Skilled nursing facilities provide 24-hour care for people who need help with daily activities and medical support. They serve older adults, people with disabilities, and those recovering from illness or injury. DSHS partners with facilities across Washington to ensure respectful, high-quality care.
- Billing Resources
- Nursing Facility Billing Guide (Online | PDF)
- Nursing Facility Rates and Reports
- State-funded long-term care for Noncitizens
- Information for MAGI Apple Health
- Classic Medicaid Financial Contacts or For Escalation and Troubleshooting (PDF)
- Nursing Facility Notice of Action Form (DSHS 15-031 PDF | Word)
- Intake and Referral Form (DSHS 10-570 PDF | Word)
- How to apply for Medicaid
- ProviderOne
- Log into ProviderOne
- Learn ProviderOne
- ProviderOne Billing and Resource Guide (PDF)
- Home and Community Services/AAA Operations Information
- Nursing Home Guidelines “The Purple Book” (PDF)
- List of Provide/Administrator Letters
- Inpatient Hospital Assessments and Transitions
- Aging and Long-Term Care Manual
- Nurse Delegation
- Behavioral Health Support Training Calendar
- Resources
- Find Local Services, Information, and Resources
- Medicare.gov Find and Compare Providers Near You
- Behavioral Health Support for Providers
- National Alliance for Care at Home: Find a Provider
- Centers for Medicare & Medicaid Services
- Medicaid.gov Nursing Facilities
- Information on Apple Health Managed Care
- Map of Apple Health managed care service area (PDF)
- Behavior Support Training and Consultation
- Behavior Support Training Opportunities
Expanded Behavioral Supports
Expanded Behavioral Supports is available at certain skilled nursing facilities for people with complex behavioral and medical support needs. These facilities provide additional services to help address behavioral needs, support medical stability, and connect people with behavioral health services. Only facilities with an Expanded Behavioral Supports contract can provide these services through Medicaid.
- Contracted Expanded Behavior Supports Skilled Nursing Facilities
Facilities County Alaska Gardens Health & Rehabilitation Center Pierce Alderwood Manor Spokane Alderwood Post Acute & Rehabilitation Snohomish Americana Health and Rehabilitation Center Cowlitz Apple Valley Yakima Auburn Post Acute King Avalon Care Center at Northpointe Spokane Avalon Healthcare Bellingham Whatcom Avamere at Pacific Ridge Pierce Benson Heights Rehabilitation Center King Brookfield Health and Rehabilitation of Cascadia Clark Cashmere Care Center Chelan Colfax Health and Rehabilitation of Cascadia Whitman Emerald Care Yakima Emerson Health & Rehab Spokane Garden Village Yakima Gig Harbor Health and Rehabilitation Pierce Grays Harbor-Health and Rehabilitation Grays Harbor Hallmark Manor King Heartwood Extended Healthcare Pierce Highland Health and Rehabilitation Cascadia Whatcom Hudson Bay Health and Rehabilitation Clark Lacey Post Acute Rehabilitation Thurston Life Care Center Federal Way King Life Care Center of Kennewick Benton Life Care Center of Richland Benton Life Care Center of Skagit Valley Skagit Linden Post Acute Yakima North Bend Post Acute King Park Manor Rehabilitation Center Walla Walla Queen Anne Healthcare King SEATTLE MEDICAL POST ACUTE CARE King Shelton Health and Rehabilitation Mason Spokane Health & Rehabilitation Spokane Tacoma Nursing and Rehabilitation Center Pierce The Oaks at Timberline Clark Transitional Care Center of Seattle King
Skilled Nursing Facilities with a Ventilator/Tracheostomy Designation
Some skilled nursing facilities are specially equipped to support people who need ventilator or tracheostomy care. These facilities have the staff, equipment, and services needed to meet complex respiratory care needs.
The designation helps connect facilities, respiratory care providers, and Home and Community Services to support people who need ongoing ventilator or tracheostomy management. Arris Healthcare provides respiratory services and durable medical equipment for designated facilities.
For additional information regarding billing requirements and the wraparound rates associated with the Ventilator/Tracheostomy designation, skilled nursing facilities can refer to the applicable Health Care Authority billing guide.
- Facilities with a Ventilator/Tracheostomy Designation
Facility Address Phone Regency at Northpointe
NPI 16694192711224 E Westview Ct
Spokane, WA 99218(509) 465-8800 Everett Center
NPI 18513484601919 112th St
Everett, WA 98204(425) 513-1600 Seattle Medical Post-Acute Care
NPI 1851386957555 16th Ave
Seattle, WA 98122(206) 324-8200 Park Rose Care Center
NPI 13160455373919 19th St
Tacoma, WA 98405(253) 752-5677 Rainier Rehabilitation
NPI 1407271430920 12th Avenue SE
Puyallup, WA 98372(253) 841-3422 Vancouver Specialty
and Rehabilitative Care
NPI 18114933641015 N Garrison Rd
Vancouver, WA 98664(360) 694-7501 Hudson Bay Health
and Rehabilitation
NPI 17903520788507 NE 8th Way
Vancouver, WA 98664(360) 254-5335
Exceptional Rate Approval for Skilled Needs
The Exceptional Rate for Skilled Needs provides an opportunity to support eligible fee-for-service Medicaid recipients residing in a Skilled Nursing Facility when additional resources are needed to support complex care needs, facilitate stabilization, or prepare the individual for transition to a home and community-based setting.
