Assisted Living in Washington

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Medically Reviewed by: Christopher Norman, Board Certified Nurse Practitioner (NP)

Key Takeaways

  • The median monthly cost of assisted living in Washington is $6,000 per month—that’s about 29% higher than the national average.
  • Unlike many other states, Washington’s Medicaid programs will cover the full cost of assisted living for Medicaid-eligible seniors.
  • The state of Washington does not have minimum assisted living staffing ratios, so it’s important to check that the facilities you’re considering are adequately staffed.
  • Washington’s Area Agencies on Aging and state ombudsman programs can help you or a loved one navigate the assisted living experience.

Retirees seeking independent or assisted living in Washington will appreciate the state’s rich natural beauty as well as its thriving cultural life. The Pacific Northwest’s “Evergreen State” is known for its mild climate, mountain vistas, and beautiful Pacific coastline, including the San Juan Islands.

The population of older adults in Washington is steadily growing, and the state has a wide range of attractive options for retirees, from independent living communities to high-quality assisted living facilities. Whether you’re seeking senior living near the state’s world-renowned national parks, including Olympic and Mount Rainier, or near its urban centers, such as Seattle or Spokane, Washington has a great deal to offer. Favorable tax policies, excellent air quality, and expansive Medicaid programs also make Washington a popular place for seniors to retire.

Assisted Living in Washington: The Big Picture

The National Center for Assisted Living (NCAL) reported that Washington has 2,000 assisted living communities with a total of 41,500 beds. On average, each facility serves 22 people.

In Washington’s assisted living facilities, according to the NCAL, 50% of residents are over the age of 85, and 28% of them rely on Medicaid for their long-term care. Additionally, 65% of assisted living facilities in Washington provide some skilled nursing care.

assisted living in washington

Cost of Assisted Living in Washington 

The cost of living index in Washington is 114.2, which means that Washington is about 14% more expensive than the national average. However, it’s still more affordable than its West Coast counterparts, Oregon and California, which are about 21% and 38% above the national average, respectively. 

In Washington, the median monthly cost of assisted living is $6,000, which is about 29% higher than the national average. Still, that median monthly cost varies depending on your location within Washington. For example, the cost of assisted living in Seattle is much higher than in other major cities in Washington. 

Assisted Living Cost Comparison for Washington Cities

City in Washington
Median Monthly Cost of Assisted Living$4,805
Median Monthly Cost of Assisted Living$6,750
Median Monthly Cost of Assisted Living$4,888
Median Monthly Cost of Assisted Living$5,750
Walla Walla
Median Monthly Cost of Assisted Living$3,211

Will Medicare Pay for Assisted Living in Washington? 

Medicare will not pay for any form of long-term care, whether the care is received at home or in a facility. Because Medicare is regulated by the federal government, this is true in every state, including Washington. 

Here’s what Medicare will usually cover for assisted living residents: 

  • The cost of physician-ordered physical, occupational, and speech therapy, which residents can often receive onsite in assisted living settings
  • Up to 100 days of care in a skilled nursing facility
  • Outpatient health care services and some prescription drug costs 

Will Medicaid Pay for Assisted Living in Washington? 

Medicaid is regulated by both the federal and state governments, which means that its coverage will vary widely from state to state. In most cases, Medicaid will cover the cost of personal and medical care received within assisted living, but it will not pay for the cost of room and board. When it comes to assisted living, Washington state’s Medicaid programs are more expensive than many other states. 

How Does Medicaid Help With the Cost of Assisted Living in Washington? 

Washington state has a unique Medicaid program, called Apple Health, that covers the full cost of assisted living for Medicaid-eligible seniors through the Community Options Program Entry System (COPES), a Medicaid waiver program. Washington residents eligible for this program will be offered one or more of the following Medicaid service packages for assisted living

  • Adult Residential Care (ARC): This package is for seniors who need some help with medication reminders and activities of daily living (ADLs). Medicaid-eligible residents who qualify for this package are mostly independent but need occasional assistance throughout the day. 
  • Enhanced Adult Residential Care (EARC): This level of care includes all the services provided in the ARC package, with the addition of occasional nursing care. 
  • Enhanced Adult Residential Care-Specialized Dementia Care Services: This level of care includes all the services in the EARC package, with the addition of specialized care for dementia. 
  • Assisted Living: This Medicaid benefit includes a private apartment and some help with medication management and ADLs. 

