Skip Navigation Links Wyoming Department of Health

Intermediate Care Facility for the Mentally Retarded (ICF/MR) - Wyoming Licensure Information


The definition of an Intermediate Care Facility for the Mentally Retarded is a facility which provides on a regular basis health-related care and training to mentally retarded individuals or persons with related conditions, who do not require the degree of care and treatment of a hospital or nursing facility and services above the need of a boarding home.

A valid state license is required prior to providing care to any client/patient/resident.

Following are the requirements and procedures through which your agency may be approved to be licensed as a provider of Intermediate Care Facility for the Mentally Retarded services.
 
Click below for a license application for State licensure.  Please fill out the application in its entirety and submit to our office, along with the required fee.  After reviewing the regulations, please contact one of our engineers at (307) 777-7123 to discuss the building requirements and any construction review approval process.  Once we have approved these items, a provisional license will be issued, and you will be able to start providing services to clients/patients/residents.
 
When you have clients/patients/residents for which you are providing services, your agency must request, in writing, that a health survey be conducted.  An unannounced survey will be provided by state surveyors as soon as scheduling permits.  When the initial survey has been completed and the facility is found to be in compliance with the regulations, a permanent license will be issued.
 
A license permits an applicant to operate a healthcare facility in Wyoming.  It does not enroll or certify a provider or supplier of healthcare services to participate in federal certification programs (Medicare/Medicaid).

ICF/MR: New Facility or Change of Ownership Application

Please note: This license application is provided in MS Word format. If you experience problems opening the license application or want to request that the application be e-mailed to you in PDF format, please contact us by e-mail or by telephone: (307) 777-7123


ICF/MR Licensure Checklist
     
 Word Format    PDF Format

ICF/MR Rules and Regulations
      Chapter 13 (Licensure) - 06-08-2001

Healthcare Facility Construction Rules and Regulations
      Chapter 3 - 04-03-2008
      Chapter 3 Guidelines:  Word Format    PDF Format