CHA News

CDPH Issues AFL on Interdisciplinary Team Treatment Decisions in SNFs

For skilled-nursing facility leaders, case managers, compliance officers

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The California Department of Public Health (CDPH) has issued All Facilities Letter (AFL) 20-83, regarding the interdisciplinary team (IDT) medical decision-making process for skilled-nursing facility residents who are unable to provide informed consent and do not have a representative to make decisions on their behalf.  

The AFL provides updated information and guidance based on the court’s decision in California Advocates for Nursing Home Reform (CANHR), et al. v. Sonia Angell. It includes requirements that the skilled-nursing facility provide written and verbal notification to the resident and to another party whose interests are aligned with the resident and to include a patient representative in the IDT.  

The deadline for compliance for the IDT patient representative participation is July 27, 2021. If no patient representative has been selected by that date, the facility must apply to the Superior Court for appointment of an appropriate decision maker or an order for continued medical treatment. CHA continues to work with CDPH and other key stakeholders to clarify implementation and related oversight.