How to Check if You’re Eligible for Medicaid in Washington 

To be eligible for Medicaid coverage of long-term care in Washington, you must be 65 years old or older or between the ages of 18-64 and blind or disabled. You must also meet certain criteria based on your financial situation and your degree of medical need.

To find out if you qualify for Medicaid coverage in Washington state, go to the Washington Connection website and follow the directions beneath “See If I Qualify.” According to the website, qualifying questions take about 15 minutes. The “See If I Qualify” page also offers a “See If I Qualify” tutorial video, for those who like a step-by-step visual aid. 

How to Apply for Medicaid in Washington 

Once you’ve determined that you may be eligible for Medicaid in Washington, it’s time to submit an application. Here’s a guide to get you started: 

  • First, as an adult aged 65 or over, you will need to apply for Apple Health Classic Medicaid Coverage, which Washington differentiates from Apple Health (Medicaid) coverage. 
  • Visit the Washington State HealthCare Authority’s application and renewal page. Scroll down to the part of the page, titled “How to apply for or renew Apple Health Classic Medicaid coverage.” There, you’ll see several options for how to apply, including online or in person. You can print a paper application or use the number provided to request one be sent to you. 
  • If you choose to apply in person, do so through your local Area Agency on Aging (AAA). There, a social worker can work with you directly to help you complete your Medicaid application. 
  • Be prepared to provide documentation to the social worker who is handling your Medicaid application. These documents may include bank statements, proof of income, residency status, and more. 

Other Ways to Finance Assisted Living in Washington

Washington residents who don’t qualify for Medicaid will need to use some form of private pay or long-term care insurance to pay for assisted living. Here’s a list of the personal savings and assets many people use to pay for assisted living in Washington: 

  • Personal savings: Pension payments, stocks, Social Security benefits, and IRA or 401(k) accounts can be used to cover the cost of assisted living. It’s worth noting that in Washington, withdrawals from retirements are not taxed, nor are public or private pension income. This makes Washington a tax-friendly state for retirees. 
  • Long-term care insurance: Seniors who hold long-term care insurance policies can be reimbursed for the cost of long-term care. Know the details of your policy, though. Some policies have a 90-day out-of-pocket period before expenses can be reimbursed.
  • The value of your home: Proceeds from the sale of your home can be put toward assisted living expenses. Some people also pay for assisted living with a reverse mortgage, which allows you to borrow money using your home as security for the loan. Always check with a trusted financial advisor before signing off on this kind of financial agreement.

Free Assisted Living Resources in Washington

If you or your loved one is looking for high-quality assisted living, Washington has many free resources available to guide you through the process. 

Area Agencies on Aging (AAA)

An Area Agency on Aging is a community organization, either public or private nonprofit, designed to serve the needs of all seniors in that region or area. AAA refers to the type of organization, but the names of AAAs will vary by region.

Washington residents can turn to their local AAAs for help with transportation, nutrition support, Medicaid applications, the search for assisted living, and much more. 

Veterans Affairs (VA) 

Veterans and their families can receive a host of federal benefits, including health care, pension payments, life insurance, and housing assistance. Before checking with your state’s Department of Veterans Affairs, make sure you’re getting the federal benefits you’re entitled to. 

At the state level, veterans are also eligible for many services. In the state of Washington, for example, there are four Medicaid- and Medicare-certified Veterans Homes that provide personal care, nursing care, and more.  

Social Security Offices 

Social Security benefits can help seniors pay for the cost of assisted living. You can apply to start receiving your Social Security benefits as early as age 62. Keep in mind that the longer you wait to start receiving benefits—up to the age of 70—the more your monthly benefit will increase. 

