Citations in Wyoming
Statistics, citations and compliance trends for long-term care facilities in Wyoming.
Statistics for Wyoming (Last 12 Months)
Financial Impact (Last 12 Months)
Latest citations in Wyoming
Failure to protect a resident from abuse by another resident. A CNA observed one resident hit another resident in the face with a closed fist, and the injured resident had facial redness and an abrasion near the eye. The injured resident had severe cognitive impairment, dementia, depression, psychotic disorder, and wandering behaviors, while the other resident had moderate cognitive impairment, severe depression, schizophrenia, and a history of TBI. Staff interviews confirmed the injured resident was scared, skittish, and afraid for safety after the incident.
Failure to Provide Individualized Activity Programming: Three residents with dementia or other significant cognitive impairment had documented activity preferences, but staff did not consistently provide or reapproach activities to match those interests. One resident was observed in-room for long periods without activities being offered, another had limited activity participation despite stated preferences for reading, news, and outdoor time, and a third had no evidence of activity participation and the resident representative reported no invitations to activities. COTA input confirmed the facility lacked an activity director and did not facilitate independent activities for some residents.
Insulin pens in a rehab cart were found without open dates or with open dates beyond the 28-day use period. An RN confirmed the pens were available for resident use, and the DON stated staff were expected to date insulin when it was removed from the refrigerator and discard it when expired. Facility policy required insulin to be dated when first used.
Failure to maintain resident dignity during incomplete incontinence care. A resident with severe cognitive impairment, CVA, depression, BPH, total assist needs for toileting, dressing, and personal hygiene, and total bowel and bladder incontinence was observed in bed with pants down, a used brief under the legs, perineal area exposed, brown substance on the thigh, and the privacy curtain open while the roommate was present. RN stated it appeared care had been started and not finished, and CNA reported leaving the resident exposed for a skin check because the peri area was bleeding and hurting.
A resident was transferred to the hospital for evaluation, and the resident's representative was verbally notified of the transfer and bed-hold, but there was no evidence that written notice was provided. The representative stated the facility did not notify her of changes such as hospital transfers, new medication orders, or health status changes, and the DON confirmed the lack of written documentation.
Failure to Complete Significant Change MDS Assessment: A resident with dementia, progressive neurological conditions, and seizure disorder had an admission MDS that coded no mobility device use and independence with ADLs, but later was observed ambulating with a walker and gait belt. Quarterly MDSs still did not code walker use and showed increased ADL assistance needs, yet no comprehensive or significant change MDS had been completed. MDS coordinators said they were unaware of the walker use, believed the resident likely should not have been coded as independent, and confirmed the significant change MDS was missed.
Failure to Protect a Resident from Abuse by Another Resident
Penalty
Summary
The facility failed to ensure a resident was free from abuse by another resident. Resident #37 had severe cognitive impairment with a BIMS score of 3 out of 15 and diagnoses including non-Alzheimer’s dementia, depression, psychotic disorder, and daily wandering behaviors. Resident #13 had moderate cognitive impairment with a BIMS score of 10 out of 15, a PHQ-9 score of 24 indicating severe depression, and diagnoses including schizophrenia and a personal history of traumatic brain injury. An incident report documented that a CNA observed resident #13 hit resident #37 on the left side of the face, and both residents were sent to the ED. A progress note described redness and an abrasion on the left side of resident #37’s face near the eye, with additional reddened areas on the left cheekbone. Interviews with the resident’s representative, CNA, LPN, and RN indicated resident #37 was scared, skittish, quiet, stoic, and afraid for safety after the incident, and staff confirmed resident #13 punched resident #37 multiple times with a closed fist.
