Nursing Homes in Wyoming
As people get older, the risk of developing medical conditions such as arthritis and heart disease becomes greater. Nursing homes play a vital role in caring for seniors with short and long-term medical conditions. They have the facilities to provide around-the-clock care for residents with ongoing medical issues as well as those recovering from illness or surgery. The staff is a blend of registered nurses, licensed practical nurses, therapists and certified nursing assistants. Other staff members ensure residents' rooms are cleaned, provide meals and plan social activities.
There are 36 nursing homes in Wyoming caring for approximately 2,000 residents. Seniors comprise 17.9% of the state's population of almost 577,000, so those in nursing homes account for roughly 2% of Wyoming's older citizens. This figure may rise as Americans are increasingly living longer.
This guide answers the question of if and how Medicaid pays for nursing home care in Wyoming, as well as who is eligible and how they can apply. It also lists useful resources and touches on other financial options for seniors and their families if Medicaid can't help. Finally, it briefly covers the rules and regulations governing Wyoming's nursing homes.
Cost of Wyoming Nursing Homes
The average cost of nursing homes in Wyoming is $220 per day. This is higher than the national average which is $228 per day.
Can You Use Medicaid to Pay for Nursing Home Care in Wyoming?
Wyoming Medicaid will pay up to 100% of nursing home care costs for applicants who satisfy its qualifying criteria. The number of Wyoming residents enrolled in Medicaid and CHIP, as of December 2022, is 82,405 — about 14.3% of the population.
Not every senior who qualifies for Medicaid wants to enter an institution. Therefore, Wyoming Medicaid can pay many costs for those who can be cared for safely in their home or community through waiver programs collectively called Home and Community-Based Services. The most commonly used of these is the Community Choices Waiver, which will effectively pay for the same services provided in a nursing home, such as skilled nursing approved by a physician, personal care, home-delivered meals and an emergency response system. It's worth noting that waivers, unlike Medicaid, are not entitlement programs. Access isn't guaranteed immediately and joining a waiting list is likely required.
Eligibility for Medicaid in Wyoming
To be eligible for Medicaid, the applicant must satisfy income and assets restrictions. A single person (or an individual from a two-person household) can't have an annual income of more than $32,904 or assets greater than $2,000. Not all income and assets count. For example, veterans receiving Aid and Attendance won't count those payments. With assets, the person can exclude up to one car, any personal belongings, household furnishings or their primary home in most cases. Countable assets include real property that isn't the primary home, savings, stocks, bonds and investments. Per spousal impoverishment rules, the applicant can transfer some of their income and assets up to $148,620 to their spouse.
| Income Limits* | Asset Limits | |
|---|---|---|
| Single Person | $32,904 | $2,000 |
| Two-Person Household | $32,904 | $2,000 (applicant)$148,620 (non-applicant) |
*Per year
For Wyoming Medicaid to pay for nursing home care, the applicant must also be:
- A U.S. Citizen or legal permanent resident who has lived in the country for a minimum of 5 years
- A Wyoming resident
- Aged 65 or older, blind or disabled
- Deemed medically in need after an assessment by a public health nurse
- Verified as SSI eligible or been hospitalized for at least 30 consecutive days
Applying for Medicaid in Wyoming
Wyoming Medicaid lets seniors and their families apply for Medicaid through six options, each catering to people with different communication preferences. These are:
- Online: Seniors comfortable with computers can visit the Department of Health's online portal.
- Phone: Those who prefer to use the phone can call (855) 294-2127 to speak to someone who can guide them through the process.
- Fax: Seniors who want a hard copy of their application can download a paper copy and fax it to (855) 329-5205.
- In-person: Those within a reasonable distance who prefer to talk to someone face to face can visit the following address: Wyoming Department of Health, Customer Service Center, 3001 E. Pershing Blvd., Suite 125, Cheyenne, WY 82001.
- Mail: Alternatively, if they prefer to use mail, they can post a paper copy of the application to the above address.
- Email: Seniors more comfortable using email can send an electronic copy of the application to the department's dedicated email address.
What Information You Will Need
All applicants need to provide evidence to support their applications. The most common of these are:
- Proof of identity, such as a passport
- Proof of age, such as a birth certificate
- Proof of Wyoming residency, such as a driver's license
- Social Security number
- The policy numbers of health insurance for the entire household
- Proof of the last 30 days of income and assets, such as bank and investment statements
Additional Medicaid Support & Resources in Wyoming
Seniors and families in Wyoming thinking about applying for Medicaid can access numerous free resources that can help in different ways. The following table contains three of them, including links to their websites, contact information and a short explanation of how they can help.
