In California, all healthcare facilities providing direct care services are required to have a signed California Department of Public Health (CDPH) Form 530 on file for each non-employee individual who is paid for direct care services (i.e. independent contractors). To help facilities fulfill this requirement, the Nursa app will automatically create and help clinicians e-sign a CDPH 530 form each time they submit a shift report for a shift worked at a facility located in California. Facility users can subsequently e-sign and download these forms to remain in compliance with state health department regulations.
How do I fill out CDPH 530 forms?
As a facility user for shifts in California, you will be able to easily sign and complete the CDPH 530 form when submitting your facility shift report.
- Complete your shift report as normal
- The form will pop up and you will give your electronic signature
- Click "Sign and Confirm"
- Submit shift report
Note: If a facility user does not complete their shift report and it is auto-verified, the form will need to be signed before downloading.
How do I download CDPH 530 forms?
- Click the menu in the top left corner
- Scroll to "Data" tab
- Select "CDPH 530"
- If connected to multiple facilities, Select a Facility
- Filter by the shift date range you are interested in
- Select the forms you wish to download
-
Select "Sign Selected" if signatures are still needed
- Note: You can only download forms that are signed
- Select "Download Selected" to download forms
Note: This form is only available for facilities located in California.