Washington senior care research
Washington Senior Care Research
SeniorTrustHub organizes Washington DSHS Adult Family Homes, Assisted Living Facilities, and Enhanced Services Facilities separately from CMS Nursing Homes, Home Health, and Hospice. They are not one Washington senior-provider total. No score and no ranking.
Separate official universes
Source families, not one Washington senior-provider total
Adult Family Homes, Assisted Living Facilities, Enhanced Services Facilities, CMS Nursing Homes, CMS Home Health, and CMS Hospice are not added together. A county on these records is a facility address county, not a service area.
6,179
Adult Family Homes
DSHS GIS current · as of 2026-09-04
557
Assisted Living Facilities
DSHS GIS current · FacilityType BH · as of 2026-09-04
193
CMS Nursing Homes
Independent overlay · as of 2026-08-01
74
CMS Home Health
Independent overlay · as of 2026-05-27
50
CMS Hospice
Independent overlay · as of 2026-08-19
Trace this number
Count of current GIS rows with FacilityType AF.
- Source: https://services2.arcgis.com/WW3T8U6q5EkZ9U3n/arcgis/rest/services/Long_Term_Care_Residential_Care_view/FeatureServer/1
- Agency clock: 2026-09-04
- Source grain: FacilityType = AF and GDLArchiveDate IS NULL
- Identity: see catalog row for this metric
- Coverage: ACQUIRED_CURRENT_SNAPSHOT
- Limitation: AFH != ALF. AFH != Nursing Home. Not CMS certified by this file.
Trace this number
National CMS Nursing Home directory identities in Washington. Live unique CCN query reconciles to the overlay.
- Source: https://data.cms.gov/provider-data/dataset/4pq5-n9py
- Agency clock: 2026-08-01
- Source grain: CMS Nursing Home CCN with state = WA
- Identity: see catalog row for this metric
- Coverage: ACQUIRED_CURRENT_SNAPSHOT
- Limitation: Not summed with DSHS AFH/ALF. CMS CERTIFIED != STATE LICENSED.
What the files show
Source-backed findings
- Adult Family Homes are Washington’s large state-licensed residential class. The current DSHS GIS layer has thousands of Adult Family Homes — far more settings than Assisted Living Facilities — because AFHs are small licensed homes, not campus buildings. This does not mean best care; quality rank; safer than ALF.
- AFH and ALF are different DSHS licenses. Adult Family Home (AF) and Assisted Living Facility (BH) stay separate in the official type code. Capacity, setting, and rules differ. They are not one ‘residential care’ total. This does not mean one combined Washington senior-provider number.
- State residential care is not CMS certification. DSHS GIS AFH/ALF/ESF identities are LicenseNumber. CMS Nursing Home, Home Health, and Hospice identities are CCN. This snapshot does not add those universes together. This does not mean every AFH is a nursing home; CMS certified equals state licensed.
- Facility phone and address are source-native on the GIS layer. Current GIS rows carry TelephoneNmbr and LocationAddress at high occupancy. Email and website columns are not in this layer. This does not mean missing email means the facility has no email.
- CMS Nursing Homes keep federal inspection and ownership depth. Washington CMS Nursing Homes reuse the national exact-CCN inspection, penalty, staffing, and ownership products. AFH/ALF do not inherit those federal files. This does not mean no deficiencies means a clean record; a deficiency is a quality rank.
Question 1
What senior-care classes does Washington regulate?
DSHS Residential Care Services licenses Adult Family Homes, Assisted Living Facilities, Enhanced Services Facilities, and Nursing Homes. CMS separately certifies Nursing Homes, Home Health, and Hospice. Supported living (SL) and Group Training (GT) appear in the same residential GIS layer but are not public senior-care core tiles.
Questions 2–4
Adult Family Homes, Assisted Living, and Nursing Homes stay separate
Current GIS Adult Family Homes: 6,179. Current GIS Assisted Living Facilities: 557. Enhanced Services Facilities: 16. AFH is a small licensed home. ALF is a community assisted-living facility. A nursing home is a different DSHS license and, when Medicare/Medicaid certified, a CMS CCN. ALF is not SNF.
6,128 / 6,179
AFH facility phones
WA_DSHS_FACILITY_PHONE
547 / 557
ALF facility phones
WA_DSHS_FACILITY_PHONE
16
Enhanced Services Facilities
Kept separate from Assisted Living
Trace this number
Count of current GIS rows with FacilityType BH (Assisted Living Facility).
