Attachment_B_Pricing_Template.pdf
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- Emergency Department
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- 17-236-SOL-00010
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Attachment B, Pricing Template
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| Attachment_A_Management_and_Staffing_Scenarios.pdf |
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Attachment B – Pricing Template
Day Shift Night Shift Mid‐Shift Day Shift Night Shift Mid‐Shift
0001 Emergency Department Director 1 N/A N/A N/A 1 $0.00
0002 Emergency Department Physician 1 1 1 1 4 $0.00
0003 Internal Medicine Physician (With ED Experience) 0 $0.00
0004 Family Practice Physician (With ED Experience) 0 $0.00
0005 Physician Assistants (PA) 0 $0.00
0006 Advanced Practice Nurses (APN) 1 1 1 1 1 1 6 $0.00
0007 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
0008 Registered Nurses (RN) 3 3 1 3 3 1 14 $0.00
0009 Medical Support Assistants (MSA) 1 1 1 1 1 1 6 $0.00
0010 Other Categories 0 $0.00
$0.00
0011 Emergency Department Director 1 N/A N/A N/A 1 $0.00
0012 Emergency Department Physician 1 2 1 2 6 $0.00
0013 Internal Medicine Physician (With ED Experience) 0 $0.00
0014 Family Practice Physician (With ED Experience) 0 $0.00
0015 Physician Assistants (PA) 0 $0.00
0016 Advanced Practice Nurses (APN) 1 1 1 1 4 $0.00
0017 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
0018 Registered Nurses (RN) 1 2 2 1 2 2 10 $0.00
0019 Medical Support Assistants (MSA) 1 1 1 1 4 $0.00
0020 Other Categories 0 $0.00
$0.00
0021 Emergency Department Director 1 N/A N/A N/A 1 $0.00
0022 Emergency Department Physician 1 1 1 1 4 $0.00
0023 Internal Medicine Physician (With ED Experience) 0 $0.00
0024 Family Practice Physician (With ED Experience) 0 $0.00
0025 Physician Assistants (PA) 0 $0.00
0026 Advanced Practice Nurses (APN) 1 1 2 $0.00
0027 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
0028 Registered Nurses (RN) 3 3 3 3 12 $0.00
0029 Medical Support Assistants (MSA) 1 1 1 1 4 $0.00
0030 Other Categories 0 $0.00
$0.00
$0.00
Pine Ridge Hospita Subtotal
Omaha/Winnebago Hospital (OWH), Winnebago, Nebraska
Omaha/Winnebago Hospital Subtotal
BASE YEAR ‐ Total All EDs
Pine Ridge Hospital (PRH), Pine Ridge, South Dakota
BASE YEAR
EMERGENCY DEPARTMENT MANAGEMENT AND STAFFING SERVICES OPTIONS
(As defined in the PWS) Number of
Staff Subtotal Costs
CLINs RFP Labor Category Burden Labor
Rate
Contractor Managed & Staffed ED Federally Managed & Contractor Staffed ED
Rosebud Hospital (RBH), Rosebud, South Dakota
Rosebud Hospital Subtotal
1001 Emergency Department Director 1 N/A N/A N/A 1 $0.00
1002 Emergency Department Physician 1 1 1 1 4 $0.00
1003 Internal Medicine Physician (With ED Experience) 0 $0.00
1004 Family Practice Physician (With ED Experience) 0 $0.00
1005 Physician Assistants (PA) 0 $0.00
1006 Advanced Practice Nurses (APN) 1 1 1 1 1 1 6 $0.00
1007 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
1008 Registered Nurses (RN) 3 3 1 3 3 1 14 $0.00
1009 Medical Support Assistants (MSA) 1 1 1 1 1 1 6 $0.00
1010 Other Categories 0 $0.00
$0.00
1011 Emergency Department Director 1 N/A N/A N/A 1 $0.00
1012 Emergency Department Physician 1 2 1 2 6 $0.00
1013 Internal Medicine Physician (With ED Experience) 0 $0.00
1014 Family Practice Physician (With ED Experience) 0 $0.00
1015 Physician Assistants (PA) 0 $0.00
1016 Advanced Practice Nurses (APN) 1 1 1 1 4 $0.00
1017 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
1018 Registered Nurses (RN) 1 2 2 1 2 2 10 $0.00
1019 Medical Support Assistants (MSA) 1 1 1 1 4 $0.00
1020 Other Categories 0 $0.00
