36C24418Q9425-001.docx

Performance Work Statement

1. GENERAL:

1.1. Services Provided: The Contractor shall provide the Wilkes-Barre Veterans Affairs Medical Center (WBVAMC) (Wilkes-Barre) and its satellite facilities with nursing and nursing support services of appropriately qualified candidates to perform the requirements of this CONTRACT.

1.2. Place of Performance - Contractor shall furnish services at the WBVAMC Wilkes-Barre, PA and its satellite offices located throughout the catchment area.

1.3. Policy/Handbooks- the contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1.3.1. VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

1.3.2. - VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.3.3. - VHA Handbook 1100.19 Credentialing and Privileging - http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.3.4. VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

1.3.5. - Privacy Act of 1974 (5 U.S.C. 552a) as amended http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.4. Definitions/Acronyms- Terms used in this BPA shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.4.1. ABU: American Board of Urology

1.4.2. ACGME: Accreditation Council for Graduate Medical Education

1.4.3. ACLS: Advanced Cardiac Life Support

1.4.4. AOD: Admitting Officer of the Day

1.4.5. BLS: Basic Life Support

1.4.6. BBA: Balanced Budget Act of 1977

1.4.7. BPA: Blanket Purchase Agreement

1.4.8. CCNE: Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation

1.4.9. CDC: Centers for Disease Control and Prevention

1.4.10. CDR: Contract Discrepancy Report

1.4.11. CEU: Certified Education Unit

1.4.12. CIO: Chief Information Officer

1.4.13. CME: Continuing Medical Education

1.4.14. WBVAMC: Wilkes-Barre Veterans Affairs Medical Center: Unless identified with the name of a different VA medical Center, for purposes of this contract,, this term shall mean the Wilkes-Barre Medical Center.

1.4.15. CMP: Civil Monetary Penalty

1.4.16. CMS: Centers for Medicare and Medicaid Services

1.4.17. Contracting Officer (CO) – The person executing this contract, on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

1.4.18. Contracting Officer’s Representative (COR) – A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract, and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.4.19. Contractor: A supplier or contractor awarded a contract, to provide specific supplies or services to the government. The term used in this contract refers to the prime Contractor.

1.4.20. COS: Chief of Staff

1.4.21. CPARS: Contractor Performance Assessment Reporting System

1.4.22. CPR: Cardiopulmonary Resuscitation

1.4.23. CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.4.24. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.4.25. DEA: Drug Enforcement Agency

1.4.26. DNR List: Do Not Return List – Individuals placed on this list may not provide services at the WBVAMC without prior authorization of the CO.

1.4.27. ED: Emergency Department

1.4.28. FAR: Federal Acquisition Regulation

1.4.29. FTEE: Full Time Employee Equivalent

1.4.30. HIPB: Health Integrity and Protection Board

1.4.31. FSMB: Federation of State Medical Boards

1.4.32. HHS: United States Department of Health and Human Services

1.4.33. HIPAA: Health Insurance Portability and Accountability Act

1.4.34. HR: Human Resources

1.4.35. ISO: Information Security Officer

1.4.36. Key Personnel: Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

1.4.37. Medical Emergency - a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, Causing impairments to body functions, or Causing serious or permanent dysfunction of any body-organ or part.

1.4.38. MOD: Medical Officer of the Day

1.4.39. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.4.40. NCQA: National Council of Quality Assurance

1.4.41. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org

1.4.42. Non-Contract Provider - any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

1.4.43. NP: Nurse Practitioner

1.4.44. NPDB: National Practitioner Data Bank

1.4.45. NPPES: National Plan and Provider Enumeration System

1.4.46. OIG: Office of the Inspector General (this could refer to the OIG of different agencies and/or departments)

1.4.47. PA: Physician Assistant

1.4.48. PALS: Pediatric Advanced Life Support

1.4.49. POP: Period of Performance

1.4.50. PPD: Purified Protein Derivative – a medical test to determine if an individual suffers from tuberculosis (TB)

1.4.51. PWS: Performance Work Statement.

1.4.52. QA/QI: Quality Assurance/Quality Improvement

1.4.53. QM/PI: Quality Management/Performance Improvement

1.4.54. QASP: Quality Assurance Surveillance Plan

1.4.55. ROC: Report of Contact

1.4.56. Subcontractor: One that enters into Contract with a prime Contractor. The Government does not have privity of contract, with the subcontractor.

