Skilled nursing facilities: reimbursement rates.

Header changed from Senate/Assembly passage lines and Governor receipt block to 'STATE OF CALIFORNIA AUTHENTICATED ELECTRONIC LEGAL MATERIAL' with Chapter 61 designation and approval date of July 6, 2026.

Page numbers changed from page 97 (enrolled) to page 96 (chaptered), and page markers changed from 'SB 165' to 'Ch. 61' throughout the document.

Line wrapping and indentation adjusted throughout to conform to the chaptered law format; no changes to statutory text content are apparent in the visible portion of the diff.

The quality assurance fee for skilled nursing facilities now ceases to be assessed after December 31, 2027 instead of December 31, 2026 (Section 1324.29, Health and Safety Code).

Article 7.6 of the Health and Safety Code (governing the quality assurance fee) becomes inoperative after December 31, 2027 instead of December 31, 2026, and is repealed on January 1, 2029 instead of January 1, 2028 (Section 1324.30).

The Medi-Cal Long-Term Care Reimbursement Act remains operative until December 31, 2027 instead of December 31, 2026, and is repealed on January 1, 2029 or the date the director certifies all closeout activities are complete, whichever is later (Section 14126.033, Welfare and Institutions Code).

Section 14126.036 of the Welfare and Institutions Code is now amended and repealed rather than merely amended, as a conforming change to align with the extended sunset dates.

The quality assurance fee assessment end date is extended from December 31, 2026 to December 31, 2027 (Section 1324.29 of the Health and Safety Code).

The Medi-Cal Long-Term Care Reimbursement Act operative date is extended from December 31, 2026 to December 31, 2027, with repeal moved from January 1, 2028 to January 1, 2029 (Sections 1324.30 and 14126.036 of the Health and Safety Code).

A new provision in Section 14126.036(b) allows the article to be repealed on January 1, 2029, or on the date the director certifies all closeout activities are complete, whichever is later - providing an earlier exit if wind-down finishes sooner.

Rate increase provisions for skilled nursing facilities are extended to include the 2027 calendar year. Facilities meeting workforce standards continue to receive uncapped labor cost increases (trended audited costs), while those not meeting standards receive up to 5 percent annual increases on labor costs and 1 percent on non-labor categories.

The bill is declared an urgency statute under Article IV of the California Constitution, meaning it takes effect immediately upon enactment rather than on July 1. The stated necessity is to extend and maintain financing structures supporting skilled nursing facilities and ensure continued access to long-term care.

The bill's scope expanded from a single-section placeholder expressing legislative intent to a multi-section amendment of the Health and Safety Code (Sections 1324.29 and 1324.30) and Welfare and Institutions Code (Sections 14126.033 and 14126.036).

The vote requirement changed from majority to two-thirds, and the fiscal committee designation changed from 'no' to 'yes', reflecting the bill's new substantive budgetary impact.