A broken hip is one of the most common reasons an older adult goes from living independently to needing care overnight. Here is how the hospital-to-rehab-to-home path works in Washington and how to plan it.
By Diane Whitfield, CSA · October 18, 2026
A fall on a wet Seattle sidewalk, a loose rug or a dark stairway can lead to a hip fracture, and families often have only a day or two to make decisions. Surgery usually happens within a day or two of the injury at a hospital such as Harborview, UW Medical Center, Swedish, Overlake, EvergreenHealth, Providence Everett or a MultiCare facility in Tacoma. Recovery after that is a process of weeks to months, not days.
The most useful thing you can do early is ask the hospital team two questions: what is the expected discharge date, and what level of help will your parent need on that day? The answers shape every choice that follows.
Most patients leave the hospital for one of three places: a skilled nursing facility for short-term rehabilitation, an inpatient rehabilitation unit if they can tolerate intensive therapy, or home with home-health therapy. The hospital case manager or discharge planner will recommend one based on your parent's strength, cognition and home setup.
Original Medicare Part A may cover a skilled nursing stay after a qualifying inpatient hospital stay of at least three days. Coverage is full for the first 20 days and requires a daily copayment from day 21 through day 100, as long as skilled care is still needed. Medicare Advantage plans have their own rules and often require prior authorization, so ask the plan directly. Time spent under observation status does not count toward the three-day inpatient requirement, so ask the hospital which status applies.
You have the right to choose your skilled nursing facility. Ask for a list, check each one in the DSHS Residential Care Services inspection lookup on fortress.wa.gov, and ask about their hip-fracture therapy experience, weekend therapy hours and discharge planning.
Many people return home after rehabilitation, but some find that stairs, bathing or meal preparation are no longer safe. A home evaluation by a physical or occupational therapist before discharge can identify grab bars, raised toilet seats, a shower chair and furniture changes. In-home care agencies can provide help with bathing, dressing and meals during the first weeks.
If your parent cannot manage safely alone, a move to assisted living (RCW 18.20) or an adult family home (RCW 70.128) may make sense. Adult family homes with six or fewer residents can offer a quiet environment and close attention during recovery. Typical private-pay costs in the region run roughly $6,000–$8,000 a month for assisted living and $4,500–$7,000 for an adult family home, though prices vary by city and level of care.
If your parent has limited income and resources, Washington Apple Health (Medicaid) may help pay for long-term care, including services at home through the COPES waiver. Applications and assessments go through DSHS Home and Community Services. Your local Area Agency on Aging, such as Aging and Disability Services in King County, Homage in Snohomish County or Aging and Disability Resources in Pierce County, can explain options at no cost.
Veterans may qualify for VA Aid and Attendance through VA Puget Sound, which can supplement the cost of care for eligible wartime veterans and their spouses.
After a hip fracture, the risk of another fall is real. Ask your parent's clinician about a bone-density evaluation and osteoporosis treatment, a review of medications that cause dizziness, vision and footwear checks, and ongoing balance exercise. Many Puget Sound senior centers and community programs offer evidence-based fall prevention classes. Good lighting, night lights on the path to the bathroom and removing loose rugs are inexpensive changes that matter.
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