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

Who to call first in Vancouver

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 Vancouver

Many moves into an Adult Family Home start with a hospital stay. If your loved one is at PeaceHealth Southwest Medical Center or Legacy Salmon Creek Medical Center, 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.

If your loved one lives in Oregon now

Vancouver sits across the river from Portland, and many families here are moving a parent from Oregon, or from a Portland hospital, into a Washington home. A Portland discharge planner may know Oregon care homes well and Washington ones less so, so it helps to arrive with a short list of Vancouver homes that fit.

Medicaid is run by each state. To have Washington Medicaid pay for a Vancouver Adult Family Home, your loved one applies in Washington; Oregon long term care benefits do not follow them across the river. Call Region 3 intake before the move and ask how to time the application, so there is no gap in coverage.

Homes in Clark County are licensed and inspected by Washington DSHS, not Oregon, so look up inspection reports on the Washington side. Every Vancouver listing on Wayvo links to them.

What care costs in Vancouver

No official survey is published for Clark County alone, so these are Washington statewide figures. Vancouver Adult Family Homes set their own rates; ask each one for its price in writing.

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 Vancouver

Washington Medicaid can pay for care in an Adult Family Home for people who qualify on income, savings and care needs. In Vancouver, 502 of 530 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.