TX HHS Form 3642. ICF/IID Medicaid Bed Reallocation Application

The TX HHS Form 3642, ICF/IID Medicaid Bed Reallocation Application, is a crucial tool for healthcare providers in Texas. This form helps solve the problem of insufficient Medicaid bed capacity by allowing applicants to request reallocated beds for their facilities. The application is typically filled out by healthcare providers, such as corporations, LLCs, partnerships, or individuals/sole proprietors, who need to increase their Medicaid bed capacity.

The form requires key information from the applicant, including name and contact details, community information (precinct, city, ZIP code), and the number of Medicaid beds requested. The application also asks about the applicant's readiness to utilize the reallocated beds, occupancy rates, waiting lists, and any additional information related to identified need for the reallocated beds. Key features include the requirement for immediate readiness to use the reallocated beds and the need to provide documentation of a waiting list if applicable.

The TX HHS Form 3642 is an essential tool for healthcare providers in Texas who need to increase their Medicaid bed capacity. Here are some key points to keep in mind:

• Applicants must be immediately ready to utilize the reallocated beds.
• The number of Medicaid beds requested cannot exceed six.
• Documentation of a waiting list is required if applicable.
• The form is used by healthcare providers, such as corporations, LLCs, partnerships, or individuals/sole proprietors, who need to increase their Medicaid bed capacity.