TX HHS Form 6515. CLASS or DBMD Nursing Assessment

The TX HHS Form 6515, CLASS or DBMD Nursing Assessment Addendum D, is a crucial tool for healthcare professionals to delegate tasks effectively. This form helps solve the problem of ensuring that unlicensed individuals are competent in performing specific nursing tasks under the supervision of a registered nurse (RN). The addendum provides a framework for documenting delegation and competency verification.

The key features of this form include spaces for recording individual's name, Medicaid number, assessment date, task details, and RN signature. The form also highlights the importance of verifying the unlicensed person's competency to perform tasks that fall under 22 Texas Administrative Code §225.10. This ensures that delegated tasks are performed safely and efficiently.

This form should be used in scenarios where a registered nurse needs to delegate specific nursing tasks to an unlicensed individual, such as a certified nursing assistant (CNA) or home health aide. The addendum provides a standardized process for documenting delegation and competency verification, which is essential for maintaining accurate records and ensuring compliance with regulatory requirements.