Kindred Hospital Seattle - First Hill is a 23 bed nursing care facility. It is situated in the First Hill neighborhood of Seattle, Washington. With an average per-household income of $37,606, the facility is in a primarily middle ...
Nursing Homes in Washington
- SeniorAdvice's Guide to Nursing Homes in Washington
- Nursing Care Directory for Washington
- Nursing Care Costs in Washington
- Financial Assistance for Nursing Homes in Washington
- Washington Nursing Care Rules and Regulations
- Free Nursing Care Resources in Washington
Washington ranks second in AARP’s Long-Term Services and Supports State Scorecard, making the state among the best choices for nursing home care. It’s also awarded by U.S. News & World Report as the country’s top state, where it excels especially in infrastructure, economic performance, education and health care. In addition, the Evergreen State’s natural beauty presents seniors with breathtaking views of The Cascades or Puget Sound. Over 1.2 million Washingtonians, or about 16% of the state’s residents, are aged 65 and older, and they have a choice when it comes to long-term care.
Seniors needing 24-hour skilled nursing can choose from at least 203 licensed nursing homes in Washington. Nursing home stays are ideally temporary for those who need post-hospital, transitional or short-term respite care. Longer stays are not unusual for those who require specialized medical care without the need for hospital admission. This guide presents information on nursing home care in Washington, particularly its estimated costs, financial aid programs, regulatory requirements and free resources.
SeniorAdvice's Guide to Nursing Home Care in Washington
The overall SeniorScore of Washington is 70, only slightly below the national average of 72. This rating is calculated using over 100 data points that are relevant to seniors, and these measures make up four general categories with individual SeniorScores.
Washington’s General Quality of Life scores 66 for its four mild seasons. Western Washington receives greater rainfall due to its location on the Pacific Coast, while Eastern Washington has a generally dry climate. Snowfall throughout the state is also significantly lower than the national average. Health & Safety gets a SeniorScore of 65 for the state’s high number of Medicare-accredited physicians and many senior care options available. Washington is among the country’s top-ranking states when it comes to health care, and its life expectancy of approximately 80 years is above the national average.
The Evergreen State scores 63 in the Recreation & Leisure category. Many of Washington’s national, state and municipal parks are ADA-accessible, and there are nearly 2,000 churches throughout the state. The Finances SeniorScore of 56 may be due to an above-average cost of living and high senior care costs, but this is compensated by the state’s higher median income and senior-friendly tax rates. With a 0% income tax rate, Washington exempts retirees from Social Security, pension and retirement withdrawal taxes.
Top Nursing Care in Washington
Avamere Olympic Rehabilitation of Sequim is a 125 room nursing home facility situated in Sequim, Washington. The surrounding area has a dense population, with roughly 28,000 poeple living in the 98382 zip code. It is a primarily middle ...
Judson Park is located at 23620 Marine View Drive South in Des Moines, Washington. It is a 96 bed senior housing community. With a median family income of $59,070, the community is in a primarily middle class ...
Issaquah Nursing and Rehabilitation Center is a 140 bed nursing care facility located in Issaquah, Washington. With a median per-household income of $94,297, the community is in a largely well-to-do area. It is densely populated, with around 27,000 ...
Aldercrest Health and Rehabilitation Center is a 128 unit nursing facility situated in Edmonds, Washington. With a median family income of $75,933, the facility is in a mostly well-to-do area. It has a dense population, with about 37,000 ...
Situated within the Bitter Lake neighborhood of Seattle, Washington, Ida Culver House Broadview Ncc is a 74 bed senior housing community. The facility is in a predominantly middle income area, with an average per-family income of $57,182. It ...
Manorcare Health Services - Salmon Creek is a 120 room nursing home facility situated in Vancouver, Washington. The facility is in a generally middle income area, with an average family income of $70,201. With roughly 18,000 people residing ...
Snohomish Health and Rehabilitation is a 91 bed nursing care facility located within the Northwest Snohomish area of Snohomish, Washington. The community is in a mostly middle income area, with a median per-family income of $74,068. It is ...
