The California Department of Health has issued an All Facilities Letter (AFL) notifying long-term care facilities of new citation criteria and civil penalty increases under Assembly Bill (AB) 323. Effective January 1, 2022, the burden of proof for issuing Class "AA" citations will change from "direct proximate cause" to "substantial factor" in the death of a resident. AB 323 also creates a new category of citation for skilled nursing facilities and intermediate care facilities, with penalties ranging from $15,000 to $60,000. Additionally, the bill increases civil penalty amounts for Class "AA," "A," and "B" citations, as well as "willful material falsification" or "willful material omission" in health records. The new regulations do not affect civil penalty amounts for other types of long-term care facilities. Healthcare facilities are responsible for ensuring compliance with all laws and regulations, regardless of whether they have been expressly notified by the Department of Health.

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