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Nursing Homes in Washington
When a chronic condition or disability makes living at home a challenge, it may be time to consider the transition to nursing home care. Of Washington’s 7,614,893 residents, 13.2% are seniors aged 65 and above, and 15,094 live in nursing homes throughout the state. Skilled nursing facilities provide seniors with around-the-clock care and supervision, meals, medical services and recreational activities. Staff are thoroughly trained and qualified to care for seniors with complex needs, including those suffering from Alzheimer’s or dementia. In Washington, nursing home rates for a semiprivate room average $9,581 per month according to the 2020 Genworth Cost of Care Survey. Private rooms are almost $1,370 more with prices ranging around $10,950.
This guide provides an overview of the cost of nursing home care throughout Washington state and explains how Medicaid can help pay for the care that seniors need. We also highlight a number of financial assistance programs and resources that seniors and their loved ones may find helpful.
The Cost of Nursing Home Care in Washington
At $9,581 per month for a semiprivate room, nursing home costs in Washington are somewhat more expensive compared to surrounding states. In Idaho, for example, rates are about $900 cheaper at $8,669. Prices are higher in Oregon, however, where seniors can expect to pay $10,114. To the south in California, prices drop to $9,247. Rates in Montana are among the lowest in the northwestern part of the nation. Seniors there pay just $7,665, which is in line with the average cost for the United States as a whole.
Nursing home prices vary throughout Washington with the cheapest rates typically found in the southern part of the state. Prices are lowest in the Yakima area where seniors pay only $7,908 for a semiprivate room. In Longview, about one hour north of Portland, Oregon, prices reach $8,213. Costs in the Seattle and Bremerton areas are among the priciest in the state at $10,624 and $10,646, respectively.
Yakima
$7908
Longview
$8213
Bellingham
$8517
Wenatchee
$9034
Spokane
$10615
Seattle
$10624
Bremerton
$10646
Seniors in Washington have other options in addition to nursing home care. Adult day care, which offers social activities and supervision in a community-based center, is the best value at $2,167 per month. Assisted living costs about $5,750; in this setting, residents receive room and board, meals and personal care, but skilled nursing usually isn’t included. In-home care and home health care cost $5,941 to $6,031 on average. Home health care provides medical services that basic home care doesn’t, such as wound care, medication administration and management of chronic conditions.
Adult Day Care
$2167
Assisted Living
$5750
Home Care
$5941
Home Health Care
$6031
Nursing Home Care
$9581
Does Medicaid Cover Nursing Home Care in Washington?
Just under 2 million people are covered by Medicaid in the state of Washington. The state offers expanded coverage so this number includes low-income adults and children. Three out of every five nursing home residents in Washington are covered by Medicaid. For seniors residing in nursing homes, the program covers costs such as room and board, medication, laundry services, medication, general nursing care and medical equipment.
Washington has 221 nursing homes and all of them accept Medicaid. These homes collectively provide over 21,000 beds and offer hospital-like levels of care on a 24/7 basis. The Washington State Long-Term Care Partnership Program may help to cover some of the fees involved in nursing home care such as transportation. Those seniors who require skilled nursing care but would prefer to remain in their own homes or community may be eligible for one of the Home and Community Based Care Waivers and Programs.
Medicaid Eligibility in Washington
Medicaid coverage in Washington is determined based on financial need. A registered nurse or physician will carry out an assessment to determine if the applicant requires skilled nursing care. The Washington State Health Care Authority carries out the financial check and determines if the applicant meets all the criteria to receive Medicaid coverage for nursing home care.
Households must have an income within 133% of the federal poverty level to qualify for coverage. For 2023, they can earn up to $32,904 per person applying (so $65,808 for a couple). However, assets must be less than $2,000 for a single applicant or $3,000 for a couple who apply together. If someone applies and has a spouse, that spouse must have less than $148,620 in assets, and the applicant can only have $2,000.
2022 Medicaid Income Limits for Seniors in Washington
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,620 |
| Two Person | 2 | $65,808*** | $3,000 |
*Except for a $100/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient's monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
How to Apply for Medicaid in Washington
Residents can apply online via the Washington Connection Portal, in person at their nearest Home and Community Services Office or by completing Form 18-005 and mailing it to the Washington State Department of Social and Health Service. Applicants must prepare all of the required documents before applying. The process can take a couple of months and any missing documents can delay the process even longer.