Redmond Care and Rehabilitation Center is located within the Grass Lawn neighborhood of Redmond, Washington. It is a 139 unit nursing facility. The facility is in a mostly upper class area, with an average per-family income of $93,173. ...
Canterbury House is located at 502 29th Street SE in Auburn, Washington. It is a 100 room senior care community. The community is in a mostly middle class area, with a median per-family income of $40,586. With ...
Located within the Springfield neighborhood of Olympia, Washington, Providence Mother Joseph Care Center is a 152 bed senior care community. With an average household income of $58,257, the facility is in a predominantly middle income area. It has ...
Located in the Interlake neighborhood, Overlake Terrace is a senior housing community serving Redmond, Washington. The community is in a mostly affluent area, with a median per-household income of $93,173. It is densely populated, with approximately 59,000 residents ...
Bothell Health Care is a 99 room skilled nursing facility. It is located in the Alderwood Manor neighborhood of Bothell, Washington. With a median per-family income of $85,127, the facility is in a generally upper class area. ...
Park West Skilled Nursing Center is a 139 bed nursing facility. It is located in the Admiral neighborhood of Seattle, Washington. With a median per-household income of $75,728, the facility is in a primarily upper class area. ...
Located within the Brighton neighborhood of Seattle, Washington, Kline Galland Home is a 205 unit senior housing facility. With a median family income of $51,093, the community is in a mostly middle income area. It is heavily populated, ...
Manorcare Health Services - Lacey is a 120 room nursing care facility situated close to the The Birches neighborhood of Lacey, Washington. The community is in a generally middle income area, with an average household income of $58,777. ...
Burien Nursing and Rehabilitation Center is situated nearby the Arbor Heights neighborhood of Burien, Washington. It is a 140 bed nursing home facility. The encompassing area is heavily populated, with about 27,000 poeple living in the 98146 zip ...
Located within the Cascade neighborhood of Seattle, Washington, Mirabella Seattle is a 42 room senior care community. With roughly 22,000 poeple living in the zip code of 98109, the neighboring area has a dense population. It is a ...
Regency Auburn Rehabilitation Center is located at 414 17th SE in Auburn, Washington. It is a 96 bed nursing facility. With an average per-family income of $40,586, the facility is in a mostly middle income area. ...
Park Ridge Care Center is situated within the Olympic Hills area of Seattle, Washington. It is a 115 unit senior community. With roughly 34,000 poeple living in the 98155 zip code, the surrounding area has a dense population. ...
The Cost of Nursing Home Care in Washington
Washington is the Pacific Northwest’s second most expensive state for nursing home care. Based on Genworth Financial’s Cost of Care Survey 2020, its average cost of $9,581 per month is over $1,800 more expensive than the national average of $7,756. The region’s most expensive state is Oregon at $10,114, costing over $500 more. Seniors save the most in Montana by nearly $2,000 with its average of $7,665. Idaho, at $8,669, is also relatively affordable, with a savings of approximately $900. Seniors can spend about $300 less when opting for California at $9,247.
- Washington: $9,581
- United States: $7,756
- Idaho: $8,669
- Montana: $7,665
- Oregon: $10,114
- California: $9,247
The Cost of Nursing Home Care in Washington’s Top Cities
Seattle, Bremerton and Spokane are the state’s most expensive areas for nursing home care with comparable costs of over $10,600. State capital Olympia, at $9,520, is a more affordable option in the Puget Sound region, while Yakima is the state’s cheapest area for nursing home care at $7,908 per month. Bellingham is also more affordable at $8,517. Seniors opting for the Tri-Cities metro area can expect to pay close to Kennewick’s average of $9,642.
- Seattle: $10,624
- Bremerton: $10,646
- Olympia: $9,520
- Spokane: $10,615
- Yakima: $7,908
- Bellingham: $8,517
- Kennewick: $9,642
Senior Care Cost Comparison in Washington
For older Washingtonians who may not require 24-hour skilled nursing care, community-based care options are significantly more affordable than nursing home care. Adult day care is the cheapest option at $2,167. In-home and home health care have comparable costs close to $6,000, while assisted living may be a cost-effective choice at $5,750. Memory care is similar to assisted living but provides specialized support, which contributes to its more expensive cost of $7,188.
