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Nursing HomeMedicaid Investigative

Laramie Health and Rehabilitation

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

503 S 18th St, Laramie, WY 82070105 bedsLicensed & Active
2/5
Medicare
Inspection
Quality
Staffing
Google rating
3.2/5

based on 28 Google reviews

Laramie Health and Rehabilitation Nursing Home in Laramie, WY — Street View
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5/ 10
high Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Low overall rating (2/5 stars)
  • Low staffing rating (2/5 stars)
  • Above-median deficiencies (6 vs median 5.0)
  • High RN turnover (57%)

Below average in WY · Below recommended RN staffing · $43,618 in fines

Source: Medicare data

What this means for your family

While some families report positive end-of-life care, the facility has a recurring pattern of serious neglect allegations, including hygiene issues and understaffing. If you consider this facility, conduct unannounced visits at different times of the day and specifically observe the cleanliness of rooms and the responsiveness of staff to call lights.

Google Reviews

Google Reviews

28 reviews analyzed
Laramie Health and Rehabilitation (also known as Cottonwood) receives highly polarized feedback, with recent reviews oscillating between high praise for individual staff members and severe allegations of neglect. Families report significant concerns regarding basic hygiene, understaffing, and poor communication, while others highlight compassionate care during end-of-life transitions. Prospective families should be aware of the stark contrast between these experiences and exercise caution.

Quality Themes

Tap a score for details
Food2.0Staff5.0Clean2.0ActivitiesN/AMeds1.0Memory2.0Comms4.0ValueN/A

Strengths

  • Compassionate individual nursing staff
  • Supportive end-of-life care
  • Helpful admission process
  • Responsive communication for some families

Concerns

  • Severe understaffing leading to neglect (mentioned by 5 reviewers)
  • Poor hygiene and lack of basic care (unshaved, soiled, dehydrated) (mentioned by 4 reviewers)
  • Loss of resident personal property (mentioned by 2 reviewers)
  • Unresponsive management and lack of follow-up (mentioned by 3 reviewers)

Rating Trends

Tap a year to see what changed

2345.0'16(2)4.02.0'20(8)5.01.0'22(4)2.83.3'24(14)4.2'25(10)

How They Respond to Reviews

57%response rate

This facility responds to some reviews.

Questions for Your Tour

  • 1We noticed the management team is very active in responding to feedback; how do you typically handle it when a family member has a concern about their loved one's daily care?
  • 2With the recent focus on improving staffing, what specific steps are being taken to ensure there are enough caregivers available during night and weekend shifts?
  • 3How do you ensure that residents' personal hygiene and grooming needs, like shaving or skin care, are consistently met every day?
  • 4What is your process for managing medications to ensure everything is administered accurately and on schedule?
  • 5Could you tell us more about the dining experience and how you are working to improve the variety and quality of the meals served?
  • 6How does the facility handle medical emergencies or sudden changes in a resident's health after hours?

Personalized based on this facility's data


Key Review Excerpts

My mother was in Cottonwood recently for the last few weeks of her life. Everyone on their staff was amazing! They were prompt and attentive and she felt safe when we weren’t there.

Memory care family member · 2025★★★★★

Care here is poor food on the floor in residences room with ants all over, patients are sitting in there own urine. And when a patient is unable to feed themselves they don't feed them.

Long-term resident's family · 2022☆☆☆☆

The staff were extremely supportive and kind towards me and made the admission process an easy one. I’ve been able to get to know the nursing staff and they are wonderful.

Memory care family member · 2023★★★★★
Source: 28 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.50hrs
67%
Registered nurses for medical care
Total Nursing
3.14hrs
77%
All nurses + aides combined
Staff Turnover
47%
Lower is better (< 30% = good)
RN Turnover
57%
Lower is better (< 30% = good)

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 34 measures

Medicare Rating
2/ 5
Better Than Avg

10

measures

Worse Than Avg

14

measures

Mixed Results

10

measures

Long-Stay Residents
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility70.6%
Worse than Avg
Here
70.6%
US
93.4%
WY
94.5%
Albany
91.5%
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility70.6%
Worse than Avg
Here
70.6%
US
93.4%
WY
94.5%
Albany
91.5%
💉

Residents vaccinated for the flu

↑ Higher is better
This Facility77.6%
Worse than Avg
Here
77.6%
US
95.5%
WY
94.3%
Albany
94.2%
💉

