The California Department of Public Health has issued an All Facilities Letter (AFL) reminding skilled nursing facilities (SNFs) of the mandatory use of specific forms to document direct care service hours per patient day (DHPPD). Effective July 1, 2020, the department will not count direct care service hours that are not recorded on the required forms. The letter also highlights that non-compliance may result in loss of Skilled Nursing Facility Quality and Accountability Supplemental Payment Program (QASP) payments and administrative penalties. SNFs are advised to refer to AFL 19-16 for guidelines on using the forms and meeting minimum staffing requirements.

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