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.

$9581

Washington

$7756

The United States

$8669

Idaho

$10114

Oregon

$9247

California

$7665

Montana

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.

$7908

Yakima

$8213

Longview

$8517

Bellingham

$9034

Wenatchee

$10615

Spokane

$10624

Seattle

$10646

Bremerton

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.

$2167

Adult Day Care

$5750

Assisted Living

$5941

Home Care

$6031

Home Health Care

$9581

Nursing Home Care

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 2022, they can earn up to $30,276 per person applying (so $60,552 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 $137,400 in assets, and the applicant can only have $2,000.

2022 Medicaid Income Limits for Seniors in Washington



Income Limits Per Year

Asset Limits

Single Applicant

$30,276

$2,000

Married (One Spouse Applying)

$30,276

$2,000 for applicant, $137,400 for non-applicant

Married (Both Spouses Applying)

$60,552

$3,000

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 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.

(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 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

Services

(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.

(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.

(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.

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

Seniors and their families have access to a number of supportive services and programs in Washington to assist them in finding the best options to suit their particular medical and financial situation. These services can help families to afford the care their loved one requires in a skilled nursing facility or in their own homes. 

Resource

Contact

Service

(360) 725-3548

The Aging & Disability Resources Centers are a coordinated network of offices that runs throughout the state of Washington to provide seniors with information and support regarding in-home care and nursing home care. The program helps seniors to access resources that may help them to delay the move to a nursing home.

(206) 320-5325

PACE or Program of All-inclusive Care for the Elderly is a Medicare program that provides free in-home or community-based care to frail seniors who require full-time care. In order to be eligible, seniors must require nursing home level care but be able to safely age in place with the required assistance. Services offered include transportation to medical appointments, personal care, basic nursing care, nutrition assistance services and hospital-level care if needed. 

(360) 485-9761

The Washington Association of Area Agencies on Aging is comprised of thirteen agencies with the aim of supporting and enhancing the lives of seniors in the state. The agency can help seniors and their caregivers find financial assistance programs that may be able to help them pay towards nursing care expenses. Additional services offered by the agencies include caregiver support, respite care, wellness programs and case management for those seniors who require long-term nursing home care. 

COVID-19 Rules for Nursing Homes in Washington

The following information is based on research done on several government websites, including dshs.wa.gov. These rules apply to Independent Living Communities and other types of senior living facilities. We’ve most recently updated this data on 2/15/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for Washington Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes

Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for Washington Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

No

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

Rules for Washington Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

No

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

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 Requirements
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 Coverage
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.