8 licensed beds in Adult Family Home

Increase capacity to 8 beds in Adult Family Homes.

If you’re excited about having up to 8 licensed beds in your adult family home, here is what you need to know about applying for and being granted a capacity increase.

It’s important to understand that being granted a license for 7 or 8 Residents is not automatic. This law requires you to demonstrate your ability to provide safe care for all Residents and meet several other criteria.

As you June 2023, 157 AFHs are licensed for 7 or 8 out of 4,215 total AFHs in WA state.

Applying for 7 or 8 licensed beds in adult family homes

DSHS will only accept and process your application for 7 or 8 beds when:

  1. You’ve been licensed for at least 2 years
  2. You’ve been licensed for 6 residents for at least 12 months prior to applying for 7 or 8 beds;
  3. You’ve completed 2 full inspections without enforcement actions.

Granting your 7-8 licensed beds application

Prior to your increased capacity license being granted, DSHS will do a few things:

  1. Inform your local jurisdiction of your request and allow those various authorities to provide “recommendations” as to whether or not DSHS should approve your request. While your local jurisdiction will NOT have the power to “approve” or “consent” to your request, they will weigh in and offer recommendations to DSHS related to your request.
  2. DSHS will conduct an inspection to determine your compliance with licensing standards and assess your ability to meet the needs of 7 or 8 frail seniors.
  3. DSHS will interview and accept feedback from your current residents related to their quality of care and life and their views regarding the addition of 1 or 2 more residents.
    1. You may be wise to ‘sell the idea’ to your existing families before you apply…
      1. From your families’ perspective, more Residents in the AFH means potentially less time available to care for their parents.
      2. PRO TIP: Brainstorm several compelling reasons for having more residents in your AFH will improve everyone’s quality of life and care.

Applying – What to Prepare and Submit

  1. An attestation that an increase in the number of beds will not adversely affect the health, safety, or quality of life of current residents in your home (i.e., you declare that something is a fact);
    1. PRO TIP: rather than only saying that having 8 residents will not negatively affect current Residents, focus on showing how having 8 residents will benefit everyone in the home. For example, a higher budget would permit a more robust activities program. Think of all the ways 8 Residents could positively contribute to everyone in your AFH.
    2. PRO TIP: show your current activities plan and an “enhanced plan” to be implemented with 8 residents.
  2. Demonstrate your ability to comply with emergency evacuation standards;
    1. PRO TIP: Ensure your Emergency Plan is solid, well thought out, and contains clear procedures. This requires more know-how, but your fire drills should be comprehensive, clear, accurate, and show full evacuation times well under 5 minutes.
  3. A sprinkler system in place;
  4. POSSIBLE: You’ll need to attest to not serving individuals for whom the court has made a special finding under RCW 71.05.280.
  5. Pay DSHS fees associated with licensing applications and additional inspections.

Meeting Other Expectations

While most of the expectations are outlined in the law, the details of what DSHS may want to see from you to “objectively verify” your proficiency in those areas aren’t clear.

For example, you may need to demonstrate your ability to meet all financial obligations. What and how much will they want to see? This depends on individual circumstances, but you must be proficient with finances and financial planning. That means you should be able to produce accurate financial reports such as;

  • Profit and Loss statement
  • Cash flow statements
  • Balance a sheet
  • Business Bank statements with a sufficient cash balance
  • Savings and emergency cash reserves
  • A Net Worth statement

Management Experience

You must show successful management experience under your current ownership. If you recently got your license via a Change of Ownership (CHOW), DSHS may look for a two-year track record under your management, starting when your CHOW took effect.

What does DSHS look for to assert your management experience? The law doesn’t spell out the specifics, but typical items that communicate your management capabilities are;

Staffing

  • Low staff turnover
  • 24/7 staff
  • A clear staffing plan with a schedule

A written Activities Plan that is consistently implemented.

Complaints

If you have complaint investigations on record, they will be looked at. If families or residents have complaints about you or your AFH operation, it reflects discontentment with your ability to offer and promote a high-quality service or a positive experience.

