Seattle at a Glance
Seattle Nursing Home Market Overview
America's Quality Leader
Seattle has the highest average star rating (3.5) of any major U.S. city. With 60% of facilities earning 4-5 stars (12 of 20), Seattle offers families exceptional quality options unavailable in most markets.
Only 2 one-star facilities (10%) compared to 40-50% in struggling markets like Chicago and Atlanta. Seattle families have genuine quality choices.
Seattle's nursing home market reflects Washington State's progressive healthcare standards and the Pacific Northwest's quality-of-life culture. With 4 five-star facilities and 8 four-star options, Seattle provides the highest concentration of excellent nursing homes in America.
The trade-off for this exceptional quality: Seattle is the most expensive nursing home market we've analyzed at $450/day ($164,250/year)—48% above the national median. However, this premium pricing delivers measurably superior care, safety, and staffing.
Market Characteristics
- •Highest Quality in U.S.: 3.5-star average beats all major metros
- •60% High-Quality Rate: 12 of 20 facilities earn 4-5 stars
- •4 Five-Star Facilities: Hearthstone, Queen Anne Healthcare, Caroline Kline Galland, Shoreline
- •Minimal Poor Quality: Only 2 one-star facilities (10%)
- •World-Class Healthcare: UW Medicine, Swedish, Virginia Mason, Harborview
- •Premium Pricing: $450/day - highest costs but exceptional quality
Seattle Nursing Home Costs (2025)
Cost Comparison
Highest Costs in the Nation
Seattle's $450/day average is 48% above the national median ($305/day)—the highest among major U.S. cities. This premium costs an additional $52,925 annually compared to the national average.
Financial Planning Strategies
1. Washington Apple Health (Medicaid)
Washington's Medicaid program covers nursing home care for eligible residents. Income limit is approximately $2,829/month for individuals (2025). Given Seattle's high costs, Medicaid planning is critical for most families.
2. Long-Term Care Insurance (Critical)
With Seattle's $450/day costs, long-term care insurance is especially valuable. Policies providing $300-400/day can cover 67-89% of expenses. Washington State's new WA Cares Fund (starting 2025) provides limited long-term care benefits.
3. Veterans Benefits
Veterans and surviving spouses may qualify for Aid & Attendance benefits up to $2,431/month (2025), covering 43-54% of Seattle nursing home costs. Washington State Veterans Home in Retsil and Orting offer additional options.
4. Home Equity & Reverse Mortgages
Seattle's high real estate values mean many seniors have significant home equity. Reverse mortgages or home sales can fund several years of care. Work with Washington elder law attorneys to structure home sales around Medicaid eligibility.
5. Spend-Down Planning
Work with a Washington elder law attorney to structure assets for Medicaid eligibility while protecting savings. Washington has a 5-year lookback period. Plan early given Seattle's premium costs and limited Medicaid bed availability.
Seattle Quality Analysis
The Seattle Quality Standard
Seattle's 3.5-star average represents the highest quality market in America—significantly exceeding the national 2.8-star average. With 60% of facilities earning 4-5 stars, Seattle offers families odds unavailable elsewhere.
Only 10% of Seattle facilities are one-star rated (2 facilities), compared to 40-50% in struggling markets. This means even Seattle's lower-rated facilities maintain standards that would be considered acceptable in most cities.
Star Rating Distribution
What This Means
- ✓Exceptional Five-Star Options: 4 facilities (20%) provide elite care—double the national average
- ✓60% High-Quality Rate: 12 of 20 facilities earn 4-5 stars—triple most major markets
- ✓Deep Four-Star Bench: 8 four-star facilities (40%) provide excellent backup options
- ✓Minimal Poor Quality: Only 2 one-star facilities (10%) vs 40-50% in struggling markets
Key Quality Indicators
Staffing Data
RN hours per resident per day
Review staffing data for individual facilities on Medicare.gov
Inspection Results
Health & safety citations
Our database shows zero major deficiency citations across Seattle facilities
Seattle's Top-Rated Nursing Homes
Seattle's Advantage: With 12 facilities earning 4-5 stars, Seattle families have unprecedented choice. Tour multiple options to find the best fit for location, size, and specialized services.
