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LICENSING AND CERTIFICATION

All Facilities Letters - 2023

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*All Facilities Letters are listed in ascending order by release date, with updated AFLs listed directly after their original version

Bulletin NumberFacility Type AffectedSubjectRelease Date
AFL 23-01 
Skilled Nursing Facilities (SNF)
Intermediate Care Facilities (ICF)
Assembly Bill (AB) 895: Notice to Prospective Residents
01/18/2023
AFL 23-02 
General Acute Care Hospitals (GACH)
Assembly Bill (AB) 1394 – Suicide Screening Requirement
01/18/2023
AFL 23-03 
Hospice Facilities (HOFA)
Skilled Nursing Facilities (SNF)
Intermediate Care Facilities (ICF)
Assembly Bill (AB) 1852 – Automated Drug Dispensing Systems
01/18/2023
AFL 23-04 
Skilled Nursing Facilities (SNFs)
Assembly Bill (AB) 1907 – Frequency of Inspections
01/18/2023
AFL 23-05 
​General Acute Care Hospitals (GACH)
Acute Psychiatric Hospitals (APH)
Chemical Dependency Recovery Hospitals (CDRH)
​Assembly Bill (AB) 2096 – Revision and Expansion of Permitted Licensure of Chemical Dependency Recovery (CDR) Services

​01/18/2023
​AFL 23-06 
​Skilled Nursing Facilities (SNFs)
​Assembly Bill (AB) 2511 – Skilled Nursing Facilities: Backup Power Source
​01/18/2023
AFL 23-07 
​General Acute Care Hospitals (GACH)
Special Hospitals (SH)
Skilled Nursing Facilities (SNF)
Congregate Living Health Facilities (CLHF)
Hospice Facilities (HOFA)
​Senate Bill (SB) 988 – Compassionate Access to Medical Cannabis Act
​01/18/2023
AFL 23-08 
(Supersedes AFL 19-18)

General Acute Care Hospitals (GACH) Skilled Nursing Facilities (SNF)

​Requirements to Report Outbreaks and Unusual Infectious Disease Occurrences 

​01/18/2023
​AFL 23-09 
(Supersedes AFL 20-75.1)

​All Facilities

​Coronavirus Disease 2019 (COVID-19) Outbreak Investigation and Reporting Thresholds

​01/18/2023
​AFL 23-10 
​Skilled Nursing Facilities (SNF)
​Recommendations for the Prevention and Control of Influenza in California Skilled Nursing Facilities (SNFs) for the 2022-2023 Season during the Coronavirus Disease 2019 (COVID-19) Pandemic
​01/18/2023
AFL 23-11 
​All Facilities

​Availability of Waivers to Continue Operations During the Series of Atmospheric River Systems
​01/19/2023
​AFL 23-12 
(Supersedes AFL 20-74.1)

​Skilled Nursing Facilities (SNFs)
​Coronavirus Disease 2019 (COVID-19) Recommendations for Personal Protective Equipment (PPE), Resident Placement/Movement, and Staffing in Skilled Nursing Facilities
​01/24/2023
​​AFL 23-13 

​All Facilities 
​Notice of Expiration of Temporary Waivers Related to the Coronavirus Disease 2019 (COVID-19) Pandemic   
​02/07/2023
​​AFL 23-14​ 

​Hospice Agencies

Hospice Facilities

​Notice of Stakeholder Meeting for Hospice Regulations​
​02/13/2023
AFL 23-15​ 

​Skilled Nursing Facilities (SNFs)

​Notice of Stakeholder Meeting for Modifying SNF Application Fees
​03/10/2023
​​AFL 23-16​ 

​Skilled Nursing Facilities (SNFs)​
​Clarification on Family Council Requirements
​04/12/2023
AFL 23-17​ 


​Skilled Nursing Facilities (SNFs)
Intermediate Care Facilities (ICFs)
​Assembly Bill (AB) 1502 – Change of Ownership and Change of Management Requirements 
​06/12/2023
AFL 23-18 

​Skilled Nursing Facilities (SNFs)
Intermediate Care Facilities (ICFs)