You can find a local Social Security office or apply to start receiving your Social Security benefits through the Social Security Administration website

Community Living Connections 

Washington’s Community Living Connections is a state-wide resource offering resources for long-term care, end-of-life care, disability services and supports, health services, and more. 

Assisted Living vs Other Types of Care in Washington

While the cost of assisted living is higher in Washington than the national average, there are still several Washington cities±—including Spokane and Walla Walla—where assisted living is close to or below the national average. Still, assisted living isn’t financially feasible for everyone, and it’s not always the right choice for the level of care you need. Work with family members, close friends, and trusted healthcare professionals to determine what kind of long-term care is most appropriate. Here are a few options: 

Independent Living: Also called retirement communities, independent living offers older adults housekeeping, three restaurant-style meals per day, and onsite activities such as yoga, walking groups, and outings. Our research showed that all-inclusive fees for independent living in Washington range from $1,839 to $6,000 per month, depending on the facility’s location and the size of the apartment. Personal care services are available in independent living through third-party contractors. 

Assisted Living: Assisted living communities offer housekeeping, three communal meals per day, onsite activities, and daily help with ADLs and medication. The average monthly cost for assisted living in Washington is $6,000, and additional fees for personal care services could increase that fee. 

Nursing Home: All of the services available in assisted living are also available in a nursing home, with the addition of skilled nursing care provided by RNs. In Washington, the average monthly cost for nursing home care starts at $9,429.

Memory Care: Also called special care units, memory care can be found in both assisted living facilities and nursing homes. The average monthly cost for memory care varies by facility. OUr research found that the cost falls somewhere in between the cost of assisted living care and nursing care, depending on individual needs. 

Aging in Place: Staying at home with the help of in-home care is also an option worth considering, especially if you can’t find a residential facility that meets your or a loved one’s needs. Usually, Medicaid will cover in-home care services more readily than it covers the cost of an assisted living facility. In-home care includes: 

  • Personal companions, or homemakers, provide companionship, light housekeeping, some meal preparation, and help with errands. 
  • Home health aides assist you or a loved one with ADLs such as bathing and dressing. They will also help with housekeeping and meal preparation. 
  • In-home nursing services can be administered by a registered nurse (RN) who visits the home. Skilled nursing care is essential for anyone who is aging in place and needs assistance with wound care or chronic illnesses like diabetes. 
  • Adult day centers provide social activities for older adults during the day while also offering caregivers a break from caregiver responsibilities. 

Assisted Living Laws and Regulations in Washington

Assisted living facilities are not regulated by the federal government. Instead, they receive oversight and guidance on the state level. This means that the laws and regulations governing assisted living facilities will vary from state to state. Keep reading for an overview of assisted living regulations in Washington. 

Assisted Living Definition and Scope of Care in Washington

According to the NCAL’s 2022 State Regulatory Review, the state of Washington defines assisted living as any home or institution maintained for the purpose of providing housing, basic services, and assuming responsibility for the safety and well-being of its residents.

The NCAL review defines the scope of care for assisted living facilities in Washington according to basic services, optional services, and third-party services. 

Scope of Care for Services Provided in Washington Assisted Living Facilities

Basic Services
Meals, including snacks and some special diets
Medication assistance
Arranging for health care appointments
Coordinating health care services
Monitoring functional status of residents
Emergency assistance
Optional Services
Assistance with Activities of Daily Living (ADLs)
Intermittent nursing services
Health support services
Medication administration
Adult day services
Care for residents with dementia, mental illness, or developmental disabilities
Specialized therapeutic diets
Transportation services
Third-party Services
Onsite care from licensed health care practitioners
Home health care

Assisted Living Requirements for Residents in Washington

The NCAL lists the following requirements for potential residents of assisted living facilities in Washington: 

