TX HHS Form 3651. Memory Care Disclosure Statement for Nursing Facilities

The TX HHS Form 3651, Memory Care Disclosure Statement for Nursing Facilities, helps facilities provide transparency about their memory care services to residents. This form should be used by nursing facilities that advertise, market, or promote providing memory care services.

This disclosure statement requires facilities to provide specific information about the services they offer, including whether they have specialized units or programs for residents with dementia. Facilities must also indicate if they are certified to provide care to residents with Alzheimer's disease and related disorders. The form includes sections for facility name, address, administrator, and date completed.

The purpose of this disclosure statement is two-fold: it empowers consumers by providing consistent categories of information about memory care services, allowing families to make informed decisions; and it helps facilities develop and define their philosophy, care, and services specifically targeting residents with dementia. By completing this form, nursing facilities can demonstrate their commitment to transparency and quality care.