Here's a rundown of recent changes made at the five facilities operated by the Wyoming Department of Health.

Wyoming Retirement Center:

The philosophy of patient care at the Retirement Center, a long-term care facility in Basin, has changed over the past several years. Administrator Anita Cox-Mills said the state is in the process of making the facility more like a home and less like an institution.

The facility has accomplished this by increasing employee morale.

Cox-Mills tells her housekeeping staff, "Yes, you are cleaning the patient's room, but you can read to them or write a letter for them."

Also, the facility is in the process of taking out all the nursing stations because a person wouldn't have a nursing station in his or her home.

Inspection results have improved dramatically over the past few years. The home went from having the worst ratings possible to some of the best in the state.

In July, the Retirement Center opened a day care center for employees to attract more people to help address staffing shortages.

Wyoming Pioneer Home:

Instead of having off-white walls like most hospitals, the staff at the Pioneer Home spent the summer painting the hallways in colors such as cornflower blue and mauve to make the facility more like home.

During the late 1980s, the Pioneer Home, an assisted-living facility in Thermopolis, began its shift to be less like an institution. It stopped accepting so many residents and gave residents their own bathrooms and more space to call their own.

Also, staff began adding more activities. In 1999, it began a senior weightlifting class and still continues to offer a variety of activities for all residents.

After state officials thought about shutting the facility down in 1999, Sharon Skiver, facility manager, said community members were shaken up about the possibility of losing the Pioneer Home.

With the facility's perseverance, community members are now beginning to calm down and realize the facility is in Thermopolis to stay.

Wyoming State Hospital:

In February 2004, the State Hospital in Evanston opened a new hospital for its acute psychiatric patients. It cost about $8.7 million.

Walking into it, one would not know it was a hospital for people with mental illness. The lobby looks like a great room in a ski lodge with high cathedral ceilings and a huge stone fireplace.

"There are lots of windows in it," said Roger Scarborough, manager of the extended services program. "You could be in here without any lights on. We do not want to be an institution, but we want to be as airy and homelike as possible."

About two years ago, the hospital put in several apartments on campus for people trying to transition back into the community. The hospital simulates community living for them to make the transition easier.

The people living in these apartments have nurses check on them during the day.

Most recently, the hospital has moved some of its geriatric patients from the acute hospital to their own unit. These are patients who have lived at the facility for years and will probably die at the State Hospital.

This frees up beds for the hospital to serve more patients and makes the geriatric patients more comfortable.

Wyoming State Training School:

Even before a 1991 lawsuit required people with disabilities to be moved to "the least restrictive environment," staff members at the Training School in Lander were moving patients out of dormitories and into smaller houses on the campus.

Now, there are about 18 small group homes on campus that house from three to 12 people each.

Also, the center has built a large horse-therapy barn for residents and added different types of therapies to its program over the years, including the latest aquatic therapies and horticulture therapy.

Recently, the institution began serving people with acquired brain injuries to fill empty beds and expand services.

Diane Baird-Hudson, superintendent, said the Training School is known throughout the country.

She said people at similar facilities in other states look at Wyoming's center as a model of how an intermediate care facility should be run. People tell her they can't believe a facility like the Training School is in Wyoming, the least populated state in the country.

Veterans' Home of Wyoming:

Even though the Veterans' Home in Buffalo has not had as many problems in the past as some of the other facilities, the staff has still been working to improve the efficiency and patient care at the facility.

There are 126 veterans' homes across 48 states and Puerto Rico, so these types of facilities are a lot more common than the other four state health care facilities.

The Veterans' Home renovated one of its buildings about two years ago and turned it into meeting rooms and state offices. Jack Tarter, superintendent, said he wanted to get rid of wasted space.

"The space was available, and we wanted to make good use of taxpayers' money," Tarter said. "Use promotes preservation."

Also, the facility has updated technology on campus, creating a computer lab for residents to use and linking with the Sheridan Veterans Affairs Medical Center through telemedicine so residents have quick and easy access to medical care.

- Compiled by Allison Rupp