Information You Will Need:
- A social security number
- Proof of income
- Proof of identification
- Copy of birth certificate
- Proof of citizenship or legal residency if not born in the United States
- Documentation regarding resources ( bank statements, life insurance and property tax statements)
- Any other supporting documents which may support the application
- VA discharge papers for veterans
- Property deeds
Additional Medicaid Support & Resources in Washington
The following list contains contact details and information regarding support agencies that can assist seniors and their families in navigating the complicated process of applying for Medicaid benefits.
| Resource | Contact | Services |
|---|---|---|
| The National Council on Aging | Online Only | The National Council on Aging provides information on the basics of applying for Medicaid and offers an online eligibility test that assists family members and seniors in finding out if they qualify before applying for cover. The website provides instructions on how to apply for Medicaid in each state. |
| Washington State Healthcare Authority | (800) 562-3022 | Apple Health is the name of Medicaid in the state of Washington. The program is administered by the Washington State Healthcare Authority. This website provides information on applying for Apple Health and the eligibility requirements. Seniors can phone consultants or visit one of the offices in person to be guided through the process of applying for Medicaid coverage. |
| Benefits.gov | Online Information | Benefits.gov is a federal website that provides basic information for seniors and their families who are starting to look at Medicaid. It includes contact numbers and useful website links. |
Does Medicare Cover Nursing Home Care in Washington?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- Meals
- A semiprivate room
- Medications
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn’t Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support and Resources in Washington
Families and seniors who are looking at Medicare may wonder if it may be able to assist in covering some of the costs associated with nursing home care. Health insurance cannot assist in the long term, but it may be able to help with some of the initial costs. Trained consultants and advisors associated with the organizations listed below may be able to provide interested parties with information that is helpful in their particular situation.
| Resource | Contact | Description |
|---|---|---|
| Office of the Insurance Commissioner | (800) 562-6900 | The Office of the Insurance Commissioner runs the Statewide Health Insurance Benefits Advisors (SHIBA) services. Trained consultants can provide free, unbiased and confidential assistance to seniors and their family members. The advisors can determine if the senior is eligible for Medicare and help them apply for any possible benefits. Consultants can make referrals to other programs or insurance companies if they would be a better option for that senior. |
| BenefitsCheckUp | (800) 794-6559 | BenefitsCheckUp is operated by the National Council on Aging. It is an online service that lists healthcare options available to a senior after they have answered a series of questions. The list of results includes links to the services they are eligible for. Seniors or family members can contact the helpline for additional assistance. |
| Medicare.gov | (800) 633-4227 | Medicare.gov is a website that is run by the federal government. It provides information on Medicare that seniors and their family members can access 24/7. The website provides general information, state-specific content, links to websites and phone numbers. The site has a live chat function that enables visitors to ask questions and receive replies from trained advisors at any time of the day. |
Other Financial Assistance Options for Nursing Home Care in Washington
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
| Name | How To Apply | How It Works |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov | If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. 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. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be able to use it to pay for skilled nursing care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not typically be eligible to sign up for a LTC insurance policy. |
Free and Low-Cost Resources for Seniors in Washington
There are many resources in Washington that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington Area Agencies on Aging | Area Agencies on Aging in Washington work with state, federal and local agencies to support the needs of older adults and their caregivers. Seniors can receive short-term and long-term in-home care for medical and nonmedical needs, such as hygiene, memory support, meal delivery, light housekeeping and mobility assistance. Other services include nonemergency medical and nonmedical transportation, adult day service programs, medication monitoring and community involvement options. These programs are designed to help older adults maintain their independence. |
Cash Assistance Programs
Cash assistance programs in Washington provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Financial Assistance for Senior Care and Senior Living
Whether living in their own home or in a senior living community, Washington seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington Aging and Long-Term Support Administration (ALTSA) | 800-562-6028 | ALTSA is a statewide education and training organization devoted to providing support for caregivers and seniors with Alzheimer's and other forms of dementia. The program hosts an annual the Taking Care, Giving Care conference to provide technical training for caregivers, and enrolled care providers can receive news and updates through the member website and printed information packets. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Washington seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington Commodity Supplemental Food Program (CSFP) | 360-902-1800 | The Washington Commodity Supplemental Food Program provides healthy food to qualifying state residents aged 60 and older. CSFP ensures Washingtonians receive supplemental nutrition via shelf-stable goods and fresh produce, including vegetables, cereal, potatoes and fruits. The program, which encourages a healthier lifestyle, is currently available in 27 out of the 39 counties in the state. Residents can use the CSFP locator to find the providers closest to them. |
