Who ALTSA Is and What They Do
ALTSA is the Aging and Long-Term Support Administration, the DSHS division that licenses and oversees adult family homes, assisted living facilities, and nursing homes in Washington. They handle complaints about care quality, safety, staffing, medication, abuse, and neglect.
They have legal authority to enter a home unannounced, interview residents and staff privately, review records, and issue citations or enforcement actions ranging from fines to suspending a license.
How to File a Complaint
The fastest way is by phone: 1-800-562-6078 — the Complaint Resolution Unit hotline. It's staffed during business hours and has a recording for after-hours intake.
You can also file online through the DSHS website by searching "DSHS complaint resolution unit." The online form lets you upload photos, documents, and a written narrative.
Complaints can be filed anonymously. Your identity is protected by law, even from the home, though sometimes the nature of a complaint makes the source obvious.
What They Investigate
ALTSA investigates almost anything a family might be concerned about: care quality and supervision, medication errors, falls and injuries, staffing levels and training, food and nutrition, building safety, abuse (physical, emotional, sexual, financial), neglect, resident rights violations, and the home's response to a prior complaint.
They do not investigate billing disputes, contract disputes, or family disagreements about care decisions — those go to other channels.
Timeline: What Happens When
After you file, ALTSA triages the complaint. Urgent complaints (immediate threat to health or safety) trigger an inspection within two business days. Standard complaints are investigated within ten business days.
An investigator visits the home unannounced. They interview the resident (privately, away from staff), review records, and document findings. If a violation is substantiated, the home receives a citation and must submit a plan of correction. The result becomes part of the home's public record — exactly the kind of record the next family will check before placement.
What ALTSA Can — and Can't — Do
ALTSA can cite the home, fine it, restrict new admissions, require a corrective plan, or in serious cases suspend or revoke the license.
ALTSA cannot remove a resident from the home, force a refund, or directly intervene in a one-time care decision. If your loved one is being abused or neglected and needs to be moved immediately, ALTSA can't pull them out — you and the home's family contact have to coordinate that. Hospital admission or a sibling's home is often the safest interim step.
When to Also Call Adult Protective Services (APS)
If you suspect abuse, neglect, financial exploitation, or self-neglect of a vulnerable adult, file with APS in parallel: 1-866-363-4276. APS is a separate DSHS division focused on individual safety rather than facility oversight. They can investigate the person's situation, coordinate emergency services, and refer to law enforcement if needed.
Filing with both ALTSA and APS is appropriate when the concern involves both a facility problem and individual harm. Check the home's DSHS record before and after →
Frequently Asked Questions
Q: Will the home know it was me? A: ALTSA protects your identity by law. Some complaints make the source obvious — if you're worried, ask the intake worker about anonymity options.
Q: What if my parent doesn't want me to file? A: If the situation is serious, file anyway. ALTSA and APS exist precisely because vulnerable adults can't always advocate for themselves.
Q: Can I see the report after they investigate? A: Yes — substantiated investigations become public record and are added to the home's DSHS file.
Q: What if I want to move my parent immediately? A: Coordinate with the home, your family, and (if needed) the hospital. ALTSA's role is regulatory; family advocacy moves people.