In 2019, 15.4% of Washington’s residents were at least 65 years old, according to the U.S. Census Bureau. The state’s senior population is expected to grow, with the Washington Office of Financial Management estimating that 26.7% of residents will be 65 or older by 2040. Due to its favorable tax policies, the Evergreen State is one of the best places to retire. The state also has a low crime rate, lower-than-average property taxes and a booming economy.

Due to the high cost of living in Washington, the cost of senior living exceeds the national average in most cases. For instance, assisted living costs a monthly average of $5,500, which is nearly $1,500 more than the national average of $4,051. This guide covers the average costs of senior living in Washington, explains what seniors can expect to pay for different levels of care and provides information about programs that may help cover some of the costs of senior living.

The Cost of Senior Living in Washington

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

Based on the Genworth 2021 Cost of Care Survey, the costs of assisted living, independent living, memory care and nursing home care in Washington are significantly higher than the national averages. Most long-term care options are expected to be more expensive than independent living, which costs the least at $3,900 per month. Independent living is suitable for seniors who are able to function daily without nonmedical care and medical support.

Assisted living at $6,000 and memory care at $7,500 cost far greater compared to independent living due to the inclusion of personal care and around-the-clock supervision. Nursing homes provide the highest level of care, including 24-hour skilled services. That’s why they’re the most expensive option at $9,429 for semiprivate accommodations.

The Cost of Assisted Living in Washington

In the Pacific Northwest, Washington is the most expensive state for assisted living with an average cost of $6,000 per month, $1,500 higher than the national average of $4,500. Idaho is the most affordable state at $3,838, costing nearly $2,200 less than the Evergreen State. Oregon at $5,045 is cheaper than Washington by almost $1,000, while Montana’s average of $4,450 per month saves older Washingtonians close to $1,600 per month. Outside the Northwest, California’s average assisted living cost of $5,250 is $750 lower than Washington, while Nevada at $3,750 is considerably more affordable by about $2,300 per month.

The Cost of Nursing Home Care in Washington

Nursing home care in Washington costs $9,429 per month for a semiprivate room, approximately $1,500 higher than the national median of $7,908. The most expensive neighboring state is Oregon at $10,342, about $900 more than Washington. Idaho and Montana are considered affordable with respective averages of $8,517 and $7,574. These rates save Evergreen State seniors $900 to $1,900 monthly. Further south, California and Nevada are comparable to Washington with nursing home care costing over $9,000.

Can You Use Medicaid to Pay for Senior Living in Washington?

Washington’s Medicaid program is called Apple Health. It helps eligible beneficiaries pay for senior living through specific Long-Term Services and Supports. These LTSS programs include the Apple Health State Plan, and there are several Medicaid waivers that may cover senior care services provided in the recipients’ home, nursing homes and alternative residential care establishments, such as assisted living facilities and adult family homes.

Room and board in ALFs and AFHs are not covered. Independent living services in retirement communities and affordable senior housing are also not covered by Apple Health’s LTSS program, but those who are eligible for regular Medicaid may still receive other forms of health care coverage.

Functional eligibility for these LTSS programs is determined through Comprehensive Assessment Reporting Evaluation (CARE) screenings conducted by a case manager or social services worker designated by the Washington Department of Social and Health Services. The DSHS also determines the applicants’ financial eligibility based on maximum income and asset requirements.

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	Partial	Medicaid and Medicaid Waivers	Yes for state plan; no for waivers
Independent Living	None	N/A	N/A
Memory Care	Partial	Medicaid and Medicaid Waivers	Yes for state plan; no for waivers
Nursing Home Care	Full	Medicaid	Yes

*Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not an entitlement, then participant caps could be in place, and there may be a waiting list.

Medicaid’s Coverage of Assisted Living & Memory Care in Washington

There are multiple Medicaid coverage options for assisted living and memory care in Washington. They include the Apple Health State Plan and various waiver programs.

