1. Program Definition and Services
Skilled Nursing Services provide specialized care to individuals who require medical attention and support on an extended basis. Services include:
- Nursing care provided by registered nurses (RNs) or licensed vocational nurses (LVNs)
- Assistance with personal care activities
- Medication administration and management
- Rehabilitation services (e.g., physical therapy, occupational therapy)
- Wound care and other medical treatments
2. Regulations
The primary regulations governing Skilled Nursing Services in California are:
- California Code of Regulations, Title 22, Section 74652
- California Code of Regulations, Title 22, Section 70627
- California Health and Safety Code, Section 1250(c)
3. Licensing or Certification
A state license is required to operate a Skilled Nursing Facility (SNF) in California. The license is issued by the California Department of Public Health (CDPH).
4. Responsible State Agency
The California Department of Public Health (CDPH), specifically the Licensing and Certification Program, is responsible for licensing and oversight of SNFs.
5. Application Process
The application process is conducted through the CDPH Centralized Applications Branch (CAB). Applicants must submit a completed application packet, which includes various forms and supporting documents.
6. Required Documentation
Required documentation includes:
- Completed application forms
- Evidence of financial capacity to operate the facility
- Information on prospective owners, directors, and board members
- Proof of compliance with staffing requirements
- Facility floor plans and other relevant architectural documents
7. Timeline for Approval
The exact timeline for approval is not specified. However, AB 1502 requires applicants to submit a complete application to CDPH at least 120 days before the proposed change of ownership or management.
8. Pre-Application Process
There is no specific pre-application process mentioned, but prospective providers should thoroughly review all requirements and gather necessary documentation before applying.
9. Pre-Application Training
While not explicitly mentioned for initial licensure, AB 749 requires nursing home medical directors in California to be certified within five years of employment (by January 1, 2027, for those employed as of January 1, 2022).
10. Additional Notes
- SNFs in California must provide a minimum of 3.5 hours of direct care by nurses and certified nursing assistants (CNAs) per resident each day, with at least 2.4 of those hours provided by CNAs
- Recent legislation (AB 2511) has introduced new requirements for SNFs, including increasing onsite fuel storage for emergency power systems from 6 to 96 hours
- SNFs can be freestanding or operate as a distinct part of a hospital
- Most SNFs in California are certified to participate in both Medicare and Medi-Cal programs
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