E2SSB 5337
SignedSenate
Memory care services
Creating a certification for memory care services.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill establishes a state certification program for memory care services in Washington to standardize definitions and quality of dementia care in assisted living facilities. It requires facilities to meet specific staffing, training, facility design, and operational standards to legally use the term 'memory care' or operate a memory care unit after July 1, 2026.
- Creates a new state certification program for memory care facilities and memory care units within assisted living facilities, administered by the Department of Social and Health Services (DSHS).
- Requires facilities to meet specific staffing, training, and facility design standards—including 24-hour awake staffing, six hours of annual dementia-specific staff training, and secure outdoor areas—to obtain and maintain certification.
- Mandates that certified facilities provide daily structured programming, including independent, individual, and group activities, and maintain policies for managing wandering and behavioral challenges.
- Requires facilities to disclose detailed staffing and service information to residents and families, including overnight awake staff availability and direct care staffing levels per bed.
- Prohibits facilities from using terms like 'memory care' or operating units with restricted egress without certification after July 1, 2026, and allows the Attorney General to enforce violations under the Consumer Protection Act.
- Includes a sunset provision: the certification program expires on December 1, 2028, unless extended by the legislature.
Who is affected
- Assisted living facilities (especially those offering memory care) — Assisted living facilities that wish to market or operate as providing memory care or dementia care must obtain state certification starting July 1, 2026, and meet new staffing, training, facility design, and operational standards.
- Residents with dementia and their families — Residents with dementia and their families will benefit from clearer information about what memory care services are offered, standardized care expectations, and safer physical environments designed for dementia needs.
- Assisted living facility staff (especially those in memory care units) — Staff working directly with memory care residents must complete at least six hours of annual dementia-specific training and meet new staffing requirements, including 24-hour awake coverage and feeding assistance protocols.
- Department of Social and Health Services (DSHS) — The Department of Social and Health Services (DSHS) will be responsible for creating and enforcing the new certification program, including inspections, rulemaking, and maintaining a public registry of certified facilities.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
Mandates secure outdoor areas, 24-hour awake staffing, and structured daily programming designed to reduce wandering-related injuries and elopement—key causes of hospitalization and death among people with dementia. These changes directly improve resident safety and reduce preventable emergency care use.
Public SafetyPeopleRef: Sec. 2(2)(vii), Sec. 2(2)(viii), Sec. 2(2)(ix)Requires semiannual dementia-specific assessments, weather-monitored outdoor access, and disaster planning tailored to dementia needs—reducing risks of falls, dehydration, hypothermia, and hospitalization during emergencies. Evidence shows such tailored care improves clinical outcomes and delays nursing home placement.
HealthcarePeopleRef: Sec. 2(2)(v), Sec. 2(2)(viii)(H), Sec. 5(2)(b)Mandates public disclosure of staffing levels (including overnight awake staff) and certification status, empowering families to make informed choices and hold facilities accountable. This transparency addresses longstanding information asymmetries that have disadvantaged low-income and rural families seeking care.
Rights & LibertiesPeopleRef: Sec. 5(2)(b), Sec. 4(2)Creates a state certification program administered by DSHS, which may create modest new public-sector jobs in inspection and rulemaking. However, the fiscal impact is described as “minimal to moderate,” suggesting limited net job creation beyond existing licensing staff.
Business & EmploymentPeopleRef: Sec. 4(2), Sec. 2(2)(b)(i)Authorizes the Attorney General to enforce violations under the Consumer Protection Act, giving families legal recourse against deceptive marketing of un certified “memory care” services. This deters false advertising and protects vulnerable consumers from substandard care sold under misleading branding.
Public SafetyPeopleRef: Sec. 4(2)
Potential Concerns (4)
Mandates 6 hours of annual dementia-specific training for all direct-care staff in memory care units, which increases labor costs for facilities—especially small operators—without state funding to offset training expenses or hiring. While training improves care quality, the cost burden falls disproportionately on facilities serving lower-income residents, many of which operate on thin margins.
Business & EmploymentPeopleRef: Sec. 2(2)(vi)(C)Requires physical modifications—including secure outdoor areas, restricted egress, and specialized room layouts—that may be cost-prohibitive for older or smaller facilities, potentially forcing closures or conversion to non-memory-care operations. This could reduce supply of memory care beds in rural or low-income areas, worsening access for vulnerable populations.
HousingPeopleRef: Sec. 2(2)(iv), Sec. 2(2)(viii)Bars facilities with recent enforcement actions (e.g., citations for resident harm) from certification, even if those actions were resolved and do not reflect current operations. This may penalize facilities serving high-need populations where staffing shortages and complex care needs increase citation risk, potentially reducing care options for low-income dementia patients.
Business & EmploymentLean peopleRef: Sec. 2(2)(b)(ii)-(iii)Sunsets the certification program after December 1, 2028, unless extended by the legislature, creating regulatory uncertainty for facilities investing in long-term infrastructure and staffing changes. This may discourage sustained quality improvements and complicate long-term workforce planning.
Local GovernmentLean peopleRef: Sec. 4(2)
Who Is Most Affected
Facilities that currently use the term 'memory care' without certification will need to invest in physical upgrades, staffing changes, and administrative compliance. Small or undercapitalized facilities—especially those in rural areas or serving Medicaid-heavy populations—may struggle to meet requirements, potentially leading to closures or reduced service capacity. Larger chains with capital reserves are better positioned to absorb costs.
Families and residents benefit from standardized definitions, transparent staffing disclosures, and safer physical environments—reducing anxiety about care quality and preventing avoidable injuries. However, if facility closures occur due to compliance costs, access may shrink in underserved areas, disproportionately affecting low-income and rural families.
Direct-care staff gain clearer career-path expectations and required training, which may improve job satisfaction and retention. However, increased training requirements without wage supplements or staffing adjustments could increase workload and burnout, especially in facilities already facing high turnover.
DSHS gains new regulatory authority and fee-revenue authority, but must allocate staff time to rulemaking, certification reviews, and enforcement. The fiscal impact is described as “minimal to moderate,” suggesting manageable burden, but the sunset clause introduces uncertainty about long-term program stability.
Medicaid-dependent facilities may benefit from the certification option requiring proof of a Medicaid-enhanced rate contract (Sec. 2(2)(a)), which could incentivize better compensation for dementia care under Medicaid—though many facilities may not qualify due to low Medicaid reimbursement rates.