How to start an assisted living facility in Wyoming

Wyoming requires a Assisted living facility license (may include secured units and dementia-dedicated facilities) from Wyoming Department of Health, Aging Division — Healthcare Licensing and Surveys (HLS) to operate an assisted living facility. Fee: A license fee goes with the application, and a survey fee is charged for initial and relicensure inspections (W.S. 35-2-907(c)). Amounts are not on the page.

License required

Yes

License

Assisted living facility license (may include secured units and dementia-dedicated facilities)

Issuing agency

Wyoming Department of Health, Aging Division — Healthcare Licensing and Surveys (HLS)

Fee

A license fee goes with the application, and a survey fee is charged for initial and relicensure inspections (W.S. 35-2-907(c)). Amounts are not on the page.

Medicaid waiver coverage

HHS's 2015 compendium reported a Medicaid 1915(c) Assisted Living Facility waiver. Wyoming has since restructured its aging waivers; the current program was not confirmed.

Regulation

HLS Rules Ch. 4 (Licensure of Assisted Living Facilities) and Ch. 12 (Program Administration of Assisted Living Facilities)

1. Complete the State Initial/CHOW license application and checklist and submit them with the fee
2. Call an HLS engineer about building requirements and construction review
3. Receive a provisional license once building items are approved, and begin serving residents
4. Request a health survey in writing once you have residents
5. Pass the unannounced initial survey to get a permanent license

Program

Wyoming Medicaid and Kid Care CHIP (Wyoming Department of Health, Division of Healthcare Financing, Office of Medicaid)

Enrollment portal

Discover Your Provider (DyP) provider enrollment portal, run by HHS Technology Group (HTG)

Fiscal agent

CNSI (operates the Benefits Management System claims processing); provider enrollment is contracted to HHS Technology Group (HTG)

Application fee

Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. WDH's enrollment page does not list a separate state fee.

Fingerprinting

WDH says enrolling under a taxonomy considered high-risk can add steps, and a provider specialist will reach out. Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check.

Site visit

Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. WDH's enrollment page does not describe a separate state site visit process.

Revalidation

Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years. After an April 2026 CMS request, WDH sent CMS a two-year off-cycle revalidation plan on June 5, 2026. Under an August 17, 2026 notice, high-risk providers must revalidate in the DyP portal by October 31, 2026. Every enrolled provider must also report an NPI by then; providers without one are treated as high risk. Missing the deadline means payment suspension, then termination on February 1, 2027.

Full Wyoming Medicaid enrollment guide →

CON program

No

Wyoming certificate of need details →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Assisted living facilities — active organization NPIs (NPPES)

39 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

59,335 (as of Jun 1, 2026)

All Wyoming Home care Medicaid rates, ranked →

• WY Children's Mental Health Waiver (1915(c))
• WY Community Choices Waiver (CCW) (1915(c))
• WY Comprehensive Waiver (1915(c))
• WY Supports Waiver (1915(c))

Wyoming waivers and waiting lists →