Our goal at HHSC is to provide quality, consistent, efficient, and accountable regulatory inspection of our Long-Term Care Providers and Facilities (including the Home and Community-based Services [HCS] and Texas HomeLiving [TxHmL] waiver programs). Please take a few moments to let us know about the recent HHSC LTC Regulatory Services visit to your facility/agency/home.

If you have questions or concerns about the survey visit and would like to speak to someone directly, please call:

1-800-458-9858(Voice)
1-888-425-6889 (TDD)

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* Facility or Agency Name:

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* Demographic Information

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* Region Number?  Please select the HHSC Administrative Region in which your facility/agency is located. If you do not know your facility/agency's region number, click here.

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* Facility/Agency Program Type

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* Survey Visit Exit Date

Date

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* Type of Visit (You may check as many as required)

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* Surveyor Professionalism and Courtesy

  Always Most of the time Sometimes Never
The conduct of the surveyor(s) during the visit was professional and courteous to staff.
The conduct of the surveyor(s) during the visit was professional and courteous to residents/individuals.
The surveyor(s) followed regulatory protocols and applied standard survey procedures.
The surveyor(s) considered all pertinent evidence.
The surveyor(s) kept you informed of their progress during the course of the survey.
The surveyor(s) considered all evidence presented to refute deficiencies/violations prior to exit.

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* Survey Feedback

  Always Most of the time Sometimes Never
We understand the survey preliminary findings.
The survey team explained the standards that resulted in citations.
We found the survey to be a positive learning experience.
We found the survey team to be knowledgeable of regulatory standards.
We can apply the information learned in the survey process to our program.

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* Additional comments:

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