On Tuesday, July 10, the California Department of Public Health held a stakeholder meeting regarding the development of the new skilled nursing facility staffing ratio “Patient Need/Acuity Waiver,” which is slated to undergo regulatory review through 2018.
In June 2017, the legislature released a final state budget that included a last minute budget deal increasing the Nursing Hour per Patient Day (NHPPD) minimum, from 3.2 Hours to 3.5 hours beginning July 2018. The proposal also requires that within the 3.5 NHPPD, certified nursing assistants (CNAs) cover 2.4 hours. The legislation created two different waiver processes by which a skilled nursing facility could waive the new requirements, including a “workforce shortage” waiver and a “patient needs” waiver. While the process for applying for the workforce shortage waiver has already been developed, the patient needs waiver is still undergoing review.
LeadingAge California has continued to communicate its ongoing concerns with the new staffing requirements, as facilities are already struggling to recruit and retain qualified certified nursing assistants. At the stakeholder meeting, LeadingAge California explicitly stated that the patient needs wavier should be as fluid and simple as possible to apply for, and that the waiver renewals should not be time limited.
The Department is hosting another stakeholder meeting on Tuesday, July 24 to revisit the patient needs waiver. LeadingAge California will be participating in this meeting to further communicate our concerns.