In a Washington adult family home, Medicaid can pay for your parent's care but not room and board, capped at $885.26 a month in 2026 for Medicaid residents., Washington adult family homes are licensed neighborhood houses for two to six adults, or up to eight with state approval. If one has been suggested for your mom or dad, you're probably wondering who's there at night and how you'd pay.

What Is an Adult Family Home in Washington?

Under Revised Code of Washington (RCW) 70.128.010, an adult family home serves two to six adults who aren't related to the provider, or up to eight with approval from the Department of Social and Health Services (DSHS), which licenses these homes. For how small residential care homes work across the country, see our guide to board and care homes.

Adult family home Assisted living facility
Residents 2 to 6, or up to 8 with DSHS approval 7 or more (some licensed for 3 to 6 by July 1, 2000 keep that license)
Licensing law RCW 70.128 RCW 18.20
COPES residents served? Yes Yes

Sources: RCW 70.128.010, RCW 18.20.020, DSHS COPES manual.

Who Pays for an Adult Family Home

Money is often where the worry sits, so split the bill in two: care, and room and board.

COPES is a Washington Medicaid 1915(c) waiver for people who meet nursing-facility level of care, including in adult family homes. Federal law lets waivers like COPES pay only for services "other than room and board," so housing and meals stay with your parent.

In 2026, a COPES resident in a Medicaid-contracted Washington adult family home keeps a $108.74 monthly personal needs allowance, pays room and board up to $885.26 a month, and puts the rest of their available income toward care after allowable deductions. The resident also owes the home any third-party resources: money others pay toward their personal care or medical services.

In 2026, the $885.26 monthly room-and-board amount for a COPES resident of a Medicaid-contracted Washington adult family home is a cap, not a price. Washington sets that room-and-board cap at the federal benefit rate minus the personal needs allowance, and the allowance is adjusted every year. After an Apple Health client dies, the state may also file liens to recover what it paid for COPES services. Check Apple Health income and asset limits for eligibility.

Who Is in the Home, and How They're Trained

Will someone be there? A Washington adult family home provider must live in the home or hire a resident manager who does, unless the home has 24-hour staffing with a decision-maker always present. At least one qualified caregiver, someone who has finished orientation and basic training, must be present in a Washington adult family home whenever any resident is home, apart from a narrow exception written into a resident's care plan with their consent.

Present isn't the same as awake. Each home's disclosure form must state whether it has awake staff at night, so read that line and ask how the home answers a call for help at 3 a.m.

Under Washington adult family home rules, a caregiver who isn't exempt completes 2 hours of orientation and 3 hours of safety training before giving care, then 70 hours of basic training within 120 days of hire. Registered nurses, licensed practical nurses and certified nursing assistants are exempt from the long-term care worker training that Washington adult family homes require of caregivers. Washington adult family home providers, resident managers and certified aides complete 12 hours of continuing education a year.

If your parent has dementia, the provider and resident manager of a Washington adult family home must complete dementia specialty training before the home admits them, and other caregivers within 120 days of hire. DSHS's dementia specialty curriculum is an 8-hour class.

Before You Sign

Every Washington adult family home must give you two standard DSHS forms before admission, and share them with interested families on request.

  • Disclosure of services: personal care, nursing, specialty designations, the usual daytime caregiver count, awake night staff, and Medicaid acceptance.
  • Disclosure of charges: charges not covered by the home's daily or monthly rate or by Medicaid, Medicare or other programs.

A Washington adult family home must disclose every fee and deposit in writing, including what it refunds if your parent leaves, before taking any money, or it can't keep them. If a resident dies, is hospitalized or moves for more appropriate care and doesn't return, a Washington adult family home refunds what was paid minus its daily rate for the days the resident lived there or held the bed, keeping at most five extra days' charges from a private-pay resident who didn't give the agreed notice. A Washington adult family home must pay any refund owed within 30 days of the resident's discharge.

A Washington adult family home can change its charges only after 30 days' written notice, except in emergencies, or 14 days' notice in a home licensed for six or fewer when a resident's condition changes substantially.

If the Home Says Your Parent Must Leave

A move-out notice can land like a blow. A Washington adult family home may discharge a resident only when it can't meet their needs and the move is needed for their welfare, when someone's safety or health is endangered, when payment hasn't been made, or when the home stops operating. The home must first try reasonable accommodations, unless the resident agrees to the move.

A Washington adult family home normally gives 30 days' written notice of a discharge, but can give it as soon as practicable when safety is at risk, when urgent medical needs require an immediate move, or when the resident has been away 30 or more days. A resident discharged in violation of these rules must be readmitted when a gender-appropriate bed opens. A Washington adult family home closing voluntarily owes 30 days' written notice and a discharge plan.

If Medicaid pays, the notice must say that, subject to legislative funding, your parent has a right to a free lawyer, reachable through the discharge defense screening line at (888) 437-0017, and the home must send a copy to the Washington State Long-Term Care Ombudsman Program within three days. Here's what an ombuds can do.

How to Check Out an Adult Family Home in Washington

Find licensed homes with DSHS's Adult Family Home Locator. A Washington adult family home must post its latest inspection report and recent complaint investigation reports in a common area, and show three years of reports on request, so read them on each visit.

Operating an adult family home in Washington without a license is a misdemeanor, and public agency staff may not refer anyone to an unlicensed home.

Residents may raise grievances without reprisal. Report problems to the DSHS Complaint Resolution Unit at 1-800-562-6078, and suspected abuse or neglect to Adult Protective Services at 1-877-734-6277. In immediate danger, call 911.

Frequently Asked Questions

Can a Washington adult family home keep my parent after they qualify for Medicaid?

The home's disclosure of services form tells you. Each Washington adult family home's disclosure form must say whether it admits Medicaid clients and whether it keeps residents who later become eligible for Medicaid, so read that line before your parent's savings run low.

Can a Washington adult family home cut back its services?

Yes, with notice. A Washington adult family home must give residents at least 30 days' written notice before reducing its services for reasons beyond its control, and 90 days' notice if a voluntary cut will lead to discharging residents.

Can an adult family home in Washington turn my parent away?

Yes. A Washington adult family home can decline to admit someone whose needs it decides it can't meet, as long as it follows state and federal law.

Learn More

Care TypesAssisted Living in WashingtonAssisted living in Washington has a median of about $7,600/month. How it differs from an adult family home, whether COPES pays, and how to vet a place. MedicaidHow Washington Medicaid HCBS Waivers WorkWashington Medicaid HCBS waivers run mainly through COPES, a 1915(c) waiver for adults at nursing-facility level of care. See who qualifies and how to apply. CaregiverDementia Care in Washington: A Family Caregiver's GuideA 2026 guide to dementia caregiving in Washington: Alzheimer's Association helpline, COPES and Medicaid coverage, respite routes, getting paid, and VA benefits. Care TypesCost of Senior Care in WashingtonWhat senior care costs in Washington in 2026: assisted living runs about $7,600 a month, a nursing home about $13,155 a month. See every setting and how to pay. Care TypesOregon Adult Foster Homes: Licensing, Staffing and Who PaysOregon adult foster homes care for five or fewer adults with a caregiver on duty 24 hours. See Class 1-3 rules, who pays room and board, and Portland's rule. Care TypesBoard and Care Homes: What They Are, What They Cost, and Who They SuitBoard and care homes are small homes, usually 20 or fewer residents, with meals, personal care and 24-hour staff. What they cost, who pays, and how to vet one.

Find personalized help checking whether your parent may qualify for COPES in an adult family home at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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