Wyoming Mental Health Inpatient Licensing

Author: A. Ant, CADC-II, Licensing & Accreditation Expert

Disclaimer: This content is provided for general informational purposes only and should not be construed as legal, regulatory, or licensing advice. Requirements change frequently. Consult qualified professionals for guidance specific to your situation.

Inpatient psychiatric care in Wyoming has exactly one state license behind it, the hospital license, and the rule that governs a freestanding psychiatric hospital has been on the books since June 18, 1999. Healthcare Licensing and Surveys (HLS), part of the Department of Health’s Aging Division, issues it. Two facts make that license easier to plan around. Since July 1, 2026, the bed expansion limits that used to sit in W.S. 35-2-906 are gone, repealed by 2025 HB0289 (Chapter 102). And a hospital accredited by a nationally recognized body that federal regulations approve renews without a fresh state inspection. Outside a hospital, Wyoming has no residential mental health license at all, which this guide also covers.

Inpatient Mental Health Settings and What Each One Needs

Rows restate W.S. 35-2-901 to 35-2-907 and the HLS rules. The non-hospital row is our reading of what those texts leave out.

Setting	State license	Governing rule	State fee	Term
Freestanding psychiatric hospital	HLS psychiatric hospital license	Health Quality Chapter 15, Licensure of Psychiatric Hospitals (1999)	$1,000	One year, July 1 to June 30
General hospital with an inpatient psychiatric unit	HLS hospital license, and the unit must also meet Chapter 15	HLS Chapter 12, Licensure of Hospitals (2023), Section 22	$1,000 ($500 if it is a critical access hospital)	One year, July 1 to June 30
Adult residential mental health home, private pay	No category found in W.S. 35-2-901(a)(x)	None found	None	Not applicable

A 1999 Rule Still Sets the Psychiatric Hospital Standard

Requirements here come from the Chapter 15 text HLS posts, the rule listing on rules.wyo.gov and W.S. 35-2-904.

Chapter 15 carries the title “Rules and Regulations for Licensure of Psychiatric Hospitals” and the rules.wyo.gov listing still shows its June 18, 1999 effective date as current. Its leadership requirements are specific. The Clinical Director has to be a Wyoming licensed physician who meets the training requirements of the ABPN or the AOBNP. Nursing services answer to a Director of Psychiatric Nursing Services, an RN who either has graduate preparation in psychiatric or mental health nursing (a master’s or its equivalent) or qualifies through education and experience. On medications, the rule is one sentence: “The Psychiatric Hospital shall have a pharmacy directed by a registered pharmacist.”

Two short clocks in Chapter 15 are worth putting in the policy manual on day one. Patient grievances: “Written reports of the grievances and resolutions shall be provided to the Licensing Division within ten (10) days after the grievance is filed.” Survey deficiencies: HLS sends them within 10 working days, and the correction date in the plan of correction may not be later than 60 days after the last day of survey. A general hospital that opens a psychiatric unit does not escape any of this, since Chapter 12, Section 22 says “Hospitals which provide inpatient psychiatric services shall also meet the State’s Rules and Regulations for Licensure of Psychiatric Hospitals.”

Getting the License From HLS

The psychiatric hospital page on the HLS site links the State Initial-CHOW License Application, a Word form used for new hospitals and changes of ownership, together with its instructions and a licensure checklist. If the download fails, the HLS facility types page says to “please request the application via e-mail to: wdh-ohls@wyo.gov.” The instructions are blunt about payment: “Only checks are accepted for payment.” An emailed application, sent with the subject line “License Application Submission,” still needs the original signature page and the check mailed to the Hathaway Building, Suite 510, 2300 Capitol Avenue, Cheyenne, WY 82002.

Then the building. An HLS engineer reviews it (the engineer is reached through the main line, (307) 777-7123), and W.S. 35-2-906(a) requires plans and specifications to go to HLS “for preliminary inspection and approval prior to commencing construction.” Once the paperwork and building clear, the page says “a provisional license will be issued,” the hospital starts admitting, and it then asks HLS in writing for its unannounced initial survey. Nothing about this order is optional, because the same page states “A valid state license is required prior to providing care to any clients.”

The fee is $1,000 under W.S. 35-2-904 for a psychiatric hospital, and the license year runs July 1 to June 30. A hospital licensed in May pays the full fee for those two months and again in July, by our reading of the full-fee rule. A later change of name, location or bed count is a revised license at $250. We found no statutory deadline for HLS to decide an application, so build the calendar around the engineer review and the survey request rather than a promised turnaround.

