Washington State Guide

How to Start a Home Care Agency in Washington State

Your complete 2026 guide to launching a home care business in Washington state, from DOH In-Home Services Agency licensing to navigating the Evergreen State's unique tax structure and the WA Cares Fund.

Published April 4, 2026 · 28 min read

TLDR — Washington State at a Glance

State license required?
Yes — DOH license mandatory for both non-medical and skilled agencies under RCW 70.127.
Licensing agency
WA Department of Health (DOH) for In-Home Services and Home Health
Estimated startup costs
$45,000 – $110,000 (non-medical)
$120,000 – $300,000+ (home health)
Timeline to launch
3 – 5 months (non-medical) | 6 – 12 months (home health)
State tax
No income tax — B&O tax on gross receipts (0.471% – 1.5%)

1Washington State Market Overview

A tech-forward state with a growing senior population and unique programs

Washington state offers a compelling opportunity for entrepreneurs looking to start a home care agency. With a population of approximately 7.8 million people and a rapidly aging demographic, the Evergreen State combines strong private pay demand in its affluent tech-hub metro areas with robust public programs including Apple Health (Medicaid) and the first-in-the-nation WA Cares Fund long-term care insurance program. Washington is one of the few states that requires a DOH license for non-medical in-home services agencies, providing a regulated environment that helps quality agencies stand out.

7.8M
Population
~16%
Aged 65+
39
Counties
$16.66
2026 Min Wage

Washington's home care demand is concentrated in its western urban corridor but extends statewide. The Seattle-Tacoma-Bellevue metropolitan area is home to major employers like Amazon, Microsoft, and Boeing, creating a population of tech-savvy families who research and select home care services online. The state's large Asian and Pacific Islander communities — including Chinese, Vietnamese, Filipino, Indian, and Korean populations, especially in the Seattle metro — create significant demand for culturally competent, multilingual home care services.

Regional Market Breakdown

Seattle Metro (King County)

The economic engine of the state with 2.3M+ residents. Tech-industry wealth drives premium private pay rates, but competition is intense and office rents are among the highest in the nation. Very strong demand for multilingual services serving Chinese, Vietnamese, Indian, and Korean communities.

Tacoma / South Sound (Pierce County)

Home to Joint Base Lewis-McChord (JBLM), the largest military installation on the West Coast. Strong TRICARE referral opportunities and a growing senior population. More affordable than Seattle while still accessing the metro market. Pierce County has over 900K residents.

Spokane & Eastern Washington

The inland hub of eastern Washington with a metro population over 580K. Lower cost of living, less competition, and strong demand for home care services. Fairchild Air Force Base adds military families. The eastern WA market offers the best startup cost-to-opportunity ratio.

Olympia, Vancouver & Other Metro Areas

Olympia is the state capital with a large government workforce aging into home care. Vancouver (Clark County) borders Portland, OR and benefits from no state income tax while accessing the Portland labor market. Bellevue and the Eastside offer premium private pay demand from affluent tech families.

Why Start a Home Care Agency in Washington

No state income tax saves you money — only B&O tax on gross receipts instead of profits
WA Cares Fund creates a brand-new payer source unique to Washington — up to $36,500/person in LTC benefits
Premium private pay rates in the tech-affluent Seattle-Bellevue metro with strong demand
Large Asian/Pacific Islander communities creating demand for culturally competent multilingual care

2Home Care vs. Home Health in Washington

Both types require DOH licensure under RCW 70.127

Washington licenses both types of agencies. Unlike many states that only license skilled home health agencies, Washington's In-Home Services Act (RCW 70.127) requires DOH licensure for both non-medical in-home services agencies and skilled home health agencies. This means you cannot operate even a non-medical personal care agency without a DOH license.

Non-Medical In-Home Services

  • Personal care (bathing, dressing, grooming)
  • Companion care and socialization
  • Meal preparation and light housekeeping
  • Medication reminders (not administration)
  • Transportation and errands
  • Respite care for family members

DOH In-Home Services Agency license required

Under the In-Home Services Act (RCW 70.127).

Home Health (Skilled)

  • Skilled nursing care
  • Physical, occupational, and speech therapy
  • Wound care and injections
  • Medical social services
  • Home health aide services
  • Medication administration

DOH Home Health Agency license required

Plus Medicare certification for Medicare billing.

