Big Horn Rehabilitation and Care Center
1851 Big Horn Ave, Sheridan, WY 82801Map
Medicare/Medicaid certified128 certified beds~74 residents/dayFor profit - Limited Liability company
What Special Focus status means moreless
CMS keeps a short national list of nursing homes with the most persistent serious problems — the Special Focus Facility (SFF) program. SFF homes get inspected about twice as often and must improve or face termination from Medicare/Medicaid. 'SFF candidate' means the home qualifies for the list but isn't on it yet (the list has limited slots per state). Some SFF homes do graduate and improve; the designation means CMS is watching closely right now.
What to do with this: ask the administrator where the home is in the SFF process and what the improvement plan is. Verify status at medicare.gov/care-compare.
Last standard health inspection: May 7, 2026
Big Horn Rehabilitation and Care Center is a 128-bed for-profit, LLC-owned nursing home in Sheridan, Sheridan County, Wyoming, serving an average of 74 residents per day. As of CMS data processed June 1, 2026, its overall rating is 1 of 5 stars.
CMS star ratings
CMS scores every nursing home 1–5 stars overall, built from three sub-ratings. moreless
Medicare inspects and measures every certified nursing home, then rolls the results into a 1–5 star overall rating. It combines three parts: health inspections, staffing, and quality measures. Five stars means much better than average — it does not mean perfect. One star means much worse than average — it does not mean every shift is bad. Stars are a screening tool, not a verdict. They can lag reality by months, and they can't see things like how kind the aides are or how the building smells at 7am.
What to do with this: use stars to build a shortlist, then visit in person. Nothing on this site replaces walking the halls.
Health-inspection stars are graded on a curve within each state — never compare stars across state lines. moreless
CMS sets health-inspection star cutoffs separately for each state: roughly the top 10% of homes in a state get 5 stars, the bottom 20% get 1 star, no matter how the state compares to others. That means a 4-star home in one state and a 4-star home in another state may have very different inspection records. The stars tell you how a home compares to its neighbors, not to the whole country. That's why this site shows your state's median next to each star rating — and never a national star comparison.
What to do with this: compare stars only between homes in the same state. To compare across states, use staffing hours — those are real numbers, not curves.
Not all three sub-ratings are equally hard to game: inspections are the most objective, quality measures the least. moreless
The three sub-ratings come from different sources. Health inspections are done on-site by trained state surveyors who show up mostly unannounced — the most objective signal. Staffing comes from payroll records that facilities must submit and CMS audits — quite reliable. Quality measures are partly self-reported by the facility from its own resident assessments — useful, but the facility grades some of its own homework.
What to do with this: when sub-ratings disagree, weigh the inspection star most and the quality-measure star least.
Staffing
Reported hours per resident per day, from payroll records. Hours, unlike stars, can be compared across states.
Hours per resident per day: total staff hours worked, divided by the number of residents. moreless
If a home reports 3.5 total nursing hours per resident per day, that's all nursing staff time across 24 hours — roughly one caregiver-hour every 7 hours per resident, spread across day, evening, and night shifts. On a real floor it decides whether call lights get answered in 5 minutes or 25, whether someone has time to help with dinner, and whether night shift is one aide for a hall or two. Unlike star ratings, hours are actual numbers, so they CAN be compared across state lines.
What to do with this: compare a home's hours to the state and national medians shown, and ask the facility how the hours split across day, evening, and night shifts.
RN (registered nurse) hours
LPN (licensed practical nurse) hours
Nurse aide hours
Total nursing hours
CMS also adjusts these numbers for how sick each home’s residents are — a home with sicker residents needs more staff for the same star. This home’s case-mix-adjusted total: 3.67 (US median, adjusted: 3.78).
CMS also adjusts staffing numbers for how sick each home's residents are. moreless
A home full of short-term rehab patients needs different staffing than a home caring for people with advanced dementia or ventilators. Case-mix adjustment estimates how many hours a home's particular residents need, then scales the reported hours so homes can be compared fairly. A home with sicker residents needs more staff for the same star. This page shows reported (raw payroll) numbers and compares them only to other reported numbers — like with like.
