TX HHS Form 8613. Office of the State Long-term Care Ombudsman Conflict of Interest Identification. Removal and Remedy

The TX HHS Form 8613, Office of the State Long-term Care Ombudsman Conflict of Interest Identification, Removal and Remedy, is a crucial tool for identifying, addressing, and resolving potential conflicts of interest within the ombudsman program. This form helps ensure that the ombudsman's services are delivered impartially and in accordance with ethical standards.

The form requires the submission of specific information, including the type of conflict, the date it was identified, and a description of the conflict itself. Additionally, the scope of the conflict must be specified, including any organizations or businesses affiliated with the conflict, as well as businesses operated by the same owner. This information is essential for determining the necessary changes to ombudsman program procedures.

The form also outlines specific areas that require changes to ombudsman program procedure, including intake procedures, contact with residents and providers, communications, complaint-handling procedures, employment or volunteer responsibilities within the local ombudsman entity, and other changes. By completing this form, individuals can ensure that they are taking the necessary steps to address potential conflicts of interest and maintain the integrity of the ombudsman program.

• The TX HHS Form 8613 is used to identify, address, and resolve potential conflicts of interest within the ombudsman program.
• The form requires the submission of specific information about the conflict, including its type, date identified, and scope.
• The form outlines areas that require changes to ombudsman program procedure, ensuring the integrity of the program is maintained.