We arrange tours, appointments, and even moving support so you don’t have to
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.
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.
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.
This home is ranked 8th out of 13 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.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Weekend Total Nursing
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 |
Occupancy lower than 85% suggests more openings may be available.
North Big Horn Hospital District, a Wyoming Special Hospital District is administrated by Jessica Miller.
Key information about the people who lead and staff this community.
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.
Read the full inspection reports for this facility, including detailed findings and corrective actions.
Show Inspection ReportsWyoming average 5.6
Last Health inspection on May 2025
Wyoming average 18.9
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).
100% better than Wyoming average
Wyoming average: 0.2
289% worse than Wyoming average
Wyoming average: 1.8
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
17% worse than Wyoming average
7% better than Wyoming average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.8 hours
No contractors work on this role.
Assists with medical care and medications.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.1 hours
No contractors work on this role.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.9 hours
No contractors work on this role.
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
0 contractor hours this quarter
No contractor roles were reported this quarter.
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 74 | 0 | 74 | 26,762 | 92 | 100% | 9.9 |
| Physical Therapist | 33 | 0 | 33 | 9,623 | 76 | 83% | 7.2 |
| Registered Nurse | 21 | 0 | 21 | 7,038 | 92 | 100% | 9.8 |
| Medication Aide/Technician | 16 | 0 | 16 | 6,849 | 92 | 100% | 10.2 |
| Other Dietary Services Staff | 14 | 0 | 14 | 4,001 | 92 | 100% | 7.4 |
| Nurse Aide in Training | 17 | 0 | 17 | 3,195 | 82 | 89% | 9.5 |
| Licensed Practical Nurse | 15 | 0 | 15 | 2,946 | 91 | 99% | 10.1 |
| RN Director of Nursing | 6 | 0 | 6 | 2,205 | 87 | 95% | 8.7 |
| Clinical Nurse Specialist | 5 | 0 | 5 | 1,849 | 82 | 89% | 7.6 |
| Mental Health Service Worker | 3 | 0 | 3 | 1,095 | 63 | 68% | 7.7 |
| Occupational Therapy Aide | 2 | 0 | 2 | 957 | 69 | 75% | 8.4 |
| Nurse Practitioner | 1 | 0 | 1 | 504 | 63 | 68% | 8 |
| Administrator | 1 | 0 | 1 | 488 | 61 | 66% | 8 |
| Dietitian | 1 | 0 | 1 | 339 | 39 | 42% | 8.7 |
| Dental Services Staff | 2 | 0 | 2 | 128 | 11 | 12% | 7.5 |
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)
137% higher than Wyoming average
Wyoming average: $40K
87% more fines than Wyoming average
Wyoming average: 2.7
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
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.
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.
Mar 20, 2025
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.
Mar 22, 2024
Last updated: Jan 2026
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
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
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
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%
Percent of long-stay residents whose ability to move independently worsened
29.7%
55% worse than Wyoming average
Wyoming average: 19.1%
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%
Percent of long-stay residents experiencing one or more falls with major injury
5.4%
9% worse than Wyoming average
Wyoming average: 4.9%
Percent of long-stay high risk residents with pressure ulcers
1.5%
69% better than Wyoming average
Wyoming average: 5.0%
Percent of long-stay residents with a urinary tract infection
0.8%
76% better than Wyoming average
Wyoming average: 3.1%
Percent of long-stay residents who lose too much weight
5.4%
17% better than Wyoming average
Wyoming average: 6.5%
Percent of long-stay residents who have depressive symptoms
9.5%
47% worse than Wyoming average
Wyoming average: 6.4%
Percent of long-stay residents who received an antipsychotic medication
30.1%
32% worse than Wyoming average
Wyoming average: 22.7%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
96.4%
In line with Wyoming average
Wyoming average: 94.1%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
90.9%
In line with Wyoming average
Wyoming average: 94.3%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
77.4%
In line with Wyoming average
Wyoming average: 74.6%
Percent of short-stay residents who newly received an antipsychotic medication
1.8%
19% better than Wyoming average
Wyoming average: 2.3%
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.
56% of new residents, usually for short-term rehab.
25% of new residents, often for short stays.
19% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
155
Residents meet regularly to discuss policies, care quality, and activities
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.
Historical financial and operational data for North Big Horn Hospital District, a Wyoming Special Hospital District based on CMS SNF Cost Reports.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #4 / 12Payroll — State benchmarkedThis home is ranked 4th out of 12 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.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Most residents typically stay for a few weeks or months before returning home or moving on.
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.
Add your location
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.
Whitney Barrett is the Director of Nursing at North Big Horn Hospital District, a Wyoming Special Hospital District.
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.
According to WY state health department records, North Big Horn Hospital District, a Wyoming Special Hospital District's license number is 15452.
The team at North Big Horn Hospital District, a Wyoming Special Hospital District can be reached at [email protected].
Jessica Miller is the administrator of North Big Horn Hospital District, a Wyoming Special Hospital District.
North Big Horn Hospital District, a Wyoming Special Hospital District has 192 beds.
Yes — there are 21 photos of North Big Horn Hospital District, a Wyoming Special Hospital District in the photo gallery on this page.
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
Thank you for your interest!
Our team will be in touch shortly to help with next steps.
