Based 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. The findings were: 1. Review of the admission MDS assessment dated [DATE] showed resident #9 had a BIMS score of 15 out 15, which indicated the resident was cognitively intact, and had diagnoses which included wound infection, displaced simple supracondylar fracture without intercondylar fracture of the right humerus, unspecified open wound of the right elbow, and methicillin resistant staphylococcus aureus. …
F580 citations in Wyoming
Notifying of changes · Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Wyoming cites F580 more often than its own record predicts
2.26 times the share F580 takes of citations nationally.
Of every deficiency written in Wyoming in 2025, this is the portion that was F580.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Wyoming surveyors wrote
F580 findings written in Wyoming, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on medical record review, and staff and resident representative interview, the facility failed to notify the responsible party following a change of condition in 1 of 3 sampled residents (#1) reviewed. The findings were: 1. Review of the quarterly MDS assessment dated [DATE] showed resident #1 had severe cognitive impairment, and had diagnoses which included, Alzheimer's dementia, diabetes mellitus, and urinary incontinence. Further review showed the resident required staff assistance with bed mobility and personal cares. Review of a 7/30/25 Braden score assessment showed the resident was at severe risk for developing pressure ulcers. The following concerns were identified:a. Review of the nursing progress note dated 7/13/25 and timed 12:14 PM showed . …
The short window
Recent years
| Year | Share of Wyoming citations | vs expected |
|---|---|---|
| 2023 | 0.67% | 0.47× |
| 2025 | 3.35% | 2.26× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Wyoming surveyors cite →
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