The process is intended to address exceptional care needs that are not adequately supported through the resident’s existing Medicaid nursing facility rate. Exceptional rate requests are reviewed based on the individual’s needs, the circumstances of the request, and the services or resources necessary to support the resident’s care and transition goals. The authority for exceptional care rate add-ons for covered Medicaid residents is established in WAC 388-96-781.
- Who May Be Eligible
This may be considered for people who:
- Are eligible for fee-for-service Medicaid.
- Are residing in a Skilled Nursing Facilities under a custodial Medicaid stay.
- Have exceptional care needs requiring additional support beyond what is available through the standard SNF rate, particularly when those resources are necessary to stabilize the individual, address barriers to discharge, or prepare for transition to a home and community setting.
Eligibility and approval are determined on an individual basis. Approval is not automatically based solely on a resident’s diagnosis, length of stay, or anticipated discharge needs.
- What an Exceptional Rate May Support
Depending on the individual circumstances and approved request, an exceptional rate may provide resources to support:
- Specialized equipment needed to safely care for the resident during their Skilled Nursing Facilities stay.
- Resources needed to address barriers to stabilization or discharge.
- Supports that facilitate preparation for transition to a home and community setting.
- Other exceptional care needs that are appropriate for consideration under the applicable Medicaid requirements.
The exceptional rate is intended to provide additional resources for exceptional care needs and is not intended to replace services or expenses that are otherwise covered through the residents’ existing Medicaid benefit or the Skilled Nursing Facilities' standard rate.
- Items Generally Not Covered
Exceptional rates do not typically cover routine or separately payable expenses, including:
- Medications.
- Total parenteral nutrition.
- Additional routine staffing hours.
- Other costs that are expected to be covered through the Skilled Nursing Facilities existing rate or another available Medicaid benefit.
Each request is reviewed based on the specific circumstances and the purpose of the requested funding.
- Approval Process
The Skilled Nursing Facilities should identify the exceptional care need, the barrier it creates, and the specific resource or support being requested. Supporting documentation should demonstrate why the resource is necessary and how it will support the resident’s care, stabilization, or transition goals.
Requests are reviewed through the applicable state process, and approval must be obtained before the exceptional rate or associated funding is provided. When approved, the exceptional payment is added to the nursing facility’s Medicaid rate in accordance with applicable requirements. WAC 388-96-782 provides the payment authority for applicable exceptional direct care rate add-ons.
For additional requirements and regulatory detail, refer to:
WAC 388-96-781, Exceptional care rate add-on—Covered Medicaid residents, and
WAC 388-96-782, Exceptional direct care—Payment.To request an Exceptional Rate for Skilled Care, contact:
Regional Contacts Medicaid Nursing Facility Transitions
Public Benefits Program Managers: sesdshpchelpdesk@dshs.wa.gov
Transition Support
- Learn about Lifeline phone services
- Room & Care: Find and Book Assisted Living Directly
- Family Caregiver Alliance: Hiring in-home help
- Roads to Community Living
One of Washington’s programs that helps people move from nursing homes and other care facilities back into their homes and communities.
Eligible participants may include people living in nursing homes, hospitals, or residential habilitation centers who are ready to transition to a qualified community setting.
This person-centered program supports individuals with complex, long-term care needs. It promotes independence, dignity, and inclusion—and is part of the federally funded Money Follows the Person initiative.
- Transitional Care of Seattle
Transitional Care of Seattle is a DSHS-owned Skilled Nursing Facility that was acquired and opened during the COVID-19 pandemic and is operated by Evergreen Healthcare.
Located in the City of Seattle, Transitional Care of Seattle specializes in complex transitions from acute care settings, with a focus on individuals with significant medical and behavioral needs, including bariatric residents weighing up to 1,000 pounds. The facility works closely with Home and Community Services to support individuals who are dually eligible for Medicare and Medicaid and serves as a resource for complex post-acute care and transition needs statewide.
TCCS is not contracted with any managed care organizations.
- Developmental Disabilities Administration
Events and trainings, DDA provider resources, county best practices, policies and rules, and more.
- Managed Care and Medicare
Washington’s Dual Special Needs Plan program helps coordinate care for people who qualify for both Medicare and Medicaid. It’s designed to support smooth transitions between care settings and connect individuals with the services they need. Visit our website Cross System Care Coordination.
- Preadmission Screening and Resident Review
Information and Trainings:
- Washington State Health Care Authority PASRR Screening Process
- Medicaid.gov: Preadmission Screening and Resident Review
- Washington State PASRR Program Contractors by County Map (HCA 82-0431 PDF)
- PASRR Training Video: January 2024
- 2025 Annual PASRR Hospital Nursing Facility Presentation (PDF)
- CareLearn
CareLearn is an online training solution that provides accessible DSHS-approved training and continuing education on a variety of topics. CareLearn helps non-union, family and paid long-term caregivers in various care settings easily access free training and can reduce the amount of time caregivers need to be away from the people they care for.
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Medicaid and Long-Term Care Services for Adults
(22-619 Multiple Languages)
Adult Protective Service
(22-810 Multiple Languages)
Choosing care in an Adult Family Home or Assisted Living Facility
(22-707 Multiple Languages)
Resources for Individuals in Skilled Nursing Facilities
(22-2032 Multiple Languages)
Roads to Community Living
(22-1297 Multiple Languages)
Technology Support Services
(22-2033 English Only)