Safety Net Assessment (SNA)

The following letter and attachments were sent to facilities on March 8, 2019. Please read through these documents carefully and return them to the Department by May 15, 2019.


The Safety Net Assessment (SNA), which is a fee on non-Medicare resident days in nursing facilities, was set up by the Legislature in 2011. The Safety Net has two rates: a rate, currently $23.00; and a low rate, currently $1.00. Additionally, some facilities are exempt. The Safety Net Assessment is outlined in 388-96-910 WAC. The money raised by the Safety Net Assessment, along with matching federal funds, is used to maintain and enhance Medicaid nursing facility rates. The monthly Safety Net Assessment reports and any money owed must be postmarked by the 20th of the following month. If you have any questions about the Safety Net Assessment, please email, or contact Tiffany Hills, Nursing Facility Rate Manager, at (360) 725-2472 or

Safety Net Assessment Reports

Effective with reporting January SNA Days in February of 2019, please use the most recent form showing ALTSA-ORM (12-2018) in the bottom left corner. Starting with the January Days, we are capturing the Medicaid Managed Care Days separately.

Past Rate Change Notices