Failure to Provide Individualized Activity Programming
Penalty
Summary
The facility failed to ensure individual activities were provided to meet the interests and support the physical, mental, and psychosocial well-being of 3 residents reviewed for activity participation. Resident #34 had diagnoses including non-Alzheimer's dementia and depression, and the annual MDS showed the resident valued going outside for fresh air, reading books, newspapers, and magazines, being around animals, keeping up with the news, and doing favorite activities. The activity care plan listed interests such as animals, board games, volunteering, dining out, movies, spending time outdoors, listening to the radio, watching sports, and TV, but the resident representative stated staff offered activities and did not reapproach after refusals. Continuous observation showed resident #34 remained in the room in a recliner for extended periods on 7/29/26 without activities being offered, despite scheduled activities that day including daily chronicle, fun with fitness, reading time, treats, music, and reading/trivia. The activity participation record showed the resident was offered activities 115 times from 4/28/26 through 7/29/26, mostly independent activities, with 52 refusals documented. COTA #1 stated the facility did not have an activity director, she did not perform activities daily, and the facility did not facilitate independent activities for resident #34 or resident #123. Resident #123 had a BIMS score of 8/15, indicating moderate cognitive impairment, and diagnoses including progressive neurological conditions, non-Alzheimer's dementia, and seizure disorder or epilepsy. The resident stated it was very important to read books, newspapers, and magazines, keep up with the news, and go outside for fresh air, and the care plan listed preferred activities such as arts and crafts, ceramics, visiting with others, shuffleboard, sports, TV, movies, listening to oldies, and being outdoors. The activity participation record showed 75 activity offers with 10 refusals. Resident #178 had a BIMS score of 3/15, severe cognitive impairment, and diagnoses including nontraumatic intracerebral hemorrhage and macular degeneration; the resident preferred animals, music, favorite activities, and going outdoors, but observations and the resident representative indicated the resident did not participate in group or individual activities, had not been invited to activities, and had no activity calendar in the room. The record showed no evidence of activity participation.
Insulin Pens in Rehab Cart Were Undated or Kept Past Open Dating
Penalty
Summary
Drugs and biologicals were not labeled in accordance with accepted professional principles when insulin medications in rehabilitation unit cart A were found without required open dates or with expired open dates. During observation of the cart with RN #1, insulin glargine-yfgn 100 units/mL pens were present with an open date 30 days prior to the observation and another pen had no open date, and insulin lispro KwikPens 100 units/mL were present with an open date 48 days prior to the observation and another pen had no open date. RN #1 stated the insulin pens were good for 28 days and confirmed the medications were available for resident use. The DON stated staff were expected to date insulin when it was removed from the refrigerator and made available for use, and to discard insulin when it expired. Facility policy stated insulin products should be stored in the refrigerator until opened and that the date should be noted on insulin vials and pens when first used.
Failure to Maintain Resident Dignity During Incomplete Incontinence Care
Penalty
Summary
The facility failed to treat a resident with respect and dignity and to care for the resident in a manner and environment that promoted maintenance or enhancement of quality of life. The resident had a significant change MDS showing a BIMS score of 5, severe cognitive impairment, diagnoses including CVA, depression, and BPH, bilateral impairment of the upper and lower extremities, total assistance needs for toileting, dressing, and substantial/maximal assistance for personal hygiene, and was always incontinent of bowel and bladder. The care plan identified impaired balance and dependence for bed mobility, dressing, and personal hygiene. During observation, the resident was found lying in bed with pants pulled down around the ankles, a used brief rolled up under the upper legs, brown substance on the left upper thigh, and the perineal area exposed while the lift sling remained under the resident, the mechanical lift was beside the bed, the bed was elevated, and the privacy curtain was open with the roommate present. RN #3 stated it appeared someone had been changing the resident and got called away without finishing. CNA #1 stated he had placed the resident in bed with the brief tucked under the resident and left the resident exposed for a skin check because the peri area was bleeding and hurting. The DON stated staff were expected to check residents every 2-3 hours and finish providing care, and also stated the facility did not have a policy related to turning, repositioning, or checking residents.