Community First Choice (CFC) State Plan

The CFC program covers care services provided in the recipient’s home or in assisted living facilities and adult family homes that are contracted to provide Home- and Community-Based Services. Such services may include community transition support, personal assistance, nurse-delegated services, respite care, assistive technology, and skills acquisition training that helps enhance the individual’s ability to perform daily living activities. CFC does not cover room and board.

CFC participants must be qualified for an institutional level of care and meet financial criteria under the Apple Health State Plan’s categorically needy (CN) or alternate benefit plan (ABP) scope of care. Otherwise, financial eligibility may be considered based on income requirements under a Home- and Community-Based (HCBS) waiver.

Applications for CFC may be made online through Washington Connection or in person at a local Home & Community Services (HCS) office.

Community Options Program Entry System (COPES) Waiver

COPES is a Medicaid HCBS waiver program that pays for long-term services and supports provided in private homes and contracted assisted living and memory care facilities. Services covered in a residential care community may include nursing services, skilled care, specialized equipment and supplies, functional/wellness training, transportation and one-time community transition support. Room and board are not covered.

Seniors who might not qualify for CFC may be eligible for COPES. They must be aged 65+ and require a nursing facility level of care. The applicant must also be financially eligible as determined by DSHS in terms of applicable exemptions on income and resources.

Similar to CFC, applications for COPES may be submitted online or through a local HCS office.

Residential Support Waiver

The RSW program is for eligible residents receiving specialized care in ALFs with Expanded Community Services (ECS) and in AFHs providing Specialized Behavior Support (SBS). In addition to services similarly covered by CFC and COPES, this waiver also covers necessary SBS services provided in a residential setting. Qualified RSW recipients must be determined to require a nursing facility level of care but are eligible for community-based placement given their behavioral challenges.

The financial criteria and application procedures for RSW are similar to CFC and COPES.

Specialized Dementia Care Program

CFC enrollees and other Medicaid-eligible seniors with dementia may be qualified for the DSHS Specialized Dementia Care Program. This specialized service package usually includes personal care and supervision by certified staff as well as medication assistance, intermittent nursing and tailored activities. These services must be provided by contracted ALFs with an Enhanced Adult Residential Care-Specialized Dementia Care (EARC-SDC) designation. Applicants must be diagnosed with Alzheimer’s or other irreversible dementias and be determined to require memory care.

Medicaid’s Coverage of Nursing Home Care in Washington

Apple Health LTSS pays for nursing home care through its State Plan. The costs of Medicaid-funded nursing home care services include direct and indirect care components that are reimbursed by the DSHS based on the specific Medicaid payment rate for a particular nursing home. The effective coverage period starts upon a request for a CARE assessment or when the client begins receiving nursing home care, whichever is later.

Medicaid-eligible nursing home care recipients must meet the financial criteria for any of Apple Health’s scope of care categories which are Categorically Needy (CN), Medically Needy (MN), Alternative Benefit Plan (ABP) and Medical Care Services (MCS). Applicants exceeding the income limit may use spenddown policies to qualify for coverage. Recipients may benefit from personal needs allowances, income retention for non-applicant spouses and housing maintenance allowances for nursing home residents who are determined to be able to return home within six months of an institutionalized stay.

Eligibility for Medicaid in Washington

The income and resource limits for the CN and MN scope of care are SSI-based and applicable to Medicaid for the Aged, Blind or Disabled. For 2022, this limit is $841 per month. Individuals who require a nursing home level of care can qualify for Medicaid LTSS or waivers if they earn up to 300% of the federal benefit rate under the special income limit, which is $2,523, but most of their income must be used for care. These figures are subject to change every January. The table below shows data as of 2022.

2022 Washington Medicaid Income Limits

	Income Limits*	Asset Limits
Single Person	$10,092 or $30,276	$2,000
Two-Person Household (Only one applicant)	$10,092 or $30,276 for applicant	$2,000 for applicant $137,400 for non- applicant
Two-Person Household (Two applicants)	$15,132 or $60,552	$3,000

*per year

Older Washingtonians applying for Apple Health for long-term care must be:

• Aged 65 and older.
• Washington State residents who are U.S. citizens or permanent residents.
• Determined via a CARE assessment to require a nursing facility level of care.

