Last updated 2026-07-26
TL;DR
Washington's assisted living license lookup lives on the DSHS Aging and Long-Term Support Administration website. It lets you search by facility name, city, or county to confirm a license is active, check capacity, and pull recent inspection reports before you move a family member in or open your own facility.
Where is the Washington assisted living license lookup tool?
Washington's Department of Social and Health Services (DSHS), through its Aging and Long-Term Support Administration (ALTSA), maintains the public facility search for licensed assisted living facilities, adult family homes, and nursing homes. The tool is commonly called the "Resident Care Facilities" or long-term care facility search, and it's the closest thing the state has to an official license lookup. You search by facility name, city, or county rather than a license number, since Washington doesn't publish a simple license-number lookup box the way some states do for professional licenses. The results show the facility type (assisted living facility, adult family home, or enhanced services facility), address, capacity, and licensing status. Some listings link out to inspection or complaint history. ALTSA's licensing division, Residential Care Services, is the actual licensing authority behind the data. If a facility doesn't appear in the search, that's a real red flag, more than a database glitch. Confirm with your state licensing agency directly before assuming a facility is unlicensed [1].
What is assisted living?
Assisted living is a residential care option for adults, most often older adults, who need help with daily activities like bathing, dressing, medication management, or meals but don't need the round-the-clock skilled nursing care a nursing home provides. Residents typically live in private or semi-private apartments and get personal care services plus some level of health monitoring. In Washington, this category is licensed as an "assisted living facility" under state law, and it's distinct from an adult family home, which is a smaller, home-based setting (typically 2 to 6 residents) licensed under a different chapter of state code. Both fall under ALTSA oversight, but the physical setting, staffing ratios, and resident capacity differ significantly. Nationally, assisted living is regulated at the state level, not federal. There's no single federal definition or licensing scheme, which is why the term means something slightly different in every state. That's also why the lookup tool matters so much: it's the only reliable way to confirm what license a specific building actually holds.
What is a group home?
A group home is a residential setting where a small number of unrelated people, often people with intellectual or developmental disabilities, mental illness, or in recovery from substance use, live together with staff support. It's a broader term than "assisted living" and covers a wider range of populations, more than seniors. Group homes can be licensed under several different state programs depending on who they serve. In Washington, a group home serving adults with developmental disabilities may fall under Developmental Disabilities Administration (DDA) licensing rules, while one serving seniors needing personal care would more likely be licensed as an adult family home or assisted living facility through ALTSA [2]. The practical difference for an operator: the licensing agency, staffing requirements, and physical plant rules change based on who you're serving, more than the size of the building. If you're planning to open a facility, figure out your target population first. That decision drives almost every other regulatory choice you'll make, and it's the first thing covered in a state-specific assisted living facility planning guide.
What is an assisted living facility (and what is assisted living facility, exactly, under Washington law)?
Under Washington law, an assisted living facility is a licensed facility that provides housing and basic services, plus domiciliary care, to seven or more residents who are not related to the operator. The legal definition sits in RCW 18.20.020, which defines "assisted living facility" as a facility licensed under chapter 18.20 RCW that provides housing, basic services, and assumes responsibility for resident safety. The key regulatory thresholds worth knowing: facilities with six or fewer unrelated residents generally fall under the adult family home license (chapter 70.128 RCW) instead, a different licensing chapter with different staffing and inspection rules [3]. That size cutoff, seven or more residents, is one of the most commonly misunderstood facts about Washington licensing, and it's worth confirming directly with ALTSA before you commit to a building or lease, since local zoning may treat the two license types differently too. See our guide on zoning and property considerations for more on how facility size interacts with local land use rules. Washington's assisted living facilities are also categorized by the specialty services they're licensed to provide, things like dementia care or specialized behavioral health support carry additional licensing endorsements and staff training requirements layered on top of the base assisted living license [4].
