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​​​​​​​​​​​​​​​​​​​​​​​Skilled Nursing Facility Accountability Sanctions Program (ASP)

​The Skilled Nursing Facility (SNF) Accountability Sanctions Program (ASP) imposes monetary sanctions on facilities that fail to meet one or more quality or equity measures established by DHCS on a per Med-Cal bed day basis. ASP is authorized by Welfare & Institutions Code Section 14126.026 (added by Assembly Bill (AB) 186 (Chapter 46, Statutes of 2022)) to assess a sanction of up to five dollars ($5) for each Medi-Cal bed day within the rating period. For each measure, the aggregate sanction assessed shall not exceed one hundred f​​​​​​ifty thousand dollars ($150,000) in a single rating period.

For ASP program-related questions or concerns, please contact ASP support staff at SNFASP@dhcs.ca.gov.

For additional information regarding other Nursing Facility Financing Reform programs authorized by AB 186, please see Nursing Facility Financing Reform AB 186.

​SNF ASP Policy Letter

On December 10, 2025, DHCS released SNF ASP Policy Letters 25-002 (supersedes Policy Letter 24-001) and 25-003 (supersedes Policy Letter 24-002), providing updated guidance for the SNF ASP for Measurement Years (MY) 2024 and 2025, respectively

On September 25, 2025, DHCS published the SNF ASP Policy Letter 25-001 outlining the SNF ASP Appeals and Waivers processes.

On December 12, 2024, DHCS published the SNF ASP Policy Letter 24-002​​ to provide an overview for Measurement Year 2025.

On May 15, 2024, DHCS released the Revised SNF ASP Policy Letter 24-001 (Supersedes Policy Letter 23-001).

​SNF ASP Methodology​

On July 19, 2024, DHCS published the SNF ASP Methodology​ for Measurement Year (MY) 2024.

SNF ASP FAQs

On March 26, 2025, DHCS released a FAQs document​ addressing common questions regarding the program. 

SNF ASP Webinar

Next Meeting:

​To be announced.

​Meeting Tips:

How To Raise Hand During a Meeting
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To Join by Telephone (audio-only)

Please call +1 279-895-6425 and enter phone conference ID: 134 273 094​#

To request to speak during the public comment period, please press *5.​

​​Past Meetings:

June 27, 2025, Presentation Materials​

October 21, 2024 Presentation Materials​​

​AB 186 E-mail Distribution List

This e-mail service (ListServ) has been created so interested stakeholders can receive relevant updates on the AB 186 programs (ASP, WQIP, and WSP).

Sign up for the e-mail distribution list.

Last modified date: 12/10/2025 1:20 PM