Adult Day Care Wyoming

All states: adult day services map

Wyoming adult day services at a glance

Last verified against state sources: 2026-10-21.

How is adult day care regulated in Wyoming?

Wyoming has one license for adult day care, the adult day care facility license, issued by the Wyoming Department of Health (WDH). The rules define it as a social model program, and there is no separate adult day health care license. Wyoming Medicaid pays for the service under the name Adult Day Services and adds its own provider certification on top of the license.

Three layers of rules can apply to a Wyoming center, and each comes from a different part of WDH:

• Licensing (WDH Aging Division and Healthcare Licensing and Surveys). Two rule chapters apply to every center, whatever the payer. The Chapter 2 licensure rules (Wyoming Administrative Rules 048.0026.2, under W.S. 35-2-901 and following) cover the license itself, renewal, surveys and transfers. The Chapter 7 program administration rules (048.0003.7) cover day-to-day operations, staffing, space, services and records. A separate Chapter 1 fee rule sets license fees.
• Medicaid (WDH Division of Healthcare Financing). The Community Choices Waiver (WY.0236) pays for Adult Day Services for older adults and adults with physical disabilities. The Comprehensive and Supports waivers pay for Adult Day Services for people with intellectual and developmental disabilities. Both are 1915(c) home and community based services waivers run by the Division's HCBS Section.
• Other funding (WDH Aging Division, Community Living Section). The state-funded Wyoming Home Services program lists adult day care among the services it covers.

The licensing rules define an adult day care facility as any facility, not otherwise certified by WDH, that provides help with activities of daily living and supervision, based on a social model, to 4 or more adults age 18 or older with physical or mental disabilities (Chapter 2, Section 4(b)). Chapter 7 describes it as a structured group program giving health, social and related support services in a protective setting for part of a day, under an individual activity care plan. We did not find a separate dementia license or model.

Until July 1, 2026, the Community Choices Waiver used two models, Adult Day Health and Adult Day Social. The waiver renewal that took effect that day combined them into one Adult Day Services service, with transportation included in the rate.

Where the layers overlap, the licensing rules are the stricter layer for how a center operates: they set the only staffing ratio and the space, meal and activity rules. Medicaid adds provider certification, prior authorization, billing limits and faster incident reporting.

Do you need a license to open an adult day center in Wyoming?

Yes, if your program will give help with daily living and supervision to 4 or more adults. The license comes from WDH Healthcare Licensing and Surveys, it must be in place before you provide care, and it applies whatever the payer. A license does not enroll you in Medicaid or Medicare, which is a separate step.

How to apply. The HLS adult day care page lays out the steps:

• Submit a complete initial application with the fee.
• Contact an HLS engineer about building requirements and construction review.
• Receive a provisional license and begin services.
• Pass an initial health survey by the Aging Division, after which a permanent license is issued.

The state licensure checklist (August 14, 2025) asks for an organizational chart, admission and discharge policies, proof of liability insurance, hiring policies with registry checks, employee health and TB policies, program director qualifications, a staffing ratio policy, a medication policy, participant rights, meal times, emergency plans, an internal evaluation plan, a monthly activity schedule, and evidence of CPR and first aid coverage.

Building, money and insurance. Under Chapter 7, before you become a provider you must document a building inspection and approval by the local building official or the state fire prevention agency, state approval for sanitation, water, sewer and food service, and local fire department approval (Section 11). You must also give the state a first-year projected budget, a balance sheet and proof of funds or credit for the first year, and carry public liability insurance of at least $500,000 per occurrence and in aggregate (Section 8).

Fees. The sources disagree. The Chapter 1 fee rule (1998) lists a $100 license fee for adult day care facilities, while the current annual renewal application lists a $250 renewal fee. We did not find a stated fee for an initial license. Call HLS at (307) 777-7123 to confirm current fees.

Certificate of need. We did not find a certificate of need requirement, a moratorium or a cap on new adult day centers in the licensing rules or on the HLS page.

