TX HHS Form 5011. Statement of Deficiencies and Plan of Corrections

The TX HHS Form 5011, Statement of Deficiencies and Plan of Corrections, is a crucial document for monitoring the performance of contracted agencies in Texas. This form helps identify areas where an agency may not meet certain standards or requirements, allowing for prompt corrective actions to be taken.

This form requires key information such as the contractor's number, monitoring visit dates, type of review, and summary statement of deficiencies. The document also outlines the plan of correction, including the condition, standard number, completion date, and responsible party. This ensures that all necessary steps are taken to address any identified deficiencies.

The TX HHS Form 5011 is typically used in situations where a complaint investigation or annual compliance review reveals areas for improvement. It serves as a tool for monitoring agencies' progress towards meeting standards and requirements. Key features of this form include the requirement for each deficiency to be preceded by a full condition statement and standard number, as well as the need for a plan of correction that includes specific actions and responsible parties.

• This form is used in situations where a complaint investigation or annual compliance review reveals areas for improvement.
• The form requires key information such as contractor's number, monitoring visit dates, type of review, and summary statement of deficiencies.
• The plan of correction includes specific actions, completion date, and responsible party.