Staff Ratio Mandate - Waivers and Webinar

A message from CAHF CEO/President Craig Cornett
March 29, 2018

As most of you are aware, following a 20-year effort, SEIU was successful in convincing the Governor’s office to insert last-minute language in the 2017-18 budget trailer bill to increase staffing ratios in skilled nursing facilities. The new standards will require skilled nursing facilities to staff at 3.5 direct caregiver service hours per patient day, with 2.4 of the hours performed by certified nurse assistants, beginning July 1, 2018. This was codified in the budget bill of SB 97 last July.

As directed by the statute, facilities have an opportunity to apply to the California Department of Public Health (CDPH) for a “Workforce Shortage Waiver” and a “Patient Acuity Waiver” which were released by the department on March 29. Title 22 amendments to SB 97 can be viewed here.

These are essential tools in ensuring that our members will be able to remain in good standing when they are unable to meet the new standards. For these reasons, member facilities that may not be able to routinely staff in excess of the 3.5/2.4 requirement would be well served to consider seeking a waiver.

While CAHF continues to advocate on behalf of our members for a phase-in to meet the mandate and a meaningful waiver process among other things, we also recognize that our members need to plan and prepare for the mandate to start on July 1st.

In order to address the waivers, as well as operational and risk management issues, CAHF hosted a webinar exclusively for members on Monday, April 2, 2018  to clarify the regulations and help explain the process to obtain waivers. You can access the webinar here to hear from
CAHF Legislative Affairs Director Matt Robinson and CAHF Legal Counsel Mark Reagan.

As we continue to discuss and seek clarification from CDPH, we will continuously update our members about the regulatory and waiver process for the 3.5/2.4 requirement.

The next webinar will be held on Monday, April 23 from 2 pm - 3pm.  Register

CAHF is committed to tirelessly advocating for the best interests of its members and, in doing so, the residents that you serve. We recognize that this will be a challenging process and we will strive to be as helpful and informative as we can throughout this time frame.  We plan to provide frequent updates on the Staff Ratio Toolkit on the home page.

Questions should be directed to