- Memory Care: $7,188
- Assisted Living: $5,750
- In-Home Care: $5,941
- Home Health Care: $6,031
- Adult Day Care: $2,167
- Nursing Home Care: $9,581
Financial Assistance for Nursing Home Care in Washington
As you can see above, nursing home care is often the most expensive senior care option – sometimes even 2-3 times the cost of other types of senior living. The primary reason for this is the 24/7 skilled nursing and other medical services that are provided. Thankfully, most people aren't forced to pay for skilled nursing care entirely out-of-pocket. Rather, many qualify for financial assistance programs to help cover the cost of nursing care.
Medicaid is the most comprehensive financial assistance program – but, not all seniors are eligible for Medicaid. And because each state operates its own Medicaid program within federal guidelines, eligibility and benefits vary from state to state. Below, we provide more information on Medicaid in Washington.
Medicaid in Washington
Apple Health (Washington Medicaid) LTSS provides coverage on long-term services and supports for qualified recipients in nursing homes, community-based facilities and private residences. Participating nursing facilities each have a different Medicaid payment rate based on their specific costs. As of November 2020, enrollments in Medicaid and CHIP in Washington increased by over 68% since its coverage expansion in 2013. As for long-term care, about 95% of the Evergreen State’s 203 nursing homes accept Medicaid, and approximately 60% of the 15,000 residents are Apple Health LTSS recipients.
Medicaid Eligibility in Washington
Nursing facility services are available to individuals who are eligible for Apple Health’s four scope of care categories: Categorically Needy (CN), Medically Needy (MN), Alternative Benefit Plan (ABP) and Medical Care Services (MCS). The different financial criteria for each scope of care, as well as other eligibility requirements, are listed below:
- The CN and MN scope of care categories are related to SSI eligibility. As of January 1, 2021, the income limit for CN individuals is $794 per month and $1,191 for couples. Applicants earning above SSI income limits are eligible for MN coverage if their incomes are equal to or less than $794 after incurring allowable medical expenses.
- ABP-eligible applicants are those who do not qualify for Medicare, are aged 18-64 and have incomes at or below 133% of the federal poverty level.
- MCS recipients are ineligible for CN, MN and ABP but are eligible for ABD (Aged, Blind and Disabled) cash assistance or the HEN (Housing and Essential Needs) referral program.
- The countable resource limits for CN and MN applicants are $2,000 for individuals and $3,000 for couples.
- As of March 2021, Medicaid-funded nursing home residents receive a monthly personal needs allowance of $71.12, while Veterans Homes residents have a PNA of $160.
- Nonapplicant spouses are allowed to retain their own incomes, a variable portion of their institutionalized spouses’ incomes and a maximum amount of nonexempt resources (Community Spouse Resource Allowance).
- Functional eligibility is determined through a CARE assessment, which is based on criteria for nursing facility level of care.
- Those who are determined by doctors to likely return home within six months of nursing home care may receive Housing Maintenance Allowances.
- Applicants must be U.S. citizens or permanent residents.
Apple Health LTSS applications may be done online through Washington Connection, which also has a prescreening tool for determining eligibility for other available social services. In-person and mail applications using the Aged, Blind, Disabled/Long-Term Care Coverage form may also be completed through these local HCS offices.
Additional Financial Assistance Options
- Medicare: For the first 20 days in a skilled nursing facility, Medicare will cover the entire cost of care, and a portion of the costs up until day 100. After 100 days, Medicare won't cover any of the costs. Importantly, seniors must also have a "qualifying hospital stay" that lasts 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
- Aid and Attendance: Aid and Attendance may be available to veterans who receive a VA pension. This benefit is a monthly cash allowance that veterans receive in addition to their standard pension amount. It is intended for veterans in need of long-term care services and may be used to pay for skilled nursing care.
