Direct answer
Yes. A California private skilled nursing operator with 15 or more employees must provide donor leave under Labor Code Part 5.5: up to 30 business days of paid leave for organ donation, up to 5 business days of paid leave for bone marrow donation, and an additional unpaid 30 business days for organ donation only.
Key takeaways
- Private California SNFs are covered when the employing entity has 15 or more employees.
- Paid leave is up to 30 business days for organ donation and up to 5 business days for bone marrow donation in a 12-consecutive-month period measured from the leave start date.
- Organ donors may also receive an additional unpaid leave of up to 30 business days; the dossier does not support the same extra unpaid extension for bone marrow donation.
- Employers may require limited use of accrued sick leave, vacation, or PTO at the front end: up to 2 weeks for organ donation and up to 5 days for bone marrow donation, unless an applicable CBA blocks that requirement.
- Employees must provide written verification that they are a donor and that the donation is medically necessary.
Last updated: September 30, 2026
Does this California donor-leave law apply to a private skilled nursing facility?
Yes, if the employing entity has 15 or more employees. The controlling private-employer rule is California Labor Code Part 5.5, added by the Michelle Maykin Memorial Donation Protection Act and later amended. The statute defines an employer broadly and the research dossier did not locate an SNF-specific carve-out for private skilled nursing operators. For most California SNFs, the practical question is not whether the rule exists, but whether HR, payroll, and the scheduler are working from the same leave playbook.
How much paid leave does an employee get for organ or bone marrow donation?
Covered employers must provide paid donor leave, but the amounts differ by donation type. Organ donation carries up to 30 business days of paid leave. Bone marrow donation carries up to 5 business days of paid leave. Under the clarified California rule, the one-year period is measured from the date the employee’s leave begins and runs for 12 consecutive months, which matters when a facility is trying to count entitlement across split absences or later procedures.
California donor-leave amounts private SNFs should track
| Issue | Organ donation | Bone marrow donation | Operator note |
|---|---|---|---|
| Coverage threshold | Employer with 15+ employees | Employer with 15+ employees | Applies at the employer level, not by department |
| Paid leave | Up to 30 business days | Up to 5 business days | Count business days, not calendar days |
| Additional unpaid leave | Up to 30 business days | Not supported in this dossier | Do not assume the organ extension applies to bone marrow leave |
| Measurement period | 12 consecutive months from leave start | 12 consecutive months from leave start | Track by employee and leave-start date |
| Forced use of accrued leave at front end | Up to 2 weeks, unless barred by applicable CBA | Up to 5 days, unless barred by applicable CBA | Build this rule into the leave notice and payroll setup |
| Concurrent with FMLA/CFRA | No | No | Keep leave banks separate in HRIS and manager instructions |
| Return right | Same or equivalent position | Same or equivalent position | Document any unrelated business reason if restoration is disputed |
Is there an additional unpaid leave entitlement for organ donation?
Yes, for organ donation. California amended Labor Code section 1510 effective January 1, 2020 to require an additional unpaid leave of up to 30 business days in a one-year period for an employee who is an organ donor. The dossier supports this as an organ-donor-only extension. It does not support saying that bone marrow donors receive the same extra unpaid 30 business days, so skilled nursing operators should keep those leave paths separate in policy language and manager training.
What documentation can a SNF require before granting donor leave?
The statute gives employers a narrow but important documentation trigger: the employee must provide written verification that the employee is an organ or bone marrow donor and that the donation is medically necessary. That is the core proof standard supported by the dossier. A useful SNF workflow is to collect the verification centrally through HR, confirm the expected leave window, and then give payroll and scheduling only the operational dates they need rather than passing around medical details to unit leaders.
Can the facility require the employee to use PTO, vacation, or sick leave first?
Yes, but only within the limits the statute allows. As a condition of initial receipt of donor leave, an employer may require the employee to use up to 5 days of earned but unused sick leave, vacation, or PTO for bone marrow donation and up to 2 weeks for organ donation. That forced-use option is also subject to any applicable collective bargaining agreement. In practice, a unionized SNF should check the CBA before applying a standard payroll rule across the building.
