Wyoming adult day care facility license: HLS rules, the 1:6 ratio and the $250 fee
In Wyoming, a social-model day program that gives daily living support and supervision to four or more adults with physical or mental disabilities needs an adult day care facility license from the Department of Health, Healthcare Licensing and Surveys (HLS). The fee is $250 a year under W.S. 35-2-904, every license runs July 1 to June 30, and HLS issues a provisional license once it has approved your application and building.
Contents11 sections
Key takeaways
- The license applies once a social-model program gives daily living support and supervision to 4 or more adults aged 18+ with physical or mental disabilities. A recreation-only program that gives no help with daily living tasks is outside the rules.24
- The fee is $250 a year (W.S. 35-2-904(g)). Every license expires June 30, and the full fee is due even when you open partway through the license year.2
- Before HLS issues a provisional license, it reviews a 16-item checklist and you talk to an HLS engineer about the building. The checklist includes $500,000/$500,000 liability insurance, a Program Director who qualifies under the rule, and CPR and first-aid coverage at all times.15
- Plan for at least 1 direct-care staff member per 6 participants, 40 square feet of indoor program space per participant, and 1 toilet per 8 participants.4
- The rules are old: Chapter 2 dates from 2000 and Chapter 7 from 1999. Where an old rule clashes with the statute or with newer HLS instructions (fee table, who to pay, where plans go), follow the newer source.168
- Medicaid pays for adult day through the Community Choices Waiver. The waiver renewal approved for July 1, 2026 merged the health and social models and added a daily billing unit. Billing requires a separate certification from the Division of Healthcare Financing.10
Quick facts
| Who needs it | Social-model day program for 4+ adults (18+) with disabilities |
|---|---|
| Agency | Department of Health, Healthcare Licensing and Surveys (HLS) |
| Annual fee | $250 (W.S. 35-2-904(g)) |
| License year | July 1 to June 30, renewed annually |
| Staff ratio | 1:6 direct care staff to participants |
| Space | 40 sq ft indoor program space per participant |
| Insurance | $500,000 per occurrence / $500,000 aggregate |
Fee as published in W.S. 35-2-904(g) on 2026-10-12. HLS accepts checks only, payable to the Wyoming Department of Health (07/2021 instructions).
Wyoming licenses adult day care as a health care facility under the same act that covers hospitals, nursing homes and assisted living (W.S. 35-2-901 et seq.).2 The Department of Health’s Healthcare Licensing and Surveys office (HLS) in Cheyenne issues the license. Two old rule chapters govern it: Chapter 2 (licensure, effective April 20, 2000) and Chapter 7 (program administration, effective July 20, 1999).1 Neither chapter has been rewritten since, so a few details in them are out of date. This guide flags each one.
Who needs the license, and who does not
The statute defines an adult day care facility as any facility, not otherwise certified by the Department of Health, that is in the business of providing “activities of daily living support and supervision services programming based on a social model” to four or more people aged 18 or older with physical or mental disabilities.2 Chapter 7 describes its scope the same way: supplementary care and protection for four or more adults who are elderly, blind or disabled, who are in care for less than 24 hours a day, and who live elsewhere.4 The HLS application asks the question directly: “Do you provide care for four (4) or more adults?”7
Chapter 7 exempts two kinds of operation:4
- a home where someone cares only for people related to them by blood or marriage, and
- a facility, or part of one, that runs only a socialization or recreation program and gives no help with daily living tasks, support or supervision.
That second exemption is the line that matters for senior centers and activity clubs. Once your staff help with eating, toileting or mobility, or supervise people who can’t safely be left alone, you are past it.
Operating an unlicensed health care facility is a misdemeanor under W.S. 35-2-909. The penalty is a fine of up to $750, up to six months in jail, or both, and each calendar week of operation counts as a separate offense.2
Neighbouring Wyoming licenses a founder might confuse with this one:
- Overnight care requires a residential license. That means an assisted living facility license, or an adult foster care home license for up to five adults in a home. Adult day care is less than 24-hour care by definition, and W.S. 35-2-901(a)(xxiv) defines an adult foster care home as one providing care for up to five adults.12
- Nursing or other health care services delivered at a person’s residence fall under the home health agency license, not this one. W.S. 35-2-901(a) defines a home health agency as one “primarily engaged in arranging and directly providing nursing or other health care services to persons at their residence.”2
- Adult day care covers adults 18 and older only.2 Programs for children fall under different licenses; see the child care center and family child care home guides.
