Running a Licensed Adult Family Home

Two things decide how a home does: its inspection record and how it is paid. Most homes are paid mainly by Medicaid, at a daily rate set by each resident's CARE classification and the home's region.

The rules keep changing, so the rule-change tracker is worth a look every few months.

Your steps, in order

1. The Dos and Don'ts of Operating an AFHFourteen topics, each marked requirement or best practice.
2. DSHS Inspections & ComplianceHow inspections work and the rules cited most often.
3. A Through E: CARE ClassificationsHow each Medicaid resident's daily rate is set.
4. CBHS Tiers ExplainedBehavioral health support paid on top of the base rate.
5. The AFH Payment Field GuideECS, SBS, private pay, and what a contract list does not prove.
6. Do AFHs Pay Taxes?The B&O exemption, sales tax, and the live-in Medicaid income exclusion.
7. Getting Paid: ProviderOne BillingThe Medicaid contract, billing and pay dates, the resident's share, ECS and SBS.
8. Washington AFH Rules Have ChangedEvery rule change since 2023, old beside new.
9. Hiring a Management CompanyWhat a manager can do, what stays with you, and the DSHS filing.
10. Find a ProfessionalBookkeepers, insurance brokers and others.