Washington state will appeal to many seniors as a retirement destination for a number of reasons. With 12.3% of the state aged 65 or older, it’s quite tax-friendly to retirees, as there are no taxes on retirement and pension funds, or social security benefits. Additionally, the state ranks 2nd in the nation in the quality of its long-term care, and is home to world-class health services and award-winning medical facilities.
Paying For Assisted Living in Washington State
The Cost of Assisted Living in Washington State
The monthly median cost of assisted living in the state of Washington is $5,135, much higher than the national average of $4,000. The state shares borders with Canada and the Pacific but only two other US states, Idaho and Oregon. The median monthly cost of assisted living in Washington is significantly higher than other states in the Northwest.
The cost of the assisted living facility can vary greatly depending on the region – Seattle is by far the most expensive with a monthly median of $5,750. A cheaper alternative, Spokane, has the lowest median of $4,000. The median for other areas of the state varies, with some being closer to that of the overall state median.
Median costs for assisted living in Washington are lower than those associated with other types of care with the exception of independent living, and it is considerably less expensive than that of a semi-private room in a nursing care facility.
Financial Assistance for Assisted Living in Washington
Washington State Long-Term Care Services
Unlike many other states, Washington’s Medicaid program (Apple Health) directly pays for Assisted Living for eligible individuals. Certain facilities are contracted by Apple Health to provide three different service packages:
- Adult Residential Care (ARC): This package provides moderate help with everyday activities and reminders to take medications, but is not for individuals who are unable to take those medications on their own.
- Enhanced Adult Residential Care (EARC): This package provides all the same services that the ARC package does, but has provisions for a person that can’t or won’t take their own medications, and often some form of nursing care.
- EARC Specialised Dementia Care: This level of service is for those with dementia. All of the care options provided in the EARC level of care are also included in this package, along with intermittent nursing, specialized dementia training for staff, awake 24-hour staff, supervision, and tailored activities.
Who Is Eligible?
Anyone over the age of 18 is eligible to apply for Apple Health. In the case of elderly applicants who need assisted living, once applications have been submitted the HHS will then conduct a financial review assessment to determine eligibility. There is a $2,000 resource cap for individuals and a $3,000 cap for couples. A personal functionality assessment will also need to be completed to further determine eligibility.
How to Apply
Applications for Washington Apple Health, along with various other resources can be found on their website. Alternately, those interested in applying for Medicaid may do so by visiting their local HHS office or by calling (800) 562-3022.
More Ways to Finance Assisted Living
Some additional ways to finance assisted living costs include:
- Veterans Benefits: Veterans can take advantage of several different pension programs to help cover the cost of assisted living. For more information, see the article on benefits.va.gov.
- Life Insurance Policies: Even if a spouse or loved one hasn’t died, certain types of life insurance policies can be used to pay for assisted living. More information is available at longtermcare.acl.gov
- Long-Term Care Insurance: Long-term care insurance is a type of insurance policy that pays for long-term care when it becomes necessary, including the cost of assisted living. For more information on the benefits and drawbacks of this financing method, visit longtermcare.acl.gov.
- Reverse Mortgages: Reverse mortgages allow seniors to access the equity from a home that they own, and these funds can be used to pay for assisted living. The U.S. Department of Housing and Urban Development offers a federally insured reverse mortgage program.
Free Assisted Living Resources in Washington State
Long-Term Care Ombudsman Program
Like most other states, Washington has a Long-Term Care Ombudsman which is an elder care advocacy program. Washington’s Long-Term Care Ombudsman’s stated purpose is to:
- Promote the education of residents rights in long-term care facilities such as assisted living communities and nursing homes
- Protect residents by investigating and resolving claims of abuse, use of restraints, transfer and discharge practices, and other aspects of care relating to a resident’s dignity
- Teach residents, their relatives, friends, and communities how to advocate for themselves
For more detailed information, and to find a local office, visit the website or call (800) 562-6028 or (800) 737-7931 for those that are hard of hearing.
Area Agencies on Aging
The Area Agencies on Aging (AAA) is a network of hundreds of nonprofit organizations across America that provide federally funded services to adults over 60 in their local areas.
Washington state, like most other states, has Area Agencies on Aging that offer information on services and programs that are available locally to seniors. As Washington State is home to 29 Native American tribes, some of the agencies specifically address the needs of Native seniors.