1.4.57. TB: Tuberculosis

1.4.58. TJC: The Joint Commission

1.4.59. TMS: Talent Management System

1.4.60. VA: United States Department of Veterans Affairs

1.4.61. VAAR: Department of Veterans Affairs Acquisition Regulation

1.4.62. Veterans Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.4.63. Veterans Integrated Services Network (VISN) : The regional oversight for the VA medical centers.

1.4.64. VISTA (Veterans Integrated Systems Technology Architecture) : A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

1.4.65. VetPro: a federal web-based credentialing program for healthcare providers.

2. QUALIFICATIONS:

2.1. Staff

2.1.1. License –Personnel assigned by the Contractor to perform the services covered by this contract, shall be currently certified or licensed, as appropriate, in a State, Territory, or Commonwealth of the United States or the District of Columbia. All certifications and licenses held by the personnel working on this contract, shall be fully valid and without restriction. The qualifications of such personnel shall also be subject to review by the VA Chief of Staff and approval by the VA Facility Director. The government specifically reserves the right to reject any of the Contractor’s personnel and refuse them permission to provide services under this contract,.

2.1.2. Credentialing and Privileging – Credentialing is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor is responsible to ensure that proposed staff possesses the requisite skills and/or experience necessary to provide services under the contract,. No services shall be provided by any contractor’s staff prior to obtaining approval.

2.1.2.1. If a contractor’s staff is not credentialed or has credentials suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.2.2. Contractor shall ensure Contractor personnel will provide appropriate, effective interventions to individual patients needs according to established facility policies, safety standards and procedures as described at the orientations and trainings conducted by WBVAMC Nurse Education.

2.1.3. Technical Proficiency - Contractor’s staff shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor’s staff and contractor’s staff shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.4. Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements; all training must be completed by the contractor’s staff as required by the VA.

2.1.4.1. Contractor staff will complete orientation as describes here in.

2.1.4.2. All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems:

2.1.4.2.1. Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, relating to access to VA information and information systems;

2.1.4.2.2. Successfully complete the VA Cyber Security Awareness and Rules of Behavior training and annually complete required security training;

2.1.4.2.3. Successfully complete the appropriate VA privacy training and annually complete required privacy training; and

2.1.4.2.4. Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system access

2.1.4.2.5. The Contractor shall provide to the CO and/or the COR a copy of the training certificates and certification of signing the Contractor Rules of Behavior for each applicable employee within 1 week of the initiation of the contract, and annually thereafter, as required.

2.1.4.2.6. Failure to complete the mandatory annual training and sign the Rules of Behavior annually, within the timeframe required, is grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract, until such time as the training and documents are complete.

2.1.4.3. From time to time, the WBVAMC will require training for Contractor employees. The nature of the training varies. WBVAMC will pay for required training either based on the hours worked and submitted via the electronic time keeping system or via submission of TMS certificates indicating completion of required courses. TMS certificates will be reimbursed based on the hours listed as “Learning Hours” within each course regardless of actual time expended completing the course. Copies of all completed training will be provided to the COR as they occur.

2.1.4.4. Contractor Staff who have not worked at least one shift within the last 90 days will have to be cleared by the COR or designee prior to returning to shift work. Clearance may require attendance at an orientation and/or competency class. The contractor may have to complete a full profile, PIV request and UAR request as determined by the COR.

2.1.4.5. Contractor employees who do not maintain their training currency via the VA TMS will be placed into a Do Not Return (DNR) status.

2.1.4.6. Contractor will maintain current resumes or work histories of all employees.

2.1.5. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for staff within five (5) calendar days after contract, award and prior to the first duty shift to the COR and CO. Tests shall be current within the past year.

2.1.6 TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contractor staff. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

2.1.7 RUBELLA TESTING: Contractor shall provide proof of immunization for all contract, staff for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR.

2.1.8 OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all contractor staff; provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel ( as published in American Journal for Infection. Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.9 Conflict of Interest: The Contractor and all contractor’s staff are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of CONTRACT performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest (Jan 2008).