The application packet HLS expects
HLS uses one Initial/Change of Ownership application form for all of its facility types, with a version for each type. The adult day care version is dated 07/01/2021.7 You submit one application per facility.6 The form asks for:7
- the facility name exactly as it should appear on the license
- physical and mailing address, fiscal year end and federal EIN
- hours of operation
- the Program Director and any Assistant Director
- whether the building is owned, rented or leased
- any HLS construction project numbers
- the owner, every officer, and any separate operating company
- whether the owner or operator has ever had a health care license denied, suspended, revoked or terminated in any state
The statute requires this disclosure, and it requires a sworn application.2 Attach a readable floor plan that labels the activity area, dining room, toilet rooms, kitchen and other service areas.6
Two officers of the ownership entity must sign with original signatures, or all managing agents if they sign instead. The form warns that “in most cases, a CEO, CFO, Administrator, or Director signature will not be accepted.”7 W.S. 35-2-903(b) is the source of the two-officer rule.2
HLS takes checks only, payable to the Wyoming Department of Health.6 Chapter 2 still says checks go to the “Treasurer, State of Wyoming.” That rule predates the 2021 instructions, so use the instructions.36 You may email the application with the subject line “License Application Submission”. Even then, you must mail the original signature page together with the check, and you should not mail a full hard copy as well.6 HLS sends the license itself by email, not on paper.7
The State Licensure Checklist, revised August 14, 2025, lists what must accompany the form:5
Application and fee
The completed application form and the $250 check.
Organizational chart
It must show administrative control and the lines of authority from management down.
Admission policies
Submit a copy.
Discharge policies
Submit a copy.
Liability insurance
Proof of public liability insurance for bodily injury of at least $500,000 per occurrence / $500,000 aggregate.
Hiring policies
Include evidence of Department of Family Services central registry checks and State Board of Nursing registry checks.
Employee health policy
It must cover tuberculosis screening.
Program Director qualifications
Show how your director meets the rule (see below).
Staffing policy
State your staff-to-participant ratio.
Medication management policy
Explain how medicines are stored and given.
Participant rights
Submit a copy.
Mealtimes and snack times
List them.
Emergency plans and procedures
Submit them in writing.
Internal evaluation plan
A written plan, with a formal evaluation each year.
Activity schedule
A monthly schedule of activities.
CPR and first aid
Evidence that someone with current CPR and first-aid certification will be on the premises at all times during operating hours.
Chapter 7 also requires evidence of financial responsibility, submitted to the Aging Division. That means a projected budget for the first year of operation, a balance sheet showing the assets committed to and liabilities charged against the facility, and documentation of funds or credit for the first year.4 The 2025 checklist doesn’t list these items, but the rule hasn’t been repealed. Have them ready in case HLS asks.
The order of events
The HLS adult day page describes a short sequence:1
Read Chapters 2 and 7
HLS asks you to review the regulations first.
Submit the complete application and fee
Include the checklist items above.
Call an HLS engineer
The number is (307) 777-7123. Discuss the building requirements and whether your space needs construction review (see the next section).
Get building and health approvals
Chapter 7 requires these before you become a provider. You need approval from the local building official or the state Department of Fire Prevention and Electrical Safety. You need a Department of Health approval covering sanitation, water supply, sewerage and food service. You also need a local fire department inspection finding the facility free of fire hazards. In each case, an approved plan of correction is accepted in place of a clean inspection.4
Receive a provisional license
“Once we have approved these items, a provisional license will be issued, and you will be able to start providing services.” W.S. 35-2-904(f) allows a provisional license, with restrictions, when operating won’t endanger participants.12
Initial survey and permanent license
The Aging Division conducts an initial health survey. HLS says it issues a permanent license once the Aging Division reports that the survey is complete and the facility complies with the regulations.1 Surveys are made against Chapters 2 and 7, annually after the first one. If the two chapters conflict, Chapter 2 controls.3
Neither HLS nor the rules publish a processing time for adult day applications.
