TX HHS Form 3709. Medicaid Bed Waiver Application for Nursing Facilities

The Medicaid Bed Waiver Application for Nursing Facilities (Form 3709) is a crucial document that helps solve the problem of allocating Medicaid beds in Texas. This form is typically filled out by nursing facilities seeking to increase their capacity to accommodate patients with Medicaid coverage. The application requires detailed information about the facility, including community information, type of application, number of Medicaid beds requested, and applicant contact details.

The form also includes key features that ensure compliance with regulatory requirements. For instance, it asks if the application contains evidence of compliance as outlined in Attachment A of the instructions. If not, the applicant must identify the missing or deficient items. Additionally, the form requires disclosure about whether the applicant or any controlling person is also a controlling person of a licensed and/or certified facility.

Key points to note when filling out this application include:

• The application is for nursing facilities seeking to increase their capacity to accommodate patients with Medicaid coverage.
• The form requires detailed information about the facility, including community information, type of application, number of Medicaid beds requested, and applicant contact details.
• The application must demonstrate compliance with regulatory requirements as outlined in Attachment A of the instructions.