The California Department of Public Health (CDPH) has issued a new All Facilities Letter announcing emergency regulations for skilled nursing facilities (SNFs) regarding direct care hours. Effective July 1, 2018, SNFs must provide a minimum of 3.5 direct care hours per patient per day, with 2.4 hours provided by certified nursing assistants (CNAs). Facilities can apply for a patient needs waiver to waive the 2.4 CNA requirement, as long as they meet the overall 3.5 direct hours requirement. SNFs must post notice of a pending or approved waiver request in the facility and notify potential residents of their waiver status. The CDPH will host two stakeholder meetings in July to discuss the criteria for the patient needs waiver. Facilities unable to meet the requirements due to workforce shortages may apply for a workforce shortage waiver, as outlined in AFL 18-16.

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