2.1.10 Citizenship related Requirements:

2.1.10.1 The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract, or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals;

2.1.10.2 While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract, or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.1.10.3 If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract, for breach.

2.1.10.4 This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.1.10.5 The Contractor agrees to obtain a similar certification from its subcontractors.

2.1.11 Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) OIG has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.11.1 Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contractor’s staff are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.11.2 By submitting their proposal, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.1.12 In addition to the immunizations mentioned in section 2.1.2, the contractor will also include, at their expense, in the orientation file for each employee, the following information:

· A physical dated within 90 days of submission of employee for CONTRACT performance.

· Current BLS/ACLS cards with an expiration date beyond the last day of orientation (though it is noted that Contractor personnel will be required to maintain appropriate certification to perform on the CONTRACT, the initial/orientation requirement is the production of the appropriate card(s) with an expiration date beyond the end of orientation).

· Current Resume for RNs, LPNs, Certified Nursing Assistant and Healthcare Technicians

· Influenza immunization records.

· Current Resume or current employment history for all others.

2.2. Non Personal Healthcare Services: The parties agree that the Contractor and all contractor’s staff shall not be considered VA employees for any purpose.

2.3. Technical Direction: The services to be performed by the Contractor will be monitored by the COR.

2.4. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees.

2.5. Inherent Government Functions: Contractor and Contractor’s staff shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.6. No Employee status: The Contractor shall be responsible for protecting Contractor’s staff furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant CONTRACT:

2.6.1. Workers’ compensation

2.6.2. Professional liability insurance

2.6.3. Health examinations

2.6.4. Income tax withholding, and

2.6.5. Social security payments.

2.7 Tort Liability: The Federal Tort Claims Act does not cover Contractor or contractor’s staff . When a Contractor or contractor’s staff has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contractor’s staff ) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.80. Key Personnel: Key Personnel are those Contractor personnel whom are essential to performance of the CONTRACT requirements and/or were considered or included by the Contractor in development of solicitation response, including individuals in key management, staffing, and related positions.

2.80.1. Except as provided below, during the first ninety (90) days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. The Contractor shall notify the CO, in writing, within fifteen (15) calendar days after the occurrence of any of these events and provide the information required by paragraph (c) below. After the initial 90-day period of the contract,, the Contractor shall submit the information required by paragraph (c) to the CO at least fifteen (15) days prior to making any permanent substitutions.

2.80.2. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitution and complete Curriculum Vitae for the proposed substitute. Proposed substitute shall have comparable qualifications to those of the person being replaced. The CO shall notify the Contractor within fifteen (15) calendar days after receipt of all required information of the decision on the proposed substitution. When changes in key personnel are approved, the contract, prices may be adjusted accordingly to reflect the salary and benefits of the personnel actually providing the services.

2.80.3. For temporary substitutions where the key person will not be reporting to work for three (3) consecutive work days or more, the Contractor will provide a qualified replacement for the key person. This substitute shall have comparable qualifications to the key person. Any period exceeding two (2) weeks will require the procedure as stated in paragraph c. above.

2.81. HOURS OF OPERATION:

2.81.1. Business Hours: Monday through Friday 7:00 am-4:30 pm.

2.81.2. Work Schedule: Monday through Friday-8 hour shift between the hours of 7:00 am-4:30 pm, 40 hours a week.

2.81.2.1. Work hours: Personnel shall typically perform services during 8 hour shifts, five days a week, excluding Federal Holidays with actual work schedules to be mutually agreed upon by Contractor and VA based on patient care needs between the hours of 7:00 am and 4:30 pm.

2.81.2.2. Unless a state of emergency has been declared or clinics are otherwise cancelled by the VAMC, the Contractor shall be responsible for providing services.

2.81.3. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

· New Year’s Day

· President’s Day

· Martin Luther King’s Birthday

· Memorial Day

· Independence Day

· Labor Day

· Columbus Day

· Veterans Day

· Thanksgiving

· Christmas

· Any day specifically declared by the President of the United States to be a national holiday.