Residents vaccinated for the flu

↑ Higher is better
This Facility77.6%
Worse than Avg
Here
77.6%
US
95.5%
WY
94.3%
Albany
94.2%
💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility6.8%
Better than Avg
Here
6.8%
US
19.5%
WY
15.8%
Albany
15.7%
💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility6.8%
Better than Avg
Here
6.8%
US
19.5%
WY
15.8%
Albany
15.7%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility60.9%
Worse than Avg
Here
60.9%
US
81.8%
WY
76.5%
Albany
78.0%
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility60.9%
Worse than Avg
Here
60.9%
US
81.8%
WY
76.5%
Albany
78.0%
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility60.0%
Worse than Avg
Here
60.0%
US
79.7%
WY
77.0%
Albany
80.5%
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility60.0%
Worse than Avg
Here
60.0%
US
79.7%
WY
77.0%
Albany
80.5%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility1.5%
Better than Avg
Here
1.5%
US
1.6%
WY
1.4%
Albany
2.3%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility1.5%
Better than Avg
Here
1.5%
US
1.6%
WY
1.4%
Albany
2.3%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

6deficiencies
2penalties
Near state avg (6.8)
4 complaint-triggered
$43,618 in fines

Families have filed multiple complaint reports against this facility, with serious concerns about resident protection from abuse and neglect appearing twice in recent years (2023-2024). The facility shows recurring problems with medication management, infection control, and fire safety systems that persist across multiple surveys. While most issues have correction dates, the pattern of repeated deficiencies in critical care areas suggests ongoing operational challenges families should carefully consider.

Feb 12, 2026Complaint
1
0600Minor

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Oct 10, 2024Routine
11
0801ModerateCorrected

Nutrition and Dietary Deficiencies

Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

0882ModerateCorrected

Infection Control Deficiencies

Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.

0039ModerateCorrected

Emergency Preparedness Deficiencies

Conduct testing and exercise requirements.

0584ModerateCorrected

Resident Rights Deficiencies

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.

0761ModerateCorrected

Pharmacy Service Deficiencies

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.

0880ModerateCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0161Moderate

Construction Deficiencies

Use approved construction type or materials.

0758MinorCorrected

Pharmacy Service Deficiencies

Implement 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.

0222MinorCorrected

Egress Deficiencies

Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

0918MinorCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have generator or other power source capable of supplying service within 10 seconds.

0920MinorCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

Oct 10, 2024Complaint
1
0923ModerateCorrected

Environmental Deficiencies

Have enough outside ventilation via a window or mechanical ventilation, or both.

May 22, 2024Complaint
1
0600ModerateCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Jul 27, 2023Complaint
1
0600Moderate

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Jul 27, 2023Routine
12
0801ModerateCorrected

Nutrition and Dietary Deficiencies

Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

0812ModerateCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0374ModerateCorrected

Smoke Deficiencies

Install smoke barrier doors that can resist smoke for at least 20 minutes.

0880ModerateCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0883ModerateCorrected

Infection Control Deficiencies

Develop and implement policies and procedures for flu and pneumonia vaccinations.

0211ModerateCorrected

Egress Deficiencies

Keep aisles, corridors, and exits free of obstruction in case of emergency.

0609MinorCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

0756MinorCorrected

Pharmacy Service Deficiencies

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

0758MinorCorrected

Pharmacy Service Deficiencies

Implement 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.

0222MinorCorrected

Egress Deficiencies

Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

0321MinorCorrected

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

0753MinorCorrected

Miscellaneous Deficiencies

Have restrictions on the use of highly flammable decorations.

Federal Penalties

Fine

May 22, 2024

$35,880

Fine

Jul 27, 2023

$7,738

Ownership & Operations

Who Operates This Facility

Owner / Operator

Laramie Health and Rehabilitation

Organization Type

for profit

Chain Affiliation

Chain Name

Evergreen Healthcare Group

Chain Size

41 facilities nationwide

Chain avg rating: 2.3/5 · Rank 27 of 41

Ownership & Management

Owners

Sptihs Properties Trust

Owner · Organization

100%

Charles Schwab Investment Management, INC.

Owner (parent company) · Organization

D.e. Shaw & Co., L.p.

Owner (parent company) · Organization

Diversified Healthcare Trust

Owner (parent company) · Organization

H/2 Special Opportunities IV L.p.

Owner (parent company) · Organization

Snh Proj Lincoln Trs LLC

Owner (parent company) · Organization

Snh Trs Licensee Holdco LLC

Owner (parent company) · Organization

Snh Trs, INC.

Owner (parent company) · Organization

Key personnel

Bilotto, ChristopherOfficer / DirectorPortnoy, AdamOfficer / DirectorBilotto, ChristopherOfficer / DirectorBrown, MatthewOfficer / DirectorClark, JenniferOfficer / Director
Source: Medicare provider data

Contact

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References & Resources

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