What to do with this: if a home's reported hours look low, check whether its residents may simply need less care — and ask the facility directly.
Staff turnover
Total nursing staff turnover: 63.2% · WY median: 50.2% · RN turnover: 57.1% (WY median: 44.4%)
The share of nursing staff who left within the year. Lower is steadier. moreless
Total nursing staff turnover is the percentage of the home's nurses and aides who stopped working there during the year. Around half of nursing-home staff leaving annually is sadly common in this industry. High turnover means residents are cared for by people who don't know them — which matters enormously for dementia care, pain management, and noticing the small changes that catch problems early. Low turnover usually means staff are treated well enough to stay.
What to do with this: when you visit, ask aides how long they've worked there. Long-tenured aides are the best sign a building has.
Inspections & deficiencies
The last 3 inspection cycles, from CMS’s federal health-survey file. State-only citations and fire-safety surveys are not included — an empty list means nothing federal is in this file, not that nothing ever happened.
Each deficiency gets a letter A–L: how severe it was × how widespread it was. moreless
Surveyors grade every deficiency on a grid. Severity runs from 'potential for minimal harm' up to 'immediate jeopardy to resident health or safety.' Scope runs from isolated (one or a few residents) to pattern to widespread. A and B are paperwork-level; D–F caused no actual harm but had the potential; G–I caused actual harm; J, K, and L mean immediate jeopardy — the most serious finding a surveyor can make. Most citations nationally are D–E.
What to do with this: scan for G or higher. One J/K/L tells you more than ten D's.
Standard surveys are routine; complaint surveys happen because someone reported a problem. moreless
A standard survey is the routine top-to-bottom inspection every home gets on a recurring cycle. A complaint survey happens because a resident, family member, or staff member reported something to the state — surveyors come specifically to investigate it. Infection-control surveys focus on practices like hand hygiene and isolation procedures. A deficiency found during a complaint survey means someone cared enough to report it and a surveyor confirmed enough to cite it.
What to do with this: note which deficiencies came from complaints — they show you what residents and families actually experienced.
The F-number on each deficiency is CMS's code for which federal requirement was violated. moreless
Every federal nursing-home requirement has a tag number. F0686, for example, is the pressure-ulcer requirement; F0600 is freedom from abuse. The tag tells you exactly which rule was broken, and the description next to it is CMS's own plain-language summary of that rule. The same tag appearing across multiple inspections is a pattern worth noticing.
What to do with this: if the same tag repeats across surveys, ask the facility what changed since the last citation.
This data shows federal health surveys only — state-only citations and fire-safety surveys aren't included. moreless
CMS's public deficiency file contains federal health-survey citations. It does not include citations issued under state-only rules, fire-safety (Life Safety Code) surveys, or anything older than three inspection cycles. A facility with no rows here may still have state citations or fire-safety findings. 'No deficiencies in this file' never means 'no violations ever.'
What to do with this: for the full picture, check your state health department's site and medicare.gov/care-compare, which shows fire-safety results separately.
46 deficiencies across the last 3 inspection cycles, in CMS’s federal health-survey file:
- Quality of Life and Care: 12
- Resident Rights: 9
- Freedom from Abuse, Neglect, and Exploitation: 7
- Resident Assessment and Care Planning: 6
- Pharmacy Service: 3
- Nursing and Physician Services: 3
- Administration: 2
- Infection Control: 2
- Nutrition and Dietary: 1
- Environmental: 1
May 7, 2026Standard surveyTag F0561E — no actual harm, potential for more than minimal harm, pattern
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Deficient, Provider has no plan of correction
May 7, 2026Standard surveyTag F0583F — no actual harm, potential for more than minimal harm, widespread
Keep residents' personal and medical records private and confidential.
Deficient, Provider has no plan of correction
May 7, 2026Standard surveyTag F0609D — no actual harm, potential for more than minimal harm, isolated
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Deficient, Provider has no plan of correction
May 7, 2026Standard surveyTag F0610D — no actual harm, potential for more than minimal harm, isolated
Respond appropriately to all alleged violations.