3Business Formation in Washington

No income tax, but B&O tax on gross receipts

Caring hands representing home care services in Washington state

No state income tax: Washington is one of only nine states with no state income tax for individuals or businesses. Instead, Washington imposes a Business and Occupation (B&O) tax on gross receipts, ranging from 0.471% to 1.5% depending on the business activity classification. Most home care agencies fall under the Service and Other Activities classification at 1.5% of gross receipts. Unlike income tax, B&O tax is levied on total revenue, not on profits.

Step 1

Choose Your Business Structure

Most Washington home care agencies register as an LLC for liability protection and pass-through taxation. Since Washington has no state income tax, the LLC structure avoids double taxation concerns entirely. Filing an LLC in Washington costs $200 with the Secretary of State.

Step 2

Register with the Secretary of State

File your Certificate of Formation (LLC) or Articles of Incorporation with the Washington Secretary of State at sos.wa.gov. Online filing is available and typically processed within a few business days. Annual reports are required ($60/year for LLCs).

Washington Secretary of State
Step 3

Obtain Your EIN

Apply for a free Employer Identification Number (EIN) from the IRS at irs.gov. Required for bank accounts, payroll, and tax filings. Takes minutes to obtain online.

Step 4

Register for B&O Tax with Department of Revenue

Register your business with the Washington Department of Revenue (DOR) for B&O tax, retail sales tax (if applicable), and use tax. File through the Business Licensing Service (BLS). Most home care services are exempt from sales tax but B&O tax applies to all gross receipts.

WA Department of Revenue
Step 5

Register with Employment Security Department (ESD)

Register with the WA Employment Security Department for unemployment insurance (UI) taxes. ESD also administers the Paid Family and Medical Leave (PFML) program. You must register within 30 days of your first employee's start date.

WA Employment Security
Step 6

Register with Labor & Industries (L&I)

Washington has a state-run monopolistic workers' compensation system through L&I. You must register and obtain workers' comp coverage through L&I before hiring employees. Both employers and employees pay into the system. L&I sets rates by industry classification.

WA Labor & Industries
Step 7

City and County Permits

Check local business license requirements. Seattle requires a general business license (free registration through the city). Other cities and counties may have separate business license or permit requirements. Contact your local city clerk for specifics.

Step 8

Open a Business Bank Account

Open a dedicated business checking account. You need your EIN, Certificate of Formation, and Washington business license. Washington has many large banks and credit unions including BECU, Washington Federal, and major national banks.

4Licensing Requirements

Washington DOH licenses both non-medical and skilled home care agencies

In-Home Services Agency License — DOH

Under the In-Home Services Act (RCW 70.127), all agencies providing non-medical in-home services in Washington must obtain an In-Home Services Agency license from the Washington Department of Health (DOH). This distinguishes Washington from many states that do not regulate non-medical home care. The licensing process ensures a baseline level of quality and consumer protection. The process includes:

  • Submit In-Home Services Agency license application to DOH
  • All owners and administrators must pass DSHS background checks
  • Provide proof of workers' compensation coverage through L&I
  • Establish policies and procedures meeting DOH standards
  • Maintain compliance with ongoing DOH reporting and renewal requirements
  • Pass a DOH inspection or survey prior to licensure
WA Department of Health

Background Check Requirements

Washington requires comprehensive background checks for all individuals providing in-home care services. The state uses a dual-system approach that is more thorough than many other states:

WSP WATCH System

The Washington State Patrol (WSP) WATCH system provides statewide criminal history background checks. This searches Washington state criminal records and is typically processed within 10 business days.

DSHS Background Check Central Unit

The DSHS Background Check Central Unit conducts comprehensive background checks including state, federal (FBI), and abuse/neglect registry checks. Required for all caregivers serving vulnerable adults.

Important: Caregivers cannot begin providing services to vulnerable adults until their DSHS background check is cleared. Budget 2 to 4 weeks for processing. Disqualifying crimes are listed in RCW 43.43.830 through RCW 43.43.842.

DSHS Background Check Central Unit

Home Health Agency License — DOH

If you plan to provide skilled nursing, physical therapy, or other medical services, you must obtain a Home Health Agency license from DOH. This is a more rigorous and costly process than obtaining an In-Home Services Agency license. Requirements include:

  • Submit Home Health Agency license application to DOH
  • Pass an on-site survey/inspection by DOH surveyors
  • Designate a qualified administrator and clinical director
  • Employ or contract with RNs for clinical supervision
  • Maintain comprehensive policies, QA programs, and documentation
WA Department of Health

Medicare Certification

Medicare certification is separate from state licensure. To bill Medicare, you must apply through CMS, pass a federal survey, and meet all Medicare Conditions of Participation. In Washington, DOH serves as the state survey agency for CMS. Given Washington's growing senior population, Medicare certification provides access to a large and valuable payer source, especially for home health agencies.

