Adult family homes
Where Washington's adult family homes are
Every licensed adult family home in the state, counted by county, city and ZIP code, and compared with the number of older residents who have Medicaid. Built from the state's licensing records and the Census.
Counts are licensed homes in the Department of Social and Health Services (DSHS) records as of 9 October 2026. A licensed bed is capacity, not an occupied bed.
Look up your area
Type a city, a ZIP code or a county.
The map
Darker counties have more licensed beds for the number of residents 65 and over who have Medicaid. Counties with no homes are grey.
Every county, ranked
Sorted by licensed beds per 1,000 residents 65 and over who have Medicaid. Select a column heading to sort by it. A small county can swing a lot on a single home.
| County | Homes | Licensed beds | Residents 65+ on Medicaid | Beds per 1,000 of them | Rank |
|---|---|---|---|---|---|
| Snohomish | 1,185 | 6,859 | 16,646 | 412.1 | #1 |
| Clark | 597 | 3,479 | 9,085 | 382.9 | #2 |
| Pierce | 1,080 | 6,315 | 17,666 | 357.5 | #3 |
| Whitman | 47 | 271 | 806 | 336.2 | #4 |
| Thurston | 339 | 1,962 | 6,478 | 302.9 | #5 |
| Spokane | 635 | 3,652 | 12,203 | 299.3 | #6 |
| King | 1,818 | 10,633 | 41,699 | 255.0 | #7 |
| Lewis | 53 | 321 | 2,362 | 135.9 | #8 |
| Benton | 87 | 506 | 3,966 | 127.6 | #9 |
| Franklin | 29 | 171 | 1,707 | 100.2 | #10 |
| Asotin | 13 | 74 | 754 | 98.1 | #11 |
| Cowlitz | 46 | 270 | 2,967 | 91.0 | #12 |
| Adams | 6 | 36 | 404 | 89.1 | #13 |
| Kitsap | 71 | 406 | 4,600 | 88.3 | #14 |
| Lincoln | 3 | 18 | 286 | 62.9 | #15 |
| Grant | 28 | 154 | 2,462 | 62.6 | #16 |
| Skagit | 28 | 162 | 2,855 | 56.7 | #17 |
| Klickitat | 6 | 30 | 594 | 50.5 | #18 |
| Okanogan | 9 | 62 | 1,230 | 50.4 | #19 |
| Chelan | 17 | 93 | 2,160 | 43.1 | #20 |
| Yakima | 38 | 226 | 6,111 | 37.0 | #21 |
| Douglas | 5 | 29 | 847 | 34.2 | #22 |
| Whatcom | 27 | 151 | 4,599 | 32.8 | #23 |
| San Juan | 2 | 11 | 423 | 26.0 | #24 |
| Kittitas | 3 | 18 | 755 | 23.8 | #25 |
| Island | 8 | 44 | 1,918 | 22.9 | #26 |
| Skamania | 1 | 6 | 320 | 18.8 | #27 |
| Clallam | 7 | 41 | 2,257 | 18.2 | #28 |
| Ferry | 1 | 6 | 333 | 18.0 | #29 |
| Walla Walla | 6 | 24 | 1,391 | 17.3 | #30 |
| Grays Harbor | 6 | 34 | 2,001 | 17.0 | #31 |
| Mason | 6 | 28 | 2,183 | 12.8 | #32 |
| Jefferson | 2 | 12 | 985 | 12.2 | #33 |
| Pacific | 1 | 8 | 945 | 8.5 | #34 |
| Stevens | 2 | 12 | 1,456 | 8.2 | #35 |
| Columbia | 0 | 0 | 182 | 0.0 | — |
| Garfield | 0 | 0 | 42 | 0.0 | — |
| Pend Oreille | 0 | 0 | 367 | 0.0 | — |
| Wahkiakum | 0 | 0 | 171 | 0.0 | — |
ZIP codes with seniors on Medicaid and no licensed home
The 15 ZIP codes with the most residents 65 and over on Medicaid and no adult family home inside them. A home in a neighboring ZIP code may serve them, so this is a list of places to look at, not a list of gaps.