3. CONTRACTOR RESPONSIBILITIES

3.1. SERVICES REQUIRED:

3.1.1. Registered Nurse (RN): Contractor will ensure that Contractor RN’s are a professional nursing practice that delivers a broad range of nursing care in the context of disease or injury prevention, health promotion and restoration and health maintenance. The Contract Registered Nurse delivers/demonstrates fundamental, knowledge based care, while developing and increasing technical competencies to provide and plan nursing care for patients with simple or complex needs.

3.1.1.1 Medical/Surgical Nurse (SIN 621-025) Medical-Surgical Nurse is a professional nurse who provides holistic approach to the care of the patients requiring acute medical or surgical interventions. The Nurse functions both dependently and independently with guidance and direction from the Nurse Manager/designee. Nurses must have active, current registration as a professional nurse in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

· Contractor nurses will be assigned based on patient care needs and contractor’s experience.

· All registered nurses shall have at least two (2) years current experience in an acute care, medical/surgical unit in an urban, academic Medical Center setting exclusive of agency assignments.

3.1 3.1.1

3.1.1.1. Education requirements: required Bachelor’s Degree in Nursing or in related field or a Master’s Degree in Nursing or in related field is highly preferred.

3.1.1.2. Agency nurses assigned to WBVAMC Medical/Surgical units can expect to work 8 hour shifts, with alternating weekend shifts preferred.

3.1.1.3. The minimum requirement for all registered nurses assigned to a Medical-Surgical unit shall include a current unrestricted registered nurse license from any State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States and a current CPR/ BLS certificate accredited by the American Heart Association.

3.1.1.4. Medical-Surgical nurses with telemetry experience and certification are required on one unit. These nurses must, in addition to the credentials above, provide a current ACLS certificate accredited by the American Heart Association, a completion certificate from an accredited telemetry program, and at least two years’ experience in telemetry or intensive care setting.

3.1.1.5. Additional requirements for all registered nurses assigned to the Medical-Surgical Floor include current ACLS certificate accredited by the American Heart Association, and the Moderate Sedation Certification or equivalent.

3.1.1.2 Operating Room Nurse (SIN 621-025): Operating Room Nurse is a professional nurse who provides holistic approach to the care of the patients requiring surgical interventions by working closely with surgeons and anesthesia care providers. The Nurse functions both dependently and independently with guidance and direction from the Nurse Manager/designee. Nurses must have active, current registration as a professional nurse in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

3.1.1.6. Contractor nurses may be utilized in the Operating Room (OR), Short Procedure Unit (SPU), and Post Anesthesia Care Unit (PACU) Unit. Duty hours are normally 0700 AM – 3:30 PM, and there are times when the Nurses are required to work after normal duty hours based on the severity of procedures, OR delays, or needs of the staff. Agency Nurses are expected to take “on-call” duty when requested, and shall return to the medical center within thirty (30) minutes of notification.

3.1.1.7. All registered nurses shall have at least two (2) years prior experience in an operating room setting exclusive of agency assigned tours of duty, and shall be able to scrub and circulate.

3.1.1.8 Agency nurses assigned to the OR, SPU or PACU units can expect to work eight hour shifts Monday through Friday exclusive of holidays. On occasion, contract nurses shall provide on-call duties provided it is cost effective to the VA to do so. Contractors shall include any on- call rates exclusive to the OR service contracts. Nurses selected for on-call duty shall report to the OR suite within thirty minutes of notification.

3.1.1.8.

3.1.1.9. Education requirements: required Bachelor’s Degree in Nursing or in related field or a Master’s Degree in Nursing or in related field is highly preferred.

3.1.1.10. The minimum requirement for all registered nurses assigned to an OR/PACU shall include a current unrestricted registered nurse license from any State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States and a current CPR/ BLS certificate accredited by the American Heart Association.

3.1.1.11. Additional requirements for all registered nurses assigned to the OR/PACU include current ACLS certificate accredited by the American Heart Association, and the Moderate Sedation Certification or equivalent.

3.1.1.12. Agency nurses are preferred to have a current Certified Nurse Operating Room (CNOR) certificate accredited by the Competency & Credentialing Institute (CCI).

3.1.1.13. Prevents infection by utilization of universal precautions, correct hand washing techniques between procedures and/or patients, maintains aseptic techniques, and maintains isolation techniques. Maintains good body mechanics to prevent injury to self, patients, and staff. Uses safety protective devices for self and patient. Checks all emergency supplies and equipment per unit routine.

