TX HHS Form 8009. ICF/IID Review of Comprehensive Nursing Assessment by RN (Example Form)

The TX HHS Form 8009, ICF/IID Review of Comprehensive Nursing Assessment by RN (Example Form), is a template used to document the review and assessment of an individual's physical health, support system, mental status, social functioning, and ability to perform daily living activities. This form helps solve the problem of verifying information and decisions made by a previous registered nurse (RN) on at least an annual basis.

This form is designed to capture key information such as date of event, description of event, action taken by RN, changes in nursing service plan, and signature of RN. It should be used when there are temporary or permanent changes in the individual's physical health, support system, mental status, social functioning, ability to perform daily living activities, or medication or treatment regimen.

The form is structured around key sections, including Date of Event, Description of Event, Action Taken by RN, and Change(s) in Nursing Service Plan. It also includes a section for the signature of the RN and the date of the event. This template provides a comprehensive framework for reviewing and assessing an individual's health and well-being.