Deficient, Provider has no plan of correction
May 7, 2026Standard surveyTag F0627D — no actual harm, potential for more than minimal harm, isolated
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Deficient, Provider has no plan of correction
May 7, 2026Standard surveyTag F0628D — no actual harm, potential for more than minimal harm, isolated
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Deficient, Provider has no plan of correction
May 7, 2026Standard surveyTag F0679D — no actual harm, potential for more than minimal harm, isolated
Provide activities to meet all resident's needs.
Deficient, Provider has no plan of correction
May 7, 2026Standard surveyTag F0680C — no actual harm, potential for minimal harm, widespread
Ensure the activities program is directed by a qualified professional.
Deficient, Provider has no plan of correction
May 7, 2026Standard surveyTag F0684E — no actual harm, potential for more than minimal harm, pattern
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Deficient, Provider has no plan of correction
May 7, 2026Standard surveyTag F0699D — no actual harm, potential for more than minimal harm, isolated
Provide care or services that was trauma informed and/or culturally competent.
Deficient, Provider has no plan of correction
Show 36 more deficiencies
May 7, 2026Standard surveyTag F0761E — no actual harm, potential for more than minimal harm, pattern
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Deficient, Provider has no plan of correction
May 7, 2026Standard surveyTag F0849E — no actual harm, potential for more than minimal harm, pattern
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Deficient, Provider has no plan of correction
May 7, 2026Standard surveyTag F0880E — no actual harm, potential for more than minimal harm, pattern
Provide and implement an infection prevention and control program.
Deficient, Provider has no plan of correction
May 7, 2026Standard surveyTag F0883E — no actual harm, potential for more than minimal harm, pattern
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Deficient, Provider has no plan of correction
February 5, 2026Complaint surveyTag F0565D — no actual harm, potential for more than minimal harm, isolated
Honor the resident's right to organize and participate in resident/family groups in the facility.
Past Non-Compliance · corrected April 19, 2025
February 5, 2026Complaint surveyTag F0584E — no actual harm, potential for more than minimal harm, pattern
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Deficient, Provider has date of correction · corrected March 10, 2026
February 5, 2026Complaint surveyTag F0689D — no actual harm, potential for more than minimal harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Deficient, Provider has date of correction · corrected March 10, 2026
February 5, 2026Complaint surveyTag F0812F — no actual harm, potential for more than minimal harm, widespread
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Deficient, Provider has date of correction · corrected March 10, 2026
February 5, 2026Complaint surveyTag F0850D — no actual harm, potential for more than minimal harm, isolated
Hire a qualified full-time social worker in a facility with more than 120 beds.
Deficient, Provider has date of correction · corrected March 10, 2026
October 23, 2025Complaint surveyTag F0658G — actual harm, isolated
Ensure services provided by the nursing facility meet professional standards of quality.
Deficient, Provider has date of correction · corrected November 21, 2025
October 23, 2025Complaint surveyTag F0677E — no actual harm, potential for more than minimal harm, pattern
Provide care and assistance to perform activities of daily living for any resident who is unable.
Deficient, Provider has date of correction · corrected November 21, 2025
October 23, 2025Complaint surveyTag F0684G — actual harm, isolated
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Deficient, Provider has date of correction · corrected November 21, 2025
October 23, 2025Complaint surveyTag F0689D — no actual harm, potential for more than minimal harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Deficient, Provider has date of correction · corrected November 21, 2025
October 23, 2025Complaint surveyTag F0725E — no actual harm, potential for more than minimal harm, pattern
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Deficient, Provider has date of correction · corrected November 21, 2025
October 23, 2025Complaint surveyTag F0842D — no actual harm, potential for more than minimal harm, isolated
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Deficient, Provider has date of correction · corrected November 21, 2025
October 8, 2025Complaint surveyTag F0580D — no actual harm, potential for more than minimal harm, isolated
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Deficient, Provider has date of correction · corrected October 30, 2025
October 8, 2025Complaint surveyTag F0600D — no actual harm, potential for more than minimal harm, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Deficient, Provider has date of correction · corrected October 30, 2025
October 8, 2025Complaint surveyTag F0609E — no actual harm, potential for more than minimal harm, pattern
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Deficient, Provider has date of correction · corrected October 30, 2025
October 8, 2025Complaint surveyTag F0610E — no actual harm, potential for more than minimal harm, pattern
Respond appropriately to all alleged violations.
