50-State Regulatory Atlas Washington
State licensing summary
Washington: healthcare licensing and regulation
Washington: one license, branches listed or approved; certificate of need for medicare or medicaid agencies; compact member. Regulator: Washington State Department of Health.
Educational summary, last reviewed October 17, 2026. Not legal advice — confirm with the state licensing agency or counsel.
12 findings: 12 verified. How findings are sourced and labelled.
At a glance
- License
- State license requiredVerified
- Regulator
- Washington State Department of Health
- Branch offices
- One license, branches listed or approvedVerified
- Certificate of need
- Certificate of need for Medicare or Medicaid agenciesVerified
- Service area
- The service area the department has approved; expanding it needs an amended application and approval before services start.Verified
- In-state office
- Required: an in-state office or licensed parentVerified
- Medicare certification
- Separate federal step, only for agencies that bill MedicareVerified
Home health licensing
State license
VerifiedYes, an in-home services agency license (RCW 70.127; WAC 246-335) with home care, home health, hospice and hospice care center categories. Anyone who employs or contracts with two or more individuals to provide in-home services is subject to licensure.
In practice: Hold the authority the state requires before the first patient is admitted there, and keep its number, category and expiry with the office it covers.
Source: WAC 246-335-335WAC 246-335-315WA DOH certificate of need orderRCW 70.127.040
Certificate of need
VerifiedMedicare and Medicaid agencies only, per county: serving a new county counts as a new agency.
In practice: Matters only if the agency will be certified for Medicare or Medicaid.
Source: WAC 246-335-335WAC 246-335-315WA DOH certificate of need orderRCW 70.127.040
Branch offices
VerifiedThe license shows branch office locations. Opening or closing an office needs notice within 30 days.
In practice: Track each office’s authority on its own where the state licenses offices separately, and with the parent where it lists them.
Source: WAC 246-335-335WAC 246-335-315WA DOH certificate of need orderRCW 70.127.040
Service area
VerifiedThe service area the department has approved; expanding it needs an amended application and approval before services start.
In practice: Check the patient’s address against the approved service area before accepting a referral.
Source: WAC 246-335-335WAC 246-335-315WA DOH certificate of need orderRCW 70.127.040
Out-of-state agencies
VerifiedAt least one office in Washington, where records are kept.
In practice: A license in one state does not authorize care in another; the patient’s state decides.
Source: WAC 246-335-335WAC 246-335-315WA DOH certificate of need orderRCW 70.127.040
A Medicare-certified or listed-accredited agency “is not subject to a state licensure survey” where the department finds the standards substantially equivalent, an on-site certification or accreditation survey took place in the previous 24 months and the department receives the reports; the department may validate up to 10% (RCW 70.127.085).
In practice: The state usually keeps its complaint authority.
Source: RCW 70.127.085
Home infusion nursing
Home infusion nursing
VerifiedThe home health rules do not mention infusion; licensure follows in-home skilled services. The pharmacy exemption covers only delivering drugs and equipment with setup and education.
In practice: Confirm the license category before staffing infusion visits in this state.
Source: WAC 246-335-335WAC 246-335-315WA DOH certificate of need orderRCW 70.127.040
Staffing and nurse licensure
Nurse licensure (compact)
VerifiedMember of the Nurse Licensure Compact, implemented. A nurse with a multistate license from another compact state may practice here; the agency still needs this state’s own authority to operate.
In practice: Check each nurse’s license against the patient’s state, not the agency’s.
Nursing pool registration
VerifiedNo one may run a business providing or referring health care personnel for temporary employment in health care facilities without first registering with the Department of Health (ch. 18.52C RCW; WAC 246-845-050).
In practice: Annual placement and charge reporting applies to nursing pools from 2025.
Source: WAC 246-845-050
State coverage for healthcare staffing is partial; more states are being reviewed.
Medicare, hospice and VA programs in this state
Washington is not one of the six states in CMS’s Review Choice Demonstration for home health (Illinois, Ohio, Texas, North Carolina, Florida, Oklahoma).