|Area Agency on Aging||Address||Phone Number|
11700 Rhody Drive Port Hadlock, WA 98339
600 Lakeway Drive, Suite 100 Bellingham WA 98225
3000 Rockefeller Avenue, M/S 305 Everett, WA 98201
700 5th Avenue, 51st Floor Seattle, WA 98104
Mailing Address: PO Box 34215 Seattle, WA 98124-4215
1305 Tacoma Avenue, Suite 104 Tacoma, WA 98402
2404 Heritage Court SW, Suite A Olympia, WA 98502
201 NE 73rd Street, Suite 201 Vancouver, WA 9866
50 Simon Street SE East Wenatchee, WA 98802
MAIL – PO Box 8349
OFFICE – Meadowbrook Mall 7200 W Nob Hill Blvd Yakima, WA 98908-0349
MAIL – PO Box 151. OFFICE – 91 Wishpoosh
Toppenish, WA 98948
1222 North Post Spokane, WA 99201
PO Box 150 Nespelem, WA 99155
MAIL – 614 Division, MS-5. OFFICE – 1026 Sidney Avenue
Port Orchard, WA 98366
U.S. Armed Services Veterans receive an array of benefits through the various Veterans Affairs locations in their state. There are two types of benefits that veterans over the age of 65 can receive in relation to living arrangements, and both are dependent on the level of care that is needed.
- Aid & Attendance is an increased monthly pension that is specific to those that need more help with daily tasks such as bathing, dressing, and eating. This benefit also applies to residents that are bedridden or reside in nursing homes
- Housebound is a benefit that also pays an increased monthly pension if the veteran is confined to the home due to a permanent disability.
Both of these programs do not classify assisted living facilities as nursing homes, so although benefits may be used for assisted living, veterans must qualify or be rated to qualify to use pension fund benefits in this way. More information may be found by contacting one of the facilities on the list below.
|VA Center||Address||Phone Number|
Jackson Federal Building, 915 2nd Ave. Seattle, WA 98174
3800 Byron Ave Suite 124 Bellingham, WA 98229
(360) 733-9226 Or (877) 927-8387
1010 SE Everett Mall Way Suite 101 Everett, WA 98208
32020 32nd Ave South Suite 110 Federal Way, WA 98001
(253) 838-3090 Or (253) 838-3090
4735 E Marginal Way S, Room 1102 Seattle, WA 98134
(206) 658-4225 Or (877) 927-8387
13109 E Mirabeau Parkway Spokane, WA 99216
(509) 444-8387 Or (509) 444-8387
4916 Center St. Suite E Tacoma, WA 98409
(253) 565-7038 Or (253) 565-7038
1104 West Poplar Walla Walla, WA 99362
(509) 526-8387 Or (509) 526-8387
2119 W. Lincoln Ave Yakima, WA 98902
(509) 457-2736 Or (509) 457-2736
Social Security Offices
Social Security benefits are another option for financing assisted living costs. To gain better insight into what programs or benefits are available to you or a loved one, visiting or calling one of the numerous Washington state social security administration locations may be helpful.
|Social Security Office||Address||Phone Number|
636 120th Ave Ne Bellevue, WA 98005
710 Alabama St Bellingham, Washington 98225
151 Sw 156 Street Burien, Washington 98166
1821 Cooks Hill Rd Ste 100 Centralia, Washington 98531
880 NE Rose St College Place, Washington 99324
3809 Broadway Everett, Washington 98201
820 Simpson Ave Hoquiam, Washington 98550
8131 W Klamath Ct Suite A Kennewick, Washington 99336
321 Ramsay Way Suite 401 Kent, Washington 98032
840 Ocean Beach Hwy Suite 150 Longview, Washington 98632
18905 33rd Ave W Suite 207 Lynnwood, Washington 98036
710 E College Way Suite A Mt Vernon, Washington 98273
402 Yauger Way Sw Olympia, Washington 98502
138 W First Street Rm 113 Federal Bldg Port Angeles, Washington 98362
811 South Hill Park Dr Suite A Puyallup, Washington 98373
915 2nd Ave Suite 901 Seattle, Washington 98174
13510 Aurora Ave N Suite B Seattle, Washington 98133
9594 Mickelberry Rd Nw Silverdale, Washington 98383
714 N Iron Bridge Way Suite 100 Spokane, Washington 99202
2608 S 47th St Suite A Tacoma, Washington 98409
805 Broadway St Suite 500 Vancouver, Washington 98660
301 Yakima Street Ste 212 Wenatchee, Washington 98801
801 Fruitvale Blvd Yakima, Washington 98902
Assisted Living Laws and Regulations in Washington State
Washington State’s Department of Health and Human Services oversees the Aging and Long-Term Support Administration. This administration oversees all the regulations that are associated with the state’s long-term care services. The Residential Care Services division regulates licensing and certification, and it provides oversight for nursing homes, assisted living facilities, adult family homes, supported living, and enhanced services facilities.
Assisted Living Admission Requirements
Facilities in Washington state may admit and retain residents only if:
- They can provide services to the resident that are outlined in the facility’s disclosure information.
- There is no need for frequent evaluation by a registered nurse outside of hospice care residents or those with a short-term illness that is expected to be resolved within a 14 day period
- The individual is able to walk on their own unless the facility is licensed for partially ambulatory or non-ambulatory residents by the Washington State director of fire protection
The facility must conduct a pre-admission assessment which includes specified medical information before the resident is admitted. In the event that the information is unavailable, it must be completed within 14 days of the resident’s move-in date.