5Insurance Requirements

State-run workers' comp through L&I, PFML, and WA Cares Fund

General Liability

$2,500 - $7,000/yr
Required

Covers bodily injury and property damage claims. Recommended minimum: $1M per occurrence / $2M aggregate. Required for DOH licensure.

Professional Liability (E&O)

$2,000 - $5,500/yr
Required

Covers errors, omissions, and negligence claims. Essential for protecting your agency against malpractice and care-related claims.

Workers' Compensation (L&I)

$4,000 - $12,000/yr
Required

Washington has a MONOPOLISTIC state-run workers' comp system through L&I. You CANNOT buy private workers' comp insurance. Both employers and employees pay premiums. L&I sets rates by risk classification. Self-insurance is only available for large employers meeting strict criteria.

Paid Family & Medical Leave (PFML)

Shared premium
Required

Washington's PFML program provides up to 12 weeks of paid leave for family and medical reasons. Premium is split: employers pay ~27%, employees pay ~73% of the total rate. Administered by ESD. Mandatory for all employers in Washington.

WA Cares Fund — unique to Washington: The WA Cares Fund is the nation's first publicly funded long-term care insurance program. Employees contribute 0.58% of wages (no employer match), and qualifying individuals receive up to $36,500 in lifetime long-term care benefits, including home care services. As an employer, you must withhold WA Cares premiums from employee wages and remit them to ESD. As a home care agency, this program also creates a new payer source for your services as beneficiaries begin accessing their benefits.

L&I workers' comp is mandatory and state-run. Washington is one of only four states with a monopolistic state workers' compensation fund. You cannot purchase private workers' comp insurance. All employers must register with L&I and make quarterly premium payments. Operating without L&I coverage is illegal and can result in fines, penalties, and personal liability for workplace injuries.

6Staffing and Hiring in Washington

One of the highest minimum wages in the nation at $16.66/hr

Recruiting and retaining caregivers in Washington requires competitive compensation that reflects the state's $16.66/hour minimum wage (2026, indexed annually to CPI), one of the highest in the nation. The Seattle metro area is particularly competitive, with Amazon, Microsoft, and other tech employers driving up wages across all sectors. However, Washington's strong wages are offset by the ability to charge premium billing rates, especially for private pay clients in the Puget Sound region. Washington's diverse workforce includes many multilingual caregivers from Asian and Pacific Islander backgrounds who can serve the state's diverse senior population.

Background Checks

Washington requires DSHS background checks for all caregivers working with vulnerable adults, plus WSP WATCH criminal history checks. DSHS checks include state criminal records, federal (FBI) records, and abuse/neglect registry searches. Caregivers cannot begin providing services until cleared. Budget 2 to 4 weeks for processing.

Training Requirements

For home health aides, federal requirements mandate 75 hours of training including 16 hours of supervised clinical practice. Washington DSHS requires long-term care workers to complete basic training (including safety, infection control, and client rights). Caregivers serving DSHS clients must meet additional training requirements set by the state.

Where to Find Caregivers in Washington

WorkSource Washington
worksourcewa.com
Local CNA and nursing programs
UW, WSU, community and technical colleges statewide
WA Home Care Association
Industry networking and job boards
Community organizations
Asian/Pacific Islander community networks, military spouse groups (JBLM)

Wages and Labor Laws in Washington

Washington's minimum wage is $16.66/hour (2026, indexed to CPI annually). Seattle has its own higher minimum wage of approximately $20.76/hour for large employers. To attract quality caregivers in the competitive Puget Sound market, most agencies pay between $18 and $24 per hour for personal care aides and $22 to $32 per hour for home health aides and CNAs.

Washington labor law highlights: Weekly overtime at 1.5x after 40 hours per week (Washington follows federal FLSA standards for overtime, not daily). Washington mandates paid sick leave (1 hour per 40 hours worked). The Paid Family and Medical Leave (PFML) program provides up to 12 weeks of paid leave. Employers must also withhold WA Cares Fund premiums (0.58% of wages). Track all payroll deductions carefully: L&I workers' comp, PFML, and WA Cares Fund are all mandatory withholdings.