What is assisted living vs nursing home, and what's the real difference?
| Licensing body (WA) | ALTSA, chapter 18.20 RCW | ALTSA/DOH, chapter 18.51 RCW | |
|---|---|---|---|
| Staffing | Personal care aides, some nursing oversight | Licensed nurses on-site 24/7 | |
| Medical care level | Limited, non-skilled | Skilled nursing, rehab | |
| Typical setting | Apartment-style, private/semi-private | Hospital-like, shared rooms common | |
| Medicare coverage | Not covered for room and board | Short-term rehab stays covered under specific conditions | The distinction matters for payment too. Medicare's coverage rules are built around skilled nursing and rehabilitation, not the custodial personal care that defines assisted living. That leads directly into the next question, because it trips up a lot of families. |
Assisted living and nursing homes both provide residential care, but they sit at different points on the care intensity spectrum. Assisted living is for people who need help with daily activities but not ongoing medical or skilled nursing care. Nursing homes (called "skilled nursing facilities" in Medicare terminology) are for people who need daily medical care, rehabilitation, or 24-hour nursing supervision. | Feature | Assisted Living Facility | Nursing Home (Skilled Nursing) |
Does Medicare cover assisted living facilities?
No. Medicare does not cover the cost of room, board, or personal care services in an assisted living facility. Medicare.gov states plainly that Medicare does not pay for "custodial care" (help with daily living activities like bathing, dressing, and using the bathroom) when that's the only care a person needs, and that's precisely the kind of care assisted living provides [5]. Medicare will pay for short-term skilled nursing facility stays under specific conditions (a qualifying hospital stay of at least three days, a doctor's order for skilled care, and a facility that's Medicare-certified), and it covers medical services delivered inside an assisted living facility, like doctor visits, physical therapy, or durable medical equipment, the same way it would anywhere else [6]. But the roof over someone's head and the aide helping them get dressed each morning: that's out of pocket, or covered through other means. Medicaid is a different story. Washington's Medicaid program can help cover personal care costs in some assisted living settings through its Community First Choice option and other home and community-based services waivers, but eligibility rules and facility contracting requirements are specific and change periodically [7]. If you're researching payment options for a family member, or building a facility that plans to accept Medicaid residents, confirm current rules with Washington's Health Care Authority and ALTSA directly rather than relying on a facility's marketing materials.
What does assisted living provide, day to day?
Assisted living typically provides a private or semi-private living space, three meals a day, help with activities of daily living (bathing, dressing, toileting, mobility), medication management or reminders, housekeeping and laundry, and some level of social and recreational programming. Washington's licensing rules under WAC 388-78A require facilities to have a written service plan for each resident based on an assessment of their needs [8]. What's not typically included: skilled nursing care, complex medical treatment, or intensive behavioral health intervention, unless the facility holds a specific additional endorsement for that level of care. Facilities that market themselves as offering dementia care or "enhanced" services usually hold add-on certifications beyond the base assisted living license, and Washington's inspection reports will note whether a facility is authorized for those specialty services. Staffing levels aren't set as a single fixed ratio across all of Washington's assisted living facilities the way they are in some states' nursing home rules. Instead, state rule requires facilities to staff "sufficient" personnel to meet each resident's assessed needs around the clock, which means the real staffing level depends on the acuity of the current resident population. This is one of the areas where actual practice varies a lot between facilities, and it's worth asking directly during a tour or verifying against a recent inspection report.
How to start a group home in Washington (and how do I start a group home, step by step)
Starting a group home or assisted living facility in Washington involves several parallel tracks: choosing your population and license type, securing a compliant building, meeting staffing and training requirements, and completing the state application before you can accept residents. There's no single fast-track path, and the state does not guarantee approval timelines. Roughly, the sequence looks like this: 1. Decide your population and license type. Seniors needing personal care point toward an assisted living facility or adult family home license through ALTSA. Adults with developmental disabilities point toward DDA licensing. Behavioral health or recovery populations may fall under Washington's Health Care Authority or DSHS behavioral health licensing rules instead. Get this wrong early and you'll redo your whole application. 2. Check zoning before you sign a lease. Local jurisdictions in Washington have their own zoning and permitting rules for residential care facilities, and state fair housing law limits how cities can restrict certain group homes, but the connection between local zoning and state preemption is genuinely complicated. Confirm with your city or county planning department and your state licensing agency before committing to a property. Our zoning and property resources walk through the general framework. 3. Submit a license application to ALTSA's Residential Care Services division, including facility plans, staffing plans, and a criminal background check for the applicant and key staff. Washington requires background checks under RCW 43.43.842 for anyone with unsupervised access to vulnerable adults. 4. Prepare for a pre-licensing inspection. State surveyors will check the physical plant against fire, safety, and building code requirements before issuing a license, and Washington coordinates with the State Fire Marshal's office on life safety code compliance for licensed care facilities . 5. Write your policies and procedures manual. This covers resident rights, medication management, emergency preparedness, staff training, and abuse reporting protocols. Washington's WAC 388-78A rules spell out most of what's required in writing, and gaps here are one of the most common reasons initial applications get sent back for revision [8]. A lot of first-time applicants underestimate how much of this is paperwork before it's ever about the building. Getting the staffing plan, the emergency preparedness plan, and the resident rights policy drafted correctly the first time saves months. That's the exact gap our $299 State Group Home Licensing Kit is built to close: state-specific templates for the policy manual and application paperwork so you're not starting from a blank page or reverse-engineering another state's forms.
