Notice
The Business Analysis & Applications Unit (BAAU) is currently processing license applications received in September 2024. If you have questions, please contact BAAU at BAAU@dshs.wa.gov
The Business Analysis & Applications Unit (BAAU) is currently processing license applications received in September 2024. If you have questions, please contact BAAU at BAAU@dshs.wa.gov
AFH online license application note: There are certain symbols that create errors in the completed application. Do not use the following symbols &, =, or +. Instead, use the following terms: (and) (equals) (plus), spelling out the words, with parentheses on either side. See the updated Instructions for the license application for details. We are researching a permanent fix to this issue and will advise you of any changes.
During the application process, we communicate with applicants by email. Please make sure you check your spam or junk folder to avoid missing important messages.
To ensure that the flow of communication with the applicant(s) is as accurate as possible, Business Analysis and Applications Unit (BAAU) staff will only communicate directly with the applicant(s) either by email or phone call. This is to ensure that applicant(s) directly provide BAAU staff with accurate information; can dialogue and discuss questions about their application. Communicating directly with applicant(s) helps keep them informed and ensures that they can complete the application requirements accurately. If the applicant(s) are working with third party, they can share the communications between them and BAAU, should they decide.
All requirements in WAC 388-76-10057 must be met prior to an application being submitted to the Department. Applications submitted without the required items listed in this WAC will not be accepted.
The spouse or domestic partner of an entity representative must be included on the AFH application. The department will conduct a Washington State background check and a national fingerprint background check on the spouse or domestic partner in accordance with WAC 388-76-10115 and WAC 388-76-10161. The department will conduct a credit check on the spouse of an entity representative when the entity representative has an ownership interest in the business in accordance with WAC 388-76-10115. If this applies to you, and the information is not included on your application, BAAU will email you to request this information.
Specialty contracts such as Meaningful Day Activities, Expanded Community Services (ECS) and Specialized Behavior Support (SBS) are not transferable when there is a change in ownership (CHOW). The new owner must meet the qualifications and have a fully executed specialty contract prior to providing specialty services. Payment for specialized services cannot be issued without the appropriate specialty contract in place. Information regarding specialty contracts can be found here: Residential Long-Term Care Facilities Specialty Contracts.
Effective January 1, 2024, the Department provided Orientation class is no longer required. View the AFH Initial Inspection process informational slideshow.
During the application process, we communicate with applicants by email. Please make sure you check your spam or junk folder to avoid missing important messages.
To ensure that the flow of communication with the applicant(s) is as accurate as possible, when Business Analysis and Applications Unit (BAAU) is processing licensing and certification applications for Assisted Living Facility, Nursing Home Facility, Enhanced Services Facility and Certified Community Residential Services and Support and a third party is involved, at least one individual who is part of the applying entity must be included in all emails and/or phone calls between the third party and BAAU. This is to ensure that applicant(s) directly provide BAAU staff with accurate information; can dialogue and discuss questions about their application. We want to ensure that the flow of communication with the applicant(s) be as accurate as possible and to keep the applicant(s) informed during the application process.
The following are needed prior to applying for a license and/or contract:
Federal Employer Identification Number (EIN) - A copy of the IRS SS-4 form showing the assigned EIN number will be accepted as verification an EIN was obtained. For more information on EINs, visit https://www.irs.gov/
Unified Business Identifier (UBI) - A copy of the Washington State business license showing that the trade name has been registered with the Department of Revenue. For more information on UBIs, visit https://dor.wa.gov/open-business/apply-business-license
Certificate of Incorporation or Certificate of Formation issued by the Secretary of State. For more information on this registration, visit https://www.sos.wa.gov/corporations-charities
Specialty contracts such as Specialized Dementia Care (SDC), Expanded Community Services (ECS) or Community Stability Supports (CSS) are not transferable when there is a change in ownership (CHOW). The new owner must meet the qualifications and have a fully executed specialty contract prior to providing specialty services. Payment for specialized services cannot be issued without the appropriate specialty contract in place. Information regarding specialty contracts can be found here: Residential Long-Term Care Facilities Specialty Contracts.
During the application process, we communicate with applicants by email. Please make sure you check your spam or junk folder to avoid missing important messages.
Notice for Change of Ownership (CHOW) Applicants: In order for licensees to remain in compliance with federal and state regulations (42 CFR 489.18 and WAC 388-97-4280), the applicant must complete the state CHOW application process prior to transferring ownership of the nursing home business enterprise to another party. The effective date of the CHOW for State Licensing and Medicare/Medicaid purposes will be the Bill of Sale date or the Transfer of Operations Agreement date (whichever applies).
To ensure that the flow of communication with the applicant(s) is as accurate as possible, when Business Analysis and Applications Unit (BAAU) is processing licensing and certification applications for Assisted Living Facility, Nursing Home Facility, Enhanced Services Facility and Certified Community Residential Services and Support and a third party is involved, at least one individual who is part of the applying entity must be included in all emails and/or phone calls between the third party and BAAU. This is to ensure that applicant(s) directly provide BAAU staff with accurate information; can dialogue and discuss questions about their application. We want to ensure that the flow of communication with the applicant(s) be as accurate as possible and to keep the applicant(s) informed during the application process.
In accordance with WAC 388-96-809, for ownership changes, the assigning or terminating contractor shall provide security for estimated overpayment liability. To get the assumption of liability form, or if you have any questions, please contact the Nursing Facilities Rates Payment Coordinator (DSHS) at NFRPaymentCoord@dshs.wa.gov.
Effective immediately, the street address for submissions to be delivered via Federal Express or United Parcel Service is:
4500 10th Ave SE
Lacey, WA 98503
Nursing Home Facility License Application (DSHS 10-670)
Notice for Change of Ownership (CHOW) Applicants: In order for licensees to remain in compliance with federal and state regulations (42 CFR 489.18 and WAC 388-97-4280), the applicant must complete the state CHOW application process prior to transferring ownership of the nursing home business enterprise to another party. The effective date of the CHOW for State Licensing and Medicare/Medicaid purposes will be the Bill of Sale date or the Transfer of Operations Agreement date (whichever applies).
Download the following individual forms or informational handouts by clicking on the corresponding link:
If you are unable to view these documents online or require materials in hard copy format, please contact the Residential Care Services Business Analysis and Applications Unit at (360) 725-2420.
If you have difficulty printing these documents, please read the Print Troubleshooting Guide.
During the application process, we communicate with applicants by email. Please make sure you check your spam or junk folder to avoid missing important messages.
To ensure that the flow of communication with the applicant(s) is as accurate as possible, when Business Analysis and Applications Unit (BAAU) is processing licensing and certification applications for Assisted Living Facility, Nursing Home Facility, Enhanced Services Facility and Certified Community Residential Services and Support and a third party is involved, at least one individual who is part of the applying entity must be included in all emails and/or phone calls between the third party and BAAU. This is to ensure that applicant(s) directly provide BAAU staff with accurate information; can dialogue and discuss questions about their application. We want to ensure that the flow of communication with the applicant(s) be as accurate as possible and to keep the applicant(s) informed during the application process.
If you are interested in becoming a licensed ESF, Residential Care Services (RCS) and HCS will meet with you to outline the process and provide ongoing assistance as you develop your plan for licensing. Request an information meeting by contacting HCS Residential Support Program Manager, JD Selby at (360) 890 2640 or james.selby@dshs.wa.gov.
Once you are ready to apply for a license and/or contract: