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.




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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.















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.


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Nursing Home Care

Financial Assistance for Nursing Home Care in Washington

Most people do not pay for skilled nursing care entirely out-of-pocket. Rather, they utilize financial assistance programs to help cover the cost of nursing care. Of public financial assistance programs, Medicaid provides the most comprehensive coverage of nursing home care. 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.

Washington’s Medicaid Program

As of July 2020, there are approximately 1,803,168 Washington residents enrolled in the state’s Medicaid program with many of these beneficiaries receiving Long-Term Services and Supports (LTSS). LTSS encompasses several types of care, including in-home care, skilled nursing and assisted living.

Washington’s Medicaid program is called Apple Health. The Apple Health Long-Term Services program can help seniors afford care in one of the state’s 221 nursing homes. Apple Health may cover all or part of a senior’s nursing home expenses for those deemed financially and medically eligible. Washington considers an individual medically eligible if the personal requires significant assistance with activities of daily living, such as eating, bathing and getting dressed. Recipients must be 65 or older, disabled or blind to qualify, and they must require at least 30 consecutive days of care in a nursing home setting. The nursing home must be licensed by the state to be eligible for Medicaid funding. Several Home and Community Based Waivers are also available that pay for skilled nursing care in the senior’s own home.

Medicaid Eligibility in Washington

To qualify for Apple Health, Washington residents must have a household income within 133% of the federal poverty level. For Apple Health Long-Term, countable income must be at or below 300% of the Federal Benefit Rate. Individuals with income that exceeds this level may still be eligible for Medically Needy coverage based on the projected monthly cost of nursing home care. Resources must not exceed $2,000 per individual or $3,000 per couple if both are applying. Applicants must be a Washington state resident and U.S. citizen, national or legal alien to qualify. Residents can apply for Apple Health online via the Washington Connection portal.

Alternative Financial Assistance Options

  • Medicare: Medicare will cover the cost of one’s care in a skilled nursing facility for the first 20 days of their stay, and a portion of the costs up until day 100. After 100 days, the individual is responsible for all costs. Seniors must also have a “qualifying hospital stay” of at least 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
  • Aid and Attendance: 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: 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. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
  • Long-Term Care Insurance: Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Washington

Seniors and their loved ones have access to a variety of supportive services and programs in Washington. These services can help families afford nursing home care or get the care they need while living at home.

COPES Program(877) 501-2233To apply: Washington ConnectionThe COPES program allows individuals who qualify for nursing home care to receive services in their own home. COPES can be used to pay for a personal in-home caregiver of the recipient’s choosing. Other supports may include transportation to medical appointments and access to emergency response services.
Aging & Disability Resource Centers(360) 725-3548Washington’s ADRC system is a coordinated network that connects seniors with services and supports for both in-home and nursing home care. The program helps residents find resources that may delay the need for nursing home placement.
Program of All-Inclusive Care for the Elderly(206) 320-5325 (Spokane and King Counties)(206) 462-7100 (King County)PACE is a Medicare-based program that provides free in-home and community-based care to frail seniors aged 55 and up. Services may include personal care, nutrition education, health care and transportation to and from doctor’s appointments. To qualify, seniors must require nursing home care but be able to live safely in the community at the time of enrollment.
Nurse Delegation Programnursedelegation@dshs.wa.govSeniors who would normally require nursing home care due to certain medical needs may be able to receive these services at home via the Nurse Delegation Program. A caseworker will refer a registered nurse who can train a senior’s caregiver to perform tasks safely and effectively. Caregivers must be registered in Washington as a nursing assistant to be eligible.
Veterans Long-Term Service and Support Benefits(800) 562-2308Veterans with service-related disabilities may have their nursing home care costs fully covered by the VA. Those who can’t afford their care but do not have a disability may be eligible for reduced fees depending on their income level. Veterans who reside in a nursing home, are bedridden or require help with activities of daily living can receive an additional monthly payment to their VA pension.
Area Agencies on Aging(360) 485-9761Washington’s 13 Area Agencies on Aging can help seniors and their families find financial assistance that may pay for nursing home care. Other services offered include wellness programs, caregiver support and case management for seniors who qualify for nursing home care.

Nursing Home Laws and Regulations in Washington

Licensing RequirementsNursing homes must be licensed by the state of Washington. Licenses are valid for one year and must be renewed annually.
Staffing RequirementsAll 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 RequirementsNursing 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 RestrictionsResidents 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 RequirementsEach 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 RequirementsAll 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 ServicesFor 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 ServicesNursing 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 RequirementsNursing 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 RequirementsSNFs 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 CoverageApple Health may pay for all or part of a resident’s nursing home care costs if the person is deemed medically and financially eligible.