What is the difference between assisted living and nursing home care intensity?
The core difference is medical acuity, more than building type. Assisted living residents are generally mobile or semi-mobile, manage most of their own health conditions with support, and need help mainly with daily tasks. Nursing home residents typically need daily skilled nursing care, wound care, IV therapy, or rehabilitation following a hospital stay, and they're often less mobile or medically fragile. Washington licenses these under entirely separate chapters of state law: assisted living facilities under chapter 18.20 RCW, and nursing homes under chapter 18.51 RCW, with different staffing, physical plant, and inspection standards for each [3]. A facility can't just decide to "upgrade" its care level; it needs the separate license and the physical plant to match, including things like nurse call systems and med storage rules that differ by chapter. For families searching a license lookup tool, this distinction shows up directly in the search results: the facility type field will say "assisted living facility," "nursing home," or "adult family home," and that field tells you which regulatory rulebook applies to the building you're looking at.
How do I read a Washington license lookup search result?
Once you find a facility in the ALTSA search tool, look for a handful of specific data points: license status (active, pending, suspended, or revoked), licensed capacity (the maximum number of residents allowed), facility type, and any linked inspection or complaint reports. A facility operating over its licensed capacity, or one with a lapsed license, is a serious concern worth raising with the licensing agency directly. Inspection reports (sometimes called survey reports) show any deficiencies cited during the last state visit and whether they were corrected. Washington facilities are inspected periodically, and complaint-driven inspections can happen any time a report is filed against a facility. Reading two or three years of inspection history, when available, tells you a lot more about day-to-day operations than the license status field alone. If a facility name doesn't turn up at all in the search, try searching by city or county instead of the exact business name, since some facilities operate under a name different from their legal corporate name. If it still doesn't appear, call ALTSA's Residential Care Services division directly rather than assuming the facility isn't real. Confirm with your state licensing agency before drawing conclusions either way.
What should operators do before opening a Washington assisted living facility?
Beyond the license application itself, operators should build a realistic budget and timeline that accounts for pre-licensing inspection delays, staff hiring and training lead time, and the fact that Washington doesn't guarantee a fixed approval timeline. Facilities typically need every core policy (medication management, emergency preparedness, resident rights, abuse reporting, staff training records) drafted and ready before the state will schedule a final inspection. It's also worth building relationships early with the local fire marshal and building department, since life safety code compliance is a common holdup for first-time applicants converting an existing residential structure into a licensed care facility. Structural changes like emergency exits, sprinkler systems, or ADA-compliant bathrooms often cost more and take longer than new operators expect, though exact figures vary too much by building and jurisdiction to generalize responsibly here; get a contractor and fire marshal walkthrough before you sign anything. For operators comparing Washington's process to other states, our assisted living facilities state guide index is a good next stop, along with the facility assisted living overview for general operational planning that applies across most states.
Frequently asked questions
What is assisted living?
Assisted living is residential care for adults who need help with daily activities like bathing, dressing, or medication management, but don't require the round-the-clock skilled nursing care of a nursing home. Residents usually live in private or semi-private apartments with staff support available and some level of health monitoring built in.
What is a group home?
