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 TX HHS Form 8612, TAS/MHM Payment Exception Request, is a crucial document for healthcare providers in Texas. It helps resolve payment issues by requesting reimbursement for Transition Assistance Services (TAS) and/or Pre-Enrollment Minor Home Modifications (MHMs) that have been previously approved by the Texas Health and Human Services Commission (HHSC). This form is typically used when an applicant's enrollment into a Home and Community-based Services (HCS) program has not occurred, or when there are discrepancies in payment.
The TX HHS Form 8611, Pre-Enrollment MHM Authorization Request, is a crucial document for individuals seeking minor home modifications (MHMs) prior to enrollment in the Home and Community-based Services (HCS) Program. This form helps facilitate the authorization process by providing essential information about the requested MHM and assessments.
The TX HHS Form 8610, State Long-term Care Ombudsman Program Certified Ombudsman II Recommendation and Approval, is a crucial document that facilitates the promotion of certified ombudsmen in Texas. This form helps solve the problem of ensuring that qualified individuals are recognized as Certified Ombudsman IIs, enabling them to continue providing essential services to long-term care facilities.
The TX HHS Form 8609, State Long-Term Care Ombudsman Program Complaint for Regulatory Services Investigation, is a crucial tool for resolving issues related to long-term care facilities in Texas. This form helps address concerns about nursing facilities, assisted living facilities, or other providers that provide care and services to residents.
The Conflict of Interest Screening of a Representative of the Office Form 8607 is a crucial tool for ensuring the integrity and credibility of the Texas Long-Term Care Ombudsman Program. This form helps identify potential conflicts of interest that may impact the effectiveness of the program's work, particularly in situations where ombudsmen or interns have competing interests.
Form 8585 is a Delegation Worksheet used by Registered Nurses (RNs) in Texas when evaluating whether specific health-related tasks for individuals with stable and predictable conditions can be delegated to unlicensed personnel under 22 TAC Chapter 225. This form is always completed by an RN and attached to the comprehensive nursing assessment. Its main purpose is to document which tasks require nursing judgment, which may be delegated, and which qualify as Health Maintenance Activities (HMAs) exempt from delegation.
Form 8578, issued in November 2025, is the Intellectual Disability or Related Condition (ID/RC) Assessment used in Texas. This form is a key component in determining eligibility for services under programs such as ICF/ID, DBMD, and CLASS. It is used by medical professionals, service providers, and case managers to ensure that individuals with intellectual disabilities or related conditions receive appropriate care and support.
Form 8509 is used in healthcare settings to document tasks that a Registered Nurse (RN) delegates to unlicensed personnel. Although the form itself appears brief, it plays an important regulatory role: it creates a written trail of responsibility, clarifies who performed what task, and ensures that delegation follows state nursing rules. This type of documentation protects patients, unlicensed staff, and supervising nurses by establishing accountability and showing compliance with delegation standards.
Form 8577 is a questionnaire designed to gather information about individuals interested in Long-Term Services and Supports (LTSS) waiver programs. It helps assess eligibility, needs, and placement on interest lists for services that support people with disabilities or chronic conditions in community settings rather than institutions.
