Texas Department Of Aging And Disability Details

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Form NameTexas Department Of Aging And Disability Services Forms
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
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Texas Department of Aging

Form 8581

and Disability Services

January 2008

Home and Community-based Services (HCS)/Texas Home Living (TxHmL)

Corrective Action Plan

Provider Name

Component Code

Contract No.


Annual Certification







Section of Rule Cited



Date of Citation






Provider’s Corrective Action Plan for this Citation

1.State action that has been completed or is planned to correct this non-compliance. Indicate targeted completion date. (Correction must be completed within 90 days of review exit.)

2.Describe the monitoring system you will implement to ensure this non-compliance has been corrected.

Signature of Provider’s Representative


Approved by review facilitator

Facilitator’s Signature


Instructions to Providers

1.Complete one Corrective Action Plan form for each principle designated as “Out of Compliance at Exit.”

2.Return Corrective Action Plan forms to review facilitator within 14 calendar days of receiving the review report from DADS.

3.Certification/re-certification will be initiated by the review facilitator after accepting the Corrective Action Plan.

4.Providers will be notified by letter from DADS of certification dates.