The California Department of Health has issued a new All Facilities Letter, providing guidance and clarification for Skilled Nursing Facilities (SNFs) and Intermediate Care Facilities (ICFs) on the interdisciplinary team (IDT) process for residents unable to provide informed consent and without a healthcare decision-maker. The letter outlines the requirements for providing verbal and written notice to residents before administering treatment interventions, including the physician's determinations, proposed intervention, and lack of a healthcare decision-maker. Facilities must also provide written notice to a competent person whose interests align with the resident or a local ombudsman. A patient representative must be included in the IDT process and decision-making. Facilities should update their policies and procedures to ensure compliance with these requirements and maintain documentation in the medical record. Non-compliance may result in enforcement actions.

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