Overall Score
CMS Five-Star Quality RatingMuch below averageCMS Five-Star overall rating
- Much below average
- Below average
- Average
- Above average
- Much above average
Where it ranks
- WyomingLowest tier among peers33 rated homes · average 3.0★
- United StatesLowest tier among peers14,574 rated homes · average 3.0★
How the rating is built
- Health inspectionsStarting point1★−1.9 vs WY avg
- StaffingCan add or remove a star1★−2.3 vs WY avg
- Quality measuresCan add or remove a star3★−0.3 vs WY avg
CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.
- Special Focus Facility candidateThis facility is on the CMS candidate list for the Special Focus Facility program, meaning it is among the poorest-performing facilities in its state on recent inspections.
Ratings & measures
Tap a row to see what it meansHealth inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among peersWY avg2.9★U.S. avg2.8★
What is health inspection rating?
Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.
Why it matters
It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.
Staffing ratingCMS stars from payroll-reported hours and turnover1★Lowest tier among peersWY avg3.3★U.S. avg2.9★
What is staffing rating?
Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.
Why it matters
More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.
Quality measures ratingCMS stars from clinical outcomes and resident assessments3★Above only 28% of peersWY avg3.3★U.S. avg3.6★
What is quality measures rating?
Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.
Why it matters
It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.
Total nurse hoursPer resident per day, all nursing staff—hrsNo dataWY avg3.84Benchmark4.10
What is total nurse hours?
All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.
Why it matters
Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.
RN hoursPer resident per day, registered nurses only—hrsNo dataWY avg0.90Benchmark0.75
What is rn hours?
Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.
Why it matters
RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.
Nursing staff turnoverShare of nursing staff who left within a year · lower is better—No dataWY avg53%RN turnover—
What is nursing staff turnover?
The share of nursing staff who left within the past year, from the same payroll data.
Why it matters
High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.
Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$119,491Above only 3% of peersWY avg$28,619Fines · denials9 · 2
What is fines in the last three years?
Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.
Why it matters
Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.
Inspection history
Last three inspection cycles35citations
7inspection dates
5actual harm (G–I)
0immediate jeopardy (J–L)
Nov 19, 2025most recent
Citations by monthNov 2022 – Nov 2025
- No actual harm (D–F)
- Actual harm (G–I)
- Immediate jeopardy (J–L)
- $Fine or payment denial
Click to filter the findings below
Showing
Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.
Nov 19, 2025Cycle 1worst G · actual harm$22,315
- F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareG · isolatedCorrection pending
Mar 13, 2025Cycle 1worst G · actual harmpayment denial, $62,205
- Ensure each residentâs drug regimen must be free from unnecessary drugs.Pharmacy ServiceD · isolatedCorrected Apr 18, 2025
- F882Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.Infection ControlF · widespreadCorrected May 16, 2025
- F883Develop and implement policies and procedures for flu and pneumonia vaccinations.Infection ControlE · patternCorrected May 22, 2025
- F881Implement a program that monitors antibiotic use.Infection ControlF · widespreadCorrected May 22, 2025
- F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsE · patternCorrected Apr 18, 2025
- F692Provide enough food/fluids to maintain a resident's health.Quality of Life and CareG · isolatedCorrected Apr 18, 2025
- F744Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.Quality of Life and CareD · isolatedCorrected May 16, 2025
- F804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.Nutrition and DietaryD · isolatedCorrected Apr 18, 2025
- F679Provide activities to meet all resident's needs.Quality of Life and CareE · patternCorrected Apr 18, 2025
- F725Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.Nursing and Physician ServicesE · patternCorrected May 22, 2025
- F729Verify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining.Nursing and Physician ServicesC · widespreadCorrected Apr 16, 2025
Apr 4, 2024Cycle 2worst E · no actual harm
- F921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.EnvironmentalE · patternCorrected May 19, 2024
Mar 20, 2024Cycle 2worst F · no actual harm
- F732Post nurse staffing information every day.Nursing and Physician ServicesB · patternCorrected May 4, 2024
- F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareD · isolatedCorrected May 4, 2024