Ability to meet other safety, health, and operating standards pertaining to operating an 8-bed AFH.

Very few in this industry have this background. If such previous experience is not on your resume, focus on the following items;

  1. Fire drills and full evacuation records within the 5-minute time frame currently allowed.
    1. You may be tested on this by having every resident in bed and evacuating them while being timed by the licensor.
  2. A comprehensive Disaster Plan which is well thought out and easy to follow.
  3. A clear Medical Emergency Plan to ensure you and your staff have an effective protocol for responding to medical emergencies to keep everyone safe.

DSHS will also look at seemingly mundane things like a Parking Plan; neither you nor DSHS wants neighbors complaining about your Adult Family Home having a negative impact on local traffic.

A License for 7 or 8 is not Forever.

In the event of “serious noncompliance,” DSHS can impose the usual citations and civil fines and may also lower your license capacity to 6 residents.

Resources

DSHS Change in Licensed Bed Capacity application.

The law HB 1023.

Wrap up

As you can see, before you are granted DSHS approval for 8 Residents, you’ll need to demonstrate that you can take on the responsibility convincingly. You’ll need clear and compelling facts, figures, plans, and policies clearly laid out in writing.  You must be a strong administrator. You must be – or become – a skilled employer. You need to be able to manage others effectively and be at ease in solving complex problems.

If you need help implementing your plan, paperwork, and strategy, contact Joseph Spada for assistance in implementing the above.

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Joseph Spada
Joseph Spada

Adult Family Home Consultant, geriatric nurse, owner of Spada Care Homes, Ohana Hale Senior Living, and Savanna Healthcare; DSHS instructor of the AFH Administrator Training; speaker; author.

    26 replies to "8 Licensed Beds in Adult Family Homes"

    • Mitko

      Do you know if I am permitted to open a newly constructed home AFH with (8) licensed residents if I already had another (different physical home location) licensed for 6? Or does the 24 months period of being licensed for 6 residents need to occur in the same home? Thank you for any guidance you may be able to provide.

      • Joseph Spada

        Unfortunately, no. You need 2 years and 2 inspections at the newly licensed location before the application for 7-8 beds can be processed.

        • Mitko

          Thank you for your response!

    • Mariama Tengbeh

      Hi Joseph,
      We have been licensed for 6 beds about 2 months ago in Federal Way, WA, we are struggling to find any clients, including medicaid, any idea how we can find residents? We have signed medicaid contract with State but no clients yet, It’s been challenging with the house been empty and no clients. Are we allowed to rent this house on monthly basis to cover costs while we look for clients?

      • Joseph Spada

        There is no Magic Wand or Silver Bullet to find and admit ‘clients-on-demand.’ What I can tell you is to start “hustling!” with your brain in the right gear.

        Growing your AFH business is like putting together a puzzle. Start by building a strong business foundation and presence, figure out how to reach potential clients and referral sources with effective and compelling copywriting to draw them to you, understanding what attracts them, knowing what to say and what not say as you speak with people, campaigning and networking with the right people to generate leads, learn to give tours like a Pro, then sell!

        If you find this overwhelming, or you’re looking for a treasure map with your name on it, specific strategies and an effective plan that uniquely fits your situation, then invest in an experienced coach or mentor with a proven track record to help you chart your course and take clear steps to improve your results.

        And yes, you could rent your house but it would make it hard to bring in clients if you have tenants in the house.

        Hope that helps.

    • Jaquela Sang

      How can I find a private pay resident without a license?

      • Joseph Spada

        Ah, the Million Dollar questions everyone wants answered… for which there is no simple answer. There is no Magic Wand or Silver Bullet to find and admit ‘clients-on-demand.’

        What I can tell you is to start “hustling!” with your brain in the right gear.

        Building a 6-7-figure AFH business is like putting together a puzzle. Building your business foundation, your presence, effective and compelling copywriting to display everywhere and draw people to you, understanding what attracts private pay clients (you can’t have Medicaid unless licensed), knowing what to say and what not say as you speak with people, campaigning and networking with the right people to generate leads, learn to give tours like a Pro, then sell!