| Washington Meals on Wheels | Washington Meals on Wheels has independently run programs statewide that provide seniors with free or low-cost meals and extra supports. Pricing is on a sliding scale and ranges from no cost to 100% cost based on individual circumstances. The majority of services are open to seniors aged 60877-501-2233. Meals are served in a congregate setting or delivered to seniors based on their mobility needs. Additional services vary, but they may include emergency meal delivery, pet food delivery and transportation. | |
| Washington Second Harvest Inland Northwest | The Washington Second Harvest Inland Northwest food bank supports nutritionally insecure seniors in eastern Washington and northern Idaho. This organization sets up mobile markets that allow low-income seniors and families to shop for nutritious groceries at no cost. The organization also has 250 food pantries and meal sites in the region, offering ongoing access to food for those in need. It also offers nutrition education and hands-on cooking classes to support seniors with healthy, well-balanced meals. | |
| Washington State Food Assistance Program | 877-501-2233 | The Washington State Food Assistance Program provides grocery funds to immigrant seniors who do not qualify for the Supplemental Nutrition Assistance Program due to their immigrant status. To qualify, immigrant seniors must legally be in the U.S. and fulfill SNAP income requirements. Benefits are tied to income levels and the number of residents in a given household. Households that include a senior immigrant and a U.S. citizen may be eligible for a combination of the two programs' benefits. |
| Washington Senior Farmers Market Nutrition Program (SFMNP) | 800-422-3263 | The Washington Senior Farmers Market Nutrition Program supports both state farmers and lower-income seniors by providing vouchers for the purchase of fresh fruits, vegetables, herbs and honey from participating farmers' markets and roadside produce stands. Benefits are provided through a debit card and must be used between June 1 and October 31. In addition to providing funds for direct purchases, the SFMNP helps ensure that congregate meal sites and senior food delivery services can offer fresh produce. |
| Washington Food Lifeline | 877-404-7543 | Washington Food Lifeline manages senior food assistance programs from its Seattle-based Hunger Solutions Center. It stocks local food banks and supplies food for seniors meal programs, aiming to alleviate hunger and correct nutritional and dietary deficits experienced by many older adults. The organization has established connections with a wide variety of partner agencies, including senior housing providers and rural mobile food pantries. Seniors can locate their nearest food bank online or by calling the toll-free hotline. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Washington have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington Habitat for Humanity Aging in Place Program | Seniors choosing to reside in their own homes can apply for support and assistance from the Washington Habitat for Humanity Aging in Place program. Habitat works with human service organizations to assess residents' individual needs before making essential repairs and modifications to ensure that homes are safe and more accessible. Modifications include installing ramps, raised toilets, lever door handles and railings. It also connects older adults to community resources that can help them maintain their independence. | |
| Washington Home Repair and Modification Assistance | 877-894-4663 | The Washington Home Repair and Modification Assistance program, administered by the Washington Homeownership Resource Center, helps seniors stay safe in their homes by adding safety features, such as grab bars and wheelchair ramps. The program can also help with preventive maintenance and fixing some simple home issues, such as blocked drains and malfunctioning appliances. |
| Washington Weatherization Program | Washington's Weatherization Assistance Program relies on state and federal funding, as well as matching payments from utility companies. It helps with energyefficient upgrades that can lower your utility bills and improve your health and safety, such as installing insulation and sealing air leaks. |
Legal Resources
Many organizations offer free or low-cost legal services to Washington seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington Long-Term Care Ombudsman Program | 888-562-6028 | The Washington State Long-Term Care Ombudsman Program advocates for the rights of seniors living in nursing homes and assisted living facilities. It helps residents and their families when they have concerns about the standard of care at a facility and can address issues such as neglect or elder abuse. |
| Washington State Bar Association Moderate Means Program | 855-741-6930 | Washington State Bar Association runs a Moderate Means program that provides reduced-fee legal support to those who cannot afford legal assistance. The program covers civil legal issues including family law, housing and benefits. The association can also recommend sources for pro bono support. |
Senior Centers
Senior centers in Washington bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington State Association of Senior Centers (WSASC) | 253-288-7442 | WSASC connects seniors with the resources they need to stay healthy and live as independently as possible at any level of care. Services are delivered through the state's senior centers and include caregiver training and referrals, information services, social events and case manager services to help locate programs and other support networks seniors may need. All seniors aged 60 and over are welcome to participate in WSASC activities, though full membership in Washington costs a nominal annual fee |
Senior Engagement
