About Assisted Living Facilities

The assisted living facility provides room and board and help with activities of daily living.

These facilities in a community setting are licensed to care for seven or more residents. The assisted living facility provides room and board and help with activities of daily living. Some ALFs provide limited nursing services; others may specialize in serving people with mental health problems, developmental disabilities, or dementia (Alzheimer's disease). RCW 18-20-020(2).

Some assisted living facilities provide services through a contract with the Department of Social and Health Services. Specific services are provided in a contracted assisted living facility.

 

If you are considering care in an assisted living facility

 

 

Do you want to open an assisted living facility?

How do I apply for a contract to provide services to residents who receive state assistance?

For initial license applications, fill out and submit a completed Assisted Living Facility License Application – Initial License, along with the applicable license fee.

If you were licensed to operate an assisted living facility within the past 12 months, send a letter stating the assisted living facility name, assisted living facility license number and the type of contract(s) requested to the Business Analysis and Applications Unit (PO Box 45600, Olympia, WA 98504). An application is not required. If you already have an assisted living facility license but no contracts, fill out and submit a completed Assisted Living Facility Contract Application.

If you have at least one contract and want to apply for additional contracts, fill out and submit a completed Assisted Living Facility Contract Application – “Mini”. No fee is required for either contract application.

How do I decrease the number of licensed beds?

Licensed bed decreases can be requested by filling out and submitting a “Change in Status to the Assisted Living Facility Licensed Resident Bed Capacity or Licensed Rooms” form. 

The form is available at https://www.dshs.wa.gov/altsa/baau-application-processing-timeline. There is no fee to decrease the number of beds.

How do I increase the number of licensed beds?

Licensed bed increases can be requested by filling out and submitting a “Change in Status to the Assisted Living Facility Licensed Resident Bed Capacity or Licensed Rooms” form, along with the fee of $116 per additional bed. The fee may be prorated. The form is available at https://www.dshs.wa.gov/altsa/residential-care-services/information-assisted-living-facility-professionals.

Before the licensed bed capacity may be increased, you must: (1) obtain from the Department of Health, Construction Review Services a review and approval of additional rooms or beds, and related auxiliary spaces, if not previously reviewed and approved; and (2) ensure the increased licensed bed capacity does not exceed the maximum facility capacity as determined by the department.

How do I request an assisted living facility license and/or contract application?

You may obtain an assisted living facility license or contract application by calling the Business Analysis and Application Unit at (360) 725-2420. Assisted living facility license and contract applications are available at this website.

How long will it take to process my ALF license application?

Each assisted living facility application is unique. Because of this, it is impossible to predict how long the licensing process will take. Currently, the application process may take as long as 4-6 months.

I am constructing a new ALF. How do I start the licensing process?

New construction requires approval from the Department of Health, Construction Review Services (DOH-CRS). Contact DOH-CRS for review of all new assisted living facility construction. The application is available at https://doh.wa.gov/licenses-permits-and-certificates/facilities-z/construction-review-services-crs. Write to: Department of Health, Construction Review Services, P.O. Box 47852, Olympia, WA 98504-7852. Phone: (360) 236-2944. Fax: (360) 236-2901. Email: fslcrs@doh.wa.gov. CRS approval must be obtained before an assisted living facility license can be issued. The assisted living facility application may be submitted prior to obtaining CRS approval.

I am the 100% owner of a “for profit” corporation that is licensed to operate an assisted living facility. I want to change from a corporation to a limited liability company (LLC). I will remain the 100% owner. Do I need to submit an application?

You will need to fill out and submit a completed Change of Licensee (Operator) “Mini” application.

If you do not know which Change of Licensee (Operator) application to use, call the Business Analysis and Application Unit at (360) 725-2420.

I need to complete a change of licensee (operator) license application. Which change of licensee (operator) application do I use?

If you do not currently operate a licensed assisted living facility in the State of Washington, fill out and submit a completed Change of Licensee (Operator) “Full” application.

If you currently operate a licensed assisted living facility in the State of Washington or if you are an affiliate of an entity currently licensed to operate an assisted living facility in Washington, fill out and submit a completed Change of Licensee (Operator) “Partial” application. (An “ affiliated entity” is an entity that is owned by a licensed entity, holds interest in a licensed entity, or is a subsidiary of a licensed entity).

If you currently operate a licensed assisted living facility in the State of Washington, intend to submit license applications to operate several additional facilities, and the applicant will be the same on all applications, fill out and submit a completed Change of Licensee (Operator) “Full” application for one of the facilities. Also, fill out and submit a completed Change of Licensee (Operator) “Mini” application for each additional facility. Submit all applications simultaneously.

If you do not know which Change of Licensee (Operator) application to use, call the Business Analysis and Application Unit at (360) 725-2420.

I want to change the use of a room in my assisted living facility. How do I start?

Before using a room for a purpose other than what was approved by Department of Health, Construction Review Services, you must: (1) notify Construction Review Services in writing at least thirty (30) days before the intended change in use; and (2) obtain written approval from Construction Review Services for the new use of the room. In the notice to Construction Review Services, you need to describe the current and proposed use of the room. All additional documentation requested by Construction Review Services must be provided.

I want to remodel my assisted living facility. How do I start?