3.1.1.14. Demonstrates positive effective interpersonal skills.

3.1.1.15. Mechanical equipment in the operating room: Electro-Surgical unit, Operating Room equipment, fracture table, suction (wall outlet portable), nerve Stimulator, dermatoses (brown). Equipment not limited to this list.

3.1.1.16. Circulating Nurse’s specific duties. All nurses in the operating room must be certified to perform the following routine scrub nurse duties and procedures on all patients:

· Demonstrates proper aseptic technique

· Operates mechanics of or table

· Operates mechanics of or lights

· Assists anesthesiologist

· Positions patients properly

· Opening room

· Conducts sponge, needle, instrument and all related counts to prevent retained objects

· Completes work sheet

· Calls ICU for beds

· Calls ward report on local cases

3.1.1.17. Scrub Nurse specific duties. All nurses in the operating room must also be certified to perform the following routine scrub nurse duties and procedures on all patients:

· Demonstrates proper aseptic technique

· Minor surgery

· Rectal surgery

· Abdominal surgery

· GU surgery

· Eye surgery

· Orthopedic surgery

· ENT surgery

· Bronchoscopic procedure

· Vascular surgery

· Neurosurgery

· Chest surgery

· Bariatric Surgery

· PACU-Recovery of Patients

3.1.1.18. Short Procedure Unit nurse does preoperative assessment, OR patient preparation and recovery of patients.

3.1.1.3 Emergency Department Nurse (SIN 621-025) Emergency Department Nurses will provide prescribed medical treatment and personal care services to ill and injured veterans. Duties include documenting observations, assessments, and changes in patient's condition; collaborating with health team members to facilitate positive patient care outcomes; providing a full range of nursing care to patients with a variety of physical and/or behavioral problems; and accountable for meeting and maintaining the qualification standards. The Nurse functions both dependently and independently with guidance and direction from the Nurse Manager/designee. Nurses must have active, current registration as a professional nurse in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

· Contractor nurses may be utilized as needed in specialty units including the Emergency Department.

· All registered nurses shall have at least three (3) years recent prior experience in an emergency department or major trauma center emergency room.

· Education requirements: required Bachelor’s Degree in Nursing or in related field or a Master’s Degree in Nursing or in related field is highly preferred.

· Agency nurses assigned to the Emergency Department can expect to work twelve (12) hours shifts including no less than rotating weekends and holidays.

· The minimum requirement for all registered nurses assigned to the Emergency Department shall include a current unrestricted registered nurse license from any State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States, a current CPR/ BLS certificate accredited by the American Heart Association and a current ACLS certificate accredited by the American Heart Association.

· Agency nurses are preferred to have the Certification of Emergency Nursing (CEN) through the Board of Certifications for Emergency Nurses (BCEN). Nurses with Acute/Critical Care Nursing (CCRN) certifications through the American Association of Critical Care Nurses Certification Corporation (AACN) with ED experience will also be considered.

3.1.1.4 Intensive Care Unit Nurse (SIN 621-025): Intensive Care Unit Nurses will be accountable clinically for ensuring that nursing care complies with accepted standards of care and clinical practice. Nurses will use judgment in assessing, planning, implementing, documenting and evaluating patient care in an Intensive Care Unit (ICU) setting where life-threatening disease or injury requires close monitoring and at times, quick intervention. Coordinates and implements patient care specific to the age of the patient population served on the ICU (adult and geriatric). The Nurse functions both dependently and independently with guidance and direction from the Nurse Manager/designee. Nurses must have active, current registration as a professional nurse in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

· Contractor nurses may be utilized as needed in specialty the Medical Intensive Care Unit (MICU), Surgical Intensive Care Unit (SICU), Medical Telemetry, or the Emergency Room.

· All nurses considered for assignment to an ICU shall have completed an accredited course in Intensive Care Nursing as well certification in Moderate Sedation or equivalent. In lieu of ICU certification, candidates shall possess at least five years clinical experience in an Intensive Care Unit or other critical care environment.

· All registered nurses shall have at least three (3) years prior experience in an intensive care setting to include Critical Care experience. Nurse Managers reserve the right to determine if ICU experience is conducive to their needs.

