Texas Health and Human Services

The TX HHS Form 8625-D, Designation of a Long-Term Care Ombudsman as Representative and Request to Appeal a Nursing Facility Discharge, is a crucial document for resolving conflicts between nursing facility residents and the facilities themselves. This form enables a resident who disagrees with a facility's decision to discharge them to designate a long-term care ombudsman as their representative in the appeal process.

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 TX HHS Form 8622, Consent for Criminal History Check, is a crucial document that helps ensure the integrity of the State Long-Term Care Ombudsman Program. This form is used in situations where representatives of the Office of the State Long-Term Care Ombudsman, including volunteers and staff, need to undergo a criminal history check to verify their eligibility for the program.

The TX HHS Form 8621, Staff and Volunteer Application to Enter Certification Training, is a crucial document for individuals seeking to enter the Texas State Long-Term Care Ombudsman Program's certification training. This form helps solve the problem of ensuring that applicants meet the necessary requirements and qualifications for participation in the program.

The TX HHS Form 8620, Long-Term Care Ombudsman Activity Report, is a valuable tool for ombudsmen to document their activities and ensure the well-being of residents in long-term care facilities. This form helps solve the problem of tracking and reporting on-site visits, care plan reviews, and resident council meetings.

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 TX HHS Form 8618, State Long-Term Care Ombudsman Program Initial Certification Training Log, is a crucial document that helps ensure compliance with training requirements for long-term care ombudsmen. This form is used to track the initial certification training of new ombudsmen and serves as a record of their training hours.

Form 8617 is used within the Texas Intellectual and Developmental Disabilities (IDD) waiver programs to request an Enhanced Staffing Rate for an individual who requires more support than the standard service level provides. This document helps the state justify why additional staffing hours, closer supervision, or specialized assistance are medically or behaviorally necessary. Although the form itself appears short, completing it thoughtfully is crucial — it directly affects safety, funding, and the continuity of services.

The TX HHS Form 8615, On-site and Off-site Individualized Skills and Socialization Service Delivery Log, is a practical tool for tracking the delivery of individualized skills and socialization services to individuals. This form helps solve the problem of ensuring that service providers are accurately documenting their activities and progress with clients, which is essential for effective case management and quality care.

The TX HHS Form 8614, Grievance Regarding Ombudsman Certification Decision, is a crucial document for individuals who have been refused certification as a long-term care ombudsman or whose certification has been suspended or terminated. This form helps resolve disputes by providing a structured process for submitting grievances and supporting documentation.