TX HHS Form 3641-A. Alzheimer's Disclosure Statement for Nursing Facilities

The TX HHS Form 3641-A, Alzheimer's Disclosure Statement for Nursing Facilities, is a crucial document that helps facilities provide transparency about their services and care for residents with Alzheimer's disease and related disorders. This form empowers consumers by providing standardized information categories to compare facilities and services.

This disclosure statement must be completed by nursing facilities that advertise or promote specialized services for residents with dementia. The form requires facilities to describe the services they provide, including whether they have a specialized unit or secured unit for residents with dementia. Facilities may also attach an addendum to expand on their answers.

The purpose of this disclosure statement is two-fold: it provides consumers with consistent information to make informed decisions about care, and it helps facilities develop and define their philosophy, care, and services that specifically target residents with dementia. The form must be completed according to the care and services provided by the facility, and a copy must be made available to anyone requesting information on Alzheimer's or related dementia care.