TX HHS Form 1126. Physician's Assessment

The TX HHS Form 1126, Physician's Assessment, is a crucial document that helps resolve issues related to the placement of residents in assisted living facilities. This form is typically completed by a resident's physician when it has been determined that the individual is inappropriately placed in an assisted living facility.

This assessment requires the physician to provide their opinion on whether the resident is appropriately placed, considering factors such as ambulation status, ability to transfer independently, mental capacity, and medical condition. The form also includes a section for the physician's signature and date of completion. The completed form, along with supporting documentation, should be submitted to the Regulatory Services regional office for further action.

The TX HHS Form 1126 is an essential tool for ensuring that residents receive appropriate care and placement in assisted living facilities. Key features of this form include:

• Physician's opinion on resident placement
• Required information on resident ambulation status, transfer ability, mental capacity, and medical condition
• Submission to Regulatory Services regional office for further action