WebSend 3613 a form via email, link, or fax. You can also download it, export it or print it out. 01. Edit your 3613a online Type text, add images, blackout confidential details, add comments, highlights and more. 02. Sign it in a … WebHome Health Personal Assistance Services and Hospice Provider Use Only Form 3613 / 6-2009 Texas Department of Aging and Disability Services Form 3613 June 2009 Fax this report to 1-877-438-5827 if 15 total pages or fewer Mail this report to Texas Department of Aging and Disability Services Consumer Rights and Services Complaint Intake Unit E …
Public Use Forms by Number HHS.gov
WebGet the TX DADS 3613 you require. Open it with online editor and start editing. Fill the blank fields; engaged parties names, addresses and numbers etc. Customize the template with exclusive fillable fields. … WebSep 19, 2024 · Submit a PIR to CII, using HHSC Form 3613-A (for use by an ALF, DAHS facility, ICF/IID, NF or PPECC) or HHSC Form 3613 (for use by a HCSSA). For details … chancellor supply gulfport ms
Provider Letter Regarding Incident Reporting Requirements
WebAug 1, 2024 · What Is Form 3613-A? This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department. Form Details: Released on August 1, 2024; WebMar 24, 2024 · (a) Based on Governor Greg Abbott's March 13, 2024, declaration of a state of disaster in all Texas counties, the Texas Health and Human Services Commission (HHSC) adopts this emergency rule to establish continuing requirements and flexibilities to protect public health and safety during the COVID-19 pandemic. WebJan 6, 2024 · (a) Any individualized skills and socialization provider staff who has reasonable cause to believe that an individual is in a state of abuse, neglect, or exploitation must report the abuse, neglect, or exploitation to the Texas Health and Human Services (HHSC) Complaint and Incident Intake Section within one hour after suspecting or … harbor club at waterside