King County Assisted Living Inspection Scores: What the Data Actually Shows

Washington's DSHS inspects every licensed assisted living facility in the state and publishes the results as PDFs.¹ That's great in theory. In practice, nobody has time to read through hundreds of inspection reports to figure out which facilities are actually doing a good job. We built a scoring system to do that work, and this post covers what we found across 207 facilities in King County.

The Dataset

We track 207 licensed assisted living facilities in King County (DSHS classifies these as Boarding Homes).² Together they operate 13,989 licensed beds -- everything from 6-bed residential homes to communities pushing 200 beds. The median facility has 64 beds.

We pulled from two data sources:

• DSHS inspection reports, scored with our dual-metric system (more on that below)
• Google review ratings for 198 of the 207 facilities -- about 96% coverage³

All data is current as of February 2026.

How We Score Inspections

Each DSHS inspection report gets two scores on a 0-100 scale:

Event Score: How bad was the finding? Our pipeline pulls the text from each inspection PDF, identifies what happened, and rates severity. Low scores mean minor documentation issues. High scores for situations where residents were harmed or at elevated risk.

Response Score: How did the facility handle it? Did they take corrective action quickly? Did they address the root cause or just paper over it? Did they engage with the regulatory process or stonewall? Higher scores mean the facility owned the problem and fixed it.

These two numbers work together. A facility can score high on event severity (bad thing happened) and also high on response (they dealt with it well). Both pieces matter. You want a facility that handles problems well when they come up -- not just one that hasn't been caught yet.

The specific weighting and evaluation criteria are proprietary.

Where the Facilities Are

King County's 207 facilities spread across 30+ cities. The heaviest concentration is in Seattle with 68 facilities and 4,282 beds. After that: Bellevue (14), Renton (13), Kirkland (11), and Redmond (10).²

The average Google rating across King County is 4.39 out of 5.0, pulled from over 5,300 reviews.³ Bellevue and Kirkland facilities rate highest among cities with 10+ facilities, averaging 4.66 and 4.63 respectively. Eastside communities generally outperform Seattle proper (4.33 average) on resident satisfaction.

The highest-rated facility with real review volume is a 140-bed Bellevue community sitting at 5.0 across 144 reviews. One regional operator shows up multiple times in the top 10, which suggests they're doing something consistently right across locations. The top 10 (among facilities with 20+ reviews) span Bellevue, Seattle, Tukwila, Renton, and Redmond -- good options exist across the county, not just on the Eastside.

Rating Distribution

Most facilities rate well, but there are outliers:³

• 100 facilities (48%) rate 4.5 or higher
• 76 facilities (37%) rate between 4.0 and 4.4
• 18 facilities (9%) rate between 3.0 and 3.9
• 4 facilities (2%) rate below 3.0

Those 4 facilities below 3.0 range from small homes to large communities. When low Google ratings line up with inspection findings, that's a signal worth paying attention to.

One thing to watch for: ratings based on very few reviews. A 5.0 from one person doesn't tell you much. A 4.5 from 50+ reviewers is far more useful. We'd suggest focusing on facilities with at least 20 reviews for any real comparison.

What Inspection Scores Look Like in Practice

Here's how the dual scoring works with a real example. Consider a memory care facility with multiple inspection reports spanning 2024-2025:

Most recent report -- Event: Severe | Response: Good A staff member performed an unauthorized medical procedure on a resident shortly after admission, skipping established protocols. The facility investigated fast, suspended the employee during the investigation, and terminated them.

Earlier reports -- Event: Moderate | Response: Moderate to Good The facility got cited for issues with resident assessments and nurse delegation protocols. They used the informal dispute resolution process and got some citations modified or removed. Their leadership brought executive, nursing, and regional directors to the table for the regulatory process.

This is exactly what a single score misses. The facility had a serious incident but responded decisively. Their track record shows they engage with regulators and push back on citations when they have grounds to. A severe event score looks bad by itself. Paired with strong response scores and a pattern of active regulatory engagement, you get a much more honest picture of how the community and home office team operate.

Size and Quality

Facility size varies a lot -- 6 beds to nearly 200. Here's how ratings break down:

Size Category	Facilities	Avg Rating	Beds Range
Small (6-30 beds)	~35	4.45	6-30
Medium (31-80 beds)	~95	4.38	31-80
Large (81-130 beds)	~62	4.32	81-130
Very Large (131+ beds)	~15	4.35	131-188

Smaller facilities rate slightly higher, probably because more personalized care is easier with fewer residents. But the gap is small -- about 0.1 points between the smallest and largest categories. Several facilities with 100+ beds still hit 4.8 or higher. Size alone doesn't determine quality.