- Organ donation: employer may require up to 2 weeks of accrued sick leave, vacation, or PTO at the front end.
- Bone marrow donation: employer may require up to 5 days of accrued sick leave, vacation, or PTO at the front end.
- The statute preserves greater rights under a CBA or employee benefit plan.
- Post-2011 agreements cannot diminish the rights provided by the donor-leave law.
Does donor leave protect benefits, service time, and seniority?
Yes, with one important boundary. The statute says the absence is not a break in continuous service for salary adjustments, sick leave, vacation, PTO or annual leave, and seniority. It also expressly requires the employer to maintain and pay for group health plan coverage during leave under section 1510(a), which is the paid donor-leave provision. The research dossier does not resolve benefits treatment during the additional unpaid organ-donor extension, so operators should avoid blanket statements there and coordinate with plan terms and counsel if needed.
Can donor leave run at the same time as FMLA or CFRA?
No. California’s donor-leave statute says bone marrow and organ donation leave shall not be taken concurrently with leave under the federal Family and Medical Leave Act or the California Family Rights Act. For an operator, this means donor leave is not just another label to drop onto an existing FMLA or CFRA absence. HR should code it separately, train managers not to collapse leave buckets, and make sure any notices or payroll mappings reflect the non-concurrent rule.
Can the employee take donor leave in more than one block?
Yes. The statute allows leave to be taken in one or more periods, so a skilled nursing facility should not assume the absence must be used as a single uninterrupted block. That matters operationally when donation preparation, the procedure itself, and recovery do not line up cleanly with a weekly schedule. A leave log should therefore capture each segment, the running business-day total, and the measuring period tied to the employee’s original leave-start date.
What job must the facility give back when the employee returns?
The return right is strong. On expiration of authorized donor leave, the employer must restore the employee to the position held when the leave began or to an equivalent position with equivalent seniority status, employee benefits, pay, and other terms and conditions of employment. The statute allows an employer to decline restoration only because of conditions unrelated to the exercise of donor-leave rights. In SNF terms, that means staffing frustration or informal schedule reshuffling is not a lawful substitute for a documented, unrelated reason.
What retaliation or interference risk should a skilled nursing operator expect?
California bars an employer from interfering with, restraining, or denying the exercise of donor-leave rights, and from discriminating against an employee for using those rights or opposing an unlawful practice. The statute also authorizes a civil action in superior court for injunctive or other equitable relief. In addition, the Labor Commissioner’s retaliation complaint form expressly lists taking time off to donate organs or bone marrow as protected activity. For SNFs, the highest-risk moments are usually schedule changes, attendance points, and messy return-to-work communications.
The donor-leave rule is simple on paper and messy in operations: count business days correctly, keep donor leave separate from FMLA and CFRA, and make sure payroll, HR, and the scheduler are all enforcing the same rule.
What should a California SNF put in its donor-leave workflow?
A usable workflow is short and specific. Start with a headcount check at the employing-entity level, then confirm the donation type, collect written verification of donor status and medical necessity, calculate the available paid days, decide whether accrued PTO offsets apply, and set a separate leave code so the absence does not run concurrently with FMLA or CFRA. Before return, confirm restoration to the same or equivalent position and scrub attendance, discipline, and schedule records for retaliation risk. This is exactly the kind of cross-team process ePeople is built to organize inside a labor-law workflow.
- Confirm the employer is a private California entity with 15 or more employees.
- Identify whether the request is for organ donation or bone marrow donation.
- Collect written verification that the employee is a donor and that the donation is medically necessary.
- Count entitlement in business days, not calendar days.
- Measure the one-year period from the employee’s leave-start date and treat it as 12 consecutive months.
- Apply any allowable accrued-leave offset only within the statute’s limits and only after checking any applicable CBA.
- Keep donor leave separate from FMLA and CFRA in policy, coding, and manager instructions.
- Document the return-to-work placement as the same or equivalent job, or preserve the unrelated reason if restoration is contested.
- Review schedule changes, points, counseling, and payroll deductions for retaliation or interference risk.
