California's HSC §1276.5 (the '3.5 / 2.4 rule') requires skilled nursing facilities to provide a minimum of how many direct-care nursing hours per resident day?
Explanation
HSC §1276.65 (the staffing rule that succeeded §1276.5's earlier 3.2 standard, effective 2018) requires SNFs to provide a minimum of 3.5 direct-care nursing hours per resident day (NHPRD), with at least 2.4 hours of those provided by CNAs and the remainder by licensed nurses (RN/LVN). Title 22 CCR §71203 contains related staffing standards. The 160-hour CNA training requirement is HSC §1337(c)(2)/Title 22 CCR §71835 (CDPH approved, exceeds the 75-hour federal minimum under 42 CFR §483.152). Facilities cite for failing to meet staffing minimums.
Law Reference: HSC §1276.5; Title 22 CCR §71203This topic, taught in full in the Certified Nursing Assistant (CNA) guide. CNA — Complete Study Guide (2026) — PDF + EPUB, $19.99 · 14-day refund →
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