Texas Health and Human Services

The TX HHS Form 8612, TAS/MHM Payment Exception Request, is a crucial document for healthcare providers in Texas. It helps resolve payment issues by requesting reimbursement for Transition Assistance Services (TAS) and/or Pre-Enrollment Minor Home Modifications (MHMs) that have been previously approved by the Texas Health and Human Services Commission (HHSC). This form is typically used when an applicant's enrollment into a Home and Community-based Services (HCS) program has not occurred, or when there are discrepancies in payment.

The TX HHS Form 8611, Pre-Enrollment MHM Authorization Request, is a crucial document for individuals seeking minor home modifications (MHMs) prior to enrollment in the Home and Community-based Services (HCS) Program. This form helps facilitate the authorization process by providing essential information about the requested MHM and assessments.

The TX HHS Form 8610, State Long-term Care Ombudsman Program Certified Ombudsman II Recommendation and Approval, is a crucial document that facilitates the promotion of certified ombudsmen in Texas. This form helps solve the problem of ensuring that qualified individuals are recognized as Certified Ombudsman IIs, enabling them to continue providing essential services to long-term care facilities.

The TX HHS Form 8609, State Long-Term Care Ombudsman Program Complaint for Regulatory Services Investigation, is a crucial tool for resolving issues related to long-term care facilities in Texas. This form helps address concerns about nursing facilities, assisted living facilities, or other providers that provide care and services to residents.

The Conflict of Interest Screening of a Representative of the Office Form 8607 is a crucial tool for ensuring the integrity and credibility of the Texas Long-Term Care Ombudsman Program. This form helps identify potential conflicts of interest that may impact the effectiveness of the program's work, particularly in situations where ombudsmen or interns have competing interests.

Form 8493 is an official incident notification document used by Texas Medicaid waiver program providers to report the death of an individual receiving services. It applies to the Home and Community-based Services (HCS), Texas Home Living (TxHmL), and Deaf Blind with Multiple Disabilities (DBMD) programs.

Form 8605 is an official Texas Health and Human Services document used to confirm that a purchase or modification funded through certain Medicaid waiver programs has been completed and reviewed. It serves as formal documentation that an individual received the approved item or service, that it meets identified needs, and that required inspections or training have taken place.

Form 8590 is an official Texas Health and Human Services Commission (HHSC) document used by Local Intellectual and Developmental Disability Authorities (LIDDAs). Its purpose is to request HHSC approval to withdraw an enrollment offer for the Home and Community-based Services (HCS) or Texas Home Living (TxHmL) programs when the enrollment process cannot be completed.

Form 8571 is an official Texas Health and Human Services Commission (HHSC) document used by Local Intellectual and Developmental Disability Authorities (LIDDAs) to request corrections or changes to a person’s interest list information for Home and Community-based Services (HCS) or Texas Home Living (TxHmL) waiver programs. This form plays a critical role in ensuring that interest list dates accurately reflect a person’s eligibility history and conversations about services.

Form 8585 is a Delegation Worksheet used by Registered Nurses (RNs) in Texas when evaluating whether specific health-related tasks for individuals with stable and predictable conditions can be delegated to unlicensed personnel under 22 TAC Chapter 225. This form is always completed by an RN and attached to the comprehensive nursing assessment. Its main purpose is to document which tasks require nursing judgment, which may be delegated, and which qualify as Health Maintenance Activities (HMAs) exempt from delegation.