- Source: https://services2.arcgis.com/WW3T8U6q5EkZ9U3n/arcgis/rest/services/Long_Term_Care_Residential_Care_view/FeatureServer/1
- Agency clock: 2026-09-04
- Source grain: FacilityType = BH and GDLArchiveDate IS NULL
- Identity: see catalog row for this metric
- Coverage: ACQUIRED_CURRENT_SNAPSHOT
- Limitation: ALF != SNF. Not added to Adult Family Homes.
Trace this number
Count of current GIS rows with FacilityType EF.
- Source: https://services2.arcgis.com/WW3T8U6q5EkZ9U3n/arcgis/rest/services/Long_Term_Care_Residential_Care_view/FeatureServer/1
- Agency clock: 2026-09-04
- Source grain: FacilityType = EF and GDLArchiveDate IS NULL
- Identity: see catalog row for this metric
- Coverage: ACQUIRED_CURRENT_SNAPSHOT
- Limitation: Not merged into Assisted Living.
Question 5
Which CMS-certified facilities can TrustHub research?
CMS Nursing Homes, Home Health, and Hospice in Washington use existing national CCN routes. Live unique CCN counts reconcile to 193 / 74 / 50. Home Health office address is not a service area. Hospice is not Home Health.
Trace this number
National CMS Home Health directory identities in Washington.
- Source: https://data.cms.gov/provider-data/dataset/6jpm-sxkc
- Agency clock: 2026-05-27
- Source grain: CMS Home Health CCN with state = WA
- Identity: see catalog row for this metric
- Coverage: ACQUIRED_CURRENT_SNAPSHOT
- Limitation: HOME HEALTH != RESIDENTIAL CARE. Office geography is not a service area.
Trace this number
National CMS Hospice directory identities in Washington.
- Source: https://data.cms.gov/provider-data/dataset/yc9t-dgbk
- Agency clock: 2026-08-19
- Source grain: CMS Hospice CCN with state = WA
- Identity: see catalog row for this metric
- Coverage: ACQUIRED_CURRENT_SNAPSHOT
- Limitation: HOSPICE != HOME HEALTH.
Question 6
What inspection and enforcement data is available?
Statewide DSHS AFH/ALF/ESF inspection and enforcement bulk was not acquired as CSV/API this ticket (NO_BULK_ACQUIRED). Locator inspection pages remain search-only and are not scraped. CMS Nursing Home inspection, deficiency, penalty, staffing, and ownership stay on exact CCN. A complaint is not a violation. A deficiency is not a quality rank.
Questions 7–8
How to verify, and what remains unavailable
TrustHub’s snapshot is the current GIS extract (GDLArchiveDate IS NULL) as of 2026-09-04T16:38:57Z. Live status is on DSHS locators. Current GIS record is not independently license-in-good-standing. Email and website are not in the residential GIS. Service areas are not in these files.
State nursing homes
DSHS nursing-home GIS is not the CMS directory
Current DSHS NH GIS rows: 198 (195 NF and 3 IM). Distinct federal provider numbers: 196. Exact matches to CMS Nursing Homes: 193. Unmatched state 3; unmatched CMS 0. Name and city are not used.
Trace this number
Intersection of distinct padded nf_fed_provider_num values on current DSHS NH GIS rows with the live CMS Nursing Home WA CCN set. Name and city are not used.
- Source: DSHS nf_fed_provider_num padded ∩ CMS NH WA CCN set
- Agency clock: 2026-09-04
- Source grain: exact CCN
- Identity: see catalog row for this metric
- Coverage: ACQUIRED_CURRENT_SNAPSHOT
- Limitation: Unmatched DSHS and unmatched CMS remain unmatched. AFH/ALF are not joined.
Facility address counties
County geography is not a ranking
37 counties appear on current GIS rows. This is facility address county, not a service area, and not best/worst counties.
