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 to become certified ombudsmen in the State of Texas. This form helps solve the problem of designating qualified professionals to investigate complaints and advocate for residents in long-term care facilities.

This application requires key information, including the applicant's name, local ombudsman entity, home address, email address, phone numbers, and agreement to abide by specific rules, policies, and procedures. The form also outlines the responsibilities of a certified ombudsman, such as submitting monthly reports, attending continuing education sessions, and maintaining confidentiality.

The TX HHS Form 8623 should be used by individuals who wish to become certified ombudsmen for the State Long-Term Care Ombudsman Program. The form must be submitted to the State Long-Term Care Ombudsman Program Office Manager or emailed to [email protected], along with any required supporting documentation. Failure to comply with the program's requirements may result in dismissal from the program.