Adult family homes and nursing providers cite rapid demand growth, bed‑hold gaps and workforce pressure

Adult family homes, assisted living and skilled nursing operators told the Senate Health & Long Term Care Committee that demand for home‑and‑community‑based long‑term services is rising, that Medicaid covers the majority of residents in those settings, and that payment, workforce and insurance costs are creating bottlenecks that push patients to remain in hospitals longer.

John Ficker, executive director of the Adult Family Home Council, said adult family homes have grown substantially and now number more than 5,000 facilities across Washington with nearly 30,000 beds. He said roughly 91% of adult family homes are contracted to provide Medicaid services and that about two‑thirds of contracted beds are occupied by Medicaid or state‑funded residents. "If just 5% of our population was moved from the adult family home to a skilled nursing facility, an annual increase in expenditure by the…