One license per site. The rules do not say whether each site needs its own license. The state facility directory lists one license number per facility address. Ask HLS before you plan a second location.

Buying a center. A license cannot be assigned or transferred without prior approval. The current licensee must ask HLS in writing at least 30 days before the planned transfer, and the new licensee is bound by any plan of correction already in place. A name change needs written notice and a new application and fee (Chapter 2, Section 5(c)).

Renewal and inspections. Licenses run for one year, July 1 to June 30, and are renewed by application and fee. The state performs an initial survey and an annual renewal survey (Chapter 2, Section 5). A center that closes voluntarily must notify the state in writing at least 30 working days before closing and keep personnel, financial and medical records for at least six years after the month it closes.

Medicaid certification. To bill Medicaid you must also enroll as a Medicaid provider and be certified for Adult Day Services by the Division of Healthcare Financing. The Division certifies a new agency for one year and then recertifies at least every three years.

What are the staffing rules for adult day centers in Wyoming?

Wyoming licensing rules require at least 1 staff person on duty giving direct care and supervision for every 6 participants. Whenever 2 or more participants are present, there must also be at least one adult staff person and one other person able and willing to help in an emergency. Medicaid sets no ratio of its own, so the 1:6 licensing ratio is the one to staff to. We did not find a separate ratio for participants with dementia.

• Licensing (Chapter 7, Section 10): 1:6 direct care staff on duty. More staff are needed depending on the services offered and participants' functional level.
• Medicaid (Community Choices Waiver): no ratio specified. Providers must follow Medicaid rules, state guidance and their provider agreement.
• Medicaid (Comprehensive and Supports waivers): no numeric ratio. The three Adult Day Services tiers describe supervision instead. Basic allows periods of indirect supervision with staff on site within hearing distance, intermediate requires full-time heightened supervision, and high requires full-time supervision with staff close by. All tiers may use shared staffing.
• Other funding: we did not find staffing standards for adult day in the Wyoming Home Services program.

Minimum staff on site. One adult must be in charge on the premises during all hours. If the second person who can help in an emergency is out of voice range, an intercom or similar system is required. At least one staff person on site at all times must hold first aid certification issued within the last three years and current CPR certification, renewed every two years (Section 13).

Who counts toward the ratio. Staff counted in the ratio must be at least 18. Assistants age 14 to 18 may work under adult supervision but do not count. Volunteers who meet all personnel and health requirements may be counted.

Director. The program director must be at least 21 and meet at least one of these: 48 semester hours of related college study, certified nursing assistant status plus a score of 85 percent on an open-book rules test, two years of experience with older adults or people with disabilities, or shown administrative and supervisory knowledge. If the director is on site less than four hours a day, a qualified assistant program director is required (Section 9).

Nurses. The rules do not require a nurse on staff. Only people authorized under the Wyoming Nurse Practice Act may give medicine to participants who cannot take it themselves.

Training. All staff need emergency training and job orientation before starting, with the remaining orientation items done within one week, including how to report abuse and neglect. Direct care staff need at least 8 hours of staff development each year covering adult day care and gerontology.

Background checks. No staff person may have a felony or a misdemeanor related to abuse, neglect, exploitation or abandonment. The center must keep written proof of a Department of Family Services (DFS) central registry check or a Board of Nursing registry check, and each personnel file needs two references.

Health screening. Every staff member and volunteer needs a two-step TB skin test before working with participants (or a test within the prior six months) and a TB retest every year. We did not find any other vaccination requirement.

What does an adult day center in Wyoming have to provide?

Every licensed Wyoming center offers planned activities whenever it is open, meals and snacks based on its hours, and extra help with eating, toileting and other daily living tasks for participants who need it. Centers must meet space, restroom and rest area minimums and cannot use basements or upper floors. Transportation is optional under licensing, but if you offer it, specific rules apply.