Five-Star Facilities (4)
The Hearthstone
6720 East Green Lake Way North
Seattle's most intimate five-star facility adjacent to iconic Green Lake. Small size (40 beds) provides exceptional staff-to-resident ratios and highly personalized care. Scenic location with lake views and access to Green Lake walking paths.
- • Smallest five-star facility (40 beds) - intimate, personalized
- • Green Lake location - scenic, walkable neighborhood
- • Exceptional staff-to-resident ratios
- • Access to lake paths for outdoor programs
Queen Anne Healthcare
2717 Dexter Avenue North
Large five-star facility in prestigious Queen Anne neighborhood with views of downtown Seattle and Puget Sound. Comprehensive services including post-acute rehabilitation, memory care, and skilled nursing. Proximity to Swedish Medical Center and Virginia Mason.
- • Large five-star facility (120 beds) with full services
- • Queen Anne - premium location with Sound views
- • Comprehensive post-acute rehabilitation
- • Close to Swedish, Virginia Mason hospitals
Caroline Kline Galland Home
7500 Seward Park Avenue South
Seattle's largest five-star facility operated by the Jewish Family Service. Comprehensive campus with skilled nursing, assisted living, and rehabilitation. Adjacent to Seward Park with lake access and old-growth forest. Accepts residents of all faiths and backgrounds.
- • Largest five-star facility (205 beds) - most comprehensive
- • Seward Park location - waterfront, nature access
- • Nonprofit operation with mission-driven care
- • Full continuum from assisted living to skilled nursing
Shoreline Health and Rehabilitation
2818 NE 145th Street
Five-star facility just north of Seattle city limits in Shoreline. Quieter suburban setting with easy access to Seattle and Northgate. Strong rehabilitation programs and post-acute care. Proximity to Swedish Edmonds and UW Medical Center Northwest.
- • North Seattle location - convenient for North End families
- • Quieter suburban setting than downtown
- • Strong post-acute rehabilitation focus
- • Mid-size (114 beds) balances services and personalization
Notable Four-Star Facilities (8)
Seattle's 8 four-star facilities provide excellent alternatives with diverse locations and specializations:
Nursing Homes by Seattle Neighborhood
Seattle's 20 nursing homes span diverse neighborhoods from waterfront locations to urban centers. Here's what to expect by area:
Queen Anne
Queen Anne Healthcare (5 stars, 120 beds) sits atop Queen Anne Hill with panoramic city and Puget Sound views. Upscale neighborhood with Kerry Park, Seattle Center, and Space Needle nearby. Excellent access to Swedish and Virginia Mason hospitals.
Green Lake
The Hearthstone (5 stars, 40 beds) offers Seattle's most intimate five-star setting adjacent to Green Lake. Popular recreation area with 2.8-mile walking path, swimming beach, and extensive parks. Family-friendly neighborhood with cafes and shops.
Seward Park / South Seattle
Caroline Kline Galland Home (5 stars, 205 beds) and Kin On Health Care Center (4 stars, 100 beds) serve South Seattle. Seward Park offers waterfront access and old-growth forest. More diverse, affordable neighborhoods than North Seattle.
Fremont / Wallingford
Columbia Lutheran Home (4 stars, 116 beds) serves North Seattle's quirky Fremont neighborhood. Artistic community with Sunday market, Fremont Troll, and independent businesses. Easy access to I-5 and Aurora Bridge.
Shoreline (North)
Shoreline Health and Rehabilitation (5 stars, 114 beds) sits just north of Seattle city limits. Quieter suburban character with easier parking and highway access (I-5). Close to Northgate light rail station and Swedish Edmonds hospital.
Downtown / First Hill / Capitol Hill
Terraces at Skyline (4 stars, 34 beds), Bailey-Boushay House (4 stars, 35 beds), and Mirabella Seattle (4 stars, 46 beds) serve urban core. Walkable neighborhoods with dining, culture, Harborview Medical Center, Swedish Cherry Hill.
Washington Apple Health (Medicaid) & Financial Assistance
Washington Apple Health (Medicaid) covers nursing home care for eligible residents. With Seattle's $164,250 annual costs, Medicaid planning is essential for most families.
