TX HHS Form 8623. State Long-Term Care Ombudsman Program Certified Ombudsman Application

The TX HHS Form 8623, State Long-Term Care Ombudsman Program Certified Ombudsman Application, is a crucial document for individuals seeking certification as a certified ombudsman. This form helps solve the problem of ensuring that applicants meet the necessary requirements and responsibilities to serve as a certified ombudsman.

The application requires the applicant to provide personal information, including name, local ombudsman entity, home address, email address, and phone numbers. The applicant must also agree to abide by certain rules, policies, and procedures, such as submitting monthly reports and attending scheduled continuing education sessions. Additionally, the applicant is required to maintain confidentiality of all information pertaining to residents and complainants.

The form also outlines specific responsibilities and follow-up actions that certified ombudsmen must take, including reporting any potential conflicts of interest and criminal charges pending against them. Key features of this form include the requirement for 18 hours of continuing education per year, regular visits to facilities, and submission of monthly reports. By completing this application, individuals can demonstrate their commitment to serving as a certified ombudsman and representing the Office of the State Long-Term Care Ombudsman.

• This form is used by individuals seeking certification as a certified ombudsman for the State Long-Term Care Ombudsman Program.
• The application requires personal information, including name, local ombudsman entity, and contact details.
• Certified ombudsmen must agree to abide by certain rules, policies, and procedures, including submitting monthly reports and attending continuing education sessions.