Applying for Medicaid in Washington

Seniors in need of long-term care may apply for Apple Health LTSS through one of the following methods:

• Online: Visit Washington Connection at WashingtonConnection.org.
• Paper application: Access printable Form 18-005, and mail to the below DSHS address, or fax to (855) 635-8305.

DSHS Home and Community Services
P.O. Box 45826
Olympia, WA 98504-5826

• In person: Visit a local Home & Community Services (HCS) office.
• By phone: Call DSHS at (877) 501-2233.

Before You Apply

The Washington Apple Health LTSS booklet supplies helpful information on available long-term care options for seniors and the application process. To apply for LTSS, the applicant or his/her representative must be able to provide the following information:

• Social Security numbers
• Birthdates and other proof of identification
• Immigration status documents
• Income information
• Resource and asset information (e.g. bank account balances, property tax statements, life insurance and documents on stocks, bonds, trusts or retirement accounts)

How to Get Help

Applicants who need assistance with filling out an application form may seek help from a local HCS staff for available large-print forms, Braille materials, assistive listening devices, TTY (teletypewriters) or assistance by a qualified interpreter.

	Contact	What You Should Know
Washington Connection	(877) 501-2233	Washington Connection is a comprehensive online application portal for various public benefits, including Apple Health, Medicare Savings Programs and cash assistance. Its prescreening page helps applicants identify their needs and possible services and programs they’re qualified to receive.
DSHS Home & Community Services	(800) 422-3263	HCS is a division of the DSHS Aging and Long-Term Support Administration (ALTSA). In addition to providing assistance with Apple Health LTSS applications, this agency is responsible for determining an applicant’s financial eligibility.
Washington State Health Care Authority	(800) 562-3022	Washington’s HCA is responsible for the health care coverage of Washingtonians through Medicaid and other public programs. Recipients may refer to this agency for information on Apple Health programs and to report suspected Medicaid fraud.

Can You Use Medicare to Pay for Senior Living in Washington?

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

• Meals
• A semiprivate room
• Medications
• Skilled nursing services
• Physical therapy
• Occupational therapy
• Speech therapy
• Audiologist care
• Medical supplies
• Medical social services
• Nutritional counseling
• Ambulance transportation

What Nursing Home Care Services Aren’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.

Medicare Support & Resources in Washington

Washington State’s Office of the Insurance Commissioner (OIC) has a dedicated agency for Medicare-related information and assistance, while the state’s Health Care Authority (HCA) and Department of Social & Health Services (DSHS) help qualified Washingtonians understand and apply for Medicare Savings Programs. Seniors and families may contact the following services and programs for further assistance.

Resource	Contact	What You Should Know
Statewide Health Insurance Benefits Advisors	(360) 586-0241 or local SHIBA offices	As Washington’s State Health Insurance Program, SHIBA has volunteer advisers who provide free, unbiased and confidential counseling on Medicare plan options and other health insurance benefits. SHIBA counselors help clients assess their coverage needs and general eligibility, and they provide assistance with Medicare enrollment. SHIBA also handles the Medicare Senior Patrol project that helps clients prevent, detect and report Medicare fraud and abuse.
Medicare Savings Program	(877) 501-2233	The state’s four MSPs (QMB, SLMB, QI-1 or QDWI) help recipients pay for their Medicare premiums, copayments, deductibles and coinsurance costs. Beneficiaries must earn no more than 100-200% of the federal poverty level to qualify. An updated MSP brochure from the HCA is available to help applicants see if they qualify for a Medicare Savings Program based on their income and assets. MSP applications may be submitted online via Washington Connection or by submitting an application form to the DSHS.
Washington LawHelp for Seniors	(888) 201-1012	Established and maintained by the Northwest Justice Project, WashingtonLawHelp.org offers publicly funded legal resources to low-income Washingtonians. Its comprehensive database of free legal information and materials includes topics on elder law as well as up-to-date resources on Medicare and other health care insurance and programs. This free legal aid program also connects eligible residents to NJP lawyers who may provide free legal services.

