The California Department of Health has issued a new All Facilities Letter requiring all skilled nursing facilities (SNFs) to adopt and implement an antimicrobial stewardship policy by January 1, 2017. The policy must be consistent with guidelines developed by the federal Centers for Disease Control and Prevention (CDC), the Centers for Medicare and Medicaid Services, the Society for Healthcare Epidemiology of America, or similar recognized professional organizations. The CDC has defined seven core elements of antibiotic stewardship for nursing homes, which can be found on their website. Failure to comply with this requirement may subject a SNF to enforcement actions set forth in the Health and Safety Code section 1423. Facilities are responsible for following all applicable laws and regulations. If facilities have questions regarding this letter, they should contact their local district office. If they have questions regarding the implementation of antimicrobial stewardship in a SNF, they may contact the California Department of Public Health's Healthcare-Associated Infections Program.

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