, 3% below the WY average of 18.3 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.11 long-stay measures: 4 better, 3 worse, 4 near WY average
3 short-stay measures: 1 better, 2 worse
Long-stay residents
People who live at the home · 11 measures
Daily care & independence
Needed more help with daily activities
Percent of long-stay residents whose need for help with daily activities has increased
17.3%
↑ 3% · WY 16.8This facility: 17.3, 3% above the WY average of 16.8 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents whose need for help with daily activities has increased
17.3%
↑ 3% · WY 16.8This facility: 17.3, 3% above the WY average of 16.8 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Walking ability worsened
Percent of long-stay residents whose ability to move independently worsened
18.5%
↑ 21% · WY 15.3This facility: 18.5, 21% above the WY average of 15.3 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents whose ability to move independently worsened
18.5%
↑ 21% · WY 15.3This facility: 18.5, 21% above the WY average of 15.3 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Bowel or bladder incontinence (low-risk residents)
Percent of low risk long-stay residents who lose control of their bowels or bladder
17.6%
↓ 22% · WY 22.7This facility: 17.6, 22% below the WY average of 22.7 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of low risk long-stay residents who lose control of their bowels or bladder
17.6%
↓ 22% · WY 22.7This facility: 17.6, 22% below the WY average of 22.7 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Safety & clinical stability
Urinary tract infection
Percent of long-stay residents with a urinary tract infection
1.1%
↓ 64% · WY 3.1This facility: 1.1, 64% below the WY average of 3.1 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents with a urinary tract infection
1.1%
↓ 64% · WY 3.1This facility: 1.1, 64% below the WY average of 3.1 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Falls with major injury
Percent of long-stay residents experiencing one or more falls with major injury
6.1%
↑ 30% · WY 4.7This facility: 6.1, 30% above the WY average of 4.7 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents experiencing one or more falls with major injury
6.1%
↑ 30% · WY 4.7This facility: 6.1, 30% above the WY average of 4.7 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Pressure ulcers (high-risk residents)
Percent of long-stay high risk residents with pressure ulcers
2.2%
↓ 53% · WY 4.6This facility: 2.2, 53% below the WY average of 4.6 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay high risk residents with pressure ulcers
2.2%
↓ 53% · WY 4.6This facility: 2.2, 53% below the WY average of 4.6 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Physical & mental health
Lost too much weight
Percent of long-stay residents who lose too much weight
5.7%
↓ 5% · WY 5.9This facility: 5.7, 5% below the WY average of 5.9 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who lose too much weight
5.7%
↓ 5% · WY 5.9This facility: 5.7, 5% below the WY average of 5.9 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Depressive symptoms
Percent of long-stay residents who have depressive symptoms
7.5%
↑ 15% · WY 6.5This facility: 7.5, 15% above the WY average of 6.5 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who have depressive symptoms
7.5%
↑ 15% · WY 6.5This facility: 7.5, 15% above the WY average of 6.5 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Antipsychotic use
Percent of long-stay residents who received an antipsychotic medication
21.7%
↓ 1% · WY 21.8This facility: 21.7, 1% below the WY average of 21.8 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who received an antipsychotic medication
21.7%
↓ 1% · WY 21.8This facility: 21.7, 1% below the WY average of 21.8 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Preventive care
Pneumococcal vaccine
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
94.8%
↑ 1% · WY 94.3This facility: 94.8, 1% above the WY average of 94.3 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
94.8%
↑ 1% · WY 94.3This facility: 94.8, 1% above the WY average of 94.3 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Flu vaccine
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
90.9%
↓ 4% · WY 94.3This facility: 90.9, 4% below the WY average of 94.3 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
90.9%
↓ 4% · WY 94.3This facility: 90.9, 4% below the WY average of 94.3 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Short-stay residents
Rehab and recovery after a hospital stay · 3 measures
Physical & mental health
New antipsychotic medication
Percent of short-stay residents who newly received an antipsychotic medication
3.3%
↑ 176% · WY 1.2This facility: 3.3, 176% above the WY average of 1.2 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents who newly received an antipsychotic medication
3.3%
↑ 176% · WY 1.2This facility: 3.3, 176% above the WY average of 1.2 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Preventive care
Pneumococcal vaccine
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
81.5%
↑ 6% · WY 77.0This facility: 81.5, 6% above the WY average of 77.0 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
81.5%
↑ 6% · WY 77.0This facility: 81.5, 6% above the WY average of 77.0 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Flu vaccine
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
63.0%
↓ 18% · WY 77.0This facility: 63.0, 18% below the WY average of 77.0 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
63.0%
↓ 18% · WY 77.0This facility: 63.0, 18% below the WY average of 77.0 (among WY facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Arrows show whether a figure is above or below the average. Green is better for residents, red is worse, and yellow means within 5% of the average. The line on each bar marks the average.
