Finding care in Tacoma, WA: a local guide for families

Who to call first in Tacoma

These services are free. If you only make one call this week, make it the first one on the list; they can explain your options before you visit a single home.

Leaving the hospital in Tacoma

Many moves into an Adult Family Home start with a hospital stay. If your loved one is at MultiCare Tacoma General Hospital, St. Joseph Medical Center, MultiCare Allenmore Hospital or the VA American Lake campus in Lakewood, for veterans, the discharge planner or case manager is the person to know. These questions help:

1. Ask for the discharge planner or case manager on day one, not the day before discharge. Ask what date they expect your loved one to leave, and what care they will need after.
2. Ask whether your loved one is admitted or under observation. Medicare pays for a short rehab stay in a nursing home only after three days as an admitted patient; observation days do not count. Medicare Advantage plans can have their own rules, so ask the plan too.
3. Ask for the care needs in writing: medications, diet, help with walking and transfers, wound care, memory and behavior. Every Adult Family Home will ask for this before it can say yes.
4. If Medicaid will pay, ask the social worker to refer your loved one to DSHS Home and Community Services while they are still in the hospital, or call Region 3 intake (Pierce, Clark and eleven other counties) at 1 (800) 786-3799 yourself.
5. Know that Medicare does not pay for an Adult Family Home. It covers the hospital and a short rehab stay. Ongoing care is paid privately, through long term care insurance or VA benefits, by the WA Cares Fund, or by Medicaid.
6. You can say the plan is not safe. If you do not think your loved one can go home safely, tell the case manager clearly and ask what other options there are.

Looking beyond the city line

Tacoma is one of the Washington cities with the most Adult Family Homes, and Lakewood and Puyallup next door add hundreds more. If a parent lives in Tacoma but a son or daughter lives in Lakewood, University Place or Puyallup, it is worth searching both, because a home ten minutes from the person who visits most often usually matters more than the ZIP code on the letterhead.

Many Pierce County families are military or veteran families connected to Joint Base Lewis McChord. If your loved one is a veteran, ask the VA social worker about benefits such as Aid and Attendance, which can help pay for care in an Adult Family Home, and tell the home early so it can plan for the paperwork.

What care costs in Tacoma

Pierce County is part of the Seattle metro area in the cost of care survey, where assisted living and nursing homes cost more than the Washington average.

Adult Family Home prices vary the most, because each home sets its own rate by the care needed. The range above is Washington's typical daily rate, $135 to $473, times 30 days. Our cost of care estimator gives a range for your situation.

Other ways to pay. Long term care insurance, VA benefits for veterans and surviving spouses, and the WA Cares Fund can all help. Ask each home in writing whether a resident can stay if savings run out and Medicaid takes over.

Starting Medicaid (COPES) in Tacoma

Washington Medicaid can pay for care in an Adult Family Home for people who qualify on income, savings and care needs. In Tacoma, 369 of 378 Adult Family Homes have a Medicaid contract. There are two parts, and you can start both on the same day:

1. Apply for the money side. If your loved one is 65 or older or on Medicare, apply online at Washington Connection. You can also mail a paper application, or apply in person at a Home and Community Services office.
2. Ask for the care assessment at the same time. You do not have to wait for the financial decision. Call Region 3 intake (Pierce, Clark and eleven other counties) at 1 (800) 786-3799 and ask for a long term care assessment.
3. Name a family member as an authorized representative on the application so DSHS can talk with you and send you copies of letters.
4. Get ready for the visit. A DSHS social worker meets your loved one in person to ask about daily care, health, medications and where they want to live. Have the medication list and the doctor's name handy.
5. Start calling homes with a Medicaid contract while you wait. Tell each home the application is in process and ask whether a Medicaid bed is open now.

Our Medicaid and COPES guide explains the income and asset limits.