Updated August 27, 2026. Quick answer: California’s 2026 figure is $14,440, published in All County Welfare Directors Letter 26-03 dated February 9, 2026. Two things set California apart from every other state in this series: the look-back is 30 months, not sixty, and no period of ineligibility is calculated at all for a transfer made between January 1, 2024 and December 31, 2025.
What California publishes
| What the state lists | Figure |
|---|---|
| 2026 Statewide Average Private Pay Rate (APPR) for nursing facility services | $14,440 |
| The letter that publishes it | 26-03 |
| Date of that letter | February 9, 2026 |
| Look-back period | 30 months |
| Maximum period of ineligibility | 30 months from the date of the transfer |
| Months not reviewed for transfers at all | January 2024 through December 2025 |
| Asset limit reinstated 1/1/2026, one person | $130,000 |
| Asset limit, each additional person | $65,000 |
| Who must approve a period of ineligibility before a county imposes it | the DHCS Medi-Cal Eligibility Division |
| The worksheet counties complete | MC 176 PI |
| Unit printed beside the $14,440 figure | none – see below |
How the penalty period is calculated
- ACWDL 26-03 tells counties, “in accordance with ACWDL 90-01 and the provisions outlined in Sections 50408 and 50411 of Title 22, California Code of Regulations”, to use the 2026 statewide APPR when evaluating disqualifying transfers of non-exempt property made for less than fair market value by institutionalized individuals.
- The same letter sets two conditions for using the 2026 figure: the application date or date of institutionalization occurs on or after January 1, 2026, and the disqualifying transfer occurred within the look-back period applicable to the case. Counties are told not to apply the 2026 APPR to cases with an earlier application or institutionalization date.
- ACWDL 25-18 uses the APPR as a threshold as well as a rate: “A disqualifying transfer occurs when, during an individual’s look-back period, they were over the asset limit and made a transfer of nonexempt assets valued more than the statewide APPR for nursing facility services.”
- The look-back period begins the month before the Medi-Cal application is submitted for an applicant in long-term care, or the month before admission if the person is already receiving Medi-Cal, and extends back 30 months from that first month.
- A period of ineligibility is not a denial. Counties are told to grant restricted eligibility for nursing facility level-of-care using restricted services codes “950” or “951” and issue a Notice of Action, rather than denying Medi-Cal outright.
- The county cannot impose the penalty on its own: it submits the completed MC 176 PI worksheet and its documentation to the Medi-Cal Eligibility Division within 10 business days of discovery, the Division answers within 10 business days, and the period of ineligibility is not imposed without its approval.
- Undue hardship must be reviewed before any period of ineligibility is imposed, on the criteria in Welfare and Institutions Code section 14015.1(b), and existing cases with an active period of ineligibility must be reassessed for it as well.
- Transfers of exempt property are outside all of this. ACWDL 26-03 says that because such transfers are not by their nature made to establish eligibility, no period of ineligibility for nursing facility services can be imposed on them at all.
Once you have the figure above, the Medicaid penalty period calculator does the arithmetic. This page is the California rate record; the calculator is the class parent.
Get a second opinion before money or property moves
Transfers are the part of this system that is hardest to undo, so it is worth having someone look at the timing and at what else the household holds before a gift, a sale or a deed is made final.
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What this page does not settle
- California publishes the figure without a unit. ACWDL 26-03 prints “the 2026 Statewide Average Private Pay Rate (APPR) for nursing facility services (NFS) of $14,440” and stops there; neither that letter nor ACWDL 25-18 contains the word “monthly” or the phrase “per month” anywhere. A monthly reading is very likely – the same guidance caps the resulting penalty at thirty MONTHS – but that is an inference drawn here, not something the state printed, so this page does not put a unit in its title or its table.
- The division itself is not in either letter. Both point outward, to ACWDL 90-01 sections 50408 through 50489 and to Title 22 of the California Code of Regulations. Those documents were sought and not retrieved: the letters path returns a not-found error for 90-01, and the official regulations host returns a navigation page rather than the rule text. This page therefore reports what the 2025 and 2026 letters say and quotes no formula California did not put in them.
- The 30-month look-back is California’s own, stated by the Department in its own letter, and it is shorter than the sixty months most states apply. A transfer that would still be inside another state’s window can be outside California’s.
- There is a two-year hole in the middle of the look-back. Because the asset test was eliminated from January 1, 2024 and reinstated January 1, 2026, counties are told not to request verification, review asset data or calculate any period of ineligibility for transfers made from January 1, 2024 through December 31, 2025 – and from July 1, 2026, only months after the reinstatement are reviewed at all.
- The APPR is republished every year, “typically available at the end of January”, and which year’s figure applies is fixed by the application or institutionalization date rather than by the date of the transfer.
Eligibility is decided by the state agency on the whole file, not by this one number. Nothing here is legal advice, and no one should transfer, retitle or give away property on the strength of a worksheet.
Sources
- California DHCS, All County Welfare Directors Letter 26-03, 2026 Statewide Average Private Pay Rate for Nursing Facility Services (the figure)
- California DHCS, All County Welfare Directors Letter 25-18, Transfers of Assets for Long-Term Care Medi-Cal and Periods of Ineligibility (the method, the look-back and the approval rule)
Each source above was retrieved and read against the state text on August 27, 2026. Every figure on this page was checked against those bytes.
A transfer penalty is a separate test from the income standard that decides eligibility in the first place. For what California uses as that standard, and the state document it comes from, see Medicaid nursing home income limit in California (No Income Cap).
Related: California’s Medicaid home equity limit for a single applicant with no spouse or dependent child at home.
Related: California’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.