TX HHS Form 3054. Primary Home Care Service Delivery Record

The TX HHS Form 3054, Primary Home Care Service Delivery Record, is a crucial document that helps track the delivery of primary home care services to individuals. This form is typically used in situations where multiple caregivers are involved in providing care to an individual, ensuring that all tasks and responsibilities are accurately recorded and accounted for.

The form requires essential information such as employee names, individual names, task assignments, and scheduled or authorized hours. It also includes a note on billing services not actually provided, emphasizing the importance of accurate record-keeping to prevent fraud. Additionally, the form highlights the responsibility of attendants or authorized signers to certify that they worked the recorded hours and completed the assigned tasks.

The TX HHS Form 3054 is a valuable tool for caregivers, service providers, and administrators to ensure seamless communication and coordination in delivering primary home care services. Key features include:

• Recording of task assignments and scheduled or authorized hours
• Certification of work hours and completed tasks by attendants or authorized signers
• Avoidance of billing fraud through accurate record-keeping