Updates the statutory authority regarding penalties and appeal rights for SNFs non-compliant with the direct care service hours per patient day requirement. It has the procedure for appealing determinations of non-compliance and increase the time to file an appeal to 30 calendar days (from 15 business days) and the time for CDPH to respond to 30 days (from 10 business days).

The staffing audits for DHPPD relate to the 3.5 direct care service hours per calendar day for all direct caregivers (RN, LVN, CNA combined) and 2.4 for CNA, per AFL 21-11.

As a reminder, it is very important to review actual staffing PPD every day and not wait until the staffing audit to realize non-compliance. This means running an Infor report with actual punches, and not going by scheduled hours, since the auditors will pull payroll registers and timesheets and not the schedule.

Absent an approved staffing waiver, SNFs must pay an administrative penalty to CDPH for violating the 3.5 or 2.4 DHPPD requirement.

If the staffing audit finds at leave 5% and up to 49% of the days audited did not meet the 3.5 or 2.4 DHPPD requirement, the SNF must pay $25,000.

This translates into more than 1 of the typical 24 audit dates selected but less than 12. So having 2 or more days is $25,000. Even using expensive agency or registry help or overtime is going to be less than this penalty.

It’s $50,000 if over 49% of the audited days did not meet the requirement.

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