Deficient, Provider has date of correction · corrected October 30, 2025
October 8, 2025Complaint surveyTag F0688D — no actual harm, potential for more than minimal harm, isolated
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Deficient, Provider has date of correction · corrected October 30, 2025
January 15, 2025Complaint surveyTag F0609D — no actual harm, potential for more than minimal harm, isolated
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Deficient, Provider has date of correction · corrected February 24, 2025
November 7, 2024Complaint surveyTag F0692D — no actual harm, potential for more than minimal harm, isolated
Provide enough food/fluids to maintain a resident's health.
Deficient, Provider has date of correction · corrected January 6, 2025
November 7, 2024Complaint surveyTag F0725E — no actual harm, potential for more than minimal harm, pattern
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Deficient, Provider has date of correction · corrected December 2, 2024
November 7, 2024Complaint surveyTag F0842E — no actual harm, potential for more than minimal harm, pattern
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Deficient, Provider has date of correction · corrected December 6, 2024
September 13, 2024Standard surveyTag F0576E — no actual harm, potential for more than minimal harm, pattern
Ensure residents have reasonable access to and privacy in their use of communication methods.
Deficient, Provider has date of correction · corrected October 7, 2024
September 13, 2024Standard surveyTag F0578D — no actual harm, potential for more than minimal harm, isolated
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Deficient, Provider has date of correction · corrected October 7, 2024
September 13, 2024Standard surveyTag F0645D — no actual harm, potential for more than minimal harm, isolated
PASARR screening for Mental disorders or Intellectual Disabilities
Deficient, Provider has date of correction · corrected October 7, 2024
September 13, 2024Standard surveyTag F0677E — no actual harm, potential for more than minimal harm, pattern
Provide care and assistance to perform activities of daily living for any resident who is unable.
Deficient, Provider has plan of correction · corrected October 7, 2024
September 13, 2024Standard surveyTag F0725E — no actual harm, potential for more than minimal harm, pattern
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Deficient, Provider has date of correction · corrected December 2, 2024
September 13, 2024Standard surveyTag F0761E — no actual harm, potential for more than minimal harm, pattern
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Deficient, Provider has date of correction · corrected October 7, 2024
April 4, 2024Standard surveyTag F0641D — no actual harm, potential for more than minimal harm, isolated
Ensure each resident receives an accurate assessment.
Deficient, Provider has date of correction · corrected April 10, 2024
April 4, 2024Standard surveyTag F0657D — no actual harm, potential for more than minimal harm, isolated
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Deficient, Provider has date of correction · corrected April 10, 2024
April 4, 2024Standard surveyTag F0761E — no actual harm, potential for more than minimal harm, pattern
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Deficient, Provider has date of correction · corrected April 10, 2024
December 21, 2023Complaint surveyTag F0600G — actual harm, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Past Non-Compliance · corrected November 30, 2023
October 5, 2023Complaint surveyTag F0684D — no actual harm, potential for more than minimal harm, isolated
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Deficient, Provider has date of correction · corrected October 27, 2023
October 5, 2023Complaint surveyTag F0919D — no actual harm, potential for more than minimal harm, isolated
Make sure that a working call system is available in each resident's bathroom and bathing area.
Deficient, Provider has date of correction · corrected October 27, 2023
Fines & penalties
CMS can fine a home or stop paying for new admissions. Shown per CMS's current data window (~3 years) — not all-time. moreless
When deficiencies are serious or aren't fixed, CMS can impose a fine (a civil money penalty) or a payment denial — refusing to pay for new Medicare/Medicaid admissions until the home fixes the problem. Payment denials hit harder than most fines because they stop revenue. CMS's public dataset covers a rolling window of roughly the last three years, so the totals here are recent history, not an all-time record. Many facilities have no penalties in the window — that's common, not remarkable.
