The California Department of Public Health (CDPH) has issued a new All Facilities Letter (AFL) notifying skilled nursing facilities (SNFs) of the patient acuity waiver posting schedule. Effective July 1, 2018, freestanding SNFs must increase staffing from the current 3.2 nursing hours per patient day requirement to 3.5 direct care service hours per patient day, with Certified Nursing Assistants (CNAs) performing a minimum of 2.4 hours per patient day. The CDPH will develop a waiver process for SNFs seeking a waiver of the 2.4 CNA requirement to address individual patient needs (patient acuity waiver). SNFs will submit waiver requests using the program flexibility procedures specified in Title 22 of the California Code of Regulations section 72213. The CDPH will post a list of facilities that have applied for a patient acuity waiver on its SB 97 Stakeholder website. The CDPH will consider resident quality of care and the needs and acuity level of residents at the facility during the program flexibility request review. Following approval of the waiver application, the CDPH will post a list of facilities with approved patient acuity waivers on its SB 97 Stakeholder website.

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