All Facilities Letter (AFL 14-11)

California Department of Public Health / RON CHAPMAN, MD, MPH / April 7, 2014


This All Facility Letter (AFL) explains the informed consent process for skilled nursing facilities(SNF). This AFL and attachment supplements the prior information issued. The “questions and answers”reflect revised questions (7, 8, 16, 17, 18, 19, 20, 23) and a new question (25) in order to include physician assistants in the process for obtaining informed consent in skilled nursing facilities.

All Facilities Letter (AFL 14-18)

California Department of Public Health / RON CHAPMAN, MD, MPH / August 1, 2014


The Centers for Medicare and Medicaid Services (CMS) and the California Department of Public Health (CDPH) are committed to ending inappropriate use of antipsychotic drugs in skilled nursing facilities(SNFs). This letter identifies actions that CMS and CDPH are taking to enforce laws and regulations governing use of antipsychotics in SNFs.


In May 2011, the Office of Inspector General (OIG) of the U.S.Department of Health and Human Services issued a report on antipsychotic drug use in elderly nursing homeresidents.

All Facilities Letter (AFL 15-14)

California Department of Public Health / KAREN L. SMITH, MD, MPH / July 7, 2015


The California Department of Public Health (CDPH) encourages all nursing homes to participate in the National Nursing Home Quality Care Collaborative (NNHQCC), a comprehensive initiative sponsored by the Centers for Medicare & Medicaid Services (CMS) that seeks to achieve large-scale improvements in nursing homes throughout California and the nation.


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