- Reverse Mortgages: For those who own a home, 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. It's often a good fit for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Keep in mind that reverse mortgage loans do need to be repaid (with interest), typically within 12 months of receiving the loan.
- Long-Term Care Insurance: For seniors who already have long-term care insurance, the cost of skilled nursing care may be covered. Most policies cover at least a portion of the costs, but it depends on the specific policy terms. It's important to note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a long-term care insurance policy.
Washington Nursing Home Care Rules and Regulations
Nursing homes in Washington are licensed by the Department of Social and Health Services, Aging and Long-Term Support Administration, Residential Care Services Division. The DSHS performs unannounced full health inspections on these facilities at least every 15 months as required by federal law. The Washington Administrative Code has dedicated nursing home regulations as outlined below.
Scope of Care | A nursing home shall provide nursing, dietary, physician, social and other related services that are determined in each resident’s assessment and care plan to support the resident’s physical, mental and psychosocial well-being. There must be a full-time nursing director who is a registered nurse, and a designated charge nurse who must be an RN or licensed practical nurse. Specialized habilitative and rehabilitative services may be provided in-house or through contracted agencies. A nursing home may also offer short-term, respite and adult day health care services. |
Care Planning | A comprehensive plan of care must be developed based on the resident’s medical, nursing and mental and psychosocial needs. This plan shall be prepared by an interdisciplinary team within seven days after completion of a comprehensive assessment and reviewed at least quarterly. Comprehensive assessments must be conducted at least every 12 months, and there are periodic assessment reviews no less than every 3 months using the state-approved resident assessment instrument (RAI) to ensure continued accuracy. |
Pharmacy Services | Nursing homes are required to obtain routine and emergency drugs and biologicals for their residents through agreements with licensed pharmacies. A licensed pharmacist may be hired or contracted for consultations on the provision of pharmaceutical services, evaluation of drug records and regular (at least monthly) drug therapy reviews for each resident. Only individuals authorized by state can receive medication orders and perform medication administration, and self-administration may be done by a resident if determined safe by an interdisciplinary team. |
Staff Screening | Valid criminal history background checks must be performed every two years on all nursing home employees, contracted partners, volunteers and students who may have unsupervised contact with residents. A nursing home must not employ or accept any individual with a criminal conviction or pending criminal charges, sex offender registry record, registry-based final findings of abuse of children or vulnerable adults, court-issued restraining orders and terminated licenses due to child or adult abuse. |
Staff Training | All nonlicensed staff members providing direct care must be enrolled or have successfully completed a DSHS-approved nursing assistant training program. Those currently enrolled must complete at least 16 hours of training within four months from commencing work as nursing assistants. A nursing home must also have a staff development program facilitated by a designated RN or LPN. |
Medicaid Coverage | Apple Health LTSS covers the costs of nursing home care for individuals who meet the program’s financial and functional eligibility requirements. Medicaid recipients in nursing homes also receive personal needs allowances monthly. |
Reporting Abuse | Any mandated reporter with a reasonable cause to believe that there was an incident of abuse, neglect, abandonment, financial exploitation or misappropriation of a resident’s property must immediately report the incident to ALTSA. Reporting may be done online or by phone through the DSHS Complaint Resolution Unit hotline at (800) 562-6078. |
Free Nursing Home Resources in Washington
Washington Health Care Association
A membership organization of skilled nursing and assisted living facilities, WHCA promotes the consistent and enhanced quality of long-term care services provided by its member facilities through advocacy and regulatory functions. Its consumer pages include a directory of member nursing homes and ALFs, as well as long-term care guides and resource links.
Washington LawHelp for Seniors
WashingtonLawHelp.org is created and maintained by Northwest Justice Project, a publicly funded legal aid program for low-income Washingtonians. This website is an extensive library of free legal information, materials and resources on various subjects, including elder law topics. It also connects eligible individuals to NJP’s attorneys who may provide free legal assistance. Washington LawHelp’s nursing home Medicaid pamphlet is kept up-to-date and provides comprehensive information on financial eligibility requirements.