Accreditation Speeds Renewals, Not the First Survey

W.S. 35-2-907(a) reads: “A licensed health care facility which has been accredited by a nationally recognized accrediting body approved by federal regulations shall be granted a license renewal without further inspection.” Note the word renewal. As we read it, a new psychiatric hospital still gets HLS’s own initial survey, and accreditation pays off from the second license year forward. The statute also keeps a door open: “the division may inspect the licensed facility with regard to those matters which did not meet state standards.” Keep a crosswalk between Chapter 15 and the accreditor’s standards so the gaps, if any, are known before HLS asks.

This is a different accreditation question from the one addiction programs face. The Behavioral Health Division’s short list of The Joint Commission, CARF or NIAHO governs BHD certification, while the hospital statute speaks of a body “approved by federal regulations.” Which bodies HLS treats as qualifying is worth confirming at wdh-ohls@wyo.gov before you sign an accreditation contract.

Residential Mental Health Outside a Hospital

Here Wyoming is close to silent. The statutory facility list in W.S. 35-2-901(a)(x) has no residential mental health category, and the Behavioral Health Division’s March 2026 handbook says “Certification is not required for mental health programs unless the provider is contracted with the Division and receives State of Wyoming funding as a Behavioral Health Center.” Those contracts are a state purchasing relationship rather than a license, and they are not work we take on. Our reading is that a private-pay adult residence for people with mental illness has no state license to apply for.

That does not mean anything goes. The statute folds psychiatric care into its definition of a hospital and describes it as “the in-patient care and treatment of persons with a mental diagnosis,” and operating an unlicensed health care facility is a misdemeanor under W.S. 35-2-909. A residence that starts to look like inpatient psychiatric treatment, with on-site prescribers, locked units or acute admissions, is the kind of program we would describe to HLS in writing before opening. A co-occurring residence that takes court-ordered substance use clients is a separate matter, with BHD certification and mandatory accreditation, covered in Wyoming Drug and Alcohol Inpatient Treatment Licensing.

Ketamine in a Wyoming Psychiatric Hospital and Beyond Discharge

We found no Wyoming statute, HLS rule or Board of Nursing opinion that mentions ketamine. Fitting the hospital pharmacy rules, the controlled substance statutes and the federal REMS terms to these settings is our interpretation.

A licensed psychiatric hospital is the one Wyoming inpatient setting built to start ketamine on site, and the decisions sit with the medical staff and the pharmacist. For a hospital in the Medicare program, the federal pharmacy condition at 42 CFR 482.25 puts it this way: “A formulary system must be established by the medical staff to assure quality pharmaceuticals at reasonable costs.” The same section adds “Current and accurate records must be kept of the receipt and disposition of all scheduled drugs.” Chapter 15 puts a registered pharmacist in charge of the pharmacy. Ketamine has been a federal Schedule III drug since DEA’s final rule took effect August 12, 1999, so the formulary vote comes first. Who may order it, and how nurses watch a patient through and after a dose, get written once that vote is in. Esketamine, sold as Spravato, adds federal conditions of its own: “Healthcare Settings must be certified in the SPRAVATO™ REMS in order to treat patients with SPRAVATO™,” and patients “are required to be monitored by a healthcare provider for at least 2 hours.”

Registrations and the Monitoring Program

On the state side, W.S. 35-7-1024 requires a Board of Pharmacy controlled substance registration renewed every two years on or before July 1, with a separate registration for each location, and the DEA registration sits alongside it. Wyoming’s prescription tracking statute, W.S. 35-7-1060(b), tells a prescriber to “search the prescription tracking program for prior prescriptions issued to the patient before first issuing the prescription” for a Schedule II to V drug, and lets the Board exempt certain inpatient settings. The statute says nothing about doses given on the unit rather than prescribed, so ask the Board of Pharmacy how it treats them.

Nurses and Nurse Practitioners

The Wyoming State Board of Nursing’s advisory opinion list has no ketamine opinion. It does list “Moderate Sedation & Pain Management” and an infusion therapy statement, which we have not reviewed, so send the hospital’s RN monitoring protocol to the Board’s practice address, wsbn.practice@wyo.gov, before the first dose. For prescribers, W.S. 33-21-120 says an advanced practice registered nurse “May prescribe, administer, dispense or provide nonprescriptive and prescriptive medications including prepackaged medications, except schedule I drugs,” with no collaboration requirement in that definition. We read that as leaving the question to the hospital’s own privileging process, which can grant a psychiatric APRN ketamine orders.

Committed Patients and Residences

Involuntary hospitalization law in Wyoming is outside what we researched here. Our practical advice is to start any off-label protocol with adults who came in voluntarily and can consent for themselves, and to let hospital counsel rule on patients held under an order. A non-hospital residence is a different case. It has no license that contemplates medical services, so in our view the residence should neither stock nor give ketamine. If a resident is a good candidate, the treatment happens in a prescriber’s own office, and the house mainly keeps track of treatment days so staff can watch for after-effects that evening.

