In terms of the business and investments, you need to find a local financial advisor to help you understand, manage, and plan for transition of those businesses and assets.
Again, this is a referral situation; perhaps as you're interviewing facilities you can also ask if they have any advisors they prefer or that their residents work with. If your grandmother has been working with a CPA, that might also be a source for a referral.
Unfortunately, at some point you will have to go to Seattle to deal with it. It sucks, but it's reality. I don't think one can make a decision like this remotely, and until you're actually in the facility and talking to the staff and residents, they're not "real". Being in the facility allows you to see, hear, and smell what's going on.