TX HHS Form 6106. Private Psychiatric Hospital and Crisis Stabilization Unit Incident Report

The TX HHS Form 6106, Private Psychiatric Hospital and Crisis Stabilization Unit Incident Report, is a crucial tool for reporting and documenting incidents that occur in private psychiatric hospitals and crisis stabilization units. This form helps ensure that all reportable incidents are documented accurately and promptly, allowing for timely follow-up actions to prevent similar occurrences in the future.

This form requires the reporting of illegal, unethical, or unprofessional conduct; abuse, neglect, or exploitation of patients; and fires occurring on facility premises. The report must be submitted as soon as possible, but not later than 10 calendar days following the incident. Key information includes the date and time of the incident, facility name and address, and patient information if applicable.

When to use this form: In situations where an incident has occurred in a private psychiatric hospital or crisis stabilization unit, such as abuse, neglect, or exploitation of patients, illegal or unethical conduct, or fires on premises. Who typically fills out this form: Facility staff, management, or administrators responsible for reporting and documenting incidents.

• Reportable incidents include illegal, unethical, or unprofessional conduct; abuse, neglect, or exploitation of patients; and fires occurring on facility premises.
• The report must be submitted as soon as possible, but not later than 10 calendar days following the incident.