Are There Other Financial Assistance Options for Senior Living in Washington?

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in Washington. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov.	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free Senior Living Resources for Seniors in Washington

Older Washingtonians have access to a wealth of senior resources that can provide assistance with navigating government benefits, long-term care options and public and private service providers. These organizations share the common objectives of helping seniors maintain their independence, dignity, health, well-being and freedom of choice.

	Contact	What You Should Know
Aging and Long-Term Support Administration	(360) 725-2300	The ALTSA operates under the DSHS and administers state and federal programs for older Washingtonians through its Residential Care Services, Home and Community Services, Adult Protective Services and Tribal Affairs divisions. It partners with the state’s Area Agencies on Aging and other service providers, government agencies and community organizations to support seniors and their caregivers.
Community Living Connections	(855) 567-0252	Washington State’s CLC network links seniors, caregivers and families to their local Area Agencies on Aging and refers them to other appropriate programs and organizations with its key function as an Aging and Disability Resource Center. This ADRC  provides one-on-one options counseling on long-term services and supports, performs streamlined eligibility screenings on public programs and coordinates care through its Person-Centered Care Transitions Supports.
Washington State Senior Centers	[email protected]	The Evergreen State’s senior centers offer enriching activities and services that suit older adults’ interests, skills and needs while promoting independence, well-being and community involvement. These senior centers also function as resource hubs for information on aging, social services and family caregiver support.
Washington Health Care Association	(360) 352-3304	The WHCA performs advocacy functions and engages in regulatory participation to ensure the quality of long-term care services provided by its member establishments. It maintains a directory of participating assisted living and skilled nursing facilities throughout the state that are organized by city/town and include information about resident capacity.
Alzheimer’s Association Washington	(800) 272-3900	ALZ Washington has four offices in Lynnwood, Tukwila, Spokane and Richland that serve the state’s 47 counties, and it has a dedicated office for northern Idaho. Its Connections Care Consultation Program provides free assessments, referrals and care coordination services  to families in King and Snohomish counties as well as free phone consultations across the rest of its service area. This organization offers support groups, educational programs and volunteer opportunities.
Washington State Department of Veterans Affairs	(800) 562-2308	The WDVA helps veterans and their dependents obtain qualified state and federal benefits through its claims assistance program. These entitlements may include VA disability compensation, pensions, Aid & Attendance and health care benefits. All counties in Washington have DVA offices that are staffed by qualified Service Officers who take a case management approach in serving their clients. These VSOs can provide counseling, referrals and legal representation for VA claims. The WDVA also operates four State Veteran Homes that are certified by Medicare and Medicaid to provide 24-hour nursing home care to honorably discharged Washington-based veterans and their spouses.
Senior Community Service Employment Program	(253) 573-6759	SCSEP offers work opportunities to unemployed low-income adults aged 55 and older. This program assists job-seeking seniors in obtaining community-based job training placements to help them transition to permanent employment in their chosen fields. SCSEP participants may earn income that can help pay for senior housing, and they’re eligible to enroll in Goodwill’s career education and development programs.

COVID-19 Rules and Restrictions for Washington Senior Living Facilities

The following information is based on research done on several government websites, including dshs.wa.gov/altsa/covid-19 and cdc.gov/coronavirus. These rules apply to nursing homes 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.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are Hairdressers and other non-medical contractors still 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 being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	No (Conditions Apply)
Are senior living facilities required to cancel all group outings?	No
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

Senior Living Laws and Regulations in Washington

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations. 

The Washington State Department of Health and Social Services regulates senior living facilities throughout the state. Although some facilities are permitted to operate without a license, all senior living facilities must follow the regulations set forth in Title 388 of the Washington Administrative Code. These are some of the most relevant regulations.

