Assisted Living in Wyoming

Agency: Department of Health, Office of Healthcare Licensing and Surveys
Phone: (307) 777-7123
Website: http://wdh.state.wy.us/ohls

An assisted living facility is a non-institutional dwelling engaged in providing limited nursing care, personal care, and boarding home care, but not rehabilitative care, for persons not related to the owner.

Facility Scope of Care:
The facility shall provide: (1) Assistance with transportation; (2) Assistance with obtaining medical, dental, and optometric care; (3) Assistance in adjusting to group activities; (4) Partial assistance with personal care; (5) Limited assistance with dressing; (6) Minor non-sterile dressing changes; (7) Stage I skin care; (8) Infrequent assistance with mobility; (9) Cueing; (10) Limited care to residents with incontinence and catheters (if the resident can care for his/her condition independently); and (11) 24-hour supervision of each resident

Move-In/Move-Out Requirements:
A resident must be discharged if the facility cannot meet his or her needs with available support services or such services are not available; if the resident fails to pay; or if the resident has a history of engaging in behavior that imposes an imminent danger to self or others. Wyoming supports the philosophy of 'aging in place.' In addition, residents of secure dementia units require discharge when they score less than 10 on the Mini-Mental State Exam (MMSE), when it has been determined that intermittent nursing care has become ongoing, or when the resident requires more than limited assistance to evacuate the building

Resident Assessment:
There is no required assessment form but each resident must have an assessment upon admission, at least annually, and whenever there is a significant change in the resident's condition. The new rule requires that residents admitted to secure dementia units be assessed on the MMSE on admission, and at least annually thereafter, and score between 20 and 10.

Medication Management:
Residents are permitted to self-medicate or receive medication assistance including, but not limited to, reminders, assistance with removal of cap or medication, and observation.

Physical Plant Requirements:
Private resident units must be a minimum of 120 square feet and shared resident units must provide a minimum of 80 square feet per resident.

Residents Allowed Per Room:
A maximum of two residents is allowed per resident unit.

Life Safety:
Assisted living facilities are evaluated for safety using the Life Safety Code (National Fire Protection Association (NFPA) 101). This code requires the facilities to meet national standards for sprinkler protection using NFPA 13 Installation of Sprinkler Systems and national standards for fire alarm systems using NFPA 72, the National Fire Alarm Code, which determines the installation and maintenance of smoke detectors and applicable devices.

Alzheimer's Unit Requirements:
Assisted living rules promulgated in December 2007 allow secure dementia units under a tiered licensing system and include admission/discharge, assessment, background check, and staff training requirements for this level of care. See Move-In/MoveOut Requirements, Administrator Education/Training, Staff Education/Training, and Continuing Education sections for more information.

Staff Training for Alzheimer's Care:
See Administrator Education/Training, Staff Education/Training, and Continuing Education sections for more information

Staffing Requirements:
Staffing must be sufficient to meet the needs of all residents. For facilities with eight or more residents, there must be at least one staff person on duty and awake at all times. The facility must designate a manager who is responsible for the facility and the 24-hour supervision of residents. There must be personnel on duty to maintain order, safety, and cleanliness of the premises; prepare and serve meals; assist the residents with personal needs and recreational activities; and meet the other operational needs of the facility. There must be a registered nurse, licensed practical nurse, or certified nursing assistant (CNA) on every shift.

Staff Education Training:
A licensed nurse must be on duty on all shifts to administer P.R.N. medications and to perform ongoing resident evaluations in order to ensure appropriate, timely interventions. In addition to all other requirements, direct care staff in secure dementia units must receive additional documented training in the facility philosophy and approaches to providing care and supervision of persons with severe cognitive impairment; techniques for minimizing challenging behaviors; therapeutic programming to support the highest level of residents function; promoting residents' dignity independence, individuality, privacy, and choice; identifying and alleviating safety risks to residents; recognizing common side effects and reactions to medications; and techniques for dealing with bowel and bladder aberrant behavior.

Medicaid Policy and Reimbursements:
There is a Medicaid home and community-based services waiver program.