Adult family home providers affected by this summer’s wildfires may have questions about what happens to resident payments when a home must evacuate.

On August 7, 2026, DSHS Residential Care Services issued a Dear Provider Letter explaining how providers should handle billing while residents are temporarily displaced. DSHS’s main message is straightforward:

Only bill for care that you or your staff are actually providing.

The details depend on what happened after the resident evacuated.

If You Continued Providing the Resident’s Care

If a resident was moved to another location but you or your AFH staff continued providing their care, DSHS says you may continue claiming payment at the resident’s authorized CARE daily rate.

Keep records showing where the resident was staying, which staff provided care, what services were provided, and the dates involved.

If the Resident Went to Another Licensed Provider

If a resident was evacuated to another licensed and DSHS-contracted adult family home, assisted living facility, enhanced services facility, or other eligible residential provider, the original AFH should not continue billing the resident’s authorization.

Instead, the provider that is now caring for the resident will be authorized for the services the resident is eligible to receive.

If You Are Holding the Resident’s Bed

This is where the situation is less settled.

Some AFHs evacuated residents but remain ready to bring those residents home. The provider may be holding the resident’s room, maintaining the home, and preparing for the resident’s return even though the provider is temporarily not providing the resident’s daily care.

DSHS has asked the Centers for Medicare & Medicaid Services (CMS) for emergency approval to provide retainer payments in these situations.

A retainer payment would allow an eligible provider to receive payment for holding a resident’s place while the resident is temporarily receiving care elsewhere and is expected to return.

AFHC has been advised that CMS approval for these wildfire-related retainer payments is still pending.

Until additional guidance is issued, providers should not submit claims for a retainer payment that has not been authorized.

AFHC will continue seeking clarification about whether CMS approves these payments, who will qualify, what documentation will be required, and whether any approval will apply retroactively to evacuation dates.

Keep Your Evacuation Records

Documentation could become especially important if retainer payments are later approved.

Providers affected by an evacuation should keep records showing:

• The date the resident was evacuated and where the resident was relocated.
• Whether the AFH provider or its staff continued providing care.
• Whether another licensed and contracted provider took over the resident’s care.
• The dates each provider was responsible for the resident.
• Whether the AFH continued holding the resident’s bed.
• Whether the resident has returned or is expected to return.
• Communications with the resident, representative, case manager, DSHS, or other agencies.
• Any billing authorizations, denials, error messages, or written billing instructions received.

DSHS also issued an August 4, 2026 Emergency Evacuation Reporting letter reminding providers to report an evacuation to Residential Care Services and document important information including the evacuation date, destination, number of residents affected, continuity-of-care plan, and anticipated return date.

Having Trouble Getting Paid? Tell AFHC

AFHC has heard from providers who have been unable to bill for days following a wildfire evacuation. We want to better understand where these problems are occurring and what providers are being told.

If you experienced a denied payment, missing authorization, or unclear billing instructions following an evacuation, email info@adultfamilyhomecouncil.org.

Please include your AFH name and license number, the dates in question, where the resident was temporarily located, who provided the resident’s care, whether you held the resident’s bed, and any billing or authorization messages you received.