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 tool for monitoring and improving the performance of contracted agencies in Texas. This form helps identify areas where an agency falls short of meeting standards and outlines a plan to correct these deficiencies.

This form requires essential information such as the contractor's number, monitoring visit dates, and type of review. The summary statement of deficiencies and plan of correction sections are critical components that provide a clear overview of the issues found and proposed solutions. Common scenarios for using this form include complaint investigations, annual compliance reviews, and follow-up reviews.

The form also includes space to document each deficiency, its corresponding condition and standard number, as well as the completion date and responsible party for each corrective action. This structured approach enables agencies to track progress and ensure that necessary improvements are made in a timely manner. By using TX HHS Form 5011, contracted agencies can demonstrate their commitment to meeting standards and improving services.