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Form 3228, Application for a License to Operate a General or Special Hospital

Purpose
Form 3228 is used to apply for an initial, change of ownership or relocation license for a general or special hospital. Contact Health Facility Licensing at 512-834-6648 with any questions.

When to Prepare
The application, fees and other documents shall be submitted as required by 25 Texas Administrative Code (TAC), Chapter 133, Hospital Licensing Rules, §133.22 Application and Issuance of Initial License. Information regarding licensure for health care facilities, including contact information for the Health Facility Compliance Office for each location, is located on the Texas Health and Human Services website at https://hhs.texas.gov/doing-business-hhs/provider-portals/health-care-facilities-regulation/hospitals-general-hospitals.
The following documents, fees and actions shall be completed and approved before a license will be issued: ....

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Form 1024, Individual Status Summary

Medicaid No. Enter the individual’s Medicaid number.
CARE or Unique ID No. If the individual is enrolled in HCS, enter the individual’s Client Assignment and Registration (CARE) Identification number; if CARE has transitioned out of use, enter the Unique ID number assigned to the individual by Texas Medicaid & Healthcare Partnership (TMHP). Enter N/A if no CARE or Unique ID number exists.
Date of Birth Enter the individual’s date of birth using the mm/dd/yyyy format.
Service Area Enter the managed care service area the individual resides in. If the individual is not enrolled in HCBS, enter N/A. Link to service areas: https://hhs.texas.gov/sites/default/files//documents/services/health/medicaid-chip/programs/managed-care-service-areas-map.pdf ....

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Form H0004, Consent for a Person Sponsoring an Immigrant | Texas Health and Human Services

Downloading a Form to Your Computer
Fillable forms cannot be viewed on mobile or tablet devices. Follow the steps below to download and view the form on a desktop PC or Mac.
Right Click for PC or
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Save link as” from the menu.
Select the folder you want to save the file in and then click
Save.
Right Click for PC or
Ctrl + Click for Mac, then select
Note: Open the PDF file from your desktop or Adobe Acrobat Reader DC.
Do not click on the downloaded file at the bottom of the browser since it will not open the PDF in Adobe Acrobat Reader DC. It will try to open the file in the browser that results in the same browser error message. ....

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Medication Aide Program FAQs | Texas Health and Human Services

What is a medication aide?
A person permitted by Texas Health and Suman Services (HHS) to administer medications to residents in:
Nursing facilities,
Correctional institutions
What are the requirements to be a medication aide in Texas?
To be a medication aide in a licensed Texas facility, you must:
Read, write, speak and understand English
Be at least 18 years old
Be free of communicable diseases, and in suitable physical and emotional health to safely administer medications
Be a high school graduate or have a GED
Applicants must be employed as certified nurse aides listed on the Texas Nurse Aide Registry in active status and currently employed in a facility licensed under Texas Health and Safety Code Chapter 242 on class start date or employed on class start date as non-licensed direct care staff in a facility licensed under Chapter 247; a state supported living center or ICF/IID and have 90 days previous employment in the year preceding t ....

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Form 8578, Intellectual Disability/Related Condition Assessment | Texas Health and Human Services

Downloading a Form to Your Computer
Fillable forms cannot be viewed on mobile or tablet devices. Follow the steps below to download and view the form on a desktop PC or Mac.
Right Click for PC or
Ctrl + Click for Mac on the PDF link and click “
Save link as” from the menu.
Select the folder you want to save the file in and then click
Save.
Right Click for PC or
Ctrl + Click for Mac, then select
Note: Open the PDF file from your desktop or Adobe Acrobat Reader DC.
Do not click on the downloaded file at the bottom of the browser since it will not open the PDF in Adobe Acrobat Reader DC. It will try to open the file in the browser that results in the same browser error message. ....

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