TX HHS Form 8628. Acknowledgement of Ombudsman Access to Confidential Record

The TX HHS Form 8628, Acknowledgement of Ombudsman Access to Confidential Record, is a crucial document for ensuring the confidentiality and protection of resident records in long-term care facilities. This form grants certified ombudsmen or the State Ombudsman access to confidential records about a resident when specific conditions are met.

The form requires the ombudsman to acknowledge their authority to access records without consent, as per 26 TAC Section 88.201, and specifies the types of records that can be accessed, including medical, social, financial, and incident reports. The ombudsman must also provide their printed name, signature, and date.

This form is essential for long-term care facilities to comply with state rules and regulations, such as 26 TAC Section 554.413 and 553.269, which govern access and visitation rights. By using Form 8628, ombudsmen can ensure that they have the necessary authority to access resident records while maintaining confidentiality and adhering to program disclosure requirements.