CHEYENNE, Wyo. (AP) — Legal guardians of Wyoming State Hospital patients say serious problems persist at the mental-health facility four years after employees abandoned an incapacitated woman on a couch without food, water or bathroom use for over 24 hours.

They say the problems include a suicide, attempted suicides, sexual assault of a patient by an employee, patient-on-patient assaults, patient-on-staff assaults, incorrect medicine dosing and improper patient restraint.

Linda Gelok was found in 2015 with an awkwardly kinked neck and ants on her. She stank of urine. Gelok and her representatives settled a lawsuit against Wyoming in December.

The Wyoming Supreme Court said Gelok's case "shocks the conscience" but two organizations representing dozens of patients say there has been little meaningful change at the State Hospital.

Wyoming Department of Health officials say improvements including remodeling should alleviate conditions.