A group home is a residential setting where a small number of unrelated people, often seniors, people with developmental disabilities, or people in behavioral health recovery, live together with staff support. The specific licensing agency and rules depend heavily on which population the home serves, more than its size.
What is an assisted living facility under Washington law?
Washington law (RCW 18.20.020) defines an assisted living facility as a facility licensed under chapter 18.20 RCW that provides housing, basic services, and takes responsibility for resident safety, typically serving seven or more unrelated residents. Facilities with six or fewer residents are usually licensed instead as adult family homes.
What is assisted living vs nursing home care?
Assisted living serves people who need help with daily tasks but not medical care, while nursing homes serve people who need daily skilled nursing care, rehabilitation, or 24-hour medical supervision. Washington licenses them under separate state law chapters (18.20 RCW for assisted living, 18.51 RCW for nursing homes) with different staffing and inspection standards.
Does Medicare cover assisted living facilities?
No. Medicare does not pay for room, board, or custodial personal care in an assisted living facility, per Medicare.gov guidance. Medicare does cover medical services delivered there, like doctor visits or physical therapy, and covers qualifying short-term skilled nursing facility stays separately under specific conditions.
What does assisted living provide day to day?
Typically a private or semi-private room, meals, help with daily activities like bathing and dressing, medication management, housekeeping, and social programming. Washington rule (WAC 388-78A) requires a written, individualized service plan for each resident based on a needs assessment before care begins.
How do I start a group home in Washington?
Choose your population and matching license type, check local zoning before signing a lease, submit a license application with background checks to the state licensing agency, pass a pre-licensing inspection, and have a complete policies and procedures manual ready. There's no guaranteed timeline, so budget extra time for revisions.
How do I look up a Washington assisted living license?
Search Washington's ALTSA facility search tool by facility name, city, or county rather than a license number. Results show license status, licensed capacity, facility type, and linked inspection reports where available. If a facility doesn't appear, call ALTSA's Residential Care Services division to confirm rather than assuming it's unlicensed.
What is the difference between an assisted living facility and an adult family home in Washington?
The main legal distinction is size and licensing chapter: assisted living facilities under chapter 18.20 RCW generally serve seven or more unrelated residents in a larger, more institutional setting, while adult family homes under chapter 70.128 RCW serve six or fewer residents in a home-based setting.
Is assisted living the same as a nursing home?
No. They're licensed differently and serve different care needs. Assisted living is for people who need help with daily activities; nursing homes provide skilled nursing and medical care for people with more intensive health needs, and Washington regulates each under its own separate chapter of state law.
What should I check on a license lookup before choosing a facility?
Check the license status (active vs. suspended or lapsed), licensed capacity versus actual occupancy if known, facility type, and any available inspection or complaint history. A facility with an inactive license or unresolved serious deficiencies is worth a direct call to the state licensing agency before you commit.
Can Medicaid help pay for assisted living in Washington?
In some cases, yes, through Washington's Medicaid home and community-based services programs, but eligibility and facility contracting rules are specific and change. Confirm current details directly with Washington's Health Care Authority and ALTSA rather than relying solely on a facility's own marketing claims.
Sources
- Washington State Legislature, RCW 18.20.020: Legal definition of 'assisted living facility' under Washington law
- Washington State Legislature, RCW 70.128: Adult family homes are licensed under chapter 70.128 RCW, a separate chapter from assisted living facilities
- Washington State Legislature, RCW 18.20.030: Assisted living facilities may hold additional licensing endorsements for specialty services like dementia care
- Medicare.gov, Nursing Home Care coverage page: Medicare does not cover custodial care such as help with daily living activities when that is the only type of care needed
- Medicare.gov, Skilled Nursing Facility Care coverage page: Medicare covers short-term skilled nursing facility stays only under specific qualifying conditions including a prior hospital stay
- Medicaid.gov, Home & Community Based Services: Medicaid home and community-based services programs can help cover personal care costs in some residential settings
- Washington State Legislature, WAC 388-78A: Washington rule requires assisted living facilities to develop a written individualized service plan for each resident
- Washington State Legislature, RCW 43.43.842: Washington requires criminal background checks for people with unsupervised access to vulnerable adults in licensed care settings