Proposed Hospital Licensing Fee Increase, DOH Webinar Scheduled for May 8, 9:00-10:00 AM

April 17, 2019

Special Fiscal Watch

The Department of Health (DOH) is proposing increases to hospital licensing fees from the current $138 to $220 per bed for hospitals licensed under 70.41 RCW and from $85 to $135 per bed for psychiatric and chemical dependency hospitals licensed under 71.12 RCW, about a 60 percent increase. DOH is hosting a pre-CR102 stakeholder meeting via webinar on May 8 to outline its rationale for the increase and receive input from hospitals.  Webinar information and links to materials are below.

Effective Date

DOH expects the rulemaking to be completed and the increase to be effective by October 1, 2019. DOH could not commit to a stay on future increases but indicated they would continually monitor costs and revenues and recommend reductions to the fees if revenues were to significantly exceed costs. A brief summary from the Department is available here.

Reasons for Fee Increase

Current hospital licensing revenues only cover about 66 percent of the current cost, a gap of more than $1 million per year. DOH is required under RCW 43.70.250 to charge fees that are enough to cover regulatory program expenses such as licensing, inspections, and investigations. In 2017 licensing fees were increased by $15 to offset fire inspection costs.  Otherwise, the hospital license fees have not been modified since 2012.

While overall hospitals beds have increased in recent years due to construction of some new facilities, the additional revenue has not kept pace with the increased costs of inspection and investigation activity. Click here for more information from the Department on their cost increases and the history of licensing fees.

DOH cites the following specific reasons for the shortfall:

  • Increased number of off-campus hospital sites requiring inspection
  • Increased investigations for serious events such as infection control breaches
  • Changes to Centers for Medicare and Medicare Services rules that reduce or eliminate federal payments for dual purpose investigations, increasing the state’s cost to conduct the investigations.
  • General cost increases such as staff salaries

WSHA will be compiling questions for DOH to address during the department’s stakeholder webinar.  If you have specific questions you would like DOH to respond to during the webinar, please submit them by May 3 to Andrew Busz at  DOH will also respond to questions submitted by phone or chat during the webinar.

Webinar Information

May 8, 2019, 9:00AM – 10:00AM

To participate in the DOH webinar, go to and use access code 434-583-381 or call (312) 757-3121.


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