Washington Apple Health Eligibility (2025)
- Primary residence (up to $713,000 equity in 2025)
- One vehicle
- Personal belongings and household items
- Prepaid funeral/burial arrangements
- Life insurance (face value up to $1,500)
Application Process
- 1.Gather Documentation
Income records, asset statements, medical records, proof of Washington residency, Social Security card
- 2.Apply Online or In-Person
Apply at WashingtonConnection.org or contact Washington Health Care Authority at 1-855-923-9359
- 3.Medical Assessment
Washington conducts a Comprehensive Assessment Reporting Evaluation (CARE) to determine nursing facility level of care eligibility
- 4.Facility Acceptance
Confirm the facility accepts Apple Health before admission. High-quality Seattle facilities may have limited Medicaid bed availability
Critical: Spend-Down Planning with Seattle's High Costs
Seattle's $164,250 annual costs can deplete savings in 2-3 years for many families. Strategic Medicaid planning is essential:
- • 5-Year Lookback: Washington reviews asset transfers made within 5 years before application
- • Home Equity Protection: Seattle home values often exceed $713,000—work with elder law attorney on strategies
- • Spousal Protections: Community spouse can keep approximately $148,620 in assets (2025) and up to $3,853/month income
- • WA Cares Fund (new 2025): Washington State's long-term care benefit provides limited coverage—check eligibility
- • Elder Law Attorney: Critical for Seattle given high costs and home values
Veterans Benefits
Veterans and surviving spouses may qualify for additional assistance:
How to Choose a Seattle Nursing Home
Seattle-Specific Strategy
Seattle's exceptional quality (60% with 4-5 stars) gives you genuine choice. Your strategy:
- 1.Start with Five-Star Facilities: Tour all 4 five-star homes first
- 2.Add Four-Star Options: Select 3-4 four-star facilities based on location and specialization
- 3.Prioritize Fit Over Ratings: With so many high-quality options, focus on location, size, culture, specialized services
- 4.Plan Early for Medicaid: Seattle's high costs require strategic Medicaid planning—start 5+ years before anticipated need
Essential Tour Questions
Staffing & Care Quality
- • What is the RN-to-resident ratio on each shift?
- • What's your nurse turnover rate? (Seattle's high cost of living affects staffing)
- • How do you handle emergency situations? Which hospitals? (UW Medicine, Swedish, Virginia Mason?)
- • Do you have specialized dementia care units?
Seattle-Specific Considerations
- • How do you handle Seattle's rainy weather for outdoor access and programs?
- • What natural light/outdoor space do you offer? (Critical for Seattle's gray winters)
- • Do you offer culturally specific programming? (Seattle's diverse population)
- • Parking availability and costs? (Significant issue in Seattle)
Financial & Admission
- • What is the exact monthly all-in cost at different care levels?
- • Do you accept Washington Apple Health (Medicaid)? Bed availability for Medicaid patients?
- • What's your current waiting list? (High-quality facilities may have waitlists)
- • What happens when funds run out—do you accept Medicaid spend-down?
Red Flags to Watch For
- 🚩Facility won't let you tour unannounced: Quality facilities welcome drop-in visits
- 🚩Strong odors: Urine or fecal smells indicate inadequate care
- 🚩Residents look unkempt or isolated: Poor grooming or residents sitting alone for extended periods
- 🚩Staff seems rushed or stressed: Even Seattle's best facilities need adequate staffing
- 🚩Lack of natural light or outdoor access: Especially critical in Seattle's gray climate
- 🚩Vague cost breakdown: Seattle's high costs require complete transparency on all charges
Find Seattle's Best Nursing Homes
Search all 20 Seattle facilities. Compare 4 five-star and 8 four-star options for America's highest-quality care.
Search Facilities NowAdditional Resources
Understanding Star Ratings
Learn what CMS star ratings mean and how to use them effectively
Staffing: The #1 Quality Predictor
Why RN hours and turnover rates matter more than anything else
Facility Tour Checklist
Essential questions and observations for your facility tours
More City Guides
Comprehensive guides for other major U.S. cities
Data Sources: This guide uses 2025 CMS Medicare data, Genworth Cost of Care Survey (2024), U.S. Census Bureau demographics, and Washington State Department of Social and Health Services licensing information. Star ratings and facility information reflect the most recent CMS data available.
Disclaimer: This guide provides educational information only and should not replace professional medical or legal advice. Facility ratings and costs change over time—always verify current information directly with facilities and on Medicare.gov before making decisions.