Skip Navigation LinksAFL-15-30

State of Cal Logo

State of California—Health and Human Services Agency
California Department of Public Health

AFL 15-30
December 30, 2015

Skilled Nursing Facilities (SNFs)

Senate Bill (SB) 361 – Antimicrobial Stewardship

AUTHORITY:      Health and Safety Code (HSC) section 1275.4

All Facilities Letter (AFL) Summary

This AFL informs providers of the chaptering of SB 361, which requires all SNFs to adopt and implement an antimicrobial stewardship policy.

​SB 361 (Chapter 764, Statutes of 2015) requires that each SNF adopt and implement an antimicrobial stewardship policy by January 1, 2017. The policy must be consistent with antimicrobial stewardship guidelines developed by the federal Centers for Disease Control and Prevention (CDC), the Centers for Medicare and Medicaid Services, the Society for Healthcare Epidemiology of America, or similar recognized professional organizations. The CDC has defined seven core elements of antibiotic stewardship for nursing homes; the CDC recommendations are available at the following link:

The Core Elements of Antibiotic Stewardship for Nursing Homes

SB 361 also provides that a failure to comply with this requirement may subject a SNF to the enforcement actions set forth in HSC section 1423.
This AFL is a brief summary of the provisions of SB 361. Facilities are responsible for following all applicable laws. The California Department of Public Health’s (CDPH’s) failure to expressly notify facilities of statutory or regulatory requirements does not relieve facilities of their responsibility for following all laws and regulations. Facilities should refer to the full text of all applicable sections of the Health and Safety Code and the California Code of Regulations to ensure compliance.

If you have questions regarding this AFL, please contact your local district office. If you have questions regarding implementation of antimicrobial stewardship in a SNF, you may contact the CDPH Healthcare-Associated Infections Program, at



Original signed by Scott Vivona for

Jean Iacino
Deputy Director

Page Last Updated :