HCBS Supervised Living, finally with software that fits the form.

HCBS Supervised Living is graded on a Service Delivery Log (Form 4119) that has to be initialed in the right column, on the right day, by the right staff member, against the right activity. Sereniq is the system that gets every cell right by default.

Quick answerUpdated · Sereniq team

What software do HCBS Supervised Living providers use for Form 4119?

Sereniq is built for Texas HCBS Supervised Living providers, where the weekly Form 4119 Service Delivery Log has to be initialed by the right staff member against the right activity. DSPs document each note from the phone, a note cannot be filed without a linked IRP goal, supervisors approve the week, and administrators print Form 4119.

Overview

A Form 4119 done wrong can put roughly $2,000 per individual, per week at recoupment risk. HHSC look-backs go six months. An agency serving 12 individuals staring down a recoupment letter is staring down a six-figure clawback, almost always because documentation was generated faster than it was checked.

Sereniq fixes this at the source. The DSP documents on a phone from the floor. The narrative is polished in one tap and IRP goal links to the active 90-day plan are suggested; staff confirm the links before submit. The supervisor approves on the same device. The Form 4119 print is column-aligned to the HHSC PDF (Sun through Sat, with explicit grid geometry) so the state auditor sees what they expect to see.

HHSC forms on this page. Sereniq prints each one from the individual's record. Open a form to see how it works.

You don’t have to choose between mobile and audit-ready. HCBS Supervised Living deserves both.

What you get

  • Column-aligned Form 4119 Service Delivery Log
  • AI note polish: facts preserved, IRP goal links suggested and staff-confirmed
  • Mobile shift-gated authorship
  • Six-month look-back export in one click
  • Per-home staff scoping and home assignment rules
  • Print-aligned MAR (Form 3092) for HCBS
Provider questions

What agencies ask before switching.

Does Sereniq support Form 4119 for HCBS Supervised Living?

Yes. Sereniq renders a column-aligned Form 4119 Service Delivery Log with HCBS weekly structure, active IRP goal linkage, supervisor review, and date-range exports for HHSC look-backs.

How does Sereniq reduce recoupment risk?

The system catches problems at the source: shift-gated authorship, required IRP linkage, supervisor approval, immutable audit history, and exports that preserve the evidence trail instead of recreating it later.

Can DSPs document HCBS Supervised Living services on mobile?

Yes. The DSP app is built for notes, MAR follow-up, incidents, transportation, clock-in, and pay visibility from the phone staff already carry on shift.

See a Supervised Living week, from note to Form 4119.

Every note links to an IRP goal, and supervisors approve the week. We reply within one business day.

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