The short answer Wyoming licenses skilled home health agencies through the Department of Health; non-medical home care is not state-licensed.
What Wyoming requires
Wyoming
Licensing agency. The Wyoming Department of Health, Healthcare Licensing and Surveys unit, licenses home health agencies under the health facility statutes (Wyo. Stat. § 35-2-901 et seq.) — a valid state license is required before serving any home health client.
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No non-medical license. Wyoming does not require a state license for non-medical home care agencies offering personal care, companionship, or homemaker services.
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Surveys. Healthcare Licensing and Surveys performs initial licensure and renewal surveys, complaint investigations, and Medicare certification surveys as the CMS state agency, with plan-of-correction follow-up.
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Medicaid segment. Providers in Wyoming Medicaid HCBS (Community Choices) waivers must meet Department of Health provider certification standards, which supplies oversight for Medicaid personal care despite the absence of private-pay licensure.
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The federal baseline (applies in every state)
Federal
No federal home care license. There is no federal license for home care or home health agencies. Licensure is a state function: each state (and DC) decides whether and how to license home health agencies and non-medical personal care/companion agencies, so requirements vary dramatically by jurisdiction.
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Medicare certification (42 CFR Part 484). Agencies that bill Medicare for skilled home health must be certified as meeting the Medicare Conditions of Participation at 42 CFR Part 484 (patient rights, comprehensive assessment, QAPI, skilled professional services, home health aide standards, and more), on top of any state license.
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Accreditation with deemed status. Most new Medicare home health agencies obtain certification through a CMS-approved accrediting organization with deeming authority — ACHC, CHAP, or The Joint Commission — whose surveys substitute for the state agency's Medicare certification survey.
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State survey agencies enforce both. State survey agencies (usually the state health department) operate under agreements with CMS to survey Medicare-certified agencies, and most also run the state licensure survey program — initial surveys, renewal/recertification surveys, complaint investigations, and plan-of-correction enforcement per the CMS State Operations Manual.
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