What to do with this: a recent large fine deserves a direct question on your visit — what happened, and what changed?
Fines: 1 totaling $7,163 · Payment denials: 1 — per CMS data (rolling ~3-year window).
| Date | Type | Amount / length |
|---|---|---|
| October 8, 2025 | Payment Denial | 8 days, from November 13, 2025 |
| December 21, 2023 | Fine | $7,163 |
Ownership & chain
Who actually owns and controls the facility — individuals, companies, and their stakes. moreless
Nursing homes are often owned through layers: an operating company, a property company, management companies, and individual investors with percentage stakes. CMS publishes who holds 5%-or-greater interests and who has operational control. Ownership matters because it sets the budget: research has linked some ownership structures, especially certain chains and investment vehicles, to lower staffing. That's a pattern across the industry, not a verdict on any one building.
What to do with this: know who owns the home before you sign anything, and ask the administrator who actually sets the staffing budget.
CMS lists no chain affiliation for this facility.
| Owner / manager | Role | Stake | Since |
|---|---|---|---|
| Connell, Eric (Individual) | Adp of the snf | NOT APPLICABLE | 10/01/2024 |
| Roberts, Ana (Individual) | Adp of the snf | NOT APPLICABLE | 10/01/2024 |
| Sheridan Opco LLC (Organization) | Adp of the snf | NOT APPLICABLE | 10/01/2024 |
| Simmons, Benjamin (Individual) | Corporate director | NOT APPLICABLE | 10/01/2024 |
| Winterholler, David (Individual) | Corporate director | NOT APPLICABLE | 10/01/2024 |
| Connell, Eric (Individual) | Corporate officer | NOT APPLICABLE | 10/01/2024 |
| Simmons, Benjamin (Individual) | Corporate officer | NOT APPLICABLE | 10/01/2024 |
| North Big Horn Hospital District (Organization) | Direct ownership interest | NOT APPLICABLE | 10/01/2024 |
| Morrison, Robert (Individual) | Managing control - governing body | NOT APPLICABLE | 10/01/2024 |
| Cheyenne Sheridan Opco Holdings LLC (Organization) | Operational/managerial control | NOT APPLICABLE | 11/26/2024 |
| Connell, Eric (Individual) | Operational/managerial control | NOT APPLICABLE | 10/01/2024 |
| Morrison, Robert (Individual) | Operational/managerial control | NOT APPLICABLE | 10/01/2024 |
| Roberts, Ana (Individual) | Operational/managerial control | NOT APPLICABLE | 10/01/2024 |
| Sheridan Opco LLC (Organization) | Operational/managerial control | NOT APPLICABLE | 10/01/2024 |
Nearby facilities in Sheridan County
Most families compare 2–3 homes. Same county, sorted by overall rating:
Visiting? Go in with questions.
Built from this facility’s own CMS data — bring them on the tour.
- CMS lists this facility as a Special Focus Facility candidate — ask where the home is in the program and what the improvement plan is.
- Their reported RN hours (0.48/resident/day) are below the WY median (0.79) — ask how nights and weekends are staffed.
- Their total nursing staff turnover (63.2%) is above the WY median (50.2%) — ask how long the aides on your person's unit have worked there.
- CMS data shows 1 fine totaling $7,163 in its current data window — ask what the citations were for and what changed afterward.
- Their weekend total nurse staffing (2.95/resident/day) is lower than their overall figure (3.30) — ask who covers weekends and how shifts are filled when someone calls out.
- Their last standard health inspection was May 7, 2026 — ask what's improved since then.
- CMS records that this facility has a resident and family council — ask to speak with a council member before deciding.
Data: Centers for Medicare & Medicaid Services (data.cms.gov), processing date June 1, 2026. This site is not affiliated with CMS or any government agency.