Nursing Homes and Senior Care in Washington

Nursing Homes by City in Washington

The Washington cities with the most CMS-certified nursing homes. All 88 cities are listed below the table. Homes in Washington average 4.4 hours of nursing care per resident per day; the national median is 3.7 hours.

5-Star Nursing Homes in Washington

Homes with CMS's top overall rating, ordered by inspection rating. See all highest-rated nursing homes in Washington.

Assisted Living in Washington

Washington State Department of Social and Health Services, Home and Community Living Administration, Residential Care Services licenses assisted living in Washington. License types: Assisted Living Facility. Use the state's search to check a community's license and inspection history.

• Washington assisted living facility search
• Washington assisted living rules
• Washington assisted living licensing (Washington State Department of Social and Health Services, Home and Community Living Administration, Residential Care Services)

Memory Care Rules in Washington

Washington's term is "Certified Memory Care", a separate license or certification. Facilities must give families a written disclosure of their dementia care services.

• After July 1, 2026, an assisted living facility may not operate as a memory care facility or maintain a memory care unit without becoming certified (WAC 388-78A-2383).
• To be certified the facility must have a valid, current assisted living facility license, apply for certification and pay the initial certification fee (WAC 388-78A-2383).
• The facility must not have a pattern of uncorrected or recurring significant enforcement remedies, and must not have a stop placement, conditions on a license related to resident care, or license revocation actions before applying (WAC 388-78A-2383).
• The facility must have permanent infrastructure for the specialized needs of residents with dementia, including elements to restrict egress and meet daily activity requirements (WAC 388-78A-2383).
• A staffing plan must maintain 24-hour awake caregivers at a level adequate to respond to each resident's assessed needs, including waking and sleeping patterns and routine assistance with eating; when residents live in separate buildings or cottages, at least one awake caregiver must be physically present in each building or cottage 24 hours per day (WAC 388-78A-2383).
• Policies and procedures must cover how staff respond to and manage residents who wander, actions to take when a resident is missing, and how and when consultive services are used for residents with behavioral challenges (WAC 388-78A-2383).
• Memory care must provide at least one resident-accessible outdoor common area with a minimum of 25 square feet per resident served, firm walking surfaces, and a wall or fence at least six feet high, accessible to residents without staff assistance; older facilities may use an alternative viewing area (WAC 388-78A-2381).
• Certified memory care must post and make available a memory care disclosure with the facility's licensed bed count and staffing, including the number of awake overnight caregivers and direct care staff per resident-occupied bed and daytime and evening direct care staff ratios (WAC 388-78A-2385).
• Residents and representatives must get written notice of a significant change in staffing within 30 days of the change (WAC 388-78A-2385).
• Whenever at least one resident has dementia as a primary special need, the facility must ensure completion of dementia specialty training consistent with chapter 388-112A WAC (WAC 388-78A-2510); long-term care workers must complete specialty training within 90 days of completing basic training, or within 120 days of hire if integrated, and may not provide personal care to a resident with special needs without direct supervision until then, unless indirect supervision is allowed (WAC 388-112A-0495).

• Washington memory care rules

Medicaid Long-Term Care in Washington

Washington's Medicaid program is Washington Apple Health (Medicaid) Long-Term Services and Supports. For nursing home Medicaid (2026), the state lists an income limit of Medicaid Special Income Level (SIL) (1/1/26) $2,982 and an asset limit of $2,000 for a single person (WAC 182-513-1350). Residents keep a personal needs allowance of All other PNA Medical Institutions (1/1/26) $108.74.

• Community Options Program Entry System (COPES) waiver: in-home care and adult day
• Community First Choice and Medicaid Personal Care: in-home care. Community First Choice is a Medicaid entitlement state plan option under 1915(k). DSHS says programs such as Community First Choice or Medicaid Personal Care pay for personal care services.
• Specialized Dementia Care Program in Assisted Living Facilities: assisted living and memory care. For people diagnosed with Alzheimer's disease or another irreversible dementia who receive or are eligible for Medicaid and are assessed by a DSHS case manager as needing specialized dementia care. Due to limited funding, DSHS contracts with a small number of assisted living facilities throughout the state.
• New Freedom Consumer Directed Services: in-home care. New Freedom is currently available in King and Pierce Counties for people who live at home.
• Medicaid Alternative Care (MAC): respite. For people 55 or older who are financially eligible for Apple Health LTSS, have an unpaid family or friend caregiver, and want to live at home. Services support the unpaid caregiver and are provided instead of other Apple Health LTSS.
• Tailored Supports for Older Adults (TSOA): in-home care, respite and adult day. Supports unpaid family caregivers of people age 55 or older and can give limited support to people without an unpaid caregiver. For care receivers with higher resources than Apple Health LTSS typically allows. HCA lists TSOA Resources (1/1/26) $84,354 and TSOA Resources with CS (1/1/26) $156,883.

• Washington Apple Health (Medicaid) Long-Term Services and Supports nursing facility coverage
• Washington Medicaid long-term care limits

Nursing Home Inspections and Complaints in Washington

Washington State Department of Social and Health Services, Home and Community Living Administration, Residential Care Services inspects nursing homes in Washington for CMS. To file a complaint, call 1-800-562-6078 or use the state's complaint page.

• Washington nursing home inspection lookup
• File a nursing home complaint in Washington

Washington Long-Term Care Ombudsman

The Washington State Long-Term Care Ombudsman Program is a free, confidential advocate for residents of nursing homes and assisted living. Ombudsmen help with complaints, residents' rights and problems with care. Call 1-800-562-6028.

• Contact the Washington State Long-Term Care Ombudsman Program

Aging Services and Caregiver Support in Washington

Washington State Department of Social and Health Services, Home and Community Living Administration runs Washington's aging services, delivered through local Area Agencies on Aging. Family caregivers can get help through Family Caregiver Support Program. Adult day services are licensed or certified by Washington State Department of Social and Health Services (adult day care and adult day health centers contract with the department, an Area Agency on Aging or other department designee).

• Washington aging services: Washington State Department of Social and Health Services, Home and Community Living Administration
• Area Agencies on Aging in Washington
• Caregiver support in Washington: Family Caregiver Support Program
• Washington adult day services

Guides for Your Next Step

See how to choose a nursing home, what memory care is, how Medicaid pays for nursing home care and what Medicare covers. For local help, call the Eldercare Locator at 1-800-677-1116.

Frequently Asked Questions