Texas Health and Human Services

TX HHS Form 8626. Media Release Authorization to Photograph or Record a Resident of a Nursing or Assisted Living Facility

TX HHS Form 8626. Media Release  Authorization to Photograph or Record a Resident of a Nursing or Assisted Living Facility

The TX HHS Form 8626, Media Release Authorization to Photograph or Record a Resident of a Nursing or Assisted Living Facility, is a crucial document for individuals residing in these facilities. This form grants permission to photograph or record the resident for various purposes, including program development, reports, education, and promotion.

TX HHS Form 8625-M. Designation of a Long-Term Care Ombudsman as Representative and Request to Appeal a Medicaid Decision

TX HHS Form 8625-M. Designation of a Long-Term Care Ombudsman as Representative and Request to Appeal a Medicaid Decision

The TX HHS Form 8625-M, "Designation of a Long-Term Care Ombudsman as Representative and Request to Appeal a Medicaid Decision," is a crucial document for nursing facility or assisted living facility residents who want to request a hearing to appeal a Medicaid decision. This form allows the resident to designate a long-term care ombudsman as their representative, ensuring they receive proper representation throughout the appeals process.

TX HHS Form 8625-D. Designation of a Long-Term Care Ombudsman as Representative and Request to Appeal a Nursing Facility Discharge

TX HHS Form 8625-D. Designation of a Long-Term Care Ombudsman as Representative and Request to Appeal a Nursing Facility Discharge

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.

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

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.

TX HHS Form 8622. Consent for Criminal History Check

TX HHS Form 8622. Consent for Criminal History Check

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.

TX HHS Form 8621. Staff and Volunteer Application to Enter Certification Training

TX HHS Form 8621. Staff and Volunteer Application to Enter Certification Training

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.

TX HHS Form 8617. Individualized Skills and Socialization Enhanced Staffing Rate

TX HHS Form 8617. Individualized Skills and Socialization Enhanced Staffing Rate

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.

TX HHS Form 8614. Grievance Regarding Ombudsman Certification Decision

TX HHS Form 8614. Grievance Regarding Ombudsman Certification Decision

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.

TX HHS Form 8613. Office of the State Long-term Care Ombudsman Conflict of Interest Identification. Removal and Remedy

TX HHS Form 8613. Office of the State Long-term Care Ombudsman Conflict of Interest Identification. Removal and Remedy

The TX HHS Form 8613, Office of the State Long-term Care Ombudsman Conflict of Interest Identification, Removal and Remedy, is a crucial tool for identifying, addressing, and resolving potential conflicts of interest within the ombudsman program. This form helps ensure that the ombudsman's services are delivered impartially and in accordance with ethical standards.