Examples include administration of medications and blood glucose testing which are normally performed only by licensed nurses. A registered nurse must teach and supervise the nursing assistant or home care aide, as well as provide nursing assessments of the patient's condition. Registered nurse delegation is governed by many laws, rules, and policy regarding licensing, credentialing, training, and for each setting.
Nurse Delegation Links
- 2026 Calendar of Events
- RCW 18.79.260 Registered nurse—Activities allowed—Delegation of tasks
- WAC 246-840-910 - 970 Delegation of Nursing Care Tasks in Community-Based and In-Home Care Settings
- RCW 18.88A Nursing Assistants
- RCW 18.88B Long-Term Care Workers
- Aging and Long-Term Support Administration Long-Term Care Manual
- Developmental Disabilities Administration Nursing Services
- Contractor Meeting notes
- HCS Management Bulletins
- DOH Provider Credential Search
What Is Required for a Registered Nurse to Provide Nurse Delegation?
All registered nurses in Washington state may delegate; however, they may only do so according to the laws RCW 18.79.260 and rules WAC 246-840-910 to 970 as upheld by the Washington State Board of Nursing. To delegate to DSHS Medicaid clients, the RN must have an active, unencumbered RN license for WA state, or a multistate license, a DSHS ND contract, liability insurance, and a business license for WA state.
How to Become a DSHS Registered Nurse Delegator
DSHS HCS provides six-hour Registered Nurse Delegation Orientation classes every other month for registered nurses interested in a DSHS contract to provide delegation to DSHS Medicaid clients.
This RN Delegation Orientation class is an introduction to nurse delegation in community-based residential settings such as adult family homes, in-home, and Developmental Disabilities Certified Community residential services for Medicaid state clients. If you provide private pay ND or ND in an assisted living facility, this training class is not required. Please see the class handout.
How Do I Find DSHS Classes?
Registered Nurse Delegation Orientation class is provided at no cost every other month in different locations in WA state. Registration is required, and classes fill up fast. We typically have the capacity for 30 people per class. We are unable to accommodate a waiting list. If you are not interested in the contract and just want to take private-pay clients, please do not register. There are other options, such as the handout and LTC associations.
If the site does not allow you to register, the training is full. Please do not reach out to us via email or phone to get signed up, as we are unable to accommodate a wait list or the volume of emails we receive.
If you are an RN providing nursing services for DSHS as an employee, please contact your Human Resources department regarding other employment. You will not be able to take the training until after contacting HR and letting us know at nursedelegation@dshs.wa.gov
Here is the link to the registration information page: Registered Nurse Delegation Registration
The class training material is available to view and download for 2026. It is available for any RN who wants to learn about delegation and has resources for more information: Registered Nurse Delegation Orientation Handout.
How does an RN Contractor find clients?
DSHS does not automatically provide clients to the delegator; the delegator must market their services for themself. DSHS distributes the current list of Contracted Nurse Delegators to DSHS Case Managers, who authorize Nurse Delegation services for Medicaid clients eligible for services.
How does the Nurse Delegator get paid for delegation services?
The DSHS contracted nurse delegator receives authorization for services for state Medicaid clients from Case Managers in Home and Community Living Administration and Developmental Disabilities Administration. The contractor submits time through Health Care Authority and ProviderOne for payment of services.
How Do I Get Nurse Delegation Forms?
You can download all mandatory forms at the Nurse Delegation Forms page. The forms provided are mandatory by contract.
Resources for Current RN Delegation DSHS Contracts
- For Billing information please use the top link and for additional assistance the bottom link:
- ProviderOne Social Services Resources for Billers, Providers, and Partners
- Billing Guides and ProviderOne Basics: view the webinar | presentation slides
- Audit
- Find a DSHS Contracted RND
- Nurse Delegation Forms
- Nursing Services and Skin Observation Protocol
- DSHS Electronic Forms
Nurse Delegation Forms
Download all mandatory forms at the Nurse Delegation Forms webpage. The forms provided are mandatory by contract.
Resources for Current RN Delegation DSHS Contracts:
Contact
All Registered Nurse’s in Washington state may delegate; however they may only do so according to the laws RCW 18.79.260 and rules WAC 246-840-910 to 970 as upheld by the Washington State Board of Nursing.
To delegate to DSHS Medicaid clients the RN must have an active unencumbered RN license for WA state or multistate license, DSHS ND contract, liability insurance, and business license for WA state.
DSHS HCS provides Registered Nurse Delegation Orientation 6-hour classes every other month for Registered Nurses who are interested in a DSHS contract to provide delegation to DSHS Medicaid clients.
This RN Delegation Orientation class is an introduction to nurse delegation in community based residential settings such as adult family homes, in-home, and Developmental Disabilities Certified Community residential services for Medicaid state clients. If you provide private pay ND or ND in an assisted living facility, this training class is not required. Please see class handout.
- Registered Nurse Delegation Orientation class is provided at no cost every other month in different locations in WA state.
- Registration is required and classes fill up fast.
- We typically have the capacity for 30 people per class.
- We are unable to accommodate a waiting list.
- If you are not interested in the contract and want to just take private pay clients, please do not register.
- There are other options such as the handout and LTC associations.
If there is an open spot the registration link will direct you to the sign-in page and if it does not redirect then the training date is closed. Please do not reach out to us via email or phone to get signed up as we do not have the ability to accommodate a wait list.
If you are an RN providing nursing services for DSHS as an employee, please contact your Human Resources department regarding other employment. You will not be able to take the training until after contacting HR and letting us know at nursedelegation@dshs.wa.gov
For registration information visit Registered Nurse Delegation Registration
The class training material is available for viewing and downloading for 2026. For RN's who wants to learn about delegation, download Registered Nurse Delegation Orientation Handout (PDF).
DSHS does not automatically provide clients to the delegator; the delegator must market their services for themself. DSHS does distribute the current list of Contracted Nurse Delegators to DSHS case managers who authorize Nurse Delegation services for Medicaid clients qualified for services.
The DSHS contracted nurse delegator receives authorization for services for state Medicaid clients from case managers in the Home and Community Living Administration and the Developmental Disabilities Administration. The contractor submits time through Health Care Authority and ProviderOne for payment of services.