Green House Living for Sheridan
2311 Shirley Cove, Sheridan, WY 82801 · Sheridan County · 48 certified beds · avg 36 residents/day · certified since Aug 20, 2012
SFF Candidate
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★☆☆☆☆1/5 · CMS overall rating: 1/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Actual harm, one-off · Nov 19, 2025 · F-0689 · triggered by a complaint
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
▲ Actual harm, one-off · Mar 13, 2025 · F-0692
The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration.
Why it matters: Malnutrition and dehydration can quickly weaken a resident and lead to serious complications.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Apr 18, 2025 (Deficient, Provider has date of correction)
▲ Actual harm, one-off · Feb 1, 2024 · F-0658 · triggered by a complaint
The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow.
Why it matters: Care that falls below professional standards can directly harm a resident's health and recovery.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Jan 5, 2024 (Past Non-Compliance)
▲ Actual harm, one-off · Feb 1, 2024 · F-0684 · triggered by a complaint
The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Why it matters: Care that strays from doctor's orders or ignores the resident's wishes can lead to declining health and avoidable harm.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Jan 5, 2024 (Past Non-Compliance)
All citations in the current public record (35)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Feb 3, 2026 | E · Potential for harm, repeated | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · from a complaint |
| Feb 3, 2026 | D · Potential for harm, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint |
| Feb 3, 2026 | D · Potential for harm, one-off | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · from a complaint |
| Nov 19, 2025 | ▲ G · Actual harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint |
| Mar 13, 2025 | ▲ G · Actual harm, one-off | The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. |
| Mar 13, 2025 | F · Potential for harm, facility-wide | The facility did not designate a qualified infection preventionist — a trained person responsible for running the infection prevention and control program. · from a complaint |
| Mar 13, 2025 | E · Potential for harm, repeated | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. |
| Mar 13, 2025 | E · Potential for harm, repeated | The facility did not provide activities that meet residents' needs and interests. Nursing homes must offer meaningful activity programs, not just leave residents idle. · from a complaint |
| Mar 13, 2025 | E · Potential for harm, repeated | The facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. · from a complaint |
| Mar 13, 2025 | E · Potential for harm, repeated | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. · from a complaint |
| Mar 13, 2025 | D · Potential for harm, one-off | The facility did not provide the right treatment and services for residents with dementia or signs of dementia. Dementia care requires specific approaches, training, and patience. |
| Mar 13, 2025 | D · Potential for harm, one-off | The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason. |
| Mar 13, 2025 | D · Potential for harm, one-off | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. |
| Mar 13, 2025 | F · Potential for harm, facility-wide | The facility did not have a working program to monitor how antibiotics are used. Tracking antibiotic use helps make sure these drugs are given only when needed and remain effective. · from a complaint |
| Mar 13, 2025 | C · Minimal risk, facility-wide | The facility did not verify that its nurse aides had completed their required training, or did not retrain aides who had been out of nurse aide work for 2 years. · from a complaint |
| Apr 4, 2024 | E · Potential for harm, repeated | The facility did not keep its building and grounds safe, functional, clean, and comfortable for residents, staff, and visitors. · from a complaint |
| Mar 20, 2024 | F · Potential for harm, facility-wide | The facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. · from a complaint |
| Mar 20, 2024 | F · Potential for harm, facility-wide | The facility did not have a proper governing body legally responsible for its policies and operations, or that body failed to appoint a properly licensed administrator to manage the facility. · from a complaint |
| Mar 20, 2024 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. · from a complaint |
| Mar 20, 2024 | B · Minimal risk, repeated | The facility did not post its nurse staffing information every day. Nursing homes must publicly display how many nurses and aides are on duty each day. · from a complaint |
| Feb 1, 2024 | ▲ G · Actual harm, one-off | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint |
| Feb 1, 2024 | ▲ G · Actual harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint |
| Feb 1, 2024 | F · Potential for harm, facility-wide | The facility did not give residents reasonable access to and privacy in using ways to communicate, such as phones, mail, and email. Residents have the right to stay in touch with the outside world privately. |
| Feb 1, 2024 | F · Potential for harm, facility-wide | The facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. |
| Feb 1, 2024 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Feb 1, 2024 | D · Potential for harm, one-off | The facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint |
| Nov 17, 2022 | F · Potential for harm, facility-wide | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Nov 17, 2022 | E · Potential for harm, repeated | The facility did not have a working program to monitor how antibiotics are used. Tracking antibiotic use helps make sure these drugs are given only when needed and remain effective. |
| Nov 17, 2022 | D · Potential for harm, one-off | The facility did not give residents (and their representatives and the ombudsman, a state advocate for residents) proper advance notice before a transfer or discharge, including information about their right to appeal. |
| Nov 17, 2022 | D · Potential for harm, one-off | The facility did not give the resident or their representative written notice of how long it would hold the resident's bed during a hospital stay or approved leave. |
| Nov 17, 2022 | D · Potential for harm, one-off | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Nov 17, 2022 | D · Potential for harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Nov 17, 2022 | D · Potential for harm, one-off | The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits. |
| Nov 17, 2022 | D · Potential for harm, one-off | The facility did not have a written plan describing how it runs its quality improvement program — the ongoing process of finding problems in care and fixing them. |
| Nov 17, 2022 | C · Minimal risk, facility-wide | The facility did not make sure its staff were vaccinated for COVID-19 in accordance with the federal requirements in effect at the time. |
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (6 → 10).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2022 | 9 | 0 | F |
| 2024 | 11 | 2 | G ▲ |
| 2025 | 12 | 2 | G ▲ |
| 2026 | 3 | 0 | E |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
3 fines totaling $61,929, plus 2 Medicare payment denial periods.