Service Plans

A senior living facility must assess every new resident prior to admission. The assessor must identify the applicant’s medical and social needs, food and activity preferences, medication needs and personal care needs. Information from this assessment is used to develop an initial resident service plan.

Medication Management

Senior living facilities must have policies and procedures to promote safe medication service for every resident. Medications are only to be administered if the facility has a written order from a licensed prescriber, a nursing note documenting a telephone order from a physician or a prescription label from a licensed pharmacy. The order or prescription label must include the resident’s name, the name of the medication, the dosage, how often the medication should be taken and the name of the prescriber.

If residents can’t safely store their medications in their rooms or apartments, the facility must be responsible for medication storage. All medications must be stored together for each resident, separate from toxic substances or food and in a locked compartment that can only be accessed by authorized staff members. Each medication must be kept in a container with the manufacturer’s label or the original pharmacy label.

Background Checks

All caregivers employed by a senior living facility must undergo a Washington name and date of birth background check, which provides information about an individual’s conviction history and pending criminal charges. A facility may not employ anyone who has a disqualifying conviction or a pending charge for a disqualifying crime. Qualifying crimes include assault, felony domestic violence, murder, rape and robbery.

Applicants who pass the state background check must also undergo a national fingerprint check. If the national check uncovers a disqualifying conviction or pending charges for a disqualifying crime in another state, the applicant isn’t permitted to work as a caregiver or administrator in a senior living facility.

Training Requirements

All staff must receive appropriate training based on their job duties. This training includes safety, first aid and CPR. Additional training is required for employees of facilities with specialized care units for residents with dementia.

Specialized Care Units

Senior living facilities are permitted to operate specialized units for residents with dementia. Any facility with this type of unit must obtain information related to the resident’s personal needs, significant life experiences and patterns of behavior that could indicate the resident has an unexpressed need for support.

If a resident with dementia is capable of safely leaving the building, they must be able to do so without restriction. For buildings with restricted entrances and exits, residents and their visitors must be given freedom of movement. These buildings must also have secured outdoor spaces. Facilities providing memory care must be designed with that type of care in mind. Each facility must have common areas to promote socialization and safe outdoor areas to encourage physical activity.

Reporting Abuse and Neglect

Any staff member who suspects that a resident has been abused, neglected or exploited must file a report with the Aging and Disability Services Administration Complaint Resolution Unit hotline at (800) 562-6078. Online reports may also be filed at the Washington State Department of Health and Social Services website. If a staff member suspects that a resident has been physically or sexually abused, a report must also be filed with a local law enforcement agency.

Frequently Asked Questions

How much does assisted living cost in Washington?

Washington has higher-than-average assisted living costs. According to the Genworth Financial 2019 Cost of Care Survey, Washington seniors can expect to pay an average of $5,500 per month for assisted living, which is much higher than the national average. Costs are even higher in the Seattle area.

Are there financial assistance programs for assisted living in Washington?

Yes. Some seniors qualify for Medicaid waivers that can be used to cover the costs of assisted living. These programs, the Community Options Program Entry System and the Community First Choice Option waiver, aim to keep seniors out of nursing homes by providing the support they need to live safely in the community. The Medicaid Personal Care program may also provide funds that can be used to pay for personal care provided in an assisted living facility.

What are activities of daily living?

Activities of daily living are routine activities that all adults should be able to perform without assistance. They include eating, drinking, using the bathroom and getting dressed.

What types of amenities are commonly in assisted living communities?

Assisted living facilities typically have housekeeping and laundry services, private dining rooms, game rooms and activity centers. Most facilities also arrange social activities for their residents.

Who should consider assisted living?

Seniors who need 24/7 support should consider assisted living if they need help with some activities of daily living but don’t require the daily medical care provided in a nursing home.

Learn More About Senior Living in Washington

For more information about specific types of senior living in Washington read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in Washington

Learn more about the cost of senior living in the top Washington cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.