60 Magnolia St., Casper, WY 82604 · Natrona County · (307) 234-9381
192 certified beds, about 162 residents a day · For profit - Corporation · Medicare and Medicaid since 1990
CMS Care Compare ratings, data as of September 1, 2026 · CCN 535042 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on July 30, 2026, inspectors cited 12 health deficiencies (the Wyoming average is 7.8, the national average 9.2).
Of 43 health citations since August 2023, 8 were rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).
CMS lists 5 fines totaling $97,031 in the last three years; the largest was $34,333, and the latest is dated March 13, 2026.
Nurses and nurse aides worked 3.26 hours per resident per day, against 3.87 across Wyoming and 3.86 nationally. Registered nurses accounted for 0.62 of those hours.
47.4% of nursing staff left within the year CMS measured (Wyoming average 51.8%).
CMS links it to Evergreen Healthcare Group, an affiliated group of 43 nursing homes.
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 43 health citations on file.
Inspectors wroteBased on resident representative and staff interview, medical record review, facility incident review, and policy review, the facility failed to ensure residents were free from abuse from other residents for 1 of 8 sample residents (#37) reviewed for abuse. This failure resulted in actual harm to resident #37.
Inspectors wroteBased on observation, resident representative, and staff interviews, medical record review, and policy and procedure review, the facility failed to ensure individual activities designed to meet the interests of and support the physical, mental, and psychosocial well-being of each resident were provided for 3 of 4 sample residents (#34, #123, #178) reviewed for activity participation.
Inspectors wroteBased on observation, staff interview, professional standard review, and policy review, the facility failed to ensure insulin medications were dated with an open date in 1 of 7 medication storage units (rehabilitation unit cart A).
Inspectors wroteBased on observation, medical record review, and staff interviews, the facility failed to treat each resident with respect and dignity and care for each resident in a manner and in an environment that promotes maintenance or enhancement of his or her quality of life for 1 of 4 sample residents (#57).
Inspectors wroteBased on medical record review, resident representative and staff interview, and policy and procedure review, the facility failed to provide a written notice of transfer and bed-hold for 1 of 5 sample residents (#34) reviewed for transfer and discharge.
Inspectors wroteBased on observation, medical record review, staff interview, and CMS RAI manual review, the facility failed to complete a significant change MDS assessment for 1 of 5 sample residents (#123) reviewed for a significant change.
Inspectors wroteBased on observation, medical record review, resident and staff interview, and policy review the facility failed to ensure they had developed and implemented a comprehensive person-centered care plan for for 1 of 31 sample residents (#7).
Inspectors wroteBased on observation, staff interview, medical record review, and professional standard review, the facility failed to ensure necessary services were provided timely for 1 of 4 sample residents (#57) reviewed for activities of daily living.
Inspectors wroteBased on resident and staff interview, medical record review, and policy and procedure review, the facility failed to ensure that 1 of 3 sample residents (#14) was provided with respiratory care, including tracheostomy care.
Inspectors wroteBased on medical record review, and staff interview, the facility failed to ensure behavioral health services were provided to 1 of 3 sample residents (#13) with a psychiatric diagnosis. The following concerns were identified: 1. Review of the admission MDS assessment dated [DATE] showed resident #13 had been admitted to the facility on [DATE], had a diagnosis of schizophrenia, and a BIMS score of 10 out of 15, which indicated moderate cognitive impairment. Review of the medication administration record (MAR) showed the resident received the antipsychotic medications haloperidol 2.5 mg, clozapine 12.5 mg, aripiprazole 15 mg. [...]
Inspectors wroteBased on medical record review, and staff interview, the facility failed to ensure a pharmaceutical services procedure related to accurate acquiring, receiving, dispensing and administration of medications for 1 of 6 sample residents (#65) reviewed for medication availability.
Inspectors wroteBased on observation, staff interview, medical record review, and policy and procedure review, the facility failed to ensure an infection prevention and control program was designed to help prevent the development and transmission of communicable diseases and infections for 1 of 9 sample residents (#178).
Inspectors wroteBased on observation, staff interview, incident report review, medical record review, manufacturer's recommendation review, and mechanical lift reference guide review, the facility failed to ensure safe staff practices and safe working condition of assistive devices for 1 of 4 sample residents (#1) reviewed for accident hazards. This failure resulted in a cervical fracture to resident #1 who fell during a mechanical lift transfer which resulted in the determination of immediate jeopardy due to a failure to follow manufacturer's instructions for safe mechanical lift transfers. Corrective measures were implemented prior to the survey and compliance was determined to be met on 2/16/26.
