Effective Date of Rule: June 1, 2026.
Citation of Rules Affected by this Order: Amending WAC 246-335-990.
Adopted under notice filed as WSR 25-24-044 on November 26, 2025.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 1, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: February 3, 2026.
for Dennis E. Worsham
(1) Initial license. An applicant shall submit to the department an initial ((twelve))12-month license fee of ((three thousand two hundred eighty-three dollars))$5,000 for each service category (home care, home health, hospice) for persons not currently licensed to provide in-home services in Washington state.
(2) Adding new service categories to existing license. A licensee shall submit to the department an initial ((twelve))12-month license fee of ((three thousand two hundred eighty-three dollars))$5,000 for each new service category (home care, home health, hospice, hospice care center) for licensees not currently licensed in that category to provide in-home services in Washington state.
(3) County surcharge. An applicant or licensee shall submit to the department a service area county surcharge. One county of operation for each applicant or licensee is not subject to a county surcharge. Each additional county of operation is charged at:
(a) $500 per urban county; and
(b) $100 per rural county.
(4) Renewal license. A licensee shall submit to the department a ((twenty-four))24 month renewal fee for home care, home health and hospice agencies, based on the number of full-time equivalents (FTEs), which is a measurement based on a ((forty))40 hour week and is applicable to paid agency personnel or contractors, according to Tables 1 and 2 of this section. The department will assume a minimum of ((1))2 FTE for each approved service area per service category. The licensee shall submit to the department a ((twenty-four))24 month renewal fee for hospice care centers, based on the number of beds, according to Tables 1 and 2 of this section((:)).
(a) ((For licenses with a single service category))Unless eligible under (b) of this subsection, a licensee shall submit to the department applicable fees under Table 1:
Table 1 - Standard Renewal Fees
# of FTEs | Home Care | Home Health | Hospice | # of Beds | Hospice Care Center |
5 or less | | (($1,530.00))$2,400.00 | | (($3,283.00))$5,100.00 | | (($1,642.00))$2,500.00 | | 5 or less | (($1,642.00))$2,500.00 | |
6 to 15 | | (($1,783.00))$2,800.00 | | (($4,618.00))$7,200.00 | | (($1,856.00))$2,900.00 | | 6 to 10 | (($2,190.00))$3,400.00 | |
16 to 50 | | (($1,916.00))$3,000.00 | | (($5,256.00))$8,100.00 | | (($2,383.00))$3,700.00 | | 11 to 15 | (($3,283.00))$5,100.00 | |
51 to 100 | | (($2,244.00))$3,500.00 | | (($6,623.00))$10,300.00 | | (($4,120.00))$6,400.00 | | 16 to 20 | (($4,378.00))$6,800.00 | |
101 or more | | (($2,408.00))$3,700.00 | | (($6,820.00))$10,600.00 | | (($4,335.00))$6,700.00 | | | |
(b) ((For licenses with multiple service categories:
(i) One hundred percent of the home health category fee and seventy-five percent of the appropriate service category fee for each additional service category (home care, hospice, hospice care center); or
(ii) One hundred percent of the hospice category fee and seventy-five percent of the appropriate service category fee for each additional service category (home care, hospice care center).
(4)))A licensee shall submit to the department applicable fees under Table 2 when a licensee has satisfied the substantial equivalency requirements of WAC 246-335-350 and:
(i) Is medicare certified (home health and hospice agencies only);
(ii) Is accredited by an accrediting organization recognized by the department (home health and hospice agencies only); or
(iii) Is under contract with and monitored by DSHS or the AAA (home care agencies only).
Table 2 - Renewal Fees for Facilities Certified by Medicare, Accredited, or Contracted by DSHS or AAA
# of FTEs | Home Care | Home Health | Hospice | # of Beds | Hospice Care Center |
5 or less | | $1,700.00 | | $3,600.00 | | $1,800.00 | | 5 or less | $1,800.00 | |
6 to 15 | | $2,000.00 | | $5,000.00 | | $2,000.00 | | 6 to 10 | $2,400.00 | |
16 to 50 | | $2,100.00 | | $5,700.00 | | $2,600.00 | | 11 to 15 | $3,600.00 | |
51 to 100 | | $2,500.00 | | $7,200.00 | | $4,500.00 | | 16 to 20 | $4,800.00 | |
101 or more | | $2,600.00 | | $7,400.00 | | $4,700.00 | | | |
(5) Change of ownership. A change of ownership fee of ((three hundred fifty dollars))$500 for each licensed service category (home care, home health, hospice, hospice care center). A new license will be issued and valid for the remainder of the current license period.
(((5)))(6) The department may charge and collect from a licensee a fee of ((one thousand five hundred thirty dollars))$5,000 for:
(a) An on-site follow-up compliance survey deemed necessary in order to complete the survey process;
(b) An on-site compliance survey deemed necessary due to failure of the licensee to adequately respond to a statement of deficiencies or a directed plan of correction;
(c) An on-site compliance survey deemed necessary due to a substantiated complaint investigation; or
(d) State licensing surveys conducted during renewal periods that require on-site survey time beyond two days.
(((6)))(7) A licensee that is not subject to the state survey requirement according to WAC 246-335-350 shall pay fees according to this section.
(((7)))(8) A licensee shall submit an additional late fee in the amount of ((fifty dollars))$50 per day. The additional late fee will not exceed ((six hundred fifty dollars))$1,000, from the renewal date, which is ((thirty))30 days before the current license expiration date, until the date of mailing the fee, as evidenced by the postmark, or electronic submission.
(((8)))(9) Refunds. The department shall refund fees paid by the applicant for initial licensure as follows:
(a) If an application has been received but no on-site survey or technical assistance has been performed or provided by the department, two-thirds of the fees paid, less a ((fifty dollar))$50 processing fee; or
(b) If an application has been received and an on-site survey or technical assistance has been performed or provided by the department, one-third of the fees paid, less a ((fifty dollar))$50 processing fee.
(((9)))(10) The department may not refund applicant fees if:
(a) The department has performed more than one on-site visit for any purpose;
(b) Nine months has elapsed since an initial licensure application is received by the department, but no license has been issued due to applicant's failure to complete the requirements for licensure; or
(c) The amount to be refunded as calculated by subsection (((8)))(9)(a) or (b) of this section is ten dollars or less.