Under California Health and Safety Code, a licensed physician's assistant may sign a death certificate if:

• A. The decedent was a patient in a skilled nursing facility at the time of death and the licensed physician's assistant visited the patient within 72 hours of the patient's death
• B. The decedent was a patient in a skilled nursing facility at the time of death and the attending physician visited the patient within 72 hours of the patient's death
• C. The decedent was a patient in an acute nursing facility at the time of death and the licensed physician's assistant visited the patient within 72 hours of the patient's death
• D. The decedent was a patient in an acute nursing facility at the time of death and the attending physician visited the patient within 72 hours of the patient's death

Answer: (A)

In California, a physician assistant may sign a death certificate when the death occurs in a skilled nursing facility and the PA has personally visited the patient within the 72 hours prior to death. This setup ties the authority to a recent, direct encounter in the SNF, reflecting the PA’s clinical involvement with the patient close to the time of death. The other circumstances—such as deaths in an acute care setting or sign-off by the attending physician rather than the PA—do not meet the statutory condition. So the scenario that fits is the decedent in a skilled nursing facility with the physician assistant having seen the patient within 72 hours of death.