What hospice care is in Washington State
Hospice care is comfort-focused care for patients with a serious illness and a prognosis of six months or less. Instead of curative treatment, the team focuses on managing pain, controlling symptoms, supporting the family, and letting the patient spend their final months at home or in a residential hospice setting.
A Washington hospice aide visits patients 2–5 times a week — bathing, repositioning, toileting, skin care, vital signs, and the emotional presence that families value most. An RN case manager writes the plan of care, a hospice physician supervises, and a medical social worker and chaplain complete the interdisciplinary team. The Washington Department of Health regulates aide credentials, which are the most demanding in the country.
Washington has a well-resourced hospice market dominated by large non-profit organizations. Providence Hospice, EvergreenHealth Hospice, Franciscan Hospice (Virginia Mason / CHI Franciscan), Hospice of Spokane, and Kline Galland are among the major employers. With Seattle’s tech-driven population growth, an aging Puget Sound region, and a strong veteran population, hospice aide demand is consistent year-round.
How much hospice caregivers earn in Washington State
Washington has among the highest hospice aide wages in the U.S. BLS lists the Washington median for Home Health and Personal Care Aides around $19–$19.50/hr, with the 75th percentile near $21/hr. Hospice aides earn $1–$3/hr above that baseline because Medicare’s per-diem reimbursement supports premium wages.
Expect $21–$26/hr for HCAs in hospice roles in Seattle, Bellevue, and Tacoma. $19–$23/hr in Spokane, Yakima, and the Tri-Cities. Hospice CNAs (NA-C) typically earn $24–$30/hr in Seattle, with senior CHPNA-certified aides reaching $28–$33/hr at the largest non-profits.
Washington’s state minimum wage ($16.66/hr, higher in Seattle and SeaTac) sets a strong floor. Most hospices add an evening differential ($1–$2/hr), a weekend differential ($2–$4/hr), and pay Continuous Care shifts (long bedside vigils when a patient is actively dying) at time-and-a-half or a $30–$40/hr flat premium.
Per-visit pay is less common in Washington than in southern states because state wage-and-hour rules (meal/rest break tracking, OT calculations) favor hourly pay. When per-visit pay is offered, expect $35–$55 per aide visit plus mileage at the IRS rate.
Typical hourly pay in Washington State: $21–$26/hr (HCA) · $24–$30/hr (hospice NA-C)
Who pays for hospice care in Washington State
Hospice in Washington is funded almost entirely through Medicare, with Apple Health (Washington Medicaid), the VA, and commercial insurance filling out the rest.
What a hospice aide does day to day
A Washington hospice aide typically carries 12–16 patients with 5–7 home visits per day, 45–60 minutes each, plus documentation between visits.
- Bathing, oral care, hair and nail care, and skin assessment
- Repositioning bed-bound patients every two hours to prevent pressure injuries
- Toileting, incontinence care, and changing soiled bedding
- Vital signs (T, P, R, BP) per the plan of care
- Monitoring pain, restlessness, breathing changes, and signs of active dying
- Light meal prep and feeding assistance for patients still eating
- Emotional presence — sitting, listening, supporting family
- Documenting every visit in the agency EMR (tablet point-of-care)
- Calling the on-call RN immediately for actively dying patients or uncontrolled symptoms
- Post-mortem care after death — washing, positioning, and dressing the body before the funeral home arrives
Certifications and training to become a hospice aide in Washington State
Washington has the most stringent aide training requirements in the U.S. The Department of Health regulates four credential levels: Home Care Aide (HCA), Nursing Assistant-Registered (NA-R), Nursing Assistant-Certified (NA-C), and Medication Assistant-Certified (MA-C). Hospice aides must hold at least an HCA, but most hospices prefer NA-C.
Family member needs care? You may be able to be paid.
Washington State has several Medicaid and VA programs that let family members get paid to provide care at home — including hospice care. See the full state guide:
Read the Washington State caregiver pay guide →FAQs about hospice caregiver jobs in Washington State
Is hospice work emotionally hard?
Yes — you will be present at many deaths, typically 2–4 per month. Washington hospices (especially the large non-profits like Providence, EvergreenHealth, and Hospice of Spokane) generally offer monthly bereavement debriefs, paid mental-health days, and access to the chaplain or social worker for staff support. Most aides who stay past the first six months describe the work as deeply meaningful.
What is the difference between hospice and home health?
Home health is short-term, recovery-focused care — wound care, PT, post-op monitoring. Hospice is end-of-life comfort care for patients not expected to recover. Both require WA aide credentials, but hospice visits are longer (45–60 min) and more relational.
Can a family member be paid as a hospice aide?
Not directly through Medicare. But a family member can be paid separately for non-medical personal care through Washington’s Community First Choice (CFC) program or COPES Medicaid waiver while the hospice agency provides the medical visits on top. Spouses can be paid in some Washington programs (which is unusual).
How long do hospice patients usually have left?
Washington hospice patients have a median length of stay around 18–21 days; mean is roughly 90 days because some patients stabilize and stay on service for many months. You will see a mix of patients in their final week and patients you visit for several months.
Do I need my own car?
Yes, for nearly every Washington hospice job outside dense parts of Seattle. You are driving to 5–7 homes per day. Mileage is reimbursed at the IRS rate. A few inner-Seattle routes can be done by transit, but agencies still prefer aides with vehicles.
What happens when a patient dies on my shift?
You call the on-call RN. The RN comes to pronounce death, contacts the funeral home and physician. You perform post-mortem care: wash, remove medical devices, position, and dress the body before the funeral home arrives. Washington hospices pay your full scheduled visit even if the patient dies in the first 15 minutes.
Is hospice aide work full-time or part-time?
Both. Full-time WA hospice aides carry 12–16 patients with 5–7 visits/day. Per-diem (PRN) aides cover vacations and call-outs. Weekend-only roles are widely available at a $2–$4/hr premium.