​​Hospital and Skilled Nursing Facility COVID-19 Worker Retention Payments Registration and Application Processes

Covered Entities (CEs), Covered Services Employers (CSEs), and Physician Group Entities (PGEs) are required to register with the DHCS to participate in Hospital and Skilled Nursing Facility COVID-19 Worker Retention Payments. Once registered, CEs, CSEs, and PGEs will be approved to apply for retention payments on behalf of eligible workers.

Registration Process ​

A link to the registration form will be available on the Hospital and Skilled Nursing Facility COVID-19 Worker Retention Payment webpage on October 21, 2022. While the deadline for completing the registration form is December 21, 2022, CEs, CSEs, and PGEs are encouraged to complete the registration form soon after it is available to minimize delays in registration approval.  

After registration submission, CEs, CSEs, and PGEs will receive an email from DHCS confirming that their registration has been accepted or that additional information is required.

The following information is required on the registration form:
CEs:
  • Contact name (first and last)
  • Contact email address and phone number
  • Facility license number (CDPH-assigned 9-digit number)
  • Facility name/business name and address (as it appears on the IRS form W9, Request for Taxpayer Identification Number and Certification)
  • Facility type 
  • Payee data record entity type (e.g., corporation, partnership, sole proprietor)
  • Payee residency status (California resident or California nonresident)
  • Name(s) of contracted CSEs and PGEs providing onsite services
  • National Provider Identification number (NPI)
  • Taxpayer Identification Number (TIN) or Federal Employer ID number (FEIN)

CSEs: 

  • Name (first and last) or Business/legal name associated with the TIN/FEIN
  • Address (as it appears on the IRS form W9)
  • TIN or FEIN
  • Payee data record entity type (e.g., corporation, partnership, sole proprietor)
  • Payee residency status (California resident or California nonresident)
  • Contact name (first and last) 
  • Contact email address and phone number 
  • Qualifying facilities served (CEs contracted with to provide onsite services). 
  • Type(s) of onsite service(s) provided  
  • Digital upload of relevant portions of contract agreement with CEs, including scope of work and signature page

PGEs: 

  • Physician name (first and last) or business/legal name associated with the TIN
  • Address (as it appears on the IRS form W9)
  • NPI
  • Physician license number (if individual)
  • TIN or FEIN
  • Payee data record entity type (e.g., corporation, partnership, sole proprietor)
  • Payee residency status (California resident or California nonresident)
  • Contact name (first and last)
  • Contact email address and phone number
  • Name(s) of qualifying facilities where services are rendered
The registration form will be accompanied with detailed instructions for completion.

Application Process

On N​ovember 29, 2022, all registered CEs, CSEs, and PGEs will receive a link to the application for submitting worker information. All requests for payment must be submitted no later than 5 p.m. (PST) on December 30, 2022. DHCS encourages early submissions so all applications can be validated prior to the final due date. DHCS anticipates issuing payments to CEs, CSEs, and PGEs in January 2023. 

To expedite the submission process, CEs, and CSEs are encouraged to begin gathering the following information for each eligible worker:  
  • Name
  • Date of birth
  • Amount paid/to be paid as a bonus between December 1, 2021, and December 31, 2022 
  • Last four digits of either the worker's Social Security Number issued by the Social Security Administration or Individual Taxpayer Identification Number issued by the IRS
  • Hours the employee worked or would have worked if on approved leave or participating in a labor dispute/job action during the qualifying work period (July 30, 2022, through October 28, 2022)
  • Current mailing address
  • Time base (part time/full time)
To expedite the application submission process, PGEs are encouraged to begin gathering the following information for each eligible physician:  
  • Name (first and last)
  • Date of birth
  • NPI 
  • Medical license number 
  • Last four digits of either the physician's Social Security Number issued by the Social Security Administration or Individual Taxpayer Identification Number issued by the IRS
Additional guidance about the registration and application processes will be provided in the coming weeks.

Last modified date: 11/4/2022 10:12 AM