Handing the Series to an Outpatient Office

In our experience a short psychiatric admission usually ends before an induction course is finished. Pick the continuing office during the stay, not at discharge, and with the patient’s written release send it the dose log and the nursing observations alongside the discharge summary. Wyoming’s professional corporation statute requires that “All shareholders of the corporation are, and will continually be, licensed in the profession for which the corporation is formed.” The Medical Practice Act, as we searched it, contains no ban on lay ownership of a practice. Court decisions were outside our search, so lay employment of physicians in Wyoming remains an open question. For the ownership choices a stand-alone clinic faces, see the ketamine section of Wyoming Drug and Alcohol Outpatient Treatment Licensing.

Staffing a Wyoming Inpatient Mental Health Program

Chapter 15 fixes the top of the chart: a physician clinical director, a master’s-prepared psychiatric nursing director and a pharmacist. The therapists below them are where payroll grows. BLS’s May 2025 OEWS figures put Wyoming’s substance abuse, behavioral disorder and mental health counselors at a $62,980 median, $46,300 at the 25th percentile and $80,310 at the 75th, against $59,350 nationally. Six therapy lines at the state median would run $377,880 a year in base wages on our arithmetic, leaving out benefits and the nursing and psychiatric staff entirely. Wyoming law gives a hospital room to hire therapists before their supervised hours are finished. An LPC, LMFT or LCSW needs 3,000 hours of supervised clinical experience, including 100 hours of face to face individual supervision, under W.S. 33-38-106, and a provisional license can carry a clinician for up to 36 months while those hours accrue, so a hospital that puts provisional clinicians under a fully licensed supervisor, paying them at the provisional rate while their hours build, usually cuts its therapy salary line by 40 to 60 percent compared with putting a fully licensed clinician in every slot. Below the nursing director, our reading is that each shift can run with one RN supervising LPNs and psychiatric technicians. The unit’s census and how sick its patients are will drive the final staffing plan.

Where Wyoming Inpatient Openings Stall

Expecting accreditation to replace the first HLS survey is the common one. The statute grants renewal without inspection, not an initial license. Projects also lose weeks when an emailed packet goes in without the mailed check and original signature page the instructions call for, since HLS takes payment only by check. Residential mental health operators lose time in the other direction, searching for a state license Wyoming never created and then drifting toward hospital-level services without asking HLS where the line sits.

Frequently Asked Questions

Planning psychiatric beds or a residence in Wyoming and unsure which side of the hospital line it falls on? Send us the plan.

Sources

• Wyoming Statutes, Title 35, W.S. 35-2-901, 35-2-904 to 35-2-907, 35-2-909, 35-7-1024 and 35-7-1060: Title 35 (PDF) (checked October 20, 2026)
• WDH Health Quality Rules, Chapter 15, Licensure of Psychiatric Hospitals: Chapter 15 (PDF) (checked October 20, 2026)
• HLS Rules, Chapter 12, Licensure of Hospitals (eff. March 1, 2023): Chapter 12 (PDF) (checked October 20, 2026)
• Wyoming Secretary of State, administrative rules listing: rules.wyo.gov (checked October 20, 2026)
• WDH Aging Division, Healthcare Licensing and Surveys: HLS home and Facility types (checked October 20, 2026)
• HLS, psychiatric hospital licensure information, checklist and application: Psychiatric hospital licensure and Checklist (PDF) and Initial and CHOW instructions (PDF) (checked October 20, 2026)
• Wyoming Legislature, 2025 HB0289, Certificate of need repeal-3 (Chapter 102): Summary (PDF) and Digest (PDF) (checked October 20, 2026)
• BHD, MHSA Certification Program Handbook (March 2026): Handbook (PDF) (checked October 20, 2026)
• Wyoming Statutes, Title 33, W.S. 33-21-120 (APRN prescribing) and W.S. 33-38-102 and 33-38-106 (counselor credentials): Title 33 (PDF) (checked October 20, 2026)
• Wyoming Statutes, Title 17, W.S. 17-3-101 to 17-3-104 (professional corporations): Title 17 (PDF) (checked October 20, 2026)
• Wyoming State Board of Nursing, practice and advisory opinions: Practice (checked October 20, 2026)
• 42 CFR 482.25, via Cornell LII: Hospital pharmaceutical services (checked October 20, 2026)
• DEA final rule placing ketamine in Schedule III, 64 FR (July 13, 1999): Federal Register (checked October 20, 2026)
• Spravato REMS: Certified healthcare settings and two-hour monitoring (checked October 20, 2026)
• U.S. Bureau of Labor Statistics, OEWS May 2025, SOC 21-1018: Wyoming and National (checked October 20, 2026)