TX HHS Form 1085. State of Texas Emergency Assistance Registry

The State of Texas Emergency Assistance Registry (STEAR) Form 1085 is a crucial tool for assisted living facilities and nursing homes to register their emergency contact information. This form helps ensure that critical details are readily available in the event of an emergency, allowing for swift communication and response.

The STEAR Form 1085 requires key information, including facility name, street address, ZIP code, phone number, estimated daily average census, and evacuation plan status. Facilities must also indicate whether they have a plan in place to evacuate residents in the event of an emergency. This form is designed for completion by each facility, with the option to submit it electronically using Adobe Reader or Acrobat.

To complete the STEAR Form 1085, facilities should provide the following information:

• Facility name and contact details
• Estimated daily average census
• Status of evacuation plan for facility residents in emergency situations

Completed forms can be submitted to [email protected], with the option to save them as uniquely named PDF files. By registering their emergency contact information, assisted living facilities and nursing homes can help ensure a swift and effective response in the event of an emergency.