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State of California—Health and Human Services Agency
California Department of Public Health

AFL 18-54
December 12, 2018

All Health Care Facilities

Senate Bill (SB) 1280 - Extension of the Small House Skilled Nursing Facilities Pilot Program and Revision of Application Process

AUTHORITY:     Health and Safety Code (HSC) sections 1323.5 and 1323.6

All Facilities Letter (AFL) Summary

This AFL informs health care facilities of the chaptering of SB 1280, extending the operation of the Small House Skilled Nursing Facilities (SHSNF) Pilot Program from January 1, 2020, to January 1, 2026. This AFL also revises the SHSNF Pilot Program application process contained in AFL 17-29 by including a third application round and extending the operational deadline for all pilot facilities to October 31, 2021.

Effective January 1, 2019, SB 1280 (Chapter 115, Statutes of 2018) extends the sunset date for operation of the the SHSNF Pilot Program from January 1, 2020, to January 1, 2026.

This pilot program allows the California Department of Public Health (CDPH) to authorize the development and operation of up to ten SHSNFs. SHSNFs are small, homelike, residential facilities eligible for certification for Medicare/Medi-Cal participation and licensed to provide skilled nursing and supportive care to residents, incorporating emerging patient-centered health care concepts.

This AFL revises Attachment A to AFL 17-29, which provides information regarding the application process for the SHSNF Pilot Program. The extension of the pilot program allows CDPH to add a third round of applications, the deadline for which is June 14, 2019. As a reminder, the deadline for the second application round is December 14, 2018.

In addition, the deadline for each pilot facility to complete its development process and become operational is now October 31, 2021, instead of January 1, 2020.

A copy of the revised Attachment A accompanies this AFL. No revisions have been made to AFL 17-29’s Attachments B or C. Please refer to AFL 17-30 for the development and operating standards for each facility selected to participate in this pilot program.

If you have questions regarding any of the matters discussed in this AFL, please email them to

CDPH’s failure to expressly notify facilities of statutory or regulatory requirements does not relieve facilities of their responsibility for following all laws and regulations. Facilities should refer to the full text of all applicable sections of HSC and the California Code of Regulations to ensure compliance.


Original signed by Scott Vivona

Scott Vivona
Assistant Deputy Director


Attachment: Small House SNF Pilot Program: Application Procedures & Request for Applications

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