  • An assessment must be completed prior to admission to determine if a person is a good fit for the assisted living facility, and if so, what level of care they will need. Most residents will need help with housekeeping, meals, laundry, medication assistance, and some but not all ADLs. 
  • The potential resident must not require the frequent presence of a registered nurse (RN), except in the instance of receiving hospice care or needing care for a short-term illness. In general, the individual’s needs must not exceed the facility’s ability to care for them, as in the case of advanced stage neurocognitive diseases such as Alzheimer’s or Parkinson’s that result in uncontrolled incontinence or an inability to feed oneself. 
  • The individual must be ambulatory, meaning that they are able to walk on their own, or with the assistance of a walker or cane. Exceptions may be made if the Washington director of fire protection has approved the facility for the care of semi-ambulatory or nonambulatory residents. 

Washington Assisted Living Staff Requirements

Minimum staffing ratios help to determine the minimum number of hours that must be worked by qualified staff members in order for a facility to run smoothly and safely. Only 12 states currently require minimum staffing ratios for assisted living facilities, and Washington is not one of them. However, Washington staffing requirements do state the following terms: 

  • A qualified administrator must be responsible for the facility and its residents 24 hours per day. 
  • All long-term care workers must pass a federal and state background check in order to work in the facility. 
  • Long-term care workers must either be certified nursing assistants (CNAs) or certified home health aides (CHHAs). Both CNAS and CHHAs are trained to assist with ADLs, including continence and mobility issues. CNAs can also perform basic medical tasks, such as taking and monitoring vital signs. In addition to their medical certification, CNAs and CHHAs must complete an orientation and safety program before working with residents. 
  • Both CNAs and CHHAs must complete nurse delegation training if they perform tasks usually performed by an RN, such as medication administration or nonsterile dressing changes. Also, if a CNA is administering insulin to a diabetic resident through nurse delegation, they must successfully complete a “Special Focus on Diabetes” course and maintain communication with the designated RN. 

When visiting assisted living facilities in Washington, ask about minimum staffing ratios within each facility. For reference, the Long Term Care Community Coalition’s 2018 Assisted Living: Promising Policies and Practices report recommended a ratio of at least one staff member to every 15 residents in a multifloor facility. 

How to Report and Prevent Elder Abuse in Washington 

Unfortunately, elder abuse is a reality that Americans cannot ignore. The United States Department of Justice reports that 10% of adults 65 and older will experience some form of elder abuse in a given year. 

Elder abuse can be defined as caregiver neglect, financial fraud and exploitation, psychological abuse, sexual abuse, or physical abuse. Caregiver neglect and financial fraud and exploitation are the most common forms of elder abuse. If you believe elder abuse is occurring in a Washington assisted living facility, it’s important to make an elder abuse report

Be proactive in preventing abuse or neglect of a loved one by familiarizing yourself with Washington’s Long-Term Care Ombudsman Program. A long-term care or elder care ombudsman is an advocate for residents of nursing homes and assisted living facilities. They will help you or a loved one to get quality care and help you resolve any problems, including filing official complaints. 

Bottom Line

Washington’s favorable tax policies, expansive Medicaid programs, and beautiful natural landscapes make it an attractive place to retire.

While the cost of assisted living in Washington is higher than the national average, the cost will vary depending on where you live in the state. In more rural areas, like Walla Walla, the cost of assisted living falls below the national average. 

The scope of care in Washington assisted living facilities covers help with most ADLs as well as housekeeping, medication assistance, three meals per day, and several other onsite amenities. Most of the care in Washington assisted living facilities is delivered by CNAs or CHHAs, who can provide support with personal care and some medical tasks. 

Finding the perfect place to retire is a personal process, and no assisted living facility is one-size-fits-all. When you visit Washington assisted living facilities, be sure to ask questions about minimum staffing requirements and the level of care provided. Most importantly, make sure the community is a good fit for your individual needs and interests.

Frequently Asked Questions

In Washington state, the median monthly cost of assisted living is $6,000, although the cost varies widely depending on where you live in the state.