Source: CMS: Review Choice Demonstration for Home Health Services
Washington is not one of the six states (Arizona, California, Nevada, Texas, Georgia, Ohio) where CMS applies its provisional period of enhanced oversight to newly enrolling hospices.
Source: CMS Medical Review: Hospice
VA Community Care Network region
VerifiedWashington is in Community Care Network Region 4, administered by TriWest. Agencies join by contracting with the regional third-party administrator, not with VA. VA has re-procured the network as CCN Next Generation with two regions, East and West; which administrator serves which region from 2027 was not announced in the sources reviewed.
Time-sensitive. Region assignments change with CCN Next Generation; recheck VA’s announcements during 2027.
Source: VA: Community Care Network
Federal rules that apply in every state
Medicare certification
VerifiedMedicare certification under the home health Conditions of Participation (42 CFR Part 484) is a federal step for agencies that bill Medicare home health. It is separate from the state license. Where a state ties entry to certification, that state’s findings say so.
In practice: A branch serving a portion of the parent’s area is supervised and administered by the parent agency (42 CFR 484.2).
Source: 42 CFR 484.2
For a Medicare-certified agency, “its personnel must be qualified in all States in which they provide services” (State Operations Manual § 2184).
In practice: Nurse licensure follows the patient’s state.
Medicare’s home infusion therapy benefit is a separate Part B supplier benefit, not a home health benefit. It pays an accredited, qualified home infusion therapy supplier for professional services tied to specific parenteral drugs given through a pump that is durable medical equipment (42 CFR Part 486, Subpart I).
In practice: Most pharmacy-dispensed home infusion is not billable under this benefit; nursing for those patients is usually paid by other payers or under contract.
Compared with Texas
Branches listed on one license; county-based certificate of need for Medicare and Medicaid agencies; records 3 years.
Other service lines
State rules for these lines are being added to the guide: Medicare home health, Medicare home infusion therapy benefit, Infusion pharmacy, Hospice, Private duty nursing, Personal care and Medicaid HCBS, VA community care, Infusion suites.
Look up a licensed provider
- Provider Credential or Facility Search VerifiedWashington State Department of Health
Home health, home care, hospice and in-home services agency licenses with status, expiration and enforcement case counts, updated daily.
National lookups
- Medicare Care Compare — Home health
Medicare-certified home health agencies with quality ratings and services offered.
- Medicare Care Compare — Hospice
Medicare-certified hospices with quality measures.
- CMS Provider Data Catalog — Home Health Care Agencies (6jpm-sxkc)
All Medicare-registered home health agencies with CCN, address, ownership, services, certification date and quality measures, as CSV and an unauthenticated API.
- CMS Provider Data Catalog — Hospice – General Information (yc9t-dgbk)
Medicare-certified hospices with CCN, address, county, ownership type and certification date, as CSV and an unauthenticated API.
- CMS QCOR — HHA 2567 Statements of Deficiencies
Federal survey statements of deficiencies for home health agencies, filterable by state, survey type, tag and CCN, with a full-dataset XLSX download.
- CMS QCOR — Hospice 2567s
Federal survey statements of deficiencies for hospices.
- NPPES NPI Registry
National Provider Identifier records with addresses, authorized official and taxonomies, with a public API.
- HHS-OIG List of Excluded Individuals/Entities (LEIE)
Individuals and entities excluded from federal health care programs, with a monthly downloadable database.
- SAM.gov Exclusions
Federal exclusion records across agencies.
- Nursys QuickConfirm
Nurse license status, discipline / board-issued alerts and expiry, free to employers and the public.
Associations
- Home Care Association of Washington (HCAW)home health, hospice, home care (private duty and personal care)
Offers aide, administrator and wound care certifications, webinars, a legislative action center and PAC, licensing guidance and an annual conference.
- Washington State Hospice & Palliative Care Organization (WSHPCO)hospice, palliative care
Runs webinar networks, role-based networking groups and annual clinical conferences for hospice and palliative providers.
Official sources
About this guide. Published and maintained by Paloma Health Technologies; Findings are cited to official sources, dated and status-labelled; see the editorial policy. Educational summary, last reviewed October 17, 2026. Not legal advice — confirm with the state licensing agency or counsel.