TX HHS Form 8619. State Long-Term Care Ombudsman Program Case Record

The TX HHS Form 8619, State Long-Term Care Ombudsman Program Case Record, is a confidential document used to record and track cases related to long-term care ombudsmen in Texas. This form helps solve the problem of monitoring and resolving issues affecting residents in long-term care facilities, such as nursing homes and assisted living facilities.

The form requires key information about the case, including intake date, first action date, closed date, and a summary of the issue. It also asks if anonymity is requested and whether consent has been obtained to work on behalf of the resident. The form includes sections for recording notes, actions taken, and follow-up steps.

This form is typically filled out by long-term care ombudsmen or other authorized representatives who are working to resolve issues affecting residents in Texas long-term care facilities. Key features include:

• Confidential reporting of cases
• Required information about the case, including intake and action dates
• Section for recording notes and actions taken
• Follow-up steps to ensure resolution of issues