Failure to Provide Written Transfer and Bed-Hold Notice
Penalty
Summary
The facility failed to provide a written notice of transfer and bed-hold for resident #34 when the resident was transferred non-emergently to the hospital for evaluation. A progress note dated 11/20/25 at 12:48 PM documented the transfer, and a transfer notice showed the resident's representative was verbally notified of the transfer, but there was no evidence that the transfer notice was provided in writing. A Bed Hold Agreement dated 11/20/25 showed the resident was verbally notified of the bed hold, but there was no evidence the resident's representative was notified in writing. The resident representative stated the facility did not notify her of changes such as hospital transfers, new medication orders, or health status changes, and the DON confirmed there was no evidence that written notice for the transfer or bed-hold had been provided.
Failure to Complete Significant Change MDS Assessment
Penalty
Summary
The facility failed to complete a significant change MDS assessment for a resident with a history of progressive neurological conditions, non-Alzheimer's dementia, and seizure disorder or epilepsy. The admission MDS showed a BIMS score of 8 out of 15, no upper or lower range of motion impairment, no use of mobility devices, and independence or set-up/clean-up help only for all ADLs. However, observation later showed the resident ambulating with a walker and wearing a gait belt, which differed from the admission assessment and from subsequent quarterly MDS assessments. The quarterly MDS assessments also did not code the resident as using a walker and showed increased assistance needs, including partial/moderate assistance with oral hygiene, personal hygiene, showering/bathing, and toileting hygiene, as well as supervision or touching assistance with some other ADLs. Review of the completed MDS assessments showed no comprehensive MDS, including a significant change assessment, had been completed since admission. MDS coordinators stated they were not aware the resident was using a walker, believed the resident probably should not have been coded as independent for ADLs on the admission MDS, and confirmed that a significant change MDS should have been completed but had not been.
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Compliance trends in Wyoming
Data through Jun 2026Comparisons below measure the most recent period Jul 2025 – Jun 2026 against the prior period Jul 2024 – Jun 2025 (two equal 12-month windows). The most recent 1 months are excluded because CMS is still publishing them.
Top tags by month · last 24 months
dashed = still reportingMonthly citation counts for the 5 most-cited tags. The dashed tail is the 1-month reporting lag.
Care domain movers
Citations grouped into CFR care domains — F-tags by their §483 regulatory section (CMS State Operations Manual, Appendix PP) — measured as a rate per 100 inspections: Jul 2025 – Jun 2026 vs the prior period Jul 2024 – Jun 2025. Share is the domain's portion of citations this period; avg severity is the mean scope/severity letter and immediate jeopardy the percentage cited at J–L, both over the current period. Domains with at least 20 citations in both periods are shown; the sparkline tracks the last 12 months (left = oldest).
Immediate jeopardies · this period
Citations at the most serious scope/severity — J–L, immediate jeopardy, residents placed at risk of serious harm or death — over Jul 2025 – Jun 2026 vs the prior period Jul 2024 – Jun 2025. "Surveys with an IJ" counts distinct health inspections that had at least one.
Survey activity · by month
faded/dashed = still reportingCitations each month split into complaint-driven (unscheduled, triggered by grievances) vs standard surveys — bars, left axis — with the number of inspections as a line on the right axis. Rising inspections signal more scrutiny; a rising complaint share means more off-cycle surveys. The most recent 1 months are still being reported.
Deficiency-free survey rate
Share of health surveys that found zero deficiencies — the odds of a clean survey. Jul 2025 – Jun 2026 vs the prior period Jul 2024 – Jun 2025; the most recent 1 months are still being reported (dashed).
Penalties · by month
faded = still reportingTotal civil money penalty dollars imposed on the state's facilities each month — how hard the state is enforcing. The most recent 1 months are still being reported, and penalties often lag citations by several months.
Emerging tags
Tags that weren't established last period but surged — an early warning, distinct from movers (which track already-common tags). Criteria: fewer than 20 citations in the prior period, but at least 10 this period and 2.5× their prior volume. The sparkline shows monthly counts over the last 12 months (left = oldest).
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