Inspectors wroteBased on observation and staff interview, the facility failed to ensure infection prevention practices were implemented for 3 of 3 sampled residents (#7, #8, #9) reviewed for infection control.
Inspectors wroteBased on staff interview, medical record review and review of the bathing schedule, the facility failed to ensure activities of daily living were maintained based on the needs and choices of 1 of 3 sample residents (#11) reviewed for bathing.
Inspectors wroteBased on observation, resident and staff interview, and medical record review, the facility failed to ensure adequate supervision and assistance devices to prevent accidents for 1 of 3 sample residents (#1). The following concerns were identified: Review of the admission MDS assessment dated [DATE] showed resident #1 had a BIMS score of 12 out of 15 which indicated s/he had moderately impaired cognition, and diagnoses which included non-Alzheimer's dementia, depression, and cancer. Review of the care plan last revised on 11/19/25 showed the resident was a moderate risk for falls related to confusion, gait and balance problems, and psychoactive drug use. Further review showed a care plan intervention initiated on 11/25/24 was to be sure the resident's call light was within reach. [...]
Inspectors wroteBased on medical record review, resident representative and staff interview, facility incident review, and performance improvement plan review, the facility failed to protect the residents' right to be free from physical abuse by another resident for 1 of 8 sample residents (#12). This failure resulted in actual harm to resident #12. Corrective measures were implemented prior to the survey and compliance was determined to be met on 5/16/25.
Inspectors wroteBased on resident representative and staff interview, medical record review, and policy review, the facility failed to notify residents' physicians with changes of condition or treatment for 2 of 10 sample residents reviewed (#9, #10). This failure resulted in actual harm to resident #9 who required additional surgical intervention.
Inspectors wroteBased on observation, resident representative and staff interview, medical record review, and policy review, the facility failed to provide quality of care for 3 of 10 sample residents (#2, #4, #10). This failure resulted in actual harm to resident #4 who was hospitalized for sepsis infection.
Inspectors wroteBased on observation, resident representative and staff interview, and medical record review, the facility failed to ensure residents received necessary treatment and services to promote healing, prevent infection, and prevent new ulcer development for 1 of 5 sample residents (#9) review for pressure ulcers. This failure resulted in actual harm to resident #9 who required additional surgical intervention.
Inspectors wroteBased on resident and staff interview and medical record review, the facility failed to ensure activities meet the interest/needs of each resident for 4 of 6 sample residents (#22, #30, #41, #61) reviewed for activities.
Inspectors wroteBased on resident and staff interviews and medical record review, the facility failed to ensure sufficient staffing to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident on 2 of 5 resident care units (south, east). The census was 155.
Inspectors wroteBased on medical record review, staff interview, and policy and procedure review, the facility failed to ensure target symptoms were identified for 5 of 5 sample residents (#45, #96, #72, #114, #120) reviewed for unnecessary psychotropic medications.
Inspectors wroteBased on observation, staff interview, and policy review, the facility failed to label and provide the date medications were opened in 2 of 6 medication storage areas (south hall medication cart #1, south hall medication cart #2).
Inspectors wroteBased on resident and staff interview, medical record review, bath schedule log review, and policy and procedure review, the facility failed to ensure medical records were accurately documented for 3 of 5 sample residents (#22, #27, #130) reviewed for bathing.
Inspectors wroteBased on resident and staff interview, medical record review, and policy and procedure review, the facility failed to ensure restorative nursing care was provided to maintain residents' ability to carry out activities of daily living for 2 of 3 sample residents (#22, #100) reviewed for restorative nursing.
Inspectors wroteBased on observation, staff interview, and policy review, the facility ensure infection control procedures were implemented for 1 of 2 sample residents (#77) reviewed for enhanced barrier precautions.
Inspectors wroteBased on medical record review, staff interview, review of incident and facility documentation, and policy and procedure review, the facility failed to ensure residents were free from physical abuse by other residents for 1 of 4 allegations reviewed, which resulted in actual harm to resident #1.
Inspectors wroteBased on medical record review, staff interview, and review of incident reports, the facility failed to develop an individualized, comprehensive care plan for 1 of 5 sample residents (#2).