Washington Agencies
Aging and Long-Term Support Administration
Address: 4450 10th Avenue SE, Blake West, Lacey, WA 98503
Phone Number: (360) 725-2300
Website: https://www.dshs.wa.gov/altsa
DSHS-ALTSA partners with Area Agencies on Aging, long-term care providers and a network of government and nonprofit agencies to provide a range of services that promote choice, independence and safety of older Washingtonians. This agency’s service divisions include Residential Care Services, Home and Community Services, Adult Protective Services and Tribal Affairs. ALTSA maintains nursing home, adult family home and assisted living facility locators which indicate whether a facility accepts Medicaid. It also has a handy fact sheets page for up-to-date information on available long-term care programs.
Community Living Connections
Address: Multiple locations per county
Phone Number: (855) 567-0252
Website: https://www.dshs.wa.gov/altsahttps://washingtoncommunitylivingconnections.org
Washington State’s CLC Network connects seniors, disabled adults, caregivers and families to Aging and Disability Resource Centers that provide information and referrals to appropriate agencies for long-term services and supports. The CLC Options Counseling and Assistance provides one-on-one support in navigating local private and public services, while the Streamlined Eligibility Assistance for Public Programs guides Washingtonians in determining their eligibility for Medicaid and other state and federal programs. CLC’s Person-Centered Care Transitions Supports provides care coordination assistance to individuals who are transitioning between different care settings.
Statewide Health Insurance Benefits Advisors
Address: 302 Sid Snyder Avenue SW, Suite 200, Olympia, WA 98504
Phone Number: (360) 586-0241
Website: https://www.insurance.wa.gov/statewide-health-insurance-benefits-advisors-shiba
SHIBA is the state health insurance program (SHIP) of Washington. Its volunteer advisors provide free, unbiased, confidential counseling on Medicare and other health insurance benefits. SHIBA counselors are trained to assist clients in assessing their health care needs, determining their general eligibility, enrolling in Medicare and reporting complaints on possible Medicare fraud. Washingtonians may contact their nearest local SHIBA offices for assistance.
Washington State Long-Term Care Ombudsman Program
Address: PO Box 23699, Federal Way, WA 98093-0699
Phone Number: (800) 562-6028
Website: https://www.waombudsman.org/
The Washington State LTCOP advocates the dignity and rights of long-term care residents, particularly in nursing homes, veterans’ homes, assisted living facilities and adult family homes. Seniors, families and other concerned individuals may contact their local LTC Ombudsman offices to file complaints related to a facility’s quality of care, incidents of abuse and other related issues that threaten a resident’s well-being.
Area Agencies on Aging in Washington
The Evergreen State’s 13 AAAs administer local programs and services that support the needs of seniors aged 60 and older. The comprehensive home and community-based services they offer vary per location and are aimed toward improved quality of life and delayed institutionalization. These services may include case management, adult day care and various in-home supports. Washington’s AAA offices also have trained SHIBA counselors who can provide free Medicare counseling services to elderly beneficiaries.
Veteran Affairs Office in Washington
Each county in Washington has dedicated DVA offices, in addition to the VA Seattle Regional Office. These offices are staffed by Service Officers that take a case management approach in providing claims assistance on VA benefits such as disability compensation, pensions, Aid & Attendance and health care. Service Officers may represent eligible vets in cases under VA Seattle’s jurisdiction. The Washington State Department of Veterans Affairs also operates four Medicare and Medicaid-certified Veterans Homes that provide 24-hour skilled nursing care to qualified vets, their spouses and Gold Star parents.
Social Security Offices in Washington
DSHS issues monthly State Supplemental Payments to Washingtonian SSI recipients 65 and older and those residing in Medicaid facilities including nursing homes. These payments may be used to pay for expenses that are partially or not covered by Medicaid and Medicare. Seniors may apply for SSI benefits through local field offices under Social Security Seattle Region. Eligibility for Social Security benefits may also be determined online through SSA’s Benefit Eligibility Screening Tool (SSA BEST).
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