Post-Payment Reporting Guidance
Hospital and Skilled Nursing Facility COVID-19 Worker Retention Payments​​ 

Covered Entities (CEs), Covered Services Employers (CSEs), Physician Group Entities (PGEs), and Independent Physicians receiving a payment for two or more workers must attest that the payment was made within 60 days of receiving funds to approved eligible workers. The post-payment report must be submitted to the Department of Health Care Services (DHCS) within 90 days from receipt of funds, using the attestation link provided to the entity’s designated contact via email message sent from WRP@dhcs.ca.gov.​​ 

注意：如果您是 CE、CSE、PGE 或仅为您自己或仅为一名工人领取报酬的独立医生，则无需提交付款后报告。
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提交付款后分配报告​​ 

An attestation link will be sent to the entity’s designated contact along with the Payment Detail Report via email from WRP@dhcs.ca.gov after the payment has been issued. The following information is required to be collected as a part of the post-payment report/attestation:​​ 

• 分配给符合条件的工人的资金总额​​ 

• 获得报酬的非医务人员总数​​ 

• 获得报酬的医生总数​​ 

• 最后一次向工人发放工资的日期​​ 

• 退还给 DHCS 的无法交付/超额资金金额（如适用）​​ 

• 向 DHCS 退还超额金额的日期（如适用）​​ 

• 证明人姓名和职务​​  
  

为了完成报告，您将被要求输入您的姓氏和名字以及您在组织内的职务，以确认并证明您输入的信息是真实、准确和完整的。​​ 

证明声明：​​ 

我，依照加利福尼亚州法律，谨此声明，如作伪证，愿受处罚，从卫生保健服务部 (DHCS) 收到的拨款已发放给符合条件的员工。 据我所知，我以上提供的所有信息均真实、准确且完整。 此外，我已将超额金额和所需详细信息发送至​​  退回支票指南​​  部分。​​ 

我被授权代表该实体提交此信息。 我理解，在下面的框中输入名字和姓氏即构成我的电子签名。​​