| Contact | Service | |
|---|---|---|
| American Council on Aging | Online Only | The American Council on Aging site for Wyoming Medicaid may interest those who prefer to research the subject in detail before applying. Experts write and update the content, which covers most of what people are likely to need. The site also contains useful tools, such as a Medicaid eligibility test. |
| Medicaid Customer Service | (855) 294-2127 for Medicaid or (855) 203-2930 for Long Term Care Unit | The customer service staff at Wyoming Medicaid is able to answer most questions about the program and help callers with their applications. There are also representatives of the Long-Term Care Unit who can aid those who have already applied for a Home and Community-Based Services waiver. |
| Wyoming Department of Health, Aging Division - Community Living Section | (307) 777-7995 | The Community Living Section of the Department of Health's Aging Division specializes in helping Wyoming residents aged 60 and older. Its purpose is to help seniors live independently in the community, so it can aid those with a preference for home and community-based care over nursing home care. |
Can You Use Medicare to Pay for Nursing Home Care in Wyoming?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it's most valuable for those who are recovering from an injury, illness, or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- Meals
- A semiprivate room
- Medications
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn't Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors' day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support & Resources in Wyoming
Medicare can cover the costs of many services but can also leave seniors with out-of-pocket expenses, such as copays and deductibles. It can therefore be a confusing subject for many older people, who may miss out on opportunities to save money and get more from the program. The following table includes organizations that can help seniors understand Medicare and choose the right plans for their long-term care needs. All of them provide these services free of charge.
| Contact | Service | |
|---|---|---|
| Wyoming Center on Aging | (307) 766-2829 | The purpose of the Wyoming Center on Aging is to provide services that enhance older citizens' quality of life. It can supply educational materials on long-term care options, refer people to legal aid providers and help seniors access numerous local resources that can improve their physical and emotional health. |
| Medicare.gov | (800) 633-4227 | Medicare.gov is a federal government site. It's the primary source of information about Medicare and it can help seniors find suitable care providers and nursing homes. The site also makes it easier to sign up for Medicare and manage plans. |
| Wyoming Senior Citizens | (800) 856-4398 | Wyoming Senior Citizens is a nonprofit agency that manages several useful resources. These include the State Health Insurance Information Program, which offers certified counselors who provide seniors with unbiased information and advice about Medicare. They can also help with applications and advocate for seniors denied Medicare. |
Other Financial Assistance Options for Nursing Home Care in Wyoming
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
| How to Apply | How It Works | |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov. | If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy. |
Nursing Home Laws and Regulations in Wyoming
| Licensing Requirements | Wyoming nursing homes must be licensed by The Office of Healthcare Licensing and Surveys. They must prove they are financially stable, the facility complies with building regulations and the organization's policies and procedures meet fire safety guidelines and health and safety regulations. |
| Staffing Requirements | There must be enough staff 24/7 to provide at least 1.5 hours of nursing care or 2.25 hours of skilled care, depending on the individual resident's needs. They must include registered nurses, licensed practical nurses, certified nursing assistants and a full-time director of nursing. |
| Staff Training Requirements | Skilled nursing staff must have appropriate qualifications for their roles and certified nursing assistants must complete 75 hours of training before working in the facility. Nursing homes must ensure all staff receives ongoing training so they maintain competency, including housekeeping and food service workers. |
| Admission Restrictions | Nursing homes cannot accept seniors with conditions they don't have the equipment or competency to treat. They also shouldn't accept people with a history of violence or disruptive behavior. There can be exceptions due to medical needs, but residents should generally be aged 65 or older. |
| Care Planning Requirements | An assessment of each resident's physical, mental and psychosocial needs must happen within 14 days of their admission. A personal care plan must then be written from the assessment's results and implemented within 7 days. The resident's progress must be reviewed every 30 days thereafter. |
| Dietary and Nutritional Services Requirements | Residents must receive three nutritionally balanced meals daily that cater to their dietary needs, as well as adequate hydration. Menus must be written in advance and reviewed and updated annually, or as needed. A registered dietician or someone similarly qualified must oversee the food service program. |
| Specialized Rehabilitative Services | Nursing homes must provide physical, occupational and speech therapies from qualified and licensed professionals. They must provide restorative care that helps residents regain lost functionality, such as swallowing. All must keep biweekly progress reports and the resident's care plan must be reviewed every 30 days. |
| Medication and Pharmaceutical Services | Nursing homes must provide all the medications their residents require, including over-the-counter drugs. They must employ a licensed pharmacist or consultant to manage their pharmaceutical services and generate quarterly reports. |
| Activities Requirements | Nonmandatory activities that accommodate the interests and abilities of residents are required. This includes activities that address physical and emotional well-being as well as spiritual needs. |
| Infection Control Requirements | There must be a program designed to prevent the spread of infections in the facility. An appointed infection control officer must oversee it and staff must abide by rules relating to hand hygiene and PPE. Outbreaks must be reported to the Wyoming Department of Health. |
| Medicaid Coverage | Wyoming Medicaid pays all costs in licensed skilled nursing facilities. It also pays the majority of costs for in-home and community-based care, but not companionship or household chores. |
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