$0.00
1021 Emergency Department Director 1 N/A N/A N/A 1 $0.00
1022 Emergency Department Physician 1 1 1 1 4 $0.00
1023 Internal Medicine Physician (With ED Experience) 0 $0.00
1024 Family Practice Physician (With ED Experience) 0 $0.00
1025 Physician Assistants (PA) 0 $0.00
1026 Advanced Practice Nurses (APN) 1 1 2 $0.00
1027 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
1028 Registered Nurses (RN) 3 3 3 3 12 $0.00
1029 Medical Support Assistants (MSA) 1 1 1 1 4 $0.00
1030 Other Categories 0 $0.00
$0.00
$0.00
Federally Managed & Contractor Staffed ED
Omaha/Winnebago Hospital (OWH), Winnebago, Nebraska
Omaha/Winnebago Hospital Subtotal
OPTION YEAR ONE ‐ Total All EDs
Rosebud Hospital (RBH), Rosebud, South Dakota
Rosebud Hospital Subtotal
Pine Ridge Hospital (PRH), Pine Ridge, South Dakota
Pine Ridge Hospita Subtotal
OPTION YEAR ONE
EMERGENCY DEPARTMENT MANAGEMENT AND STAFFING SERVICES OPTIONS
(As defined in the PWS) Number of
Staff Subtotal Costs
CLINs RFP Labor Category Burden Labor
Rate
Contractor Managed & Staffed ED
2001 Emergency Department Director 1 N/A N/A N/A 1 $0.00
2002 Emergency Department Physician 1 1 1 1 4 $0.00
2003 Internal Medicine Physician (With ED Experience) 0 $0.00
2004 Family Practice Physician (With ED Experience) 0 $0.00
2005 Physician Assistants (PA) 0 $0.00
2006 Advanced Practice Nurses (APN) 1 1 1 1 1 1 6 $0.00
2007 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
2008 Registered Nurses (RN) 3 3 1 3 3 1 14 $0.00
2009 Medical Support Assistants (MSA) 1 1 1 1 1 1 6 $0.00
2010 Other Categories 0 $0.00
$0.00
2011 Emergency Department Director 1 N/A N/A N/A 1 $0.00
2012 Emergency Department Physician 1 2 1 2 6 $0.00
2013 Internal Medicine Physician (With ED Experience) 0 $0.00
2014 Family Practice Physician (With ED Experience) 0 $0.00
2015 Physician Assistants (PA) 0 $0.00
2016 Advanced Practice Nurses (APN) 1 1 1 1 4 $0.00
2017 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
2018 Registered Nurses (RN) 1 2 2 1 2 2 10 $0.00
2019 Medical Support Assistants (MSA) 1 1 1 1 4 $0.00
2020 Other Categories 0 $0.00
$0.00
2021 Emergency Department Director 1 N/A N/A N/A 1 $0.00
2022 Emergency Department Physician 1 1 1 1 4 $0.00
2023 Internal Medicine Physician (With ED Experience) 0 $0.00
2024 Family Practice Physician (With ED Experience) 0 $0.00
2025 Physician Assistants (PA) 0 $0.00
2026 Advanced Practice Nurses (APN) 1 1 2 $0.00
2027 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
2028 Registered Nurses (RN) 3 3 3 3 12 $0.00
2029 Medical Support Assistants (MSA) 1 1 1 1 4 $0.00
2030 Other Categories 0 $0.00
$0.00
$0.00
Pine Ridge Hospital (PRH), Pine Ridge, South Dakota
Pine Ridge Hospita Subtotal
Omaha/Winnebago Hospital Subtotal
OPTION YEAR TWO ‐ Total All EDs
Omaha/Winnebago Hospital (OWH), Winnebago, Nebraska
OPTION YEAR TWO
EMERGENCY DEPARTMENT MANAGEMENT AND STAFFING SERVICES OPTIONS
(As defined in the PWS) Number of
Staff Subtotal Costs
CLINs RFP Labor Category Burden Labor
Rate
Contractor Managed & Staffed ED Federally Managed & Contractor Staffed ED
3001 Emergency Department Director 1 N/A N/A N/A 1 $0.00
3002 Emergency Department Physician 1 1 1 1 4 $0.00
3003 Internal Medicine Physician (With ED Experience) 0 $0.00
3004 Family Practice Physician (With ED Experience) 0 $0.00
3005 Physician Assistants (PA) 0 $0.00
3006 Advanced Practice Nurses (APN) 1 1 1 1 1 1 6 $0.00
3007 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
3008 Registered Nurses (RN) 3 3 1 3 3 1 14 $0.00
3009 Medical Support Assistants (MSA) 1 1 1 1 1 1 6 $0.00
3010 Other Categories 0 $0.00
$0.00
3011 Emergency Department Director 1 N/A N/A N/A 1 $0.00