· Education requirements: required Bachelor’s Degree in Nursing or in related field or a Master’s Degree in Nursing or in related field is highly preferred.

· Agency nurses assigned to the MICU/SICU can expect to work twelve (12) hours shifts including no less than rotating weekends and holidays.

· The minimum requirement for all registered nurses assigned to any of the ICU shall include a current unrestricted registered nurse license from any State, District of Columbia, the

Commonwealth of Puerto Rico, or a territory of the United States, a current CPR/ BLS certificate accredited by the American Heart Association, a current ACLS certificate accredited by the American Heart Association and the Moderate Sedation Certification or equivalent.

· Agency nurses are preferred to have the Nurses with Acute/Critical Care Nursing (CCRN) certifications through the American Association of Critical Care Nurses Certification Corporation (AACN) CCRN certificate.

· All nurses in the ICU are certified to perform the following routine procedures on all patients but not limited to:

· Insertion of peripheral lines.

· Collection of blood samples by venipuncture and central lines and swan ganz catheter.

· Drawing of arterial blood from existing lines.

· Hemodynamic Monitoring

· Under the physician’s direction, the nurses in ICU may remove peripheral intravenous lines, central venous catheters and percutaneous arterial lines.

· In the event that the patient experiences chest pain or signs and symptoms of cardiac abnormalities, the nurse will perform a 12 lead EKG immediately.

· In the event that the patient develops asystole, ACLS protocol will be followed.

· In the event that a patient requires placement of an external pacemaker, the nurse will attach the patient to a pacing wire and pacing generator.

· Records pertinent information in CPRS and/or PICIS flow sheet throughout the shift.

3.1.1.5 Psychiatric Nurse (SIN 621-025): The behavioral health unit serves veteran with varying degrees of mental illness and co-morbidities requiring medical and psychiatric interventions. Nurses will be accountable clinically for ensuring that nursing care complies with accepted standards of care and clinical practice. Nurses will use judgment in assessing, planning, implementing, documenting and evaluating patient care of Veterans within an inpatient setting where mental and behavioral health diseases requires close monitoring and at times, quick intervention. Coordinates and implements patient care specific to the age of the patient population served on the unit. The Nurse functions both dependently and independently with guidance and direction from the Nurse Manager/designee. Nurses must have active, current registration as a professional nurse in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

· Experienced and qualified psychiatric registered nurses and licensed practical nurses are required to provide additional staffing for the inpatient psychiatric unit at the WBVAMC and the Residential Rehabilitation Treatment Program located at Broad Street and Snyder Avenue in Wilkes-Barre.

· All registered nurses will be psychiatric registered nurses and Licensed Practical Nurses shall have at least two years recent experience in inpatient behavioral health, and be familiar with the Recovery Model.

· Education requirements: required Bachelor’s Degree in Nursing or in related field or a Master’s Degree in Nursing or in related field is highly preferred.

· The minimum requirement for all registered nurses assigned to the Behavioral Health Department shall include a current unrestricted registered nurse license from any State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States, and a current CPR/ BLS certificate accredited by the American Heart Association.

· Agency nurses are preferred to have a certification in psychiatric/mental health in nursing accredited through the American Nurses Credentialing Center (ANCC).

3.1.1.6 Dialysis Nurse (SIN 621-025): Under the supervision of the nurse manager, the dialysis staff nurse maintains accountability for the coordination and delivery of care to patients with end stage renal disease. The responsibilities of the dialysis staff nurse include:

· For the Acute Dialysis Setting, Registered Nurses require: a current ACLS certificate accredited by the American Heart Association, minimum three (3) years’ experience performing hemodialysis on patients who are hospitalized in an acute setting, and experience with dialysis of patients in intensive care unit setting.

· Agency Nurses are preferred to have completed the ECG Course.

· Oversees the preparation of the delivery system, dialysate bath, and dialyzer and confirms that all mandatory alarm tests on the dialyzer and equipment are performed.

· Reviews physician orders for dialysis patients, collects pre-treatment dialysis data, and reviews patient records prior to dialysis.

· Conducts pre-dialysis patient assessment including obtaining patient vital signs and assessing the patient’s vascular access, laboratory findings, and the patient’s general health.