Quality measures are calculated by CMS from Minimum Data Set (MDS) resident assessments and Medicare claims.
Money and staffing.
North Big Horn Hospital District, a Wyoming Special Hospital District’s finances from its CMS cost report for the fiscal year ending December 2024, compared with 11 Wyoming nursing homes that filed a recent report. Includes all financial data for this property, which could include management/ownership changes.
FY Dec 2024
Is it financially stable?
Breaking even on care
1.3% operating margin
−3.5 pts vs prior year
Positive margin in 3 of the last 8 reported years. Net income $0.2M after other income.
Does it invest in staff?
Spends less on payroll than most Wyoming homes
49.8% payroll share of revenue
WY average 59.8%Rank #8 / 11Payroll % of net patient revenue — State benchmarked This nursing home is ranked 8th out of 11 nursing homes we track in Wyoming for payroll % of net patient revenue. Shows payroll as a percentage of net patient revenue versus the Wyoming average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Payroll rose $0.4M while revenue rose $0.6M. A low share can mean leaner staffing; check hours per resident in the staffing section.
FY 2024 scorecard
Each row shows the FY 2024 figure, the change since the prior report, the trend, and how it compares with Wyoming homes.
Revenue & profit
Profitable on care
| Metric | FY 2024 | vs prior year | Trend 2014 → 2024Trend | WY median | Compared with WY homesRank in WY | In short |
|---|---|---|---|---|---|---|
| Net patient revenue What the home earns from resident care, after discounts and bad debt. | $18.0M | +$0.6M | Trend 20142024 | WY median $11.4M | Rank in WY Rank #1 / 11Net patient revenue — State benchmarked This nursing home is ranked 1st out of 11 nursing homes we track in Wyoming for net patient revenue. Shows this facility's net patient revenue compared to the Wyoming average, among facilities reporting a recent fiscal year. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 100% of homes | Top 2% in WY Higher net patient revenue than 100% of WY homes that filed a recent report. Revenue mostly follows how big a home is. |
| Operating expenses Everything it costs to run the home: staff, supplies, rent, admin. | $17.8M | +$1.2M | Trend 20142024 | WY median — | Rank in WY Not ranked | Within revenue Operating expenses are lower than net patient revenue, so resident care covers its costs. |
| Net patient income Revenue minus operating expenses. Negative means care loses money. | $0.2M | −$0.6M | Trend 20142024 | WY median — | Rank in WY Not ranked | Profit, shrinking Resident care made money this year, less than in the prior report. |
| Operating margin Net patient income as a share of revenue. The clearest health signal. | 1.3% | −3.5 pts | Trend 20142024 | WY median — | Rank in WY Not ranked | Thin margin A margin from 0% to 5% of revenue leaves little room for unexpected costs. |
| Other income Money not from resident care: investments, grants, services. | $0.0M | — | Trend — | WY median — | Rank in WY Not ranked | Adds to profit Income from outside resident care, on top of the profit from care. |
| Net income The bottom line after other income. | $0.2M | −$0.7M | Trend — | WY median — | Rank in WY Not ranked | Profit The bottom line is above zero after other income. |
Staffing spend
Spends less of revenue on staff than most Wyoming homes
| Metric | FY 2024 | vs prior year | Trend 2014 → 2024Trend | WY median | Compared with WY homesRank in WY | In short |
|---|---|---|---|---|---|---|
| Payroll costs Salaries and wage-related benefits, not counting contract labor. | $9.0M | +$0.4M | Trend 20142024 | WY median $5.6M | Rank in WY Rank #2 / 11Payroll costs — State benchmarked This nursing home is ranked 2nd out of 11 nursing homes we track in Wyoming for payroll costs. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Wyoming average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 90% of homes | Top 10% in WY by size Higher payroll than 90% of WY homes. Payroll in dollars mostly follows how big a home is, so this compares size, not staffing levels. |
| Payroll share of revenue Payroll divided by revenue. Higher usually means more staff per resident. | 49.8% | +0.6 pts | Trend 20142024 | WY median 56.1% | Rank in WY Rank #8 / 11Payroll % of net patient revenue — State benchmarked This nursing home is ranked 8th out of 11 nursing homes we track in Wyoming for payroll % of net patient revenue. Shows payroll as a percentage of net patient revenue versus the Wyoming average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Wyoming that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 30% of homes | 10.0 pts under WY average The WY average is 59.8% of revenue. Within 3 points of it reads as near the average. |
Charts, 2014–2024 2 charts · WY benchmark drawn as a dashed line
Revenue, expenses and income
What the home earned from resident care (net patient revenue), what it cost to run (operating expenses) and the difference between the two (net patient income), for each fiscal year it filed a CMS cost report.