Because the license year is fixed, the full $250 fee is due whatever month you open. A license issued in May still expires June 30, and renewal brings a new $250 fee.2
Building, accessibility and construction review
Under W.S. 35-2-906, a licensee planning construction, alteration or an addition must submit plans to HLS for approval before work starts.2 The HLS construction page applies this to converting an existing structure for use as a health care facility, which describes most new adult day sites. HLS reviews the preliminary plans and conducts the final licensure construction survey. You can hire a registered third-party reviewer for final plan review and interim inspections at your own cost, except in the municipalities that have taken jurisdiction over health care construction.8 Chapter 7 still sends renovation plans to the Department of Administration and Information. HLS now handles plan review, so follow the construction page.48
Construction Rules Chapter 3 (effective April 3, 2008) adopts the 2006 edition of NFPA 101, the Life Safety Code, for health care facilities. Adult day care facilities are not exempt from it, but they are exempt from NFPA 99 and from the 2006 Guidelines for Design and Construction of Health Care Facilities.9 Chapter 7 requires that renovations comply with the ADA Accessibility Guidelines.4
The physical-plant rules in Chapter 7 are specific:4
| Item | Requirement |
|---|---|
| Program space | 40 sq ft of indoor floor space per participant, not counting hallways, offices, bathrooms or storage |
| Toilets | 1 per 8 participants in attendance; separate men’s and women’s bathrooms once more than 8 attend; 1 sink per 2 toilets; grab bars at every toilet |
| Small programs | With 8 or fewer participants, at least one toilet large enough for someone using a walker or wheelchair or needing help |
| Rest area | 1 bed or cot per 8 participants, with linens |
| Temperature | At least 68°F inside; fans or air conditioning available above 84°F |
| Access | At least one grade-level entrance freely accessible to wheelchairs; doorways wide enough for walkers and wheelchairs before accepting anyone who uses one |
| Outdoors | An accessible outdoor activity area and a safe drop-off and pick-up area |
| Telephone | At least one private, free, wheelchair-accessible phone, plus private space for interviews and calls |
| Kitchen | Refrigerators at 40°F or less and freezers at 0°F or less, each with a thermometer; a 2A-10B:C extinguisher; three-compartment manual dishwashing or an automatic dishwasher |
Fire safety requirements under Section 13 are as follows.4
- Install approved smoke detectors.
- Fire extinguishers must be rated at least 2A-10B:C, wall-mounted near exits and serviced every year by a state-certified technician.
- Exit doors must open from inside without a key.
- Post an evacuation plan in a conspicuous place and go over it with each participant at admission.
- Hold a fire drill at least once in every month of operation, and document each drill.
Staffing, the Program Director and training
Ratio and supervision. You need at least one direct-care staff member on duty for every six participants, and more if the program or the participants’ functional level requires it. Whenever two or more participants are present, there must be one adult staff member plus one other person able to help in an emergency.4 Only staff aged 18 or older count toward the ratio. Assistants aged 14 to 17 may work under adult supervision but don’t count.4
Program Director. The director must be at least 21 and meet one or more of these:4
- 48 semester or 72 quarter hours of college in health care, elderly care, case management, facility management or a related field
- certification as a CNA, plus a score of at least 85% on an open-book test on the rules prepared by the Aging Division
- two years of paid or volunteer experience working with older adults or people with disabilities
- demonstrated knowledge and skill in running an adult day program, including financial management
- demonstrated supervisory knowledge
If the director is on site less than four hours a day, you must designate an Assistant Program Director who meets the same qualifications. During all operating hours, one adult on the premises must be in charge.4
Screening. No staff member may have a felony conviction, or a misdemeanor conviction related to abuse, neglect, exploitation or abandonment of adults or children. You must keep written verification of a Department of Family Services central registry check, or a State Board of Nursing registry check where applicable.4 Personnel files need at least two character references.4 Every staff member and volunteer needs a two-step TB skin test before working with participants and a retest every year.4
Training.4
- Before starting work, every staff member is trained on fire, injury, missing-participant and severe-weather procedures.
- Orientation covers Wyoming’s abuse-reporting duty, among other topics, and must be finished within one week of the start date. Suspected abuse, neglect, exploitation or abandonment must be reported to law enforcement and the Department of Family Services within 24 hours.
- Direct-care staff need eight hours of in-service training each year, covering both adult day care and gerontology.
- At least one person on the premises at all times must hold first-aid certification issued within the past three years.
- At least one person on the premises at all times must hold current Red Cross or American Heart Association CPR certification, renewed every two years.
Running the program day to day
HLS surveys against these Chapter 7 operating rules:4
- Admission. Participants must be 18 or older. Each needs a TB screening and a physical examination by or under a licensed physician within 30 days before admission. Staff write an admission assessment and review it at least every six months. A preliminary program plan is written before admission and completed within 30 days.
- Agreement. Each participant signs a written agreement covering services, discharge conditions and finances. Give 30 days’ written notice of any financial change.
- Medication. Participants may manage their own medicines with a physician’s written authorization. Otherwise, medicines are locked up and given only by staff authorized under the Wyoming Nurse Practice Act. The administration log is kept for six years.
- Meals. What you serve depends on your hours. A program open 8 a.m. to 5 p.m. serves a morning snack, a midday meal and an afternoon snack, at least two hours apart. Each meal must supply at least one-fourth of an adult’s recommended dietary allowance, and the menu is planned in advance.
- Transportation. If you provide it, every passenger needs a seat and seat belt, wheelchairs must be secured, and you need vehicle liability coverage of at least $500,000 per occurrence and $500,000 aggregate.
- Rights and grievances. Post the participant rights. Post the phone numbers of the Long-Term Care Ombudsman, Protection and Advocacy, local Adult Protective Services and the Medicaid Fraud Control Unit. Review the grievance process with each participant at admission and every six months.
