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Census 2025 estimates · CMS September 2026 · CDC 2020

Senior housing development in Washington

Washington had 629,096 residents aged 75 and older in July 2025, +29.5% since April 2020 (US +23.4%), and 150,667 aged 85 and older (+15.2%). Its 193 certified nursing homes hold 18,781 beds, 124.7 for every 1,000 people 85 and older, fewer than the US ratio of 222.6. Certificate of need for nursing home beds: yes; for assisted living: not listed.

Age 75+ (2025)
629,096
Growth since 2020
+29.5%
Nursing beds per 1,000 aged 85+
124.7
Assisted living beds per 1,000 aged 75+
57.1

Demand: the older population

Age groupApril 2020July 2025ChangeUS change
75 and older485,771629,096+29.5%+23.4%
85 and older130,778150,667+15.2%+11.3%

Nationally, the Census Bureau's 2023 projections have the 75+ population growing 21% from 2025 to 2030 and the 85+ population 59% from 2025 to 2035. The bureau publishes those projections for the US only, not by state.

Supply: licensed beds

SettingBedsPer 1,000 aged 75+Per 1,000 aged 85+Source
Nursing homes (Medicare or Medicaid certified)18,78129.9124.7CMS, September 2026
Residential care / assisted living35,90057.1238.3CDC survey, 2020

US: 222.6 nursing beds and 170.1 assisted living beds per 1,000 aged 85+. Assisted living beds are CDC's 2020 survey estimate, its latest with state detail, set against 2025 population, so the ratio understates any supply added since.

Certificate of need

Nursing home beds
Yes
Assisted living
Not listed
Notes
Nursing home capital expenditures over $2.83M

From NCSL's certificate of need table (updated April 29, 2025, covering January 2025) with later changes checked on state sites on October 24, 2026. "Not listed" means NCSL does not name assisted living, not that it is exempt. Confirm with the state health planning agency before relying on it. HUD requires a state CON for nursing home beds where the state has one (Handbook 4232.1, 2.5.EE).

Counties

The 25 counties with the most residents aged 75+, with certified nursing home beds per 1,000 aged 85+.

CountyAge 75+Since 2020Share of populationAge 85+Nursing homesBeds per 1,000 aged 85+
King County155,623+28.5%6.6%41,16747123.8
Pierce County66,362+28.2%7%16,02721145.6
Snohomish County58,308+31.0%6.7%13,96617115.1
Spokane County46,700+27.7%8.4%11,33716141.1
Clark County42,280+35.3%7.9%9,330879.7
Thurston County27,658+35.6%9.1%6,0937126.7
Kitsap County27,112+37.6%9.6%6,1339168.9
Whatcom County21,761+35.5%9.2%4,7598141.6
Yakima County17,751+17.3%6.8%4,33511224.7
Benton County16,248+27.8%7.3%4,075489.3
Skagit County15,062+28.3%11.3%3,5314106.5
Clallam County12,503+22.2%16%2,8573101.9
Island County11,643+34.8%13.6%2,301148.7
Cowlitz County10,896+25.0%9.5%2,4184141.9
Lewis County8,585+23.0%9.7%1,8403137.5
Chelan County8,175+21.3%10%2,2233112.5
Grays Harbor County7,898+30.1%10.1%1,6743161.9
Mason County7,577+30.5%10.6%1,5582135.4
Grant County7,096+22.7%6.7%1,6604144
Jefferson County7,060+44.5%20.8%1,427165.9
Walla Walla County6,414+18.9%10.3%1,7864189.2
Stevens County5,615+35.7%11.3%1,2372106.7
Okanogan County4,738+26.3%10.5%1,0174192.7
Franklin County4,432+30.4%4.3%1,0001108
Kittitas County4,222+34.7%8.7%972176.1

Fastest growth in the 75+ population

  1. San Juan County: +52.2% (3,471)
  2. Jefferson County: +44.5% (7,060)
  3. Kitsap County: +37.6% (27,112)
  4. Stevens County: +35.7% (5,615)
  5. Thurston County: +35.6% (27,658)
  6. Whatcom County: +35.5% (21,761)
  7. Clark County: +35.3% (42,280)
  8. Island County: +34.8% (11,643)
  9. Kittitas County: +34.7% (4,222)
  10. Klickitat County: +34.5% (2,582)

Counties with at least 2,000 residents aged 75+.

Fewest nursing beds per 1,000 aged 85+

  1. Island County: 48.7 (112 beds, 2,301 aged 85+)
  2. Jefferson County: 65.9 (94 beds, 1,427 aged 85+)
  3. Clark County: 79.7 (744 beds, 9,330 aged 85+)
  4. Benton County: 89.3 (364 beds, 4,075 aged 85+)
  5. Clallam County: 101.9 (291 beds, 2,857 aged 85+)
  6. Skagit County: 106.5 (376 beds, 3,531 aged 85+)
  7. Stevens County: 106.7 (132 beds, 1,237 aged 85+)
  8. Franklin County: 108 (108 beds, 1,000 aged 85+)
  9. Chelan County: 112.5 (250 beds, 2,223 aged 85+)
  10. Snohomish County: 115.1 (1,607 beds, 13,966 aged 85+)

Counties with at least 1,000 residents aged 85+.

HUD Section 232 construction in Washington

Since fiscal 2001 HUD has insured 41 new construction or substantial rehabilitation loans on care facilities in Washington (24 assisted living, 17 nursing homes), $367.8 million of original principal, 6 of them since fiscal 2016.

  • FY2022: North Central Care Center, Spokane, nursing home, $5.7 million
  • FY2021: Chateau at Bothell Landing, Bothell, assisted living, $11.7 million
  • FY2021: Martha and Mary Nursing Home, Poulsbo, nursing home, $13.1 million
  • FY2017: Anderson Plaza, Shoreline, assisted living, $13.8 million
  • FY2016: PEOPLES RETIREMENT COMMUNITY, TACOMA, nursing home, $6.4 million
  • FY2016: Chateau at Bothell Landing, Bothell, assisted living, $11.7 million

Planning a building in Washington? Model the budget, lease-up and a HUD 232 construction loan.

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Sources: Census Bureau Vintage 2025 county population estimates; CMS Nursing Home Provider Information (September 2026); CDC/NCHS National Post-acute and Long-term Care Study (2020); HUD Office of Healthcare Programs endorsement database (data run 07/08/2026); NCSL. Absorption is operated by Janover Capital LLC and is not affiliated with any of them. Methodology.