3012 Emergency Department Physician 1 2 1 2 6 $0.00
3013 Internal Medicine Physician (With ED Experience) 0 $0.00
3014 Family Practice Physician (With ED Experience) 0 $0.00
3015 Physician Assistants (PA) 0 $0.00
3016 Advanced Practice Nurses (APN) 1 1 1 1 4 $0.00
3017 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
3018 Registered Nurses (RN) 1 2 2 1 2 2 10 $0.00
3019 Medical Support Assistants (MSA) 1 1 1 1 4 $0.00
3020 Other Categories 0 $0.00
$0.00
3021 Emergency Department Director 1 N/A N/A N/A 1 $0.00
3022 Emergency Department Physician 1 1 1 1 4 $0.00
3023 Internal Medicine Physician (With ED Experience) 0 $0.00
3024 Family Practice Physician (With ED Experience) 0 $0.00
3025 Physician Assistants (PA) 0 $0.00
3026 Advanced Practice Nurses (APN) 1 1 2 $0.00
3027 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
3028 Registered Nurses (RN) 3 3 3 3 12 $0.00
3029 Medical Support Assistants (MSA) 1 1 1 1 4 $0.00
3030 Other Categories 0 $0.00
$0.00
$0.00
Pine Ridge Hospital (PRH), Pine Ridge, South Dakota
Pine Ridge Hospita Subtotal
Omaha/Winnebago Hospital Subtotal
OPTION YEAR THREE ‐ Total All EDs
Omaha/Winnebago Hospital (OWH), Winnebago, Nebraska
OPTION YEAR THREE
EMERGENCY DEPARTMENT MANAGEMENT AND STAFFING SERVICES OPTIONS
(As defined in the PWS) Number of
Staff Subtotal Costs
CLINs RFP Labor Category Burden Labor
Rate
Contractor Managed & Staffed ED Federally Managed & Contractor Staffed ED
4001 Emergency Department Director 1 N/A N/A N/A 1 $0.00
4002 Emergency Department Physician 1 1 1 1 4 $0.00
4003 Internal Medicine Physician (With ED Experience) 0 $0.00
4004 Family Practice Physician (With ED Experience) 0 $0.00
4005 Physician Assistants (PA) 0 $0.00
4006 Advanced Practice Nurses (APN) 1 1 1 1 1 1 6 $0.00
4007 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
4008 Registered Nurses (RN) 3 3 1 3 3 1 14 $0.00
4009 Medical Support Assistants (MSA) 1 1 1 1 1 1 6 $0.00
4010 Other Categories 0 $0.00
$0.00
4011 Emergency Department Director 1 N/A N/A N/A 1 $0.00
4012 Emergency Department Physician 1 2 1 2 6 $0.00
4013 Internal Medicine Physician (With ED Experience) 0 $0.00
4014 Family Practice Physician (With ED Experience) 0 $0.00
4015 Physician Assistants (PA) 0 $0.00
4016 Advanced Practice Nurses (APN) 1 1 1 1 4 $0.00
4017 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
4018 Registered Nurses (RN) 1 2 2 1 2 2 10 $0.00
4019 Medical Support Assistants (MSA) 1 1 1 1 4 $0.00
4020 Other Categories 0 $0.00
$0.00
4021 Emergency Department Director 1 N/A N/A N/A 1 $0.00
4022 Emergency Department Physician 1 1 1 1 4 $0.00
4023 Internal Medicine Physician (With ED Experience) 0 $0.00
4024 Family Practice Physician (With ED Experience) 0 $0.00
4025 Physician Assistants (PA) 0 $0.00
4026 Advanced Practice Nurses (APN) 1 1 2 $0.00
4027 Emergency Department Nurse Supervisor 1 N/A N/A N/A 1 $0.00
4028 Registered Nurses (RN) 3 3 3 3 12 $0.00
4029 Medical Support Assistants (MSA) 1 1 1 1 4 $0.00
4030 Other Categories 0 $0.00
$0.00
$0.00
$0.00
Omaha/Winnebago Hospital Subtotal
OPTION YEAR FOUR ‐ Total All EDs
ALL YEARS OF THE CONTRACT ‐ Total All EDs
Federally Managed & Contractor Staffed ED
Rosebud Hospital (RBH), Rosebud, South Dakota
Rosebud Hospital Subtotal
Pine Ridge Hospital (PRH), Pine Ridge, South Dakota
Pine Ridge Hospita Subtotal
Omaha/Winnebago Hospital (OWH), Winnebago, Nebraska
Subtotal Costs
OPTION YEAR FOUR
EMERGENCY DEPARTMENT MANAGEMENT AND STAFFING SERVICES OPTIONS
(As defined in the PWS) Number of
Staff CLINs RFP Labor Category
Burden Labor
Rate
Contractor Managed & Staffed ED
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