Here is some of what the Washington State Department of Social and Health Services has to say about enhanced services facilities:

Question: What is the maximum number of clients per ESF?

Answer: 16.

Q; How many residents per room?

A: 1

Q: What are the staffing expectations?

A: In addition to on-site medical health professionals and nurses, whenever there are residents in the facility, at least two staff members must be awake and on duty inside the building. When residents are in the facility, there must be at last one staff member for every four residents present.

Q: How long does it take for an ESF to become licensed and contracted?

A: That depends on whether the facility is newly built or converted from a previous use. Other factors to consider are local zoning, unique building requirements, requirements for staff training and local inspection processes.

Q: How much does it cost to license an ESF bed?

A: $1,045 per bed at the time of license application, and $1,040 per bed annually at the license renewal.

Q: What is the daily rate?

A: $425.

Q: Can an ESF be part of another facility or on the same grounds as another?

A: An ESF may hold only one license, but, to the extent that state and federal law allow and Medicaid requires, it may be in the same building as another licensed facility, provided: that it is totally separate and discrete from the other licensed facility; and the two maintain separate staffing, unless the department overseeing it allows an exception.

Q: Are there unique training expectations for ESF staff?

A: Many of the ESF training requirements are consistent with what the state expects of other residential settings that are licensed or certified by the Department of Health’s Residential Care Services. There are, however, four trainings staff must complete before they start working at an ESF. These are as follows: de-escalation training; mental health specialty training; dementia specialty training; and home and community-based services training.