AFL 22-08 Appeal Rights for DHPPD Non-Compliance Penalties

This has the updated Welfare and Institutions Code (WIC) section 14126.022 regarding penalties and appeal rights for facilities that are non-compliant with the direct care service hours per patient day (DHPPD) requirement. It provides the procedures for appealing penalties assessed as a result of staffing audits for non-compliance with DHPPD requirements for nurses and CNAs.

SNFs found to be non-compliant with the minimum staffing requirements on fewer than five percent of the audited now have the right to request an administrative appeal, even though these SNFs are not subject to an administrative penalty. All other non-compliant SNFs will be subject to increased administrative penalties of $25,000 for having between 5 percent and 49 percent non-compliant days, or $50,000 for more than 49 percent non-compliant audited days.

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The California Department of Health has issued a new All Facilities Letter (AFL) updating penalties and appeal rights for skilled nursing facilities (SNFs) that fail to comply with direct care service hours per patient day (DHPPD) requirements. SNFs found non-compliant on fewer than 5% of audited days now have the right to request an administrative appeal, though they are not subject to penalties. Non-compliant SNFs will face increased penalties of $25,000 for 5-49% non-compliant days and $50,000 for over 49% non-compliant days. The AFL provides guidelines for SNFs to appeal penalties assessed due to staffing audits for compliance with DHPPD requirements. SNFs must submit a written request for a hearing within 15 business days of receiving written notice of audit findings. The hearing process includes limited discovery, exchange of relevant documents, and testimony under oath. The hearing officer's decision is final, with no further administrative appeal available.

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