TX HHS Form 3766. Unit Staffing Report for ICF-IID Facilities

The TX HHS Form 3766, "Unit Staffing Report for ICF-IID Facilities", is a tool used to track staffing levels and resident characteristics in Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) facilities. This form helps solve the problem of ensuring adequate staff coverage and resident care by providing a standardized way to collect data on staffing ratios and resident demographics.

The form requires information on the number of staff on duty during each shift, broken down by position (RN, LVN, DCS), as well as resident characteristics such as disability type, age, and behavior. The "Designated Week" section allows for tracking of residents' characteristics across a specific week. This data can be used to identify trends and patterns in staffing levels and resident needs.

This form should be completed by survey staff on a regular basis, ideally during a designated week, to provide an accurate picture of staffing ratios and resident demographics. The form also includes calculations for the ratio of staff to residents and average daily census, which can help facilities identify areas for improvement in terms of staffing and resource allocation.