Activities. A written activity schedule must be prepared at least monthly, posted, and kept for six months (Chapter 7, Section 12).

Meals. Meals and snacks are based on hours open. For example, a center open 8 a.m. to 5 p.m. serves a morning snack, a midday meal and an afternoon snack. Each meal must meet at least one fourth of the recommended daily allowances, and weekly menus are posted and kept for one year.

Transportation. If you transport participants, drivers need the proper license, vehicles need first aid kits, fire extinguishers and seat belts, wheelchairs must be secured, and you need vehicle liability insurance of at least $500,000.

Space and capacity. Under Chapter 7, Section 11:

• At least 40 square feet of indoor floor space per participant, not counting hallways, offices, bathrooms, storage and other areas not normally used for activities.
• At least one toilet per 8 participants in attendance, one sink per two toilets and grab bars at all toilets. When more than 8 participants attend, separate men's and women's bathrooms are required, plus an accessible unisex bathroom if needed.
• A rest area with at least one bed or cot per 8 participants, a private space for interviews and phone calls, an outdoor activity area and an accessible telephone.
• Floors above or below the first story and basements may not be used.

We did not find a rule explaining how licensed capacity is calculated.

Hours. We did not find a minimum number of days or hours a center must be open in any layer.

Written policies. The licensing rules require:

• An internal policy manual with a statement of purpose, the scope of services, and who can and cannot be served.
• A written organizational chart and staffing plan with a staffing schedule.
• Written admission and discharge policies.
• A written plan for medical emergencies, prepared with a health professional.
• A written fire and emergency evacuation plan with a drawing of exits, posted on each floor, and written plans for severe weather, loss of utilities and missing persons.
• A written plan for internal program evaluation, with a formal evaluation at least once a year at the end of the state fiscal year.
• A process for reviewing complaints and resolving grievances.
• A participant rights statement and written duties for volunteers.

Safety and postings. Fire drills are required at least monthly, documented and kept for one year. Centers post the license, the activity schedule, weekly menus, the evacuation plan, emergency numbers, participant rights, and contact numbers for the Long-Term Care Ombudsman, Protection and Advocacy, Adult Protective Services, the Medicaid Fraud Control Unit and the center's complaint contact. The latest survey report must be available for inspection.

Medicaid limits. Under the Community Choices Waiver service index, Adult Day Services are meaningful daytime activities in community settings. Transportation is included in the rate, meals are not meant to be a full nutritional regimen, and the service cannot be delivered virtually, during sleeping hours or at the same time as other waiver services. It is limited to 40 hours a week or 8,320 15-minute units per plan year. On the DD waivers, personal care may not be more than 20 percent of the service, and Adult Day Services may be provided in the home when the participant's team documents the reason.

What rules protect participants in Wyoming adult day centers?

Wyoming rules require a physical exam and TB screening within 30 days before admission, a written assessment, a signed agreement, and a program plan that is reviewed at least every six months. Suspected abuse or neglect must be reported within 24 hours, and Medicaid waiver providers must report critical incidents immediately. The rules require a written discharge plan when the center starts the discharge, but set no discharge notice period.

Who can enroll. A center may refuse adults with a communicable disease, active addiction, a history of violence, or needs beyond what the program can meet (Chapter 7, Section 7). For Medicaid waiver participants, Adult Day Services must be in the person-centered service plan and prior authorized based on assessed need.

Before admission. Under Chapter 7, Section 12:

• A TB screening and physical exam by or under a physician within 30 days before admission. The report lists diagnoses, medicines, diet, allergies, ability to take medicine on one's own and ability to exit the building without help.
• A written admission assessment of physical, social and mental status, updated at least every six months.
• A signed written agreement stating the services, the conditions for dismissal or discharge, and the financial arrangements. Participants get 30 days written notice of any financial change.

Care plan. A preliminary program plan is required before admission, completed within 30 days, and reviewed at least every six months.