7Apple Health (Medicaid) and Medicare in Washington

Government payer programs, managed care, Sandata EVV, and ALTSA

Apple Health (Washington Medicaid)

Apple Health is Washington's Medicaid program, administered by the Health Care Authority (HCA). Apple Health serves over 2.3 million Washingtonians, making it one of the larger state Medicaid programs per capita. Washington is a Medicaid expansion state. To bill Apple Health for home care services, you must enroll as a provider through HCA. Washington operates a managed care system with 5 managed care organizations (MCOs) that administer Apple Health benefits in most regions. Understanding how to contract with these MCOs is essential for agencies seeking Medicaid revenue.

WA Health Care Authority

Electronic Visit Verification (EVV)

Washington uses Sandata as its EVV vendor. Under the 21st Century Cures Act, EVV is required for all Medicaid-funded personal care and home health services. Providers delivering services through Apple Health must use the Sandata system or an approved alternative EVV system that integrates with the state platform. EVV captures the type of service, who provided it, when, where, and for whom.

AveeCare note: AveeCare currently supports EVV compliance for Arizona (AHCCCS). For Washington Medicaid EVV through Sandata, agencies seeking Apple Health reimbursement should contact us first to discuss integration options.

ALTSA (Aging and Long-Term Support Administration)

The Aging and Long-Term Support Administration (ALTSA) operates under DSHS and administers long-term care services for older adults and people with disabilities in Washington. ALTSA manages Home and Community Services (HCS), which determines eligibility and authorizes in-home services for Medicaid clients. Building relationships with ALTSA case managers and area agencies on aging is critical for agencies serving Apple Health clients. ALTSA is one of the most important referral sources in Washington for home care agencies.

DSHS ALTSA

Medicare in Washington

Medicare certification requires a separate application through CMS, passing a federal survey, and meeting all Medicare Conditions of Participation. DOH serves as the state survey agency for CMS in Washington. With over 1.2 million Medicare beneficiaries in Washington, Medicare certification is valuable for home health agencies, particularly in areas with concentrated senior populations like the Puget Sound, Spokane, and the Tri-Cities region.

WA Cares Fund as a Payer Source

The WA Cares Fund is Washington's first-in-the-nation public long-term care insurance program. Qualifying individuals can access up to $36,500 in lifetime long-term care benefits, including home care services. As this program matures, it will become an increasingly important payer source for Washington home care agencies. Position your agency now to accept WA Cares Fund benefits and understand the eligibility criteria and claims process.

8Startup Cost Estimator

Estimated costs for starting a home care agency in Washington state

Non-MedicalHome Health

Business Formation

Washington LLC registration

Filing with Secretary of State (online filing)

$200 – $200

Annual report filing

Required annually with Secretary of State

$60 – $60

City/county business license

Varies by municipality (Seattle general business license is free but requires registration)

$50 – $400

Legal and accounting setup

Attorney review, CPA setup for B&O tax compliance

$1,500 – $4,500

Licensing

DOH In-Home Services Agency license

Application fee varies; contact DOH for current schedule

$500 – $1,500

DSHS background checks (owners)

Per person; each owner/operator must pass DSHS check

$50 – $200

WSP WATCH background checks

Per person; Washington State Patrol criminal history

$30 – $100

Insurance (Annual)

General liability insurance

$1M per occurrence / $2M aggregate

$2,500 – $7,000

Professional liability insurance

Errors and omissions coverage

$2,000 – $5,500

Workers' compensation (L&I)

State-run through L&I; employer + employee contributions

$4,000 – $12,000

Surety / fidelity bond

Recommended for client trust and protection

$500 – $2,000

Office & Equipment

Office space (first 3 months)

High in Seattle metro; more affordable in Spokane, Tri-Cities

$3,000 – $12,000

Computers, phones, and software

Laptops, smartphones, scheduling software

$1,500 – $4,000

Office supplies and furniture

Desk, chairs, printer, supplies

$500 – $2,000

Marketing & Initial Growth

Website development

Professional site with local SEO for WA market

$1,500 – $5,000

Initial advertising

Google Ads, social media, community outreach

$2,500 – $8,000

Business cards and print materials

Brochures, flyers, multilingual materials

$200 – $800

Working Capital (3-6 Months)

Payroll reserve

High WA wages ($17-$24/hr avg), PFML, WA Cares withholding

$12,000 – $35,000

Operating expenses reserve

Rent, utilities, software, fuel, B&O tax payments

$5,000 – $15,000

Estimated Total (Non-Medical)

Excludes Home Health Agency license and Medicare certification costs

$37,590 – $115,260

These estimates reflect typical costs for starting a home care agency in Washington state. Actual costs vary significantly based on your service area (Seattle metro vs. eastern WA), office location, staffing needs, and business model. The no-income-tax advantage helps offset Washington's higher-than-average cost of living, particularly in the Seattle metro area.