| County | Adult Family Home | Assisted Living | Enhanced Services |
|---|---|---|---|
| King | 1,819 | 154 | 1 |
| Snohomish | 1,181 | 47 | 2 |
| Pierce | 1,074 | 58 | 3 |
| Spokane | 628 | 58 | 6 |
| Clark | 592 | 33 | 2 |
| Thurston | 335 | 16 | 1 |
| Benton | 85 | 21 | 0 |
| Kitsap | 71 | 23 | 0 |
| Lewis | 53 | 6 | 0 |
| Yakima | 38 | 17 | 0 |
| Whitman | 47 | 6 | 0 |
| Cowlitz | 44 | 8 | 0 |
| Whatcom | 27 | 17 | 1 |
| Skagit | 28 | 16 | 0 |
| Grant | 28 | 6 | 0 |
| Chelan | 17 | 11 | 0 |
| Franklin | 26 | 2 | 0 |
| Clallam | 7 | 8 | 0 |
| Island | 8 | 7 | 0 |
| Asotin | 13 | 2 | 0 |
| Walla Walla | 6 | 6 | 0 |
| Grays Harbor | 6 | 6 | 0 |
| Okanogan | 9 | 1 | 0 |
| Mason | 6 | 3 | 0 |
| Adams | 6 | 2 | 0 |
| Douglas | 4 | 4 | 0 |
| Kittitas | 3 | 3 | 0 |
| Stevens | 2 | 4 | 0 |
| Klickitat | 6 | 0 | 0 |
| Jefferson | 2 | 3 | 0 |
| Lincoln | 3 | 2 | 0 |
| San Juan | 2 | 1 | 0 |
| Columbia | 0 | 2 | 0 |
| Ferry | 1 | 1 | 0 |
| Pacific | 1 | 1 | 0 |
| Skamania | 1 | 1 | 0 |
| Pend Oreille | 0 | 1 | 0 |
Evidence depth
What each source can support
| Source | Agency | Count | Identity | Access | Limitation |
|---|---|---|---|---|---|
| DSHS Long Term Care — Residential Care GIS | Washington DSHS Residential Care Services | 6,968 | LicenseNumber; FacInstanceId | ArcGIS FeatureServer | Current GIS record is not independently license-in-good-standing. FacilityStatus OP on all current rows. DSHS != CMS. |
| Adult Family Home (FacilityType AF) | Washington DSHS RCS | 6,179 | WA-DSHS:{LicenseNumber} | Same GIS layer, filtered AF | AFH != ALF. AFH != Nursing Home. Not a CMS class. |
| Assisted Living Facility (FacilityType BH) | Washington DSHS RCS | 557 | WA-DSHS:{LicenseNumber} | Same GIS layer, filtered BH | ALF != SNF. ALF != CMS Nursing Home. No name/address CMS join. |
| Enhanced Services Facility (FacilityType EF) | Washington DSHS RCS | 16 | WA-DSHS:{LicenseNumber} | Same GIS layer, filtered EF | Not merged into Assisted Living. |
| Certified RSS / Supported Living (FacilityType SL) | Washington DSHS | 187 | LicenseNumber | Same GIS layer; not a public senior-care tile | Adjacent DDA/residential supports. Not added to AFH+ALF+NH. |
| Group Training Home (FacilityType GT) | Washington DSHS | 29 | LicenseNumber | Same GIS layer; excluded from consumer core | Not a consumer senior-care product class. |
| DSHS Long Term Care — Nursing Homes GIS | Washington DSHS RCS | 198 | nf_license_num; nf_fed_provider_num | ArcGIS FeatureServer | 198 current rows include NF 195 and IM 3. Not added to CMS 193. Staff name fields unpublished. |
| CMS Nursing Home Provider Information (WA overlay) | Centers for Medicare & Medicaid Services | 193 | CMS CCN | Provider Data Catalog query / existing national ingest | CMS CERTIFIED != STATE LICENSED. Not summed with DSHS AFH/ALF/ESF. |
| CMS Home Health Care Agencies (WA overlay) | Centers for Medicare & Medicaid Services | 74 | CMS Home Health CCN | Provider Data Catalog query / existing national ingest | HOME HEALTH != RESIDENTIAL CARE. Not an Adult Family Home. |
| CMS Hospice General Information (WA overlay) | Centers for Medicare & Medicaid Services | 50 | CMS Hospice CCN | Provider Data Catalog query / existing national ingest | HOSPICE != HOME HEALTH. |
| CMS Nursing Home inspection / deficiency / penalty (national exact CCN) | Centers for Medicare & Medicaid Services | 193 | CMS CCN | Existing SeniorTrustHub national architecture | No Washington-specific score. Deficiency != quality rank. No deficiency found != clean record. |
| CMS Skilled Nursing Facility All Owners / ownership graph | Centers for Medicare & Medicaid Services | 193 | CMS CCN | Existing SeniorTrustHub CMS ownership product | Do not infer AFH/ALF ownership by matching names. |
| DSHS AFH/ALF/ESF/NH inspection and enforcement bulk | Washington DSHS RCS | Unknown / not acquired | DSHS LicenseNumber when a future bulk file publishes one | Locator inspection pages SEARCH_ONLY; scrape forbidden | Missing bulk != zero enforcement. Complaint != violation. Name-only attach is UNSAFE. |