TX HHS Form 1573. Residential Review Evidence of Correction

The TX HHS Form 1573, Residential Review Evidence of Correction, is a crucial document that helps resolve issues identified during residential reviews. This form is typically completed by providers who have received a Residential Review Report from the Department of Aging and Disability Services (DADS). The purpose of this form is to submit evidence of correction for each checklist item marked "fail" that does not pose significant risk.

The form requires providers to submit their contact information, including phone number, as well as provide labeled evidence for each failed checklist item. This evidence can include documentation, photos, receipts, and other relevant materials. The submission deadline is within 14 calendar days of receiving the Residential Review Report from DADS. Providers must use only one of the listed methods (email, fax, or mail) to submit their evidence, along with a copy of this cover sheet.

Key requirements for completing this form include labeling each item of evidence with the corresponding checklist number and submitting all required information within the specified timeframe. Failure to comply may result in delays or issues with the review process. By using this form, providers can demonstrate their efforts to correct identified deficiencies and maintain compliance with regulatory standards.

• Submission deadline: within 14 calendar days of receiving the Residential Review Report from DADS
• Required information: contact details, labeled evidence for each failed checklist item
• Methods for submission: email, fax, or mail
• Deadline for submitting evidence: 14 calendar days from receipt of report