9Washington Compliance Checklist

Track your progress through every step

0 of 36 completed0%

Business Formation

Licensing

Insurance

Staffing

Apple Health & Medicare

Operations

Marketing

10Building Your Referral Network

Key healthcare systems, agencies, and referral sources in Washington

Washington's healthcare landscape offers abundant referral opportunities for home care agencies. The state has major health systems, a strong network of Area Agencies on Aging, and the ALTSA system that actively refers clients to licensed in-home services agencies. Building relationships with these referral sources is critical for sustainable growth, whether you serve private pay or Apple Health clients.

UW Medicine

The University of Washington medical system operates Harborview Medical Center, UW Medical Center, and Northwest Hospital. UW Medicine's discharge planners and social workers refer patients needing home care services throughout the Seattle metro.

Virginia Mason Franciscan Health

Part of CommonSpirit Health, this system operates hospitals across western Washington including St. Joseph, St. Francis, and Virginia Mason facilities. Discharge planning teams are a valuable referral pipeline for home care agencies.

Providence Swedish

Providence Swedish operates major hospitals in Seattle, Edmonds, Issaquah, and other locations across Washington. Their extensive care continuum creates regular referral opportunities for in-home care agencies.

MultiCare Health System

Based in Tacoma with hospitals throughout the Puget Sound, MultiCare is a major referral source for agencies in Pierce and South King counties. Strong relationships with their discharge planning teams can generate consistent referrals.

ALTSA & Area Agencies on Aging

The Aging and Long-Term Support Administration (ALTSA) under DSHS is one of the most important referral sources in Washington. ALTSA case managers authorize and refer clients for in-home services. Washington has 13 Area Agencies on Aging that connect seniors with services.

Military Installations

Joint Base Lewis-McChord (JBLM), Naval Station Everett, and Fairchild Air Force Base create referral opportunities through military family support programs, TRICARE, and veteran services. The VA Puget Sound Health Care System is another key referral source.

AveeCare scheduling day view for managing caregiver shifts

Efficient scheduling helps manage Washington's high-wage caregiver workforce

Referral tip: Washington's ALTSA system is unique and powerful. Case managers actively assess and refer clients to in-home services agencies. Being a DOH-licensed agency is required to receive these referrals. Prioritize building relationships with ALTSA case managers and the Area Agencies on Aging in your region.

11Marketing & Client Acquisition

How to market your home care business in Washington's tech-savvy market

Marketing a home care agency in Washington state means reaching a tech-savvy population that researches services online, values diversity and cultural competency, and includes a large concentration of tech-industry families whose aging parents need care. The Seattle metro is home to Amazon and Microsoft employees whose parents may be aging in the area or relocating to be closer to family. Digital marketing is essential in this market, and multilingual outreach to Washington's significant Asian and Pacific Islander communities provides a competitive edge.

Digital Marketing Strategies

Google Business Profile

Optimize your Google Business Profile for every city you serve. In the competitive Seattle-Bellevue market, strong reviews and regular updates are essential. Tech-savvy families will compare agencies online before making a decision.

Targeted Google Ads

Run Google Ads campaigns targeting "home care Seattle," "in-home care Tacoma," "caregiver Spokane," and equivalent phrases in Chinese, Vietnamese, Korean, and other languages. Seattle metro CPCs are competitive ($12-30+), so track ROI carefully.

SEO & Content Marketing

Build a professional website with city-specific landing pages for Seattle, Bellevue, Tacoma, Spokane, and Olympia. Create content about Washington-specific topics like WA Cares Fund benefits, ALTSA services, and Apple Health eligibility.

Social Media & WeChat

Maintain Facebook, Instagram, and NextDoor profiles. For the Chinese community in Seattle, consider WeChat marketing. Target adult children of aging parents who work at tech companies and are making care decisions for their families.

Community Outreach & Grassroots Marketing

WA Home Care Association

Join the Washington Home Care Association for industry networking, advocacy, education, and credibility. Their events and conferences connect you with other providers, referral sources, and policymakers.

