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 long-term care ombudsman program. This form helps ensure that program activities are carried out in an impartial manner, free from any actual or perceived biases.

This form requires the identification of the type of conflict, the date it was recognized, and a detailed description of the conflict itself. The scope of the conflict must also be specified, including any organizations, businesses, or individuals affiliated with the conflict. This information helps determine the necessary changes to ombudsman program procedures, such as intake procedures, contact with residents, communications with providers, and complaint-handling processes.

The TX HHS Form 8613 is essential for resolving conflicts of interest that may arise within the long-term care ombudsman program. This form should be used whenever a potential conflict is identified, ensuring that program activities are carried out in an impartial manner. The form's key features include required information on the type and scope of the conflict, as well as important sections for describing the conflict and identifying necessary procedural changes.