The California Department of Health issued an All Facilities Letter (AFL) outlining new requirements for Skilled Nursing Facilities (SNFs) and Intermediate Care Facilities (ICFs) regarding interdisciplinary team (IDT) authorized medical interventions for residents unable to provide informed consent and without a health care decision maker. The letter clarifies the IDT process and requires facilities to provide both verbal and written notice to a resident before administering a treatment intervention or a change in treatment that an IDT authorized, except in cases of emergency. Facilities must also provide written notice to a person whose interests align with the resident or to a local ombudsman. Additionally, a patient representative must participate in the IDT process and decision-making for the resident on a proposed medical treatment intervention. SNFs and ICFs must update their policies and procedures to ensure compliance with these requirements and maintain documentation in the medical record. Compliance will be verified during periodic surveys and complaint investigations, with non-compliant facilities subject to enforcement actions.

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