Discharge. Discharge is planned when the program can no longer meet the participant's needs, with the participant involved. When the center starts the discharge, it must prepare a written discharge plan. We did not find a minimum discharge notice period.

Records. Participant and personnel records are kept locked and kept at the facility for six years after enrollment or employment ends. Medication records are also kept six years. Medicaid providers must keep records of dates of service, services provided and claims for at least six years after the end of the state fiscal year of payment, or longer if an audit or claim is pending (Medicaid Rules Chapter 3, Section 8). We did not find a licensing rule that requires a daily attendance log by name, though records must be kept current.

Incidents. Centers keep written records of all accidents, injuries, illnesses and emergencies, and notify the family and physician immediately of any illness or accident that needs medical attention. Suspected abuse, neglect, exploitation or abandonment must be reported to law enforcement and DFS within 24 hours of discovery. Community Choices Waiver providers must also report critical incidents, such as abuse, neglect, exploitation and unexpected death, immediately through the Division's web-based system after making sure the person is safe, and non-critical incidents within three business days. For waiver participants, the Medicaid timeline is the stricter one.

Participant rights. Each record holds a signed copy of the participant rights statement, and every center must have a grievance process that includes access to the Long-Term Care Ombudsman.

How does Medicaid pay for adult day in Wyoming?

Wyoming Medicaid pays for Adult Day Services through the Community Choices Waiver and through the Comprehensive and Supports waivers for people with developmental disabilities. Since July 1, 2026, Community Choices pays $2.37 per 15-minute unit (S5100) for less than four hours a day and $56.89 per day (S5101) for more than four hours. Transportation is included in the rate on both waivers.

Community Choices Waiver. The WDH Division of Healthcare Financing runs this 1915(c) waiver, renewed as WY.0236.R07.00 effective July 1, 2026. Providers can be licensed adult day care facilities or eligible senior centers that are Older Americans Act grantees overseen by the Aging Division, and both must be enrolled in Medicaid and certified by the Division.

• Billing codes and units: S5100 per 15 minutes for less than four hours a day; S5101 per day for more than four hours (16 units). The two cannot be billed on the same day.
• Rates: $2.37 per 15 minutes and $56.89 per day, effective July 1, 2026, from the CCW service index.
• Limit: 40 hours a week or 8,320 15-minute units per plan year.
• Authorization: the service must be in the participant's service plan and prior authorized.
• Overlap: Adult Day Services cannot be billed at the same time as other waiver services, which is checked in Program Integrity audits.

Comprehensive and Supports waivers. These DD waivers cover Adult Day Services in three tiers (basic, intermediate and high) tied to the participant's level of service score, billed in 15-minute units under S5100, S5100 UA and S5108. The DD waiver service index (July 2026) lists rates from $2.58 to $6.73 per 15 minutes depending on the tier and the type of provider. Check the index or the DD fee schedule for the exact rate that applies to you. The index says Adult Day Services is not a habilitation service. On the Comprehensive Waiver, non-residential services are capped at an average of 35 hours a week for people at service levels 3 to 6.

Transportation. Transportation is included in the Adult Day Services rate on both waivers and is not billed separately.

Attendance documentation. Because Community Choices pays by 15-minute units or a daily unit depending on hours, the time each participant attends supports the claim. Under Medicaid Rules Chapter 3, Section 11, all required documentation, including signatures, must be complete before a claim is submitted, and documentation made afterward may be treated as insufficient, with payment withheld or recovered. The waiver's electronic visit verification requirement covers in-home services such as homemaker, personal support and respite, not Adult Day Services. We were not able to read the July 2026 CCW provider manual, so we did not confirm whether it sets specific sign-in or attendance rules for adult day. Ask the Division's HCBS Section.

Can a private-pay adult day center operate in Wyoming without Medicaid?

