In accordance with Executive Order N-11-22, this extends the temporary waiver of specified space conversion regulatory requirements until the end of the declared COVID-19 emergency. It supersedes AFL 21-36.2

Certified SNFs that wish to implement alternative space arrangements as specified in this waiver will need to apply for an 1135 waiver from the Centers for Medicare and Medicaid Services (CMS) as the blanket space waiver previously issued by CMS is now expired. SNFs seeking a CMS waiver should apply through the CMS portal.

As a condition of the waiver, SNFs shall continue to:

· comply with unusual occurrence reporting requirements specified in Title 22 of the California Code of Regulations section 72541.

· report any substantial staffing or supply shortages that jeopardize resident care or disrupt operations.

· provide necessary care in accordance with residents' needs and make all reasonable efforts to act in the best interest of residents.

· not discriminate admits or readmits, nor transfer or discharge residents based on their status as a suspected or confirmed COVID-19 case.

· institute appropriate precautions to prevent the spread of infection to health care personnel and other residents as specified in AFL 20-25.2 and in their Mitigation plan as specified in AFL 20-52.

· follow their disaster response plan.

· follow infection control guidelines from the Centers for Medicare and Medicaid Services (CMS) and the CDC related to COVID-19.

· comply with directives from their local public health department, to the extent that there is no conflict with federal or state law or directives or CDPH AFLs.

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