As of late 2024, the Washington State Department of Social and Health Services (DSHS) reported over 5,500 licensed adult family homes (AFHs), noting that this figure is growing weekly. For many families, this model of care represents a more intimate, home-like environment compared to larger facilities like nursing homes or assisted living facilities. The steady increase reflects a broader shift toward community-based care options for the state's aging population.
Why the number of adult family homes is growing
Washington state has long been a leader in home and community-based long-term care, favoring options that allow seniors and adults with disabilities to remain integrated within their communities. Several factors contribute to the ongoing growth of AFHs:
- Aging population: With one-fifth of the total U.S. population projected to be 65 or older by 2050, the demand for long-term care is consistently increasing. Washington's population trends follow this national pattern.
- Preference for smaller settings: Many individuals and their families prefer the smaller, residential feel of an AFH over a larger, more institutional setting. AFHs typically care for up to six residents, although some can be licensed for up to eight.
- Flexibility and specialization: AFHs can be more flexible in the types of care they offer, allowing for specialization in areas such as advanced dementia, developmental disabilities, or specific behavioral challenges.
- Medicaid acceptance: A significant number of AFHs accept Medicaid, making them a more accessible and affordable option for many families compared to private-pay-only facilities.
How adult family homes are regulated in Washington
The Washington State Department of Social and Health Services' (DSHS) Residential Care Services (RCS) division is responsible for licensing and regulating adult family homes. The agency conducts inspections every 9 to 18 months to ensure compliance with health and safety standards. However, the Office of the Inspector General noted in November 2024 that some homes were not inspected on time due to pandemic-related suspensions, an issue DSHS has since been working to address.
Comparison: Adult Family Homes vs. Assisted Living Facilities
Understanding the differences between AFHs and other care settings, like Assisted Living Facilities (ALFs), is crucial for making an informed decision. The following table highlights key differences:
| Feature | Adult Family Home (AFH) | Assisted Living Facility (ALF) |
|---|---|---|
| Setting | A residential home in a neighborhood. | A larger, apartment-style community setting. |
| Capacity | Typically 6 or fewer residents, up to 8 with special approval. | Can house dozens or even hundreds of residents. |
| Resident-to-Staff Ratio | Very low, often just one or two caregivers per shift. | Higher, with more residents and varying staffing levels depending on facility size and resident needs. |
| Care Environment | Home-like, intimate, and personalized. | Community-centric, with more residents and staff. |
| Services | Includes room, board, personal care, supervision, and laundry. | Offers room and board with personal care services, often with more amenities. |
| Regulation | Regulated by DSHS, with inspections every 9–18 months. | Also regulated by DSHS, with different staffing and facility requirements. |
| Best For | Individuals seeking a quieter, family-like setting with more one-on-one attention. | Individuals who prefer a more social environment and more amenities. |
The future of adult family homes in Washington
With Washington's senior population continuing to grow, the number of adult family homes is likely to increase. The state's recent legislative sessions have focused on addressing issues related to this growing sector, including adjustments to bed licensing fees and funding for services. These changes reflect the state's ongoing efforts to balance the growing demand for care with regulatory oversight and financial sustainability. For families, the robust number of AFHs across Washington offers a wide range of choices for individuals seeking community-based care.
Finding a licensed adult family home in Washington
If you're looking for an adult family home in Washington, the most reliable source is the official locator provided by the Washington State Department of Social and Health Services (DSHS). You can search for listings by county or zip code to find licensed providers in your area. The DSHS website also offers guidance on how to choose care in an AFH or assisted living facility, helping to inform your decision. For specific inquiries, your local Home & Community Services office can also assist in navigating the options.
Conclusion
There are over 5,500 licensed adult family homes in Washington state, with the number showing a consistent upward trend. This growth is a response to both the increasing demand from an aging population and a preference for personalized, community-based care settings. Regulated by DSHS, these smaller, residential-style homes offer a distinct alternative to larger assisted living facilities. For individuals and families exploring long-term care, the sheer number of options and available specializations within Washington's AFH sector provides significant choice, supported by robust state oversight.