USD, millions
Net patient revenue Operating expenses Net patient income No report
Where revenue goes
Both lines are a share of net patient revenue. Payroll share is what goes to salaries and wage-related benefits; operating margin is what is left after every operating cost (below 0%, resident care lost money). The dashed line is the Wyoming payroll average.
% of net patient revenue
Payroll share Operating margin WY payroll average No report
Year-by-year data, 2014–2024 every reported year · latest first, scroll sideways
| Metric | 2014 | 2015 | 2016 | 2017 | 2018no report | 2019no report | 2020 | 2021 | 2022 | 2023no report | 2024 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Net patient revenue | $13.8M | $14.6M | $15.2M | $15.9M | $16.2M | $13.1M | $17.4M | $18.0M | |||
| Operating expenses | $15.0M | $15.8M | $17.2M | $18.3M | $15.7M | $14.3M | $16.6M | $17.8M | |||
| Net patient income | −$1.1M | −$1.2M | −$2.1M | −$2.4M | $0.5M | −$1.2M | $0.8M | $0.2M | |||
| Operating margin | −8.1% | −8.5% | −13.8% | −14.9% | 3.3% | −9.0% | 4.8% | 1.3% | |||
| Net income | $0.7M | $0.8M | $0.1M | $0.5M | $1.6M | −$0.2M | $0.9M | $0.2M | |||
| Payroll costs | $8.7M | $8.9M | $8.9M | $8.9M | $8.2M | $7.2M | $8.6M | $9.0M | |||
| Payroll share of revenue | 62.7% | 60.9% | 58.7% | 55.6% | 50.4% | 54.6% | 49.2% | 49.8% | |||
| Beds | 192 | 192 | 192 | 192 | 192 | 192 | 216 | 192 | |||
| Gross revenue | $15.8M | $17.5M | $18.5M | $20.6M | $23.5M | $20.4M | $24.9M | $25.5M | |||
| Salaries | $6.9M | $7.3M | $7.5M | $7.5M | $6.9M | $6.0M | $7.4M | $7.7M | |||
| Wage-related costs | $1.8M | $1.6M | $1.4M | $1.4M | $1.3M | $1.2M | $1.2M | $1.2M | |||
| Contract labor | $1.0M | $1.3M | $1.3M | $1.4M | $1.3M | $1.5M | $1.7M | $1.3M | |||
| Other operating costs | $6.3M | $6.9M | $8.3M | $9.4M | $7.5M | $7.1M | $8.0M | $8.8M | |||
| Net patient revenue per day | $239 | $248 | $257 | $264 | $325 | $312 | $324 | $324 | |||
| Cost per day | $258 | $269 | $292 | $304 | $314 | $340 | $309 | $319 | |||
| Average length of stay | 225.5 days | 220.5 days | 144.9 days | 123.0 days | 177.4 days | 300.4 days | 113.9 days | 144.5 days |
Showing 2024–2022 · scroll sideways for 8 earlier years
Earlier and partial years are in the download. Download CSV
Who this home usually serves
Residents split by who pays for their care: Medicare, Medicaid, or private pay and other sources.
