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

On September 8, 2025, DHCS published SNF ASP Policy Letter 25-002​ ​Draft and Policy Letter 25-003​ Draft which update the prior policy letters for SNF ASP Measurement Years (MYs) 2024 and 2025. These drafts reflect the proposal for Pediatric Subacute (FS/PS) facilities and Institutions of Mental Disease (IMDs) to not be subject to SNF ASP MY24 and MY25. Public input is requested, and comments are due to DHCS on September 25, 2025.


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: 9/25/2025 12:13 PM