Legal & EthicalQuestion 189 of 200

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?

a.An average of 3.5 nursing hours per resident day (NHPRD), with at least 2.4 hours provided by CNAs
b.1.0 NHPRD with no CNA minimum
c.5.0 NHPRD all from RNs only
d.No statewide minimum exists

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 §71203

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