What’s the CDPH 530 Form? A Google search of form 530 may send you down numerous rabbit holes—none of which have the information you need. No, form CDPH 530 has nothing to do with real estate, taxes, or farm labor.
If you work in healthcare in California, read on to understand what the CDPH form 530 is, why it is necessary, how to fill it out, and more.
What Is the CDPH 530 Form?
The CDPH 530 is a form that the California Department of Public Health requires any non-permanent clinician staff to sign after each shift. This document must also be signed by the facility’s director of nursing or other designated employee. Any non-permanent clinicians or permanent workers who don’t typically provide direct care must complete this form after each shift or patient day in California.
Why Is the CDPH 530 Form Necessary?
The CDPH 530 tracks the hours dedicated to nursing staffing assignments that would not otherwise be recorded. This control is necessary to determine compliance with minimum staffing requirements.
The CDPH can audit facilities at any moment. Therefore, facilities must be prepared to provide any documentation the auditor requests. This documentation includes CDPH form 530.
As of July 1, 2020, the CDPH does not recognize direct care service hours not recorded on this form. Since only documented direct care hours count, a failure to fill out form 530 results in non-compliance for each day the form was not used. When a facility is considered non-compliant, it loses payments from the Quality and Accountability Supplemental Payment Program (QASP). Non-compliance may also result in an administrative penalty.
Who Needs to Fill Out Form 530?
Any person offering direct care who is not on the payroll as a direct care provider must fill out and sign form 530. In other words, employees who do not typically provide direct care, such as nursing managers and supervisors, must fill out this form if they provide nursing services. Also, freelance staff, such as independent contractor nurses, must fill out this form when working PRN shifts.
At the end of each patient day, the Director of Nursing or their designee must also sign the form verifying that the nursing assignments are accurate and that all assignments are accounted for with a staff signature. If any assignment is vacant, there must be an explanation.
Form 530 must be completed in any healthcare facility in California when the above conditions are met.
What Information Is Required for CDPH 530?
Clinicians must have the following information to complete form 530:
- The name of the facility
- The date of the patient day in MM/DD/YY format
- The name of the person who has the Director of Nursing responsibility for the day
- The appropriate shift (one, two, or three)
- The shift start time in hours: minutes and a.m./p.m. format
- The name of the specific location in the facility for the patient assignments (if applicable)
- The specific patient assignment and the name of the staff member responsible for the patient assignment
- The staff member’s discipline or license type (RN, LVN, CNA, NA, Psych Tech)
- The actual shift start and end time, including start and end times for meal breaks
- The signature of the staff member providing care and of the Director of Nursing or their designee
Here is the nursing staffing assignment and sign-in sheet for reference.
How to Fill Out the CDPH 530 Form on the Nursa Platform
While some facilities may have workflows that require a paper form to be filled out by clinicians for each shift, Nursa collects a digital copy of the CDPH form and requires a signature confirmation from the clinician upon completing any shift in California after June 13, 2024.
Clinicians
When a clinician finishes their shift, they must complete a clinician Shift Report. If the shift takes place at a facility in California, the clinician will need to answer a few additional questions, which will automatically populate into a digital copy of the CDPH 530 form required by the state of California. The clinician must also sign and confirm the digital CDPH 530 form to complete the Shift Report process.
For more information, view Nursa’s clinician guide on completing the CDPH 530 form.
Facilities
Facilities have the option to manually verify a clinician Shift Report or allow the reports to be automatically verified after two business days. If the facility is located in California, the facility user will go through the standard Shift Report process, where they can verify the clinician’s hours or adjust the hours submitted.
When verifying the clinician’s hours, the facility user can digitally sign their portion of the digital CDPH 530 form for each shift. Shifts that are automatically verified will sit in an unsigned status until the facility user is ready to sign them. Completed digital CDPH 530 forms can be downloaded individually or in bulk using a multi-select function.
Many facilities already incorporate their own internal processes into their workflows for collecting completed CDPH 530 forms from clinicians in person. Many facilities may prefer to maintain their current workflow as a stand-alone solution or in addition to the digitized solution provided by the Nursa platform.
Facilities are free to enforce whatever internal process they have established regarding the CDPH 530 requirement. That said, regardless of a facility’s preference, all California clinicians will go through the same Shift Report verification process on the Nursa platform, including digitally signing the CDPH 530 form.
If a facility with an in-person requirement forgets to collect a paper copy of the CDPH 530, the facility user can sign/download a digital copy of the CDPH 530 form for all shifts completed at their facility after June 13, 2024.
For more information, view Nursa’s facility resource on completing the CDPH form.
Post or Fill Shifts and Easily Stay in Compliance with Nursa
No one enjoys filling out paperwork, but since it is necessary, being able to fill out and sign forms quickly and easily on your own smartphone is a relief.
Another way Nursa makes things easier for facilities and clinicians is by helping them fill PRN shifts. Nursa helps facilities post the PRN jobs they need to fill and allows clinicians to pick up the PRN jobs that fit their qualifications, interests, and schedules.
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