TX HHS Form 0065. Information Regarding Authorized Electronic Monitoring for Nursing Facilities

The TX HHS Form 0065, "Information Regarding Authorized Electronic Monitoring for Nursing Facilities," is a crucial document that enables residents or their legal representatives to request authorized electronic monitoring (AEM) in nursing facilities. This form helps solve the problem of ensuring resident autonomy while maintaining facility safety and security.

To use this form, you must complete the Request for Authorized Electronic Monitoring form and obtain consent from other roommates using the Consent to Authorized Electronic Monitoring form. The resident's physician determines capacity to request AEM, and a legal representative may act on behalf of the resident if they lack capacity. The form also outlines who can consent to AEM, including other residents or their legal representatives.

It is essential to note that facilities cannot refuse admittance or discharge a resident due to a request for AEM. If such an occurrence happens, you should report it to the local office of Long Term Care-Regulatory, Texas Health and Human Services Commission (HHSC). Key points to consider when using this form include:

• The resident or their legal representative must complete the Request for Authorized Electronic Monitoring form.
• Consent from other roommates is required if multiple residents share a room.
• The facility administrator or designee receives the completed forms.