TX HHS Form 6102. Community Mental Health Center Facility Incident Report

The TX HHS Form 6102, Community Mental Health Center Facility Incident Report, is a crucial tool for reporting and documenting incidents that occur at community mental health centers in Texas. This form helps ensure that incidents are properly documented, investigated, and addressed to prevent similar occurrences from happening in the future.

This report requires facility staff to provide detailed information about the incident, including the type of abuse or neglect that occurred, the date and time of the incident, and any injuries or unknown sources. Additionally, facilities must provide patient information if the incident involves a client, including their name, admission and discharge dates, cause of death (if applicable), and disposition. The form also includes space for reporting facility information, such as the license number and provider number.

The TX HHS Form 6102 is used to report incidents that occur at community mental health centers in Texas, including cases of mistreatment, neglect, verbal, mental, sexual or physical abuse, injuries of unknown source, and the misappropriation of client property. Key features of this form include:

• Required information about the incident, patient (if applicable), and facility
• Detailed reporting of incidents involving mistreatment, neglect, or abuse
• Provision for reporting injuries or unknown sources
• Space for reporting facility information, including license number and provider number