The California Department of Public Health (CDPH) has issued a new All Facilities Letter (AFL) to provide direction on increasing uniformity in requests for program flexibility from regulatory requirements. Healthcare facilities, including nursing homes, must submit a "Program Flexibility" form (CDPH-5000) to the district office overseeing the facility. The form must include the regulation for which flexibility is requested, an explanation of the proposed alternative, and supporting evidence demonstrating how the alternative meets the intent of the regulation. The district office will review and respond within 60 days, determining the duration of the program flexibility and identifying any terms and conditions. Approved program flexibility requests will have an expiration date and are subject to specific terms and conditions. Non-compliance or inadequate patient safety may result in revocation of the program flexibility. Facilities seeking program flexibility for healthcare emergencies should refer to AFL 18-09 for an alternative application process.

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