Texas Health and Human Services

TX HHS Form 8006. ICF/IID Comprehensive Nursing Assessment (Example Form)

TX HHS Form 8006. ICF/IID Comprehensive Nursing Assessment (Example Form)

The TX HHS Form 8006, ICF/IID Comprehensive Nursing Assessment, is a practical tool designed to help healthcare professionals assess the health status of individuals with intellectual or developmental disabilities. This form is typically used in situations where ongoing care and support are required, such as in residential settings or community-based programs.

TX HHS Form 8005. ICF/IID Nursing Supervision For Unlicensed Assistive Personnel (UAP) (Example Form)

TX HHS Form 8005. ICF/IID Nursing Supervision For Unlicensed Assistive Personnel (UAP) (Example Form)

The TX HHS Form 8005, ICF/IID Nursing Supervision For Unlicensed Assistive Personnel (UAP), is an example form designed to facilitate the supervision of unlicensed assistive personnel in providing nursing care to individuals with intellectual or developmental disabilities. This form helps solve the problem of ensuring that UAP are adequately trained and supervised to provide high-quality care, thereby promoting the health and well-being of these individuals.

TX HHS Form 8003. Documentation of Transportation as Part of HCBS-AMH Service

TX HHS Form 8003. Documentation of Transportation as Part of HCBS-AMH Service

The TX HHS Form 8003, Documentation of Transportation as Part of HCBS-AMH Service, is a practical tool for service providers to document transportation services delivered to individuals receiving Home and Community Based Services Adult Mental Health (HCBS-AMH) Program. This form helps solve the problem of tracking and recording transportation services, ensuring that necessary information is captured and maintained for program evaluation and reporting purposes.

TX HHS Form 8001. Medicaid Estate Recovery Program Receipt Acknowledgement

TX HHS Form 8001. Medicaid Estate Recovery Program Receipt Acknowledgement

The TX HHS Form 8001, Medicaid Estate Recovery Program Receipt Acknowledgement, is a crucial document that helps individuals applying for long-term care services paid by Medicaid understand the state's obligation to inform them about Medicaid estate recovery. This form serves as a receipt acknowledgement, confirming that the applicant has been informed of their rights and responsibilities regarding Medicaid estate recovery.

TX HHS Form 7484. Hospital Report for Newborn Child or Children

TX HHS Form 7484. Hospital Report for Newborn Child or Children

The TX HHS Form 7484, Hospital Report for Newborn Child or Children, is a crucial document that helps hospitals report the birth of a child to the Texas Health and Human Services Commission (HHSC). This form is used by hospitals to provide essential information about newborn children whose mothers are currently eligible under the Texas Medicaid Program. The hospital must complete this form within five days after the birth of the child to avoid delays in receiving notice of the Medicaid Recipient number.

TX HHS Form 5503-MA. Verification of Curriculum by an Accredited School of Nursing

TX HHS Form 5503-MA. Verification of Curriculum by an Accredited School of Nursing

The Form 5503-MA, Medication Aide Program Verification of Curriculum, is used by the Texas Health and Human Services Commission (HHSC) to verify that the courses completed by a medication aide applicant meet the curriculum requirements specified in TAC 557.107(c)(2). This form ensures that applicants have received proper training from an accredited school of nursing before they can practice as a medication aide in Texas.

TX HHS Form 6109. Special Care Facility Incident Report

TX HHS Form 6109. Special Care Facility Incident Report

Form 6109, officially titled Special Care Facility Incident Report, is a mandatory document used by special care facilities to report serious events such as abuse, neglect, fires, injuries, medical emergencies, and other incidents affecting patients or staff. The form is designed to help regulatory authorities track safety issues, ensure timely intervention, and prevent future harm. Although the form looks straightforward, completing it accurately requires attention to detail and an understanding of reporting requirements.

TX HHS Form 5541. Corrections Medication Aide Program General Statement Enrollment

TX HHS Form 5541. Corrections Medication Aide Program General Statement Enrollment

Form 5541 serves as the enrollment application for the Corrections Medication Aide Program administered by the Texas Health and Human Services Commission (HHSC). This form is essential for individuals aiming to train and become certified as medication aides specifically in correctional settings, ensuring they can safely administer medications under regulated guidelines.

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TX HHS Form 6500. DBMD and CFC Individual Plan of Care (IPC)

TX HHS Form 6500. DBMD and CFC Individual Plan of Care (IPC)

The TX HHS Form 6500, Individual Plan of Care (IPC), is a vital tool for individuals with Deaf Blindness and Multiple Disabilities (DBMD) or Community First Choice (CFC) needs. This form helps solve the problem of creating a personalized care plan that addresses an individual's unique requirements and goals. It is typically used in situations where an individual requires ongoing support and services to maintain their independence and quality of life.