Over a year: CMS SNF Cost Report, FY2024
Snapshot: CMS Long-Term Care Facility Characteristics (quarterly), Jun 2026
Arriving
281 admissions · FY2024
Residents admitted during the year.
Medicare
134 · 48%
Medicaid
42 · 15%
Private pay & other
105 · 37%
Resident snapshot
155 residents · Jun 2026
Residents counted on the date of the latest CMS report, which updates quarterly.
Medicare
15 · 10%
Medicaid
104 · 67%
Private pay & other
36 · 23%
Leaving
385 discharges · FY2024
Residents discharged during the year.
Medicare
114 · 30%
Medicaid
158 · 41%
Private pay & other
113 · 29%
Mostly short-term rehab stays
Most residents typically stay for a few weeks or months before returning home or moving on.
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
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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-ranked to lowest-ranked based on our methodology.
The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
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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.
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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.
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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.
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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.
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A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. This is a proprietary Assisted Living Magazine grade. It is not a government rating. A dash means we have no inspection data for that facility.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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: 59.8% 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.
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CMS Certification Number: the unique federal identifier for this skilled nursing provider.
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Life Care Center of Casper – Nursing Home | NH SNF | Casper | 120
Facility
120
WY AVG
97
Rank
#4 / 14 | ? |
61.1%
Facility
61.1%
WY AVG
61.6%
Rank
#8 / 14 | -1% | 4.61
Facility
4.61
WY AVG
4.64
Rank
#4 / 13 | +34% | -1% | $0
Facility
$0
WY AVG
$39.6k
Rank
#1 / 13 | 16
Facility
16
WY AVG
20.2
Rank
#5 / 13 | 2.7
Facility
2.7
WY AVG
3.5
Rank
#5 / 13 | - | 73 | - |
45
Facility
45
WY AVG
49
Rank
#10 / 16 | Ainsley Huber | $11.4MFiscal year ending 06/2025
Facility
$11.4MFiscal year ending 06/2025
WY AVG
$11.2M
Rank
#5 / 11 | $7.7MFiscal year ending 06/2025
Facility
$7.7MFiscal year ending 06/2025
WY AVG
$6.4M
Rank
#4 / 11 | 67.1%Fiscal year ending 06/2025
Facility
67.1%Fiscal year ending 06/2025
WY AVG
59.8%
Rank
#2 / 11 | 535049 | ||||
| North Big Horn Hospital District, a Wyoming Special Hospital District | NH MC SNF | Casper | 192
Facility
192
WY AVG
97
Rank
#1 / 14 | D+ |
84.9%
Facility
84.9%
WY AVG
61.6%
Rank
#1 / 14 | +38% | 3.81
Facility
3.81
WY AVG
4.64
Rank
#7 / 13 | -32% | -18% | $97.0k
Facility
$97.0k
WY AVG
$39.6k
Rank
#12 / 13 | 39
Facility
39
WY AVG
20.2
Rank
#11 / 13 | 3.3
Facility
3.3
WY AVG
3.5
Rank
#7 / 13 | 7 | 163 | - |
71
Facility
71
WY AVG
49
Rank
#3 / 16 | - | $18.0MFiscal year ending 12/2024
Facility
$18.0MFiscal year ending 12/2024
WY AVG
$11.2M
Rank
#1 / 11 | $9.0MFiscal year ending 12/2024
Facility
$9.0MFiscal year ending 12/2024
WY AVG
$6.4M
Rank
#2 / 11 | 49.8%Fiscal year ending 12/2024
Facility
49.8%Fiscal year ending 12/2024
WY AVG
59.8%
Rank
#8 / 11 | 535042 |
Rank badges are statewide and care-type specific: each nursing home is ranked against every other WY nursing home we track that reports that metric, not just the 2 on this page. See how we rank facilities
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.
Know before you visit
Frequently Asked Questions about North Big Horn Hospital District, a Wyoming Special Hospital District
Quick answers from public records and the community's own listing.01 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.
02 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.
03 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.
04 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 84.9%.
05 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.
06 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.
07 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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