Remodels require approval from the Department of Health, Construction Review Services (DOH-CRS). Contact DOH-CRS for review of all new assisted living facility construction. Write to: Department of Health, Construction Review Services, P.O. Box 47852, Olympia, WA 98504-7852. Phone: (360) 236-2944. Fax: (360) 236-2901. Email: fslcrs@doh.wa.gov. CRS approval must be obtained before the remodeled area may be used.

The 25% owner of a “for profit” corporation wants to sell the 25% interest to the remaining owners. There will be no change in the person with control over all operational decisions. Do I need to submit an application?

You do not need to submit an application as long as the transaction complies with WAC 388-78A-2770 (1)(d). You will need to send a letter to the Business Analysis and Application Unit explaining the transaction in detail.

If you do not know if you need to submit an application, call the Business Analysis and Application Unit at (360) 725-2420.

What is an assisted living facility?

An assisted living facility means any home or other institution, however named, which is advertised, announced, or maintained for the express or implied purpose of providing housing, basic services, and assuming general responsibility for the safety and well-being of the residents, and may also provide domiciliary care, consistent with Chapter 388-78A WAC to seven or more residents after July 1, 2000. An assisted living facility that is licensed for three to six residents prior to or on July 1, 2000, may maintain its assisted living facility license as long as it is continually licensed as an assisted living facility.

“Assisted living facility” does not include (1) facilities certified as group training homes pursuant to RCW 71A.22.040; (2) any home institution or section thereof which is otherwise licensed and regulated under the provisions of state law providing specifically for the licensing and regulation of such home, institution or section thereof; (3) any independent senior housing, independent living units in continuing care retirement communities, or other similar living situations including those subsidized by the Department of Housing and Urban Development.

What is an EIN number?

An EIN number is the 9-digit number assigned to businesses by the Internal Revenue Service (IRS) for filing and reporting purposes. The applicant must have this number prior to applying for assisted living facility licensure and/or contract. A copy of the IRS CP-575 or SS-4 form showing the assigned EIN number will be accepted as verification an EIN was obtained.

What is a UBI number?

The Unified Business Identifier (UBI) is a 9-digit number issued to individuals and companies doing business in the State of Washington. The applicant must have this number prior to applying for assisted living facility licensure and/or contract. A copy of the applicant’s Master License Service Registrations and Licenses (business license), the Certificate of Incorporation or Certificate of Formation issued by the Secretary of State, or any other official document issued by any State of Washington agency.

What is domiciliary care?

Domiciliary care means:

  1. Assistance with activities of daily living provided by the licensee either directly or indirectly; or
  2. Health support services, if provided directly or indirectly by the assisted living facility; or
  3. Intermittent nursing services, if provided directly or indirectly by the assisted living facility.
What is licensed resident bed capacity?

Licensed resident bed capacity means the resident occupancy level requested by the licensee and approved by the department. All residents receiving domiciliary care or the items or services listed under general responsibility for the safety and well-being of the resident as defined in WAC 388-78A-2020 count towards the licensed resident bed capacity. Adult day care clients do not count towards the licensed resident bed capacity. (The licensee is not required to license independent units / beds.)

What is maximum facility capacity?

Maximum facility capacity is the maximum number of individuals that the assisted living facility may serve at any one time, as determined by the department. The maximum facility capacity includes all residents, all respite care residents, and all adult day care clients. Refer to WAC 388-78A-2020 for calculating maximum facility capacity.

What is the difference between ARC, EARC, and AL contracts?

Adult residential care (ARC) is a package of services provided by an assisted living facility that is licensed under Chapter 18.20 RCW and that has a contract with the department under RCW 74.39A.020 to provide personal care services.

Enhanced adult residential care (EARC) is a package of services provided by an assisted living facility that is licensed under Chapter 18.20 RCW and that has a contract with the department to provide personal care services, intermittent nursing services, and medication administration services in accordance with Parts I and III of Chapter 388-110 WAC.

Assisted living services is a package of services provided by an assisted living facility that has a contract with the department under RCW 74.39A.020 to provide personal care services, intermittent nursing services and medication administration services in accordance with Parts I and II in Chapter 388-110 WAC. Assisted living services include housing for the resident in a private apartment-like unit.

Personal care services means the same as personal care services defined in WAC 388-72A-0035. Personal care services do not include assistance with tasks that must be performed by a licensed health professional.

What is the license fee for an ALF license?

The license fee is $116 per licensed bed. The fee is calculated by multiplying the number of licensed beds by $116. For initial applications, this fee is due when the application is submitted.

Who do I contact if I have further questions regarding assisted living facility licensure?

Information regarding the assisted living facility application process can be obtained by writing to the Business Analysis and Application Unit, P.O. Box 45600, Mail Stop: 45600, Olympia, WA 98504-5600 or calling (360) 725-2420. WAC and RCW information is available at https://leg.wa.gov/about-the-legislature/legislative-agencies/cro .

Who needs to fill out a Background Check Authorization form to submit with the application?

For application purposes, background check authorization forms are required for individual applicants, entity owners, partners, officers, directors and managerial employees, group or association members, and the administrator.

It is the licensee’s responsibility to require and submit background check authorization forms on all individuals associated with the assisted living facility who have unsupervised access to residents, including, but not limited to, employees, managers, volunteers who are not residents, contractors, and students.

Who should sign the Assisted Living Facility application?

The application must be signed by the individual applicant, or by an officer, director, member, partner, or owner of 5% or more of the entity applicant who has signature authority. The signature of the administrator does not meet the requirements if the administrator does not have 5% or more ownership in the entity.