​Interdisciplinary Team (IDT) Authorized Medical Interventions for Residents Unable to Provide Informed Consent and Without a Health Care Decision Maker​

​06/14/2023
​AFL 23-19​ 

​Skilled Nursing Facilities (SNFs)
​Appeal Procedures for Direct Care Service Hours Per Patient Day Penalties
​06/15/2023
AFL 23-20​ 

​All Facilities
​Hot Summer Weather Advisory
​06/28/2023
AFL 23-21 

​General Acute Care Hospitals
​General Acute Care Hospital (GACH) Water Rationing Plan and Storage Requirements
​06/30/2023
AFL 23-22​ 

​All Health Facilities
​Fiscal Year (FY) 2023-24 Health Care Facility License Fee Schedule
​06/30/2023
AFL 23-23 


​General Acute Care Hospitals (GACHs)
Acute Psychiatric Hospitals (APHs)
Skilled Nursing Facilities (SNFs)
​California Health and Human Services (CalHHS) Data Exchange Framework (DxF)

​06/30/2023
​​AFL 23-24 

​All Facilities
Revised Licensure and Certification Application (HS 200) and Applicant Individual Information (HS 215A)
​06/30/2023
​AFL 23-25​​​​​

​All Facilities

​Weather Advisory Hurricane Hilary

​08/18/2023

​AFL 23-26​ 
​All Facilities
​​New Legal Requirement to Submit Immunization Data
​​08/25/2023​
​AFL 23-27​ 


​General Acute Care Hospitals (GACHs)

​Nurse-to-Patient Ratios Penalties and Clarification on Unpredictable Situations Affecting Staffing Levels​

​09/11/2023
​​AFL 23-28​ 


​Skilled Nursing Facilities (SNFs)
​Select Skilled Nursing Facility Recertification Surveys to be Conducted by CertiSurv
​09/14/2023
​​AFL 23-29​ 
(Supersedes AFL 22-20)​

​Skilled Nursing Facilities​

​Coronavirus Disease 2019 (COVID-19) Treatment Resources for Skilled Nursing Facilities (SNFs) ​
​09/26/2023
​AFL 23-30​ 
(Supersedes AFL 22-23.2)​

​All Hospitals
​Guidance for Response to Anticipated Adult and Pediatric Surges in Respiratory Virus Transmission 
​10/10/2023
​​AFL 23-31​ 

​Hospice Agencies
Hospice Facilities​

​Notice of Stakeholder Meeting for Hospice Regulations​
​10/13/2023
​AFL 23-32.1​ 
(Supersedes AFL 23-32)

​Skilled Nursing Facilities (SNF) 
Nursing Facilities (NF) and 
Swing Beds Non-Critical Access Hospital (SB Non-CAH)

​Centers for Medicare and Medicaid Service’s (CMS) Minimum Data Set (MDS) Resident Assessment Instrument (RAI) 3.0 Manual v1.18.11 went into effect October 1, 2023
​11/03/2023
AFL 23-33 
(Supersedes AFL 21-20.2)
General Acute Care Hospitals (GACHs)
Acute Psychiatric Hospitals (APHs)
​​Coronavirus Disease 2019 (COVID-19) Vaccine Recommendations for Eligible Individuals Prior to Discharge

​11/13/2023
AFL 23-34​ 

(Supersedes AFL ​22-09.1)​


​​All Facilities
​Coronavirus Disease 2019 (COVID-19) Vaccine Recommendations for Clinically Eligible Individuals​

​11/13/2023
​​AFL 23-35​ 

​All Facilities
​Xylazine in the Illicit Drug Supply and Patient Best Practices
​11/28/2023
​​AFL 23-36​ 

​Skilled Nursing Facilities (SNFs)
​Recommendations for Prevention and Control of COVID-19, Influenza, and Other Respiratory Viral Infections in California Skilled Nursing Facilities – 2023-24
​12/05/2023
AFL 23-37​ - NEW

​Skilled Nursing Facilities
​Skilled Nursing Facility Admission, Transfer and Discharge Requirements 
​12/22/2023


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