The California Department of Health has issued an All Facilities Letter (AFL) directing skilled nursing facilities (SNFs) and general acute care hospitals (GACHs) with temporary staffing requirement waivers to maintain efforts to increase staffing levels and return to required levels. Facilities seeking assistance may participate in the state cost-sharing program by using a state staffing contract, at the state's discretion. The California Department of Public Health (CDPH) will monitor SNFs and GACHs with staffing waivers to ensure they maintain efforts to increase staffing levels. CDPH may revoke a staffing waiver for facilities unable to demonstrate diligent efforts to recruit and retain staff. The department will continue to investigate and conduct enforcement activities. Facilities that have not maintained efforts to increase staffing may be subject to investigation and required to provide documentation of their efforts. CDPH may also conduct unannounced audits to assess these efforts.

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