WA State Info

Washington State's Department of Social and Health Services (DSHS) has a number terms that require some explanation. Most of these definations come directly from DSHS's own web pages. This document just tries to put those definitions in one page. If you need more detailed information you should contact the county Residential Care Services (RCS) office.  RCS has oversight responsibility for both Adult Family Homes and Boarding Homes.

Facility Types:

  • Adult Family Home (AFH) -- Adult Family Homes are regular neighborhood homes where staff assumes responsibility for the safety and well-being of the adult. A room, meals, laundry, supervision and varying levels of assistance with care are provided. Some provide occasional nursing care. Some offer specialized care for people with mental health issues, developmental disabilities or dementia. The home can have two to six residents and is licensed by the state. The operation of an Adult Family Home is supervised by the state and goverened by Chapter 388-76 WAC.

    When caregivers are not Registered Nurses or LPNs certain activities may be delegated to nursing assistants after training. This process is called Nurse Delegation.
  • Assisted Living / Boarding Homes (BH) -- Assisted Living and Boarding Homes are facilities in a community setting where staff assumes responsibility for the safety and well-being of the adult. Many boarding homes call themselves "Assisted Living" facilities. Housing, meals, laundry, supervision, and varying levels of assistance with care are provided. Some provide nursing care. Some offer specialized care for people with mental health issues, developmental disabilities, or dementia. The home can have seven or more residents and is licensed by the state. The operation of an Boarding Home is supervised by the state and goverened by Chapter 388-78A WAC.
  • Retirement Communities/Independent Living Facilities -- Retirement communities and independent living facilities are housing exclusively for adults (normally 55 or older). The person is generally healthy and any medical or personal care can be provided by visiting nurses or a home health aide. Staff at the retirement community does not take on the general responsibility for the safety and well-being of the adult. DSHS doesn't provide oversight for these facilities at all.
  • Nursing Homes (NH) - These are skilled nursing facilities or Long Term Care.

Contract Types:

  • Adult Family Homes that have contracts to accept Medicaid clients can have one of two types of contracts.
    • Client Services [Cpts] is the basic contract that that "most" AFH that accept Medicaid clients have.
    • Expanded Community Services (AFH) [Ctec] is an expanded contract that only a few Adult Family Homes have.
    • Specialized Behavior Support [Ctsb] ** new 2015
    • Private Duty Nursing [Ctpd] ** new 2015
  • Boarding Homes that have contracts to accept Medicaid clients can have several types of "Boarding Home Service Contracts" This information comes directly from DSHS.
    • Adult Residential Care (ARC) [Ctar] -- This service package includes helping a resident who is able to take his/her own medication but needs some help (e.g. a reminder to take it or the medication handed to him/her) and personal care (e.g. bathing, dressing, personal hygiene). Residents who need to be monitored for their safety may get limited supervision.
    • Enhanced Adult Residential Care [Cter] -- This service package includes all of the services as listed in the Adult Residential Care (ARC) package above and help for a resident who can’t take his/her own medication (medication administration). Some type of nursing care must be provided occasionally. No more than two people will share a room.
    • Enhanced Adult Residential Care - Specialized Dementia Care Services [Ctdc] -- This service package includes all services as outlined in the Enhanced Adult Residential Care package above and additional services for a resident with dementia. Learn more about this program.
    • Assisted Living [Ctal] -- This service package includes a private apartment.  Some type of nursing care must be provided occasionally and help is available for medication administration and personal care.
  • Nursing Homes report to the State that they have a specific number of beds for various government programs.
    • Medicaid Beds - These are for people that are covered by Medicaid.
    • Medicare Beds - Since Medicare doesn't cover Long Term Care these are typically for seniors that are covered by Medicare for rehab after a stay of at lease 3 days in a hospital.
    • Medicaid/Medicare Beds - These are for people cover by both programs, or these beds may be used for either program.