        If you can take these gold nuggets and run with them, then you got your answer. If you find this overwhelming, or you’re looking for a treasure map with your name on it, specific strategies and an effective plan that uniquely fits your situation, then invest in an experienced coach or mentor with a proven track record to help you chart your course.

        You could also dive into the FB rabbithole for free random advice, but don’t get lost in Wonderland.

        Hope that helps – best wishes.

    • misty

      I would love to help legislate for 6-7 residents in Oregon. currently, we can only have 5. Were in a crisis patients have no place to discharge too.

    • Ashe mulu

      Hi , I applied for adult family home license and they asked me emergency contact policy I just confused any idea what it look like.

      • Joseph Spada

        Ashe; It is hard to know specifically without seeing the DSHS feedback. Emergency Contact would be your information. It may be the “Medical Emergency Policy”

        Probably 1 of the 10 assignments you had to complete in class. If you need help understanding and preparing what they requested, please email me directly at joseph02@spadahomes.com

    • Sisay Mengstie

      If I have 5 residents already, can I still accept a couple licensed for 6 AFH?

      • Joseph Spada

        Exceeding your license capacity (6) can result in license revocation. If you’ve operated your AFH for >2 yrs you can apply for a capacity increase (RCW 70.128.066).

    • Amina Ahmed

      Joseph I have a home a looking for adult family with license transfer…it currently does not have resident in. Can you briefly tell me how that works.
      Thanks

      • Joseph Spada

        Amina, it would be best to call me directly so I can better understand what you are looking to do. I am not sure I understand your question… Thank you.

    • System required?

      Is a 13R or a 13D System required?

      • Joseph Spada

        HB 1023 does not specify the type of sprinkler system required, it only says, “(f) The home has a residential sprinkler system in place in order
        8 to serve residents who require assistance during an evacuation;”

    • Aster T.

      Hi Joseph,
      I just finished the AFH administration training class . I am now looking for a contractor to remodel my basement. Would you please help me finding a good contractor with good knowledge in converting a basement into a living space adding more rooms?

      Thanks,
      A. T.

    • Pam

      Hi Joseph
      This is Pam- I took your class administrator training in April this year. This is good information regarding 7-8 residents. I just sent my license application last week. If I need Further assistance can I reach out to you for guidance?

    • Laila Outourtit

      Hi Joseph! Thanks for sharing it with us.
      I’m currently licensed for 5 residents over 8 years ago with good standing, by reading the requirements everything looks good to me and I have except one: to be licensed for 6 residents for at least 12 months. How I can pass that or how I can apply for 8? Any suggestions or ideas…
      Thanks
      Laila

      • Joseph Spada

        Hi Laila,

        Yes, you’re correct. The 8-bed law (HB 1023) states that a Provider must be licensed for 6 residents for at least 12 months before DSHS can grant an increase to 7 or 8 beds. I am not aware that they are making any exceptions to the law. You should apply for an increase to 6 beds ASAP.

    • Lucy W Muchira

      I am one of your former employee in now pendo adh and joytera adh,I would like to start my adh,and I need a class to be able to start it.Sir I need your guidance.Thank you.

      • Joseph Spada

        Hi Lucy, I assume you are talking about the AFH Administrator Certification… I just finished teaching 3 of them; the next one I teach will be August 31 (weeknights), and the one after will be October on weekends. If you need it sooner, there is a new instructor who will teach in July I think…

    • NEVIN DRAMAN

      Hi Joseph,

      This is Nevin Draman. Do you have any idea whether there is a requirement for sprinkler and fire walls in between some areas?
      I searched for it but could not come across any info.

      I was your student in Admin training. The Turkish one, who was speaking a lot.

      • Joseph Spada

        Hi Nevin – For the 8 beds, sprinklers are required. Currently, the RCW [which is the law] is passed. DSHS will have to write their “rules” known as WAC. Regardless, the law says sprinklers are required. You can also refer to the HB 1023 for details until the WAC is written. I do not recall seeing anything about fire walls.

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