Inspectors wroteBased on observation, resident, resident representative, and staff interview, medical record review, facility policy review, and the Centers for Disease Control and Prevention (CDC) guidance review, the facility failed to ensure appropriate interventions for infection prevention were implemented to prevent the spread of infection for 1 of 1 sample resident (#1) with acute respiratory symptoms.
Inspectors wroteBased on medical record review, family and staff interview, and the resident's family's written timeline, the facility failed to ensure timely assessment and treatment for 1 of 5 sample residents (#1) with a change of condition. This failure resulted in actual harm for resident #1 who was transferred to the hospital and passed away while in the emergency room waiting area.
Inspectors wroteBased on medical record review, resident and staff interview, and facility investigation review, the facility failed to protect the residents' right to be free from misappropriation of resident property by a staff member for 1 of 2 sample residents (#1). Corrective measures were implemented by the facility prior to the survey and compliance was determined to be met on 1/23/24.
Inspectors wroteBased on medical record review and staff interview, the facility failed to develop and implement a comprehensive care plan for 2 of 5 sample residents (#1, #2).
Inspectors wroteBased on observation, staff interview, and review of the 2022 Food Code, the facility failed to ensure hand hygiene/gloving and hair restraint use was done in accordance with accepted standards to minimize cross contamination during 2 of 2 observations of meal service.
Inspectors wroteBased on observation, medical record review, staff interview, policy and procedure review, and professional reference review, the facility failed to ensure infection control procedures were followed for 2 of 2 sample residents (#86, #313) who required wound care.
Inspectors wroteBased on observation, resident and staff interview, medical record and policy review, the facility failed to ensure residents who self-administered medications were assessed and determined safe to do so by the interdisciplinary team for 1 of 12 residents (#35) reviewed for medication administration.
Inspectors wroteBased on observation, medical record review and staff interview, the facility failed to ensure the care plan was implemented for 1 of 29 sample residents (#107).
Inspectors wroteBased on medical record review, staff interview, and facility policy review, the facility failed to implement interventions to manage diabetes in accordance with physician orders and professional standards of practice for 1 of 3 sample residents (#20) reviewed for diabetes management.
Inspectors wroteBased on observation, medical record review, staff interview, and review of therapy and restorative documentation, the facility failed to provide services to maintain range of motion for 1 of 9 sample residents (#114) with limited range of motion.
Inspectors wroteBased on observation, medical record review and staff interview, the facility failed to provide adaptive equipment to prevent accidents for 1 of 6 sample residents (#107) who were reviewed for falls or accident hazards.
Inspectors wroteBased on observation, medical record review, resident and staff interview, the facility failed to implement the necessary respiratory care for 1 of 8 sample residents (#130) reviewed for oxygen services.
Inspectors wroteBased on observation, medical record review, staff interview, and review of menus, the facility failed to ensure the menu was followed during 1 of 2 meal observations. This failure affected resident #36 and #91.
Inspectors wroteBased on observation, medical record review, and staff interview, the facility failed to adequately provide a call system to 2 of 44 sample residents (#13, #20) observed for resident call systems.
24 fire safety citations on file: 11 on July 30, 2026, 5 on October 31, 2024, 8 on August 10, 2023.