Assisted Living Scope of Care
The assisted living facility must provide care for the resident that is consistent with their needs as outlined in the assessment of care. This can range from medication to dietary requirements and beyond. Facilities are required to disclose to potential residents or interested parties the standard and scope of the care provided. These should include:
- Laundry and housekeeping
- Access to medical services and or coordination of transport to and from medical facilities and appointments
- Help with medication administration and various levels of assistance up to and including nursing care, must be are available within the assisted living facility
- Food, diet, and exercise options
- Pet and smoking policies
- Access to safe and secure outdoor spaces
- Nursing services that help with medication and personal care
- Cost and payment information, including Medicaid payments policies and all ancillary charges
Assisted Living Medicaid Policy
Washington is one of the few states where Medicaid directly covers the cost of assisted living facilities for eligible seniors. Certain facilities are directly contracted by Apple Health to provide care to older adults who qualify. These facilities provide levels of care that fall into one of three categories:
- Adult Residential Care (ARC) provides moderate everyday care and medication reminders for residents that can take medications on their own.
- Enhanced Adult Residential Care (EARC) facilities offer the same services as ARC facilities, while providing some additional nursing and help for patients unable to take medications on their own.
- Enhanced Adult Residential Care Dementia Care provides all the care of EARC with additional nursing, supervision, 24-hour awake staff, and specialized staff training to care for older adults with dementia or Alzheimer’s.
Assisted Living Facility Requirements
Washington state has specific square footage requirements for all assisted living facilities. The requirements also differ depending on whether payments are being made with personal finances or if the resident receives Medicaid. The age of the building may also impact facility requirements.
- Rooms must be a minimum of 80 sq ft for single occupancy room, and 70 sq ft per resident in multiple occupancy rooms.
- Assisted living facilities who have contracts with the Washington Department of Social and Health Services (DSHS) and Aging and Long-Term Support Administration (ALTSA) must meet all room requirements to meet and maintain licensure.
- Facilities licensed before July 1st, 1989 are allowed up to four residents per unit, and those licensed after that date have a maximum capacity of two residents per room. Facilities under contract with DSHS and ALTSA are prohibited from having more than one resident in a unit unless specifically requested by the resident.
- At a minimum, facilities are required to have common use bathrooms. A private bathroom is required for all residents under DSHS/ALTSA contracts
Medication Management Regulations
Medication assistance must be provided by all assisted living facilities. This may come in the form of helping to open bottles, handing off medications, reminders, or coaching to take medications. These actions may be performed by staff that are not medical professionals. Residents that are unable to physically administer their own medications may, if able, direct others in the proper way to administer medications to them.
Medication administration services may be provided by the assisted living facility in the form of licensed nurses or nurse delegation. A facility may alter the manner in which a medication is administered in some situations. The facility must ensure that residents only have access to their own medications. Capable residents may store their own medications and do have the right to refuse medications at any time.
The administrator of the assisted living facility must be at least 21 years of age and is responsible for the performance of the facility 24 hours a day. They must also possess the education, training, and experience as outlined in the Assisted Living Facilities Regulations.
Staff Training Requirements
In addition to the specific requirements for administrators of assisted living facilities, there are also requirements for all other staff members. Before regular interaction with residents, staff members must complete an orientation and safety program. A basic safety class is also required, with demonstrated competence in the material and the procedures that are covered.
DSHS/ALTSA provides the only approved training materials and staff must have completed the materials within 120 days of being hired. Until all courses are completed satisfactorily, staff may not provide hands-on personal care to residents without supervision. When a resident with special needs is admitted to a facility, all staff must complete specialty training with the specifics of how to care for that particular resident.
Background Checks for Assisted Living
All staff hired after January of 2012, must have not only a state background check, but also a federal fingerprint-based background check.
Requirements for Reporting Abuse
All staff at assisted living facilities in Washington state are designated as mandatory reporters, and they are required by state law to report suspected abuse in the form of physical, sexual, emotional, psychological, financial abuse, neglect or abandonment. If the reporter thinks that the resident is in immediate danger, the first call should always be to 911.
The state has two methods of reporting elder abuse. The first is through the Conflict Resolution Hotline of the DHSH that can be reached at (800) 562-6078. This hotline is targeted at the elderly who live in any form of residential care home and may be used by the residents themselves. When reporting, the caller does not need to present proof of abuse. However, if they are an employee of the facility, they are required to complete a Residential Care Online Report. The second is by contacting the local adult protective services branch for your county either online or via phone. To find the phone number for your local branch, go to DHS’ website.
Residents who wish to file a complaint against a facility may do so by calling the office of the Long-Term Care Ombudsman at (800) 562-6028 or (800) 737-7931 for those that are hard of hearing. These numbers along with the physical address of the ombudsman office should be located in an area that is easily accessible to residents, along with the toll-free complaint number of the facility.