TX HHS Form 5404. Facility Observation Program

The TX HHS Form 5404, Facility Observation Program, is a checklist designed to guide newly hired Regulatory Services surveyors in conducting a comprehensive observation of a long-term care facility's operations. This form helps solve the task of ensuring that facilities are meeting essential standards and protocols.

This checklist provides a framework for observing various aspects of a facility's operations, including administration, human resources, medical records, resident rights, and abuse prevention processes. The form requires information such as employee ID numbers, dates of observation, and facility name and address. It also includes sections for comments on governing bodies, management, and resident funds.

The TX HHS Form 5404 should be used to conduct a ten-day long-term care experience facility observation program. This form is designed to accommodate the unique needs of different types of facilities, allowing surveyors to focus on specific areas of concern. The flexibility of this checklist enables surveyors to tailor their observations to the facility being observed and ensure that all necessary protocols are met.