· Verifies that patients are taking all prescribed medications and performs medication reconciliation.

· Documents findings of patient assessments and interventions and advises providers of any significant change in the patient's condition and other pertinent information.

· Discusses patient concerns and answers questions relevant to care.

· Oversees dialysis technicians in the performance of dialysis from start to finish, monitors patient reaction to treatment and performance of the dialysis machines, and demonstrates an in- depth understanding of the mechanics of dialysis.

· Assesses, prepares, and cannulates a patient’s vascular access (including needle insertion in arterioveinous fistula or grafts for aseptic connection with dialysis equipment).

· Utilizes sterile techniques to assess the dialysis catheter exit site and to apply dressing on the patient’s vascular access (dialysis catheter, arterioveinous access) per protocols.

· Maintains skills necessary to perform surveillance on dialysis access (catheter, fistula, graft) for early signs of failure or infection; this includes (if needed and after receiving the appropriate training) the ability to perform arterioveinous access monitoring using Transonic machine per protocol.

· Reviews patient’s electronic/paper records for orders as appropriate and administers dialysis- related intra-venous and/or oral medications as prescribed and/or per protocol.

· Conducts post dialysis assessment and patient discharge by evaluating treatment, documenting medication administration utilizing the appropriate protocols, assessing condition of vascular access, discharging the patient when vital signs are stable, and documenting and recording patient treatment data.

· Provides patient education/teaching applicable to the patient’s medical condition.

· Refers patient to other disciplines or services as needed (nutrition, social work, etc).

· Performs other treatments and diagnostic tests such as blood sugar testing and other tests required as part of patient treatment.

· Oversees disassembly and disinfection of dialysis equipment.

· Maintains skills necessary to do regional heparinization, separate and store blood samples, set up oxygen, administer saline, and maintain dialysis equipment.

· Performs surveillance and testing of dialysis water treatment equipment and dialysis water (such as chlorine, hardness, conductivity, water cultures) to ensure that these machines are operating within the parameters set in the facility’s written protocols.

· Demonstrates a working knowledge of dialysis laboratory tests and dialysis medications.

· Demonstrates an in-depth understanding of infection control and prevention of transmission of blood borne pathogens.

· Demonstrates a working knowledge of the national guidelines and the facility’s protocols for immunization of the dialysis patients (such as influenza, pneumococcal, and hepatitis-B vaccination).

· Counsels patient on and administers vaccines per protocols.

· Participates in quality improvement activities to include collection of data for the dialysis unit Quality Assurance Performance Improvement (QAPI) plan.

· Responds appropriately and provides assistance in emergency situations.

· Provides leadership in improving patient care, maintaining standards of care, directing and teaching personnel in a variety of settings, and providing charge nurse responsibilities as needed.

· Works closely with others on the dialysis team and participates in interdisciplinary team meetings.

· Maintains responsibility for providing coverage to the dialysis center.

· Education requirements: required Bachelor’s Degree in Nursing or in related field or a Master’s Degree in Nursing or in related field is highly preferred.

· The minimum requirement for all registered nurses assigned to the Hemodialysis Department shall include a current unrestricted registered nurse license from any State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States, and a current CPR/BLS certificate accredited by the American Heart Association.

3.2. STANDARDS OF CARE: The contractor’s staff care shall cover meet or exceed care as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

3.2.1. VA Standards: VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

3.2.2. The professional standards of the The Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx

3.2.3. The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

3.2.4. The requirements contained in this PWS

3.3. MEDICAL RECORDS

3.3.1. Authorities: Contractor’s staff providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

3.3.2. HIPAA: This CONTRACT and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this CONTRACT. Treatment and administrative patient records generated by this CONTRACT or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one

(21) calendar days after the contract, expiration date.

3.3.3. Disclosure: Contractor’s staff may have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of VHA Handbook 1907.1, Health Information management and Health Records and VHA Handbook 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

3.3.4. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 and all guidelines provided by the VAMC.

3.3.5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form.

Completed Release of Information requests will be forwarded to the VA Privacy Officer.

3.4. Direct Patient Care: 95% of the time involved in direct patient care. This is only an estimate and can change based on the needs of the Government.

3.5. Administrative: 5% of time…