Senior engagement resources and programs in Washington help older adults remain active and ensure they contribute to the community. Resources include wellness programs, volunteer opportunities, support groups and organizations that help residents connect with the community to live fulfilling lives.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington Dementia Action Collaborative Information and Resources (DAC) | 360-725-2300 | DAC offers a large number of free resources for seniors with Alzheimer's and other forms of dementia, as well as for their families. Care planning, caregiver training and referrals are available statewide, as are awareness training resources and workshops for memory care providers. The organization also provides a free online tool for seniors and families to better understand memory impairment with an online Dementia Road Map. |
Medicaid Resources
Navigating the Medicaid system is often difficult and confusing. Several Washington resources help older adults by providing advice on Medicaid options, waiver programs and eligibility criteria to help seniors receive the right health care benefits.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington Community Options Program Entry System Waiver | The state's primary waiver for home- and community-based services is the Community Options Program Entry System (COPES). This waiver has provisions for self-directed residential care and agency-based services that are coordinated by a professional care manager |
Social Security Offices
Social Security offices in Washington help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several Washington resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington Property Tax Exemptions | 360-534-1400 | The Washington State Department of Revenue offers a property tax exemption, as well as a deferment program, to seniors and disabled adults. This program can reduce your school taxes and freeze your property's assessed value starting the first year that you qualify |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Washington retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington Energy Assistance Program (EAP) | 360-725-2857 | The Low-Income Home Energy Assistance Program (LIHEAP) is available to eligible Washingtonians in every county. Depending on the need, assistance ranges from energy-efficient home improvements and utility payment grants to replacing or repairing air conditioners, air purifiers and heating systems. Eligibility requirements include income restrictions, utility costs, household size and whether an applicant has recently received a grant. Applicants must provide documentation. Each county has a respective LIHEAP provider through which interested residents must apply. |
| Washington Low Income Household Water Assistance Program (LIHWAP) | Households that are eligible for LIHEAP also qualify for help with their water bills. Payments are made directly to your utility provider to prevent disconnection or restore your water and sewer service. |
Veteran's Services
Washington retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| Washington VA Benefits and Health Care | The Washington VA Benefits and Health Care program serves the state's veterans as well as their dependents. Seniors who served in the armed forces can receive medical care, mental health services and specialized treatments at VA medical centers and statewide clinics. Seniors can also receive assistance accessing the VA benefits they're entitled to, such as retirement pensions, Aid and Attendance payments, disability compensation and property tax exemptions. Additional VA programs offer help with housing, prescription drugs and obtaining medical devices. |
Nursing Home Laws and Regulations in Washington
| Nursing Home Laws and Regulations in Washington | |
|---|---|
| Licensing Requirements | Nursing homes must be licensed by the state of Washington. Licenses are valid for one year and must be renewed annually. |
| Staffing Requirements | All SNFs must designate a physician to serve as medical director and must employ a sufficient number of staff to provide necessary care under routine and emergency conditions. Washington state does not establish staff-to-resident ratios, but each SNF must have enough staff to provide a minimum of 3.4 hours of direct care per patient, per day. |
| Staff Training Requirements | Nursing homes must have a staff training program under the direction of an LPN or RN. Excluding professionally licensed nursing staff, employees providing direct care must have successfully completed a DSHS-approved nursing assistant program as well as 16 hours of training and a competency evaluation within four months of beginning work as an assistant. |
| Admission Restrictions | Residents may not be admitted who pose a significant risk to the health or safety of themselves or others if this risk can't be eliminated with reasonable accommodation or if this accommodation would cause the SNF an undue financial or administrative burden. |
| Care Planning Requirements | Each resident must receive a comprehensive plan of care upon admission that includes measurable timetables and objectives to meet their medical and mental needs. The plan must be developed within seven days of the initial assessment. |
| Dietary and Nutritional Services Requirement | All nursing homes must provide three nutritious meals per 24-hour period while accommodating a resident's dietary needs and religious or cultural preferences. SNFs must employ a qualified dietitian on a full-time, part-time or consultant basis. |
| Specialized Rehabilitative Services | For residents who require specialized rehabilitative services, including physical therapy and mental health treatment, nursing homes must either provide the services needed or obtain services from an outside provider. |
| Medication and Pharmaceutical Services | Nursing homes must employ the services of a licensed pharmacist for consultation on all aspects of pharmacy services within the facility. Each resident's drug therapy plan must be reviewed once per month. |
| Activities Requirements | Nursing homes must provide an ongoing program of activities designed to meet each resident's physical and mental needs. Activities must be meaningful and offered at various times throughout the day. |
| Infection Control Requirements | SNFs must develop and maintain an infection control program designed to provide a sanitary environment and prevent the transmission of disease. Sufficient equipment and supplies must be provided to ensure proper cleaning, sterilizing and disinfecting. |
| Medicaid Coverages | Apple Health may pay for all or part of a resident's nursing home care costs if the person is deemed medically and financially eligible. |
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