Asian & Pacific Islander Community Organizations

Partner with Chinese, Vietnamese, Filipino, Indian, and Korean community organizations in the Seattle metro. Groups like the Chinese Information and Service Center (CISC), Vietnamese Friendship Association, and Filipino Community of Seattle serve as trusted referral sources. Having bilingual and bicultural caregivers gives you credibility.

Senior Centers & Area Agencies on Aging

Washington has 13 Area Agencies on Aging and hundreds of senior centers. Host educational workshops on WA Cares Fund benefits, Medicare options, and home care services. Build relationships with center directors for consistent referrals.

Military Family Programs (JBLM)

Connect with Joint Base Lewis-McChord family support programs, military spouse networks, and veteran service organizations. TRICARE referrals and VA programs create a steady stream of clients. Naval Station Everett and Fairchild AFB offer additional opportunities.

Healthcare Referral Relationships

Washington's healthcare system provides numerous referral opportunities for home care agencies. Key relationships to build for starting a home care agency in Washington state:

Hospital Discharge Planners

UW Medicine, Providence Swedish, Virginia Mason Franciscan, MultiCare, and PeaceHealth operate facilities across Washington. Build referral relationships with discharge planning teams at hospitals nearest your service area.

Physician Networks

Build relationships with geriatricians, family medicine physicians, and hospitalists. The UW Medicine network, Polyclinic, and community health centers across Washington are key referral sources for home care agencies.

ALTSA Case Managers

ALTSA case managers assess and authorize in-home services for Apple Health clients. Being listed as a DOH-licensed agency and building direct relationships with regional ALTSA offices is one of the most effective referral strategies in Washington.

Skilled Nursing & Rehab Facilities

Washington has over 200 skilled nursing facilities. Build relationships with social workers and discharge coordinators for post-acute care referrals. Focus on facilities in your service area for a consistent referral pipeline.

Online Reputation Management

In Washington's tech-savvy market, families research home care agencies extensively online. Your digital reputation directly impacts client acquisition. Washington families, especially those in the tech corridor, are sophisticated comparison shoppers.

Google Reviews

Aim for 50+ reviews with a 4.7+ rating in the Seattle metro. Respond to every review within 24 hours. Tech-savvy families read reviews carefully.

Caring.com

Maintain a premium profile. This directory receives significant traffic from Washington families researching home care options across the state.

NextDoor & Facebook

NextDoor is heavily used in Washington neighborhoods. Build your presence with helpful community posts and positive referrals from satisfied families.

Marketing Channel Comparison

ChannelCostTime to ResultsBest For
Google Ads (Multilingual)$$-$$$ImmediateFast leads in Seattle/Tacoma
SEO / Website$-$$4-8 monthsLong-term organic visibility
Asian Community Outreach$2-4 monthsDiverse community trust
WA Home Care Association$$1-3 monthsIndustry connections
ALTSA & Hospital ReferralsFree2-4 monthsHigh-intent referrals
Military Family ProgramsFree-$1-3 monthsTRICARE & VA clients

Washington marketing tip: The Seattle metro tech corridor is one of the most digitally savvy markets in the country. Families of aging parents who work at Amazon, Microsoft, and Boeing research home care agencies extensively online before making a decision. Invest heavily in your website, Google reviews, and content marketing. Multilingual outreach to Chinese, Vietnamese, Filipino, Indian, and Korean communities is a significant competitive advantage in the Puget Sound region.

12Frequently Asked Questions

Common questions about starting a home care agency in Washington state

13Sources and Resources

Official Washington state agency links and resources

WA Department of Health (DOH)WA Secretary of StateWA Health Care Authority (HCA)DSHS Background Check Central UnitDSHS ALTSA (Aging & Long-Term Support)WA Labor & Industries (L&I)WA Employment Security Department (ESD)WA Department of Revenue (DOR)WA State Patrol (WSP WATCH)WA Cares FundWorkSource WashingtonCMS Medicare Provider EnrollmentIRS - Employer Identification Number

Ready to manage your Washington home care agency?

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Disclaimer

This guide is for informational purposes only and does not constitute legal, financial, or professional advice. While we strive to keep this information accurate and up to date, Washington state laws, regulations, fees, and requirements may change. Always verify current requirements directly with the relevant Washington state agencies before making business decisions. Consult with a qualified attorney and accountant in Washington before starting your home care business. AveeCare is not affiliated with the Washington Department of Health, the Health Care Authority, the Department of Social and Health Services, Labor and Industries, or any Washington state agency. Published April 4, 2026.