| Date | Type | Amount / length |
|---|---|---|
| Nov 19, 2025 | Fine | $14,773 |
| Mar 13, 2025 | Fine | $40,256 |
| Mar 13, 2025 | Payment Denial | 29 days from May 8, 2025 |
| Feb 1, 2024 | Fine | $6,900 |
| Feb 1, 2024 | Payment Denial | 61 days from May 1, 2024 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Wyoming avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 5.72 | 4.47 | 3.95 | top 17% in Wyoming; top 6% in the U.S. |
| Registered Nurse hours | 2.14 | 1.09 | 0.69 | top 9% in Wyoming; top 1% in the U.S. |
| Weekend total nurse staffing | 5.31 | 3.89 | 3.50 | top 14% in Wyoming; top 4% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 1.48 | 0.65 | 0.48 | top 6% in Wyoming; top 2% in the U.S. |
| Total nursing staff turnover (%) | 73.5 | 51.8 | 45.8 | bottom 10% in Wyoming; bottom 4% in the U.S. |
| RN turnover (%) | 73.9 | 44.1 | 42.9 | bottom 7% in Wyoming; bottom 9% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 4.53, RN 1.69, weekend 4.21. Staffing rating: 4/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 2/5 · long-stay residents: 2/5 · short-stay residents: —/5
Who owns this facility
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Alternative Elder Living INC | Organization | 5% or Greater Direct Ownership Interest | 100% | 05/01/2007 |
| Alsup, Tobie | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/06/2024 |
| Alsup, Tobie | Individual | ADP of the SNF | NOT APPLICABLE | 05/06/2024 |
| Alternative Elder Living INC | Organization | Operational/Managerial Control | NOT APPLICABLE | 05/01/2007 |
| Bealer, Cathy | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/05/2024 |
| Bealer, Cathy | Individual | ADP of the SNF | NOT APPLICABLE | 05/06/2024 |
| Boedecker, Brock | Individual | Managing Control - Governing Body | NOT APPLICABLE | 01/01/2024 |
| Boedecker, Brock | Individual | Corporate Director | NOT APPLICABLE | 01/01/2024 |
| Boedecker, Brock | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/01/2024 |
| Boedecker, Brock | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2024 |
| Carlson, Tonya | Individual | Managing Control - Governing Body | NOT APPLICABLE | 05/06/2024 |
| Carlson, Tonya | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/06/2024 |
| Carlson, Tonya | Individual | ADP of the SNF | NOT APPLICABLE | 05/06/2024 |
| Coulter, Shirley | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/06/2024 |
| Coulter, Shirley | Individual | ADP of the SNF | NOT APPLICABLE | 05/06/2024 |
| Davis, Jerry | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/06/2024 |
| Davis, Jerry | Individual | ADP of the SNF | NOT APPLICABLE | 05/06/2024 |
| Dawson, Allison | Individual | Managing Control - Governing Body | NOT APPLICABLE | 05/06/2024 |
| Dawson, Allison | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/06/2024 |
| Dawson, Allison | Individual | ADP of the SNF | NOT APPLICABLE | 05/06/2024 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "How do you monitor residents' weight and eating, and what happens when someone starts losing weight?"
- "Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
- "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
- "Who is your infection preventionist, and what training do they have?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Westview Health Care Center | 0.6 mi | Sheridan, WY | ★★★★★ | 4/5 | |
| Big Horn Rehabilitation and Care Center | 0.8 mi | Sheridan, WY | ★☆☆☆☆ | 1/5 | SFF |
Compare this facility with the 2 closest →
Facility data as of CMS processing date 2026-08-01. CCN 535054.