- Evaluation and records. Complete a formal program evaluation each year at the end of the state fiscal year. Keep participant and personnel records in a locked area for six years after discharge or separation.
Fees, renewal and changes to the license
| Item | Fee |
|---|---|
| Initial license | $250 |
| Annual renewal (license year July 1 to June 30) | $250 |
| Revised license for a change of name, location or number of beds | $250 |
Sources: W.S. 35-2-904.2
HLS sends a renewal application with a cover letter, and the form is due by the date stated in that letter.3 A facility accredited by a nationally recognized accrediting body approved under federal regulations is renewed without a further state inspection.2
Licenses cannot be transferred. A buyer files a new Initial/Change of Ownership application, which HLS processes the same way as a new facility.26 Chapter 2 also requires written notice to HLS at least 30 days before a planned transfer. The new licensee takes on the previous owner’s plan of correction.3 If you close voluntarily, give HLS 30 working days’ written notice. Keep records for six years after the month of closure.3
Surveys and appeals. After each survey, HLS sends cited deficiencies within 10 working days. Your plan of correction is due within 10 working days of receiving them. The plan must name who is responsible and set a correction date no later than 60 days after the survey.3 To contest an adverse decision, you must request a hearing in writing within 10 days.3 Post the license in a public area of the facility.3
Medicaid: the Community Choices Waiver
The HLS license doesn’t enroll you in Medicare or Medicaid.1 In Wyoming, Medicaid pays for adult day through the Community Choices Waiver (CCW), run by the Division of Healthcare Financing. To bill the waiver, you need all of the following:10
- If you are an adult day care facility, a full HLS license under W.S. 35-2-901(a)(xxiii).
- Wyoming Medicaid provider enrollment.
- A separate CCW certification for the service.
Certification lasts one year for a new agency, then is renewed at least every three years.10 The CCW also lists eligible senior centers as a separate provider type for Adult Day Services.10
The waiver renewal approved effective July 1, 2026 made several changes to Adult Day Services:10
- It combined the health and social models under one updated definition.
- It folded transportation into the rate.
- It added a daily unit alongside the 15-minute unit. The two cannot be billed on the same day, and any use of the service over four hours a day must be billed as a daily unit.
- It allowed providers qualified under the developmental disabilities waiver to deliver the service.
To get certified, request access to the Wyoming Health Provider portal, complete the Division’s provider agency training modules, and pass the multi-step CCW background screening. The application itself is filed through the portal. The Medicaid enrollment and provider agreement are separate from CCW certification, and you renew them every five years.11
What is old, and what has changed
- Fees. The statutory fee table took effect July 1, 2021.6 HLS Rule Chapter 1, the fee rule cited in Chapter 2, dates from 1998 and is still listed on the HLS rules page.12 The $250 in W.S. 35-2-904(g) is the figure to pay.2
- Checklist. HLS revised the state licensure checklist on August 14, 2025.5
- Construction statute. Laws 2025, chapter 102 repealed several subsections of W.S. 35-2-906. The plan-submission requirement in subsection (a) remains.2
- Medicaid. The July 1, 2026 CCW renewal changes how adult day services are defined and billed.10
- Agency names in the rules. Chapters 2 and 7 still refer to the “Office of Health Quality” at 2020 Carey Avenue. HLS is now at 2300 Capitol Avenue, Suite 510, Cheyenne, phone (307) 777-7123, email [email protected].13
Sources
- 1 Wyoming Department of Health, Healthcare Licensing and Surveys, Adult Day Care Checked 12 Oct 2026 · Back to text ↑
- 2
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Related guides
- Wyoming assisted living facility license: Level 1, Level 2 and the HLS processWyoming · Assisted living facility
- Wyoming adult foster care home license: a capped pilot program for five residentsWyoming · Small residential care home
- Wyoming home health agency license: the two-service test, provisional license and surveyWyoming · Home health agency
Wyoming and neighboring states
Compare all 51| State | License | Who needs it | State fee |
|---|---|---|---|
| Wyoming (this guide) | Adult day care facility license | Social-model day program for 4 or more adults 18+ with disabilities | $250 (W.S. 35-2-904(g)) |
| Montana | Adult Day-Care Center license | Scheduled daily-living care for adults, no overnight; no minimum count | Not published outside the online portal (see below) |
| Nebraska | Adult Day Service (ADS) license | Group day program for 4 or more people needing age or disability support | See guide |
| Utah | Adult Day Care license (human services program license) | Day care for 3 or more impaired adults, 4 to under 24 hours a day | $990 initial; $360 renewal for 0-50 consumers ($660 above 50); plus $24 per licensed capacity |
Shortened from each state's guide and our 51-state table, as of each guide's last review. Fees are the state's own; local permits and background checks cost extra.