3.4 HPRD Direct Care Reporting Requirements

WAC 388-97-1090 and RCW 74.42.360 require that facilities provide a minimum of 3.4 direct care hours per resident day (HPRD).  For the purposes of this law, direct care staff are RNs, LPNs, and CNAs. Additionally, if you do not meet the 3.4 hours with the previously listed staff, you may count geriatric behavioral health workers, as defined in RCW 74.42.360.  Please see the Geriatric behavioral health sheets attached below for specific GBHW staff qualifications, supervision, and the percentage of total GBHW hours worked that are eligible for inclusion in the 3.4 HPRD calculation. 

The Centers for Medicare and Medicaid Services (CMS) is collecting this information via the Payroll Based Journal (PBJ).  Previously, the Department had been collecting information from each facility to determine compliance with the 3.4 requirements found in RCW 74.42.360. The RCW instructs the Department to utilize the data from the CMS Payroll Based Journal (PBJ) for oversight, but at the time of roll-out, this data was not available. CMS has begun releasing this data; therefore, the Department will now use PBJ data for determination of compliance.

The PBJ data is available to the Department approximately two quarters after the quarter that the data was due. This means that there is a two-quarter lag on the data the Department receives. 

If for any reason, you are not required to submit payroll data to CMS, you must continue to submit your hours directly to the Department on a 3.4 Reporting sheet. Additionally, if you are relying on geriatric behavioral health worker hours to meet the 3.4 requirement, those hours will need to be submitted directly to the Department, as they are not captured in the PBJ.

Geriatric behavioral health sheets should be submitted electronically to: nfrates@dshs.wa.gov, with the subject line saying: BX Hours - Q_ - Year (Ex. BX Hours - Q4 - 2023). 

In compliance with RCW 74.42.360, to include GBHW hours in the 3.4 HRD calculation, the identified staff member must qualify in one of the following categories. 

(i) The worker must:

(A) Have a bachelor's or master's degree in social work, behavioral health, or other related areas; or

(B) Have at least three years’ experience providing care for individuals with chronic mental health issues, dementia, or intellectual and developmental disabilities in a long-term care or behavioral health care setting; or

(C) Have successfully completed a facility-based behavioral health curriculum approved by the department under RCW 74.39A.078;

(ii) Any geriatric behavioral health worker holding less than a master's degree in social work must be directly supervised by an employee who has a master's degree in social work or a registered nurse.

Only a portion of the hours worked by the identified GBHW during the quarter under review are eligible for inclusion in the 3.4 HRD calculation.  “Total hours equal to the proportion of resident days of clients with a behavioral health condition identified at that facility on the most recent semiannual minimum data set.”

If you have any questions about submitting geriatric behavioral health hours, please contact Melissa Ayala, HPRD Lead, at (360) 725-2416 or Melissa.Ayala@dshs.wa.gov, or Tiffany Hills, Nursing Facility Rates Manager, at (360) 995-2809 or Tiffany.Hills@dshs.wa.gov.

Upcoming Deadlines if turning in geriatric hours

1st Quarter – Due to DSHS by May 30th each year

2nd Quarter – Due to DSHS by August 29 each year

3rd Quarter – Due to DSHS by November 29th each year

4th Quarter – Due to DSHS by March 1st each year

Forms and Letters

Geriatric behavioral health sheets


3.4 HPRD Using Payroll Based Journal Starting Quarter 3 2018

3.4 HPRD Prior to Payroll Based Journal Implementation