Yes, a center can be fully private pay, but it still needs a state license if it gives help with daily living and supervision to 4 or more adults. Wyoming's licensing rules apply whatever the payer, and the license is separate from Medicaid enrollment. Programs that only offer socialization or recreation, without daily living help and supervision, are not covered by the rules.

What falls outside the rules. Under Chapter 7, Sections 5 and 7, these are not covered:

• A home caring only for relatives by blood or marriage.
• A program that only offers socialization or recreation, without help with daily living, support and supervision.
• A program serving fewer than 4 adults, which falls outside the definition.

Protections for private-pay participants. Every licensed center must avoid deceptive advertising, sign a written agreement with each participant that states services and financial arrangements, give 30 days written notice of any financial change, honor participant rights, and keep a grievance process with access to the Long-Term Care Ombudsman. We did not find a rule on non-discrimination by payment source.

Other funding. The state-funded Wyoming Home Services program, run by the Aging Division's Community Living Section, lists adult day care among its services, along with care coordination, homemaking, personal care and respite. We did not find its adult day standards or fee rules. Older Americans Act Title III funds in Wyoming pay for supportive services, nutrition, health promotion and the family caregiver program (including respite), but the state's program handout does not name adult day care under Title III. We did not find whether the VA buys adult day health care for veterans in Wyoming; ask the VA medical center in Cheyenne or Sheridan.

The market. The state's Healthcare Facility Directory, updated October 12, 2026, lists three licensed adult day care facilities, in Casper, Sheridan and Thayne. We did not find a Wyoming adult day services association.

What is changing next for adult day in Wyoming?

As of our last check on October 21, 2026, we did not find an upcoming change to Wyoming's adult day licensing rules or Medicaid adult day payment. Three recent changes matter for operators, and all are already in effect.

• Community Choices Waiver renewal, July 1, 2026. The renewal combined the Adult Day Health and Adult Day Social models into one Adult Day Services service, with transportation built into the rate (WY.0236.R07.00).
• Medicaid rate updates, July 1, 2026. Wyoming Medicaid put new provider rates in place, including a new HCBS fee schedule. The CCW service index lists S5100 at $2.37 per 15 minutes and S5101 at $56.89 per day.
• DD waiver amendments, July 22, 2026. Amendments to the Comprehensive and Supports waivers were approved effective July 22, 2026 (HCBS services and regulations).

The licensing rules themselves date from 1999 and 2000. We did not find an announced rewrite, so ask HLS whether one is planned.

Wyoming adult day sources

• Wyoming Department of Health: Adult Day Care licensing (Healthcare Licensing and Surveys)
• Rules for Licensure of Adult Day Care Facilities, Chapter 2
• Rules for Program Administration for Adult Day Care Facilities, Chapter 7
• HLS: Adult Day Care Checklist for State Licensure (August 14, 2025)
• Community Choices Waiver renewal WY.0236.R07.00, effective July 1, 2026
• Community Choices Waiver Service Index, effective July 1, 2026
• Comprehensive and Supports Waiver Service Index, July 2026
• Wyoming Medicaid Rules Chapter 3: provider participation and claims
• WDH Community Living Section program handout (Wyoming Home Services, Older Americans Act)
• WDH Healthcare Facility Directory 2026-2027 (updated October 12, 2026)

Related reading

• The Compliance Curve: Why Adult Day Services Should Learn from Home Care Before They Have To
• How to Differentiate Your Adult Day Care Center: A Guide for Operators
• Effective Transportation Tracking for Elder Day Centers
• Adult Day Care Activity Ideas to Keep Clients Engaged
• Adult day services in every state (map)
• Adult Day Care Services and Reference Guide

Other states that license or certify every adult day center

California, Delaware, Florida, Georgia, Hawaii, Iowa, Kansas, Maine, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah. See every state on the adult day services map.

Page history

• October 21, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for adult day centers, covering attendance, care plans, transportation and billing. If you would like to talk about running your center, contact Ankota or read more about Ankota's adult day care software.