| ZIP code | County | Residents 65+ on Medicaid |
|---|---|---|
| 98104 | King | 1,164 |
| 98122 | King | 667 |
| 98660 | Clark | 651 |
| 98370 | Kitsap | 628 |
| 98550 | Grays Harbor | 544 |
| 98233 | Skagit | 485 |
| 98948 | Yakima | 445 |
| 99114 | Stevens | 445 |
| 98101 | King | 436 |
| 98105 | King | 391 |
| 98266 | Whatcom | 309 |
| 98109 | King | 304 |
| 98541 | Grays Harbor | 303 |
| 98951 | Yakima | 301 |
| 98121 | King | 296 |
The 20 cities with the most homes
| City | County | Homes | Licensed beds |
|---|---|---|---|
| Vancouver | Clark | 521 | 3,038 |
| Tacoma | Pierce | 380 | 2,200 |
| Spokane | Spokane | 347 | 1,975 |
| Everett | Snohomish | 313 | 1,806 |
| Lynnwood | Snohomish | 312 | 1,799 |
| Kent | King | 288 | 1,654 |
| Federal Way | King | 278 | 1,623 |
| Lakewood | Pierce | 275 | 1,631 |
| Spokane Valley | Spokane | 252 | 1,477 |
| Renton | King | 202 | 1,189 |
| Puyallup | Pierce | 191 | 1,122 |
| Auburn | King | 188 | 1,091 |
| Marysville | Snohomish | 184 | 1,067 |
| Olympia | Thurston | 151 | 867 |
| Seattle | King | 151 | 879 |
| Lacey | Thurston | 149 | 862 |
| Bellevue | King | 134 | 802 |
| Edmonds | Snohomish | 126 | 720 |
| Shoreline | King | 122 | 701 |
| Des Moines | King | 80 | 457 |
175 cities and 268 ZIP codes have at least one home. Use the lookup above for any of them.
Could you run one here?
Five short questions. Your answers stay in your browser. Nothing is sent unless you choose to send it to me at the end. It does the arithmetic on the numbers you give it. It is not a forecast and it is not advice: I am a broker, not an accountant or a lender.
What these numbers can and cannot tell you
- A bed is capacity. DSHS counts licensed beds. It does not publish how many are filled.
- Who is counted. Residents 65 and over who have Medicaid or other means-tested health coverage, from the Census Bureau. Washington's Medicaid long-term care also tests savings and the need for care, which the Census does not count, so this stands in for who is likely to qualify. It is not a count of who does.
- Younger adults are left out. Adults 18 to 64 with disabilities can qualify for the same care and live in these homes too. They are not in the ratio, so it overstates the beds for each eligible person.
- The ratio is a yardstick. It compares places of different size. Many people who qualify live somewhere else or pay privately, so it is not a measure of need.
- Counties, not ZIP codes, for the ratio. A home serves people from the surrounding area, so the beds-per-resident figure is shown for counties and for a radius around a place, never for a single ZIP code or city. A ZIP code or city shows its homes and beds, and the number of seniors on Medicaid who live there (shown as "under 100" when the Census estimate is too small to trust).
- Few homes does not mean a gap. A county can have few adult family homes because other kinds of care fill the role, or because nobody has opened one. These numbers cannot tell those apart.
- Census counts are estimates. They are five-year averages from the American Community Survey, with a margin of error that grows for small places.
- The calculator is arithmetic. It adds up the numbers you enter. It leaves out your own pay, income tax, repairs and reserves, closing costs, and what the house is worth when you sell, and it cannot know your residents, your staff or your licence timeline. Use it to find the question to ask, then ask an accountant.
Sources: Washington DSHS, Residential Care Services (licensed homes, fetched 9 October 2026) and the U.S. Census Bureau, American Community Survey 2020 to 2024 five-year estimates, table C27007 (Medicaid or means-tested coverage, residents 65 and over). To check a single home, use the DSHS locator. More on the money side: what owners actually make and what it costs to start.
Talk it through with me
I am a Washington broker, and my family runs an adult family home. If you want a second pair of eyes on an area, a house or the numbers above, send me where you are. It is optional. Nothing is sent until you press the button, and you see exactly what goes.
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