Skilled Nursing

CDPH Releases AFL on Staffing Audits

The California Department of Public Health (CDPH) has released a new All Facilities Letter (AFL 19-16), which replaces the previously issued AFL (18-27) on the same topic. The AFL provides guidelines for meeting the 3.5 and/or 2.4 DHPPD staffing requirements.

AFL 19-16 Summary:

In accordance with HSC sections 1276.5 and 1276.65, and W&I section 14126.022, this notice provides updated guidelines for facility requirements during state audits for compliance with the 3.5 DHPPD staffing requirements, of which a minimum of 2.4 DHPPD shall be performed by certified nurse assistants (CNAs).

The California Department of Public Health (CDPH) is replacing AFL 18-27 with AFL 19-16 to clarify the requirements and guidelines for meeting the 3.5 and/or 2.4 (CNA) DHPPD staffing requirements in skilled nursing facilities (SNFs). The guidelines in this AFL are applicable to the audit period beginning July 1, 2019, and shall remain in effect until superseded.

This AFL makes the following updates:

  • Defines the calculation for 3.5 and 2.4 (CNA) DHPPD staffing requirements.
  • Establishes midnight as the Patient Day start time.
  • Excludes direct care hours and patient census counts in subacute units.  Mandates the use of CDPH Form 530 and Form 612.
  • Clarifies direct caregiver time for nurse assistants.
  • Defines terms commonly used and referenced in the audit process.

This and all other AFLs can be found on the Department’s website here.