Washington PBJ Nursing Home StaffingWashington PBJ Staffing

187 providers • 13,819 residents • 4.25 HPRD

Phoebe J
PBJ Takeaway: Washington

4.25 HPRD (rank: 8)0.85 RN HPRD4.2% contractWA Min. ~3.46 HPRD

Washington reported 4.25 HPRD (≈ 5.6 residents per total staff) in Q3 2025. HPRD is down 0.03 since Q3 2024. This level is above the national ratio of 3.77 HPRD and ranks #8 out of 51 states.

Put another way… On a 30-bed floor at a typical Washington nursing home you'd see about 5.3 staff members, including 3.2 nurse aides. For the entire 74-resident facility (Washington average), that's about 13.1 total staff, including 7.9 nurse aides.

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Total Staffing: Washington
Total Staffing

Washington

Washington Total Staffing

Direct staff excludes Admin/DON. State min. (~3.46 HPRD) may reflect calculated equivalents by MACPAC. Direct staff excludes Admin/DON. State min. (~3.46 HPRD) may reflect calculated equivalents by MACPAC.

RN Staffing: Washington
RN Staffing

Washington

Washington RN Staffing
Resident Census: Washington
Resident Census

Washington

Washington Resident Census
Contract Staff %: Washington
Contract Staff %

Washington

Washington Contract Staff %
Washington PBJ Metrics
MetricValueNational Rank
Total Nurse Staffing HPRD4.25#8 of 51
Direct Care Nurse HPRD3.93#8 of 51
RN HPRD0.85#10 of 51
RN Direct Care HPRD0.64#9 of 51
Nurse Aide HPRD2.58#12 of 51
Contract Staff Percentage4.2%
Special Focus Facilities

Washington has facilities in the Special Focus Facility program. Select a tab to view Current SFFs, Candidates, Graduates, or facilities no longer in Medicare/Medicaid.

FacilityMonthsResidentsTotal HPRDOwnership
Alaska Gardens Health and Rehabilitation (Tacoma)21083.75For-Profit
Columbia Crest Center (Moses Lake)10613.86For-Profit
Colville Health and Rehabilitation of Cascadia (Colville)6563.78For-Profit
Crystal Cove Post Acute (Lacey)9883.42For-Profit
Spokane Health & Rehabilitation (Spokane)61133.44For-Profit

Source: CMS Special Focus Facility program

Methodology

This dashboard uses CMS Payroll-Based Journal (PBJ) data (2017–2025), along with other public datasets (Provider Information, Affiliated Entity). State staffing standards via MACPAC (2022).

Metrics

  • Hours Per Resident Day (HPRD): Total staff hours ÷ average residents. Example: 350 hours for 100 residents = 3.5 HPRD.
  • Direct Care (excl. Admin, DON): Hours per resident day for direct care staff only (RN, LPN, CNA, NAtrn, MedAide), excluding administrative and supervisory roles.
  • Contract Staff %: Share of hours provided by contract staff.
  • Census: Average number of residents during the period.

Note: Some states set minimums (e.g., NJ, CA, NY at 3.5 HPRD); a federal 3.48 minimum was recently overturned (2025). A 2001 federal study linked 4.1 HPRD to better outcomes in that study. Staffing needs vary by resident acuity (case-mix), day, and shift. Estimates on PBJ Takeaway assume roughly 60% of staff are CNAs.

Data transparency

The PBJ Dashboard pulls directly from CMS data and is carefully vetted for accuracy. Still, sometimes a bug sneaks into the jelly. That could mean: a systemic CMS data reporting issue (e.g., Q2 2017 contract staffing, missing data in 2020 due to COVID) or there could be a coding error on our part. If you spot something that looks off, please let me know via the contact form so I can set things right.

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