- F725Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.Nursing and Physician ServicesF · widespreadCorrected May 4, 2024
- F837Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.AdministrationF · widespreadCorrected Jul 1, 2024
Feb 1, 2024Cycle 2worst G · actual harmpayment denial, $6,900
- F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningG · isolatedCorrected Jan 5, 2024
- Provide appropriate treatment and care according to orders, residentâs preferences and goals.Quality of Life and CareG · isolatedCorrected Jan 5, 2024
- F576Ensure residents have reasonable access to and privacy in their use of communication methods.Resident RightsF · widespreadCorrected Feb 23, 2024
- F727Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.Nursing and Physician ServicesF · widespreadCorrected Feb 23, 2024
- F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Feb 23, 2024
- F610Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Feb 23, 2024
Mar 31, 2023Cycle 3worst G · actual harm$7,443, $4,545, $4,545, $4,196
- F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident RightsD · isolatedCorrected May 15, 2023
- F573Let each resident or the resident's legal representative access or purchase copies of all the resident's records.Resident RightsD · isolatedCorrected May 15, 2023
- F622Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.Resident RightsG · isolatedCorrected May 15, 2023
Nov 17, 2022Cycle 3worst F · no actual harm
- F888Ensure staff are vaccinated for COVID-19Infection ControlC · widespreadCorrected Dec 10, 2022
- F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident RightsD · isolatedCorrected Dec 9, 2022
- F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningD · isolatedCorrected Dec 8, 2022
- F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Jan 19, 2023
- F758Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.Pharmacy ServiceD · isolatedCorrected Dec 10, 2022
- F865Have a plan that describes the process for conducting QAPI and QAA activities.AdministrationD · isolatedCorrected Dec 9, 2022
- Notify the resident or the residentâs representative in writing how long the nursing home will hold the residentâs bed in cases of transfer to a hospital or therapeutic leave.Resident RightsD · isolatedCorrected Dec 11, 2022
- F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected Dec 9, 2022
- F881Implement a program that monitors antibiotic use.Infection ControlE · patternCorrected Dec 10, 2022
Staffing
From quarterly payroll reportsHours per resident per day
- All nursing staffRNs, LPNs and aides combined—hrs
- Registered nursesRN hours only—hrs
- Licensed practical nursesLPN hours—hrs
- Nurse aidesCNA hours—hrs
- Weekend nursingAll staff on Saturdays and Sundays—hrs
- Wyoming average
- Research benchmark (4.10 total, 0.75 RN)
Turnover & capacity
- Nursing staff turnoverShare who left within a year · lower is better—WY avg 53%
- RN turnoverRegistered nurses only—Not ranked by CMS
- Administrators who leftIn the past year—
- Occupancy48 certified beds · ~33 residents a day69%Above only 46% of peersWY avg 70%
Fines & penalties
Roughly the past three yearsEnforcement summary
- $119,491In fines
- 9Fines
- 2Payment denials
- $28,619WY avg in fines
Above only 3% of peersFewer fines than 3% of rated homes in Wyoming
Actions on record
- Nov 19, 2025Civil money penalty$22,315
- Mar 13, 2025Denial of payment for new admissionsfrom May 8, 2025
- Mar 13, 2025Civil money penalty$62,205
- Feb 1, 2024Denial of payment for new admissionsfrom May 1, 2024
- Feb 1, 2024Civil money penalty$6,900
- Mar 31, 2023Civil money penalty$7,443
- Mar 20, 2023Civil money penalty$4,545
- Mar 13, 2023Civil money penalty$4,545
- Mar 6, 2023Civil money penalty$4,196
- Feb 28, 2023Civil money penalty$3,846
- Feb 21, 2023Civil money penalty$3,496
Ownership
As filed with CMSStructure
- Ownership type
- For profit - Corporation
- Chain
- Independent
- Certification
- Medicare and Medicaid
- Location type
- Rural
- Ownership change
- None in the last 12 months
People and entities on file
Direct owners (5%+)
- Alternative Elder Living INC
Operational or managerial control
- Alternative Elder Living INC
- Memorial Hospital of Sheridan County
- Tobie Alsup
- Cathy Bealer
- Brock Boedecker
- Tonya Carlson
- Shirley Coulter
- Jerry Davis
- +16 more
Corporate directors
- Brock Boedecker
- Elizabeth Maguire
- Erin Oetken
- Rosemary Rieder
- Catherine Wallick
- Kimberlee Williams
Person Organization
Sources & notes
Public data, updated quarterlyData sources
- CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
- CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
- CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.
Notes
- CMS Certification Number 535054 · 2311 Shirley Cove, Sheridan, WY, 82801.
- Percentiles compare this facility with every rated nursing home in Wyoming and Sheridan County. Turnover and fines are inverted so a high percentile is always good.
- This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.