Ownership

Property records from the King County Assessor show a mix of ownership structures:⁴

• Healthcare REITs that own the building and lease it to operators
• Regional management companies that own and run multiple facilities with a region
• Local owner-operators one or two communities within a specific location
• Holding companies and LLCs that may be subsidiaries of larger organizations

The largest property holders in our dataset own 3-4 facilities each. Here's the thing families should know: the property owner is often not the company running the facility day to day. A REIT owns the building; a separate management company handles operations. When you're researching a facility, ask about both. Each affects the resources and leadership available to residents.

How to Use This

When you're looking at assisted living options for a family member:

1. Start with location. Pick facilities within a manageable distance from yourself or the majority of those who will be visiting. Regular family visits are one of the strongest predictors of resident satisfaction -- full stop.

2. Weight review volume over rating. A 5.0 with 1 review tells you almost nothing. A 4.6 with 72 reviews tells you a lot. Look for both high ratings and enough reviews to be meaningful.

3. Read the actual inspection reports. Our scores summarize them, but the details matter. A facility that had a serious incident and responded with real systemic changes might be a better choice than a community with no incidents and no visible accountability process.

4. Look for patterns. One bad inspection isn't a dealbreaker. Repeated violations could be. Improving scores over time suggest a facility that's actively working on getting better.

5. Research the operator and the owner. Multi-facility operators can bring consistency and resources, but quality varies location to location. Check whether their other facilities show the same standards.

Methodology

We collect inspection report PDFs directly from DSHS facility pages.¹ Each report goes through our analysis pipeline: text extraction, regulatory finding identification, and independent event and response scoring. The scoring is deterministic -- same report text, same scores, every time.

Google review data comes from the Google Places API.³ We match facilities to Google Places using address and name correlation with confidence scoring, and only include data where we're confident in the match.

Property ownership data comes from King County Assessor records.⁴

All data updates as DSHS publishes new inspection reports. This post reflects data current as of February 2026.

What's Next

We're working on a few things:

• More inspection data. Scoring additional reports to build historical trends across all facilities.
• OCR for scanned reports. Some older inspection reports are image-based PDFs that our text extraction can't handle yet. We're adding OCR to cover those.
• More counties. Expanding beyond King County to cover all of Washington State.
• Correlation analysis. Do Google ratings actually predict inspection outcomes, or are they measuring something different entirely?

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Data current as of February 2026. SeniorAIQ is an independent data platform -- we're not affiliated with any assisted living operator, REIT, or placement agency. Questions about our data? Reach us at info@senioraiq.com.

Frequently Asked Questions

How many assisted living facilities are in King County, Washington?

King County has 207 licensed assisted living facilities (classified as Boarding Homes by DSHS) with a combined 13,989 licensed beds.² Seattle has the most with 68 facilities, followed by Bellevue (14), Renton (13), Kirkland (11), and Redmond (10).

What is the average Google rating for assisted living in King County?

Across 198 rated facilities in King County, the average Google rating is 4.39 out of 5.0.³ Half of all facilities rate 4.5 or higher. Bellevue and Kirkland facilities rate highest among cities with 10+ facilities.

How does DSHS inspect assisted living facilities in Washington?

DSHS inspects all licensed assisted living facilities and publishes results as PDF reports on facility-specific pages.¹ Reports cover investigations, fire inspections, and informal dispute resolution letters. Facilities can challenge findings through an informal dispute resolution process.

What should I look for in an assisted living inspection report?

Three things: how serious the violations were, how the facility responded, and whether the same problems keep showing up. A facility that responds well to a serious finding may be a better pick than one with moderate recurring issues and no documented corrective action.

How do I compare assisted living facilities in King County?

Use multiple data points: DSHS inspection history, Google ratings (weighted by volume), facility size, location, and ownership. No single metric gives you the full picture -- inspection response quality, resident satisfaction, and operational transparency all matter.

Who owns assisted living facilities in King County?

It varies. Some are owned by publicly traded healthcare REITs, others by regional management companies, and some by local operators. The property owner is often different from the facility operator.⁴ Ask about both when you're evaluating a facility.

What is the average cost of assisted living in Washington State?

The national median is roughly $5,190 per month as of 2026.⁵ Washington runs higher than that, especially in the Seattle metro area. Costs vary significantly by facility size, location, and level of care.

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