| Date | Penalty | Amount or length |
|---|---|---|
| March 13, 2026 | Fine | $26,685 |
| May 22, 2025 | Fine | $12,438 |
| March 20, 2025 | Fine | $15,857 |
| August 15, 2024 | Fine | $7,718 |
| March 22, 2024 | Fine | $34,333 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Wyoming | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.26 | 3.87 | 3.86 |
| Registered nurses | 0.62 | 0.94 | 0.69 |
| All nursing staff on weekends | 2.65 | 3.37 | 3.42 |
| Nurse aides | 2.27 | ||
| Licensed practical nurses | 0.37 | ||
| Nursing staff turnover (share who left in a year) | 47.4% | 51.8% | 45.8% |
| Registered nurse turnover | 45.2% | 44.1% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.34 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.50 on weekdays and 2.65 on weekends, 24% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.43 in April to June 2025 to 3.26 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.26 | 0.62 | 3.50 | 2.65 | 0.0% | 0 of 90 | 162 |
| Oct to Dec 2025 | 3.31 | 0.61 | 3.56 | 2.68 | 0.0% | 0 of 92 | 169 |
| Jul to Sep 2025 | 3.16 | 0.62 | 3.40 | 2.56 | 0.0% | 0 of 92 | 163 |
| Apr to Jun 2025 | 3.43 | 0.83 | 3.67 | 2.83 | 0.0% | 0 of 91 | 157 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Wyoming, Jan to Mar 2026 | 3.61 | 0.86 | 3.80 | 3.15 | 7.5% | 0.1% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review. If you work here, your report helps start one.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Wyoming, all employers | |||
| CNAs (nursing assistants) | $18.83 | $17.88 to $22.76 | 2,830 |
| LPNs and LVNs | $30.51 | $28.27 to $34.06 | 480 |
| Registered nurses | $40.27 | $37.45 to $48.61 | 5,330 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Wyoming | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 17.3 | 16.8 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.0 | 1.5 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.1 | 3.0 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 6.1 | 4.7 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 3.3 | 1.2 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 18.5 | 15.3 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 2.2 | 4.6 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 21.7 | 21.8 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 27.2 | 18.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 11.2 | 16.7 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.1 | 1.3 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.8 | 2.3 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Shepherd of the Valley Rehabilitation and Wellness's Medicare short-stay residents. On returning residents home or to the community, CMS rates it worse than the national rate (36.6% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
36.6% this home
Worse than the national rate
US median of homes 51.5% · Wyoming: 4 better, 5 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 219 eligible stays.
11.1% this home
No different from the national rate
US median of homes 10.7% · Wyoming: 0 better, 0 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 270 eligible stays.
8.9% this home
No different from the national rate
US median of homes 7.1% · Wyoming: 0 better, 0 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 154 eligible stays.
51.6% this home
Median of homes: Wyoming57.4% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 182 residents counted.
0.8% this home
Median of homes: Wyoming1.0% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 250 residents counted.
0.9% this home
Median of homes: Wyoming1.6% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 250 residents counted.
88.9% this home
Median of homes: Wyoming93.5% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 81 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: NORTH BIG HORN HOSPITAL DISTRICT. CMS links this home to Evergreen Healthcare Group, a group of 43 nursing homes averaging 2.4 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Morrison, Robert | Managing control - governing body | Individual | 09/30/2025 | |
| Simmons, Benjamin | Managing control - governing body | Individual | 09/30/2025 | |
| Couve Financial Services LLC | Operational/managerial control | Organization | 09/30/2025 | |
| Couve Healthcare Consulting LLC | Operational/managerial control | Organization | 09/30/2025 | |
| Pacific Northwest Opco Management LLC | Operational/managerial control | Organization | 09/30/2025 | |
| Shepherd of the Valley SNF Operations, LLC | Operational/managerial control | Organization | 09/30/2025 | |
| Connell, Eric | Operational/managerial control | Individual | 09/30/2025 | |
| Lawrence, Eric | Operational/managerial control | Individual | 09/30/2025 | |
| Miller, Jessica | Operational/managerial control | Individual | 09/30/2025 | |
| Morrison, Robert | Operational/managerial control | Individual | 09/30/2025 | |
| Simmons, Benjamin | Operational/managerial control | Individual | 09/30/2025 | |
| Spielman, Shimon | Operational/managerial control | Individual | 09/30/2025 | |
| Winterholler, David | Operational/managerial control | Individual | 09/30/2025 | |
| Yenowitz, Yitzchok | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 10/14/2025 | |
| Couve Financial Services LLC | Adp of the SNF | Organization | 10/14/2025 | |
| Couve Healthcare Consulting LLC | Adp of the SNF | Organization | 10/14/2025 | |
| Pacific Northwest Opco Management LLC | Adp of the SNF | Organization | 10/14/2025 | |
| Shepherd of the Valley SNF Operations, LLC | Adp of the SNF | Organization | 10/14/2025 | |
| Shepherd of the Valley SNF Realty LLC | Adp of the SNF | Organization | 10/14/2025 | |
| Connell, Eric | Adp of the SNF | Individual | 09/30/2025 | |
| Lawrence, Eric | Adp of the SNF | Individual | 09/30/2025 | |
| Miller, Jessica | Adp of the SNF | Individual | 09/30/2025 | |
| Simmons, Benjamin | Adp of the SNF | Individual | 09/30/2025 | |
| Spielman, Shimon | Adp of the SNF | Individual | 09/30/2025 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Chosen from this home's own inspection record.
These are the official offices in Wyoming. NursingHomeClear cannot take or act on complaints.