S02 - FY21 - 36C246-20-R-0126 - HEMODIAYSIS SERVICE.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. DUNS: DUNS+4:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 106

36C24620R0126 09-03-2020

WARREN O'BRYANT, CONTRACTING SPECIALIST 757-728-7083 09-17-2020

4:00 PM EDST

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE 6

100 EMANCIPATION DRIVE

HAMPTON VA 23667

X

Y

621492

$41.5 Million

X

N/A

X

DEPARTMENT OF VETERANS AFFAIRS

CHARLES GEORGE MEDICAL CENTER

1100 TUNNEL ROAD

ASHEVILLE, NC 28805

Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667

Financial Services Center

PO BOX 149971

Austin TX 78714-9971

CONTRACTOR SHALL PROVIDE ON-SITE IN-PATIENT ACUTE CARE

HEMODIALYSIS SERVIES TO INCLUDE REGISTERED NURSES (RN'S)

AT THE CHARLES GEORGE ASHEVILLE VAMC, NC

SEE B.2: FOR THE SCHEDULE OF SERVICES

SEE B.3: FOR THE PERFORMANCE WORK STATEMENT (PWS)

X 1

Mario L Santiago

36C246-20-R-0126

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS .. 1

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SCHEDULE OF SERVICES

B.3 PERFORMANCE WORK STATEMENT

B.4. SPECIAL CONTRACT REQUIREMENTS

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS

(OCT 2018)

C.2 52.216-18 ORDERING (OCT 1995)

C.3 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.4 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.5 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.6 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.7 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR

1984)

C.8 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA

ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

C.9 VAAR 852.219-75 SUBCONTRACTING COMMITMENT MONITORING AND

COMPLIANCE (JUL 2018)

C.10 VAAR 852.237-75 KEY PERSONNEL (SEP 2019)

C.11 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.12 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JUN 2020)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 QUALITY ASSURANCE SURVIELLANCE PLAN (QASP)

D.2 CONTRACTOR CERTIFICATION: Immigration and Nationality Act of 1952, As Amended

D.3 PAST PERFORMANCE SURVEY

D.4 DEPARTMENT OF VETERANS AFFAIRS (VA) NATIONAL RULES OF

BEHAVIOR

D.5 CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT .. 77

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (JUN

2020)

ADDENDUM TO FAR 52.212-1 INSTRUCTIONS TO OFFERORS – COMMERCIAL

ITEMS

E.2 SPECIFIC INSTRUCTIONS TO OFFEROR REGARDING PROPOSAL

PREPARATIONS INSTRUCTIONS FOR PROPOSAL SUBMISSION

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT

2018)

E.4 52.212-2 EVALUATION – COMMERCIAL ITEMS (OCT 2014)

E.5 52.216-1 TYPE OF CONTRACT (APR 1984)

E.6 52.217-5 EVALUATION OF OPTIONS (JUL 1990)

E.7 52.233-2 SERVICE OF PROTEST (SPT 2006)

E.8 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (JAN 2003)

E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL ITEMS (JUN 2020)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(continuation from Standard Form 1449, block 18A.)

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR: Name: __________________________ / Title: __________________ email: __________________________ / Phone: __________________

b. GOVERNMENT:

Contracting Officer 36C246 Administrative Contracting Officer Mario L. Santiago Warren O’Bryant 757-251-4254 / mario.santiago@va.gov 757-728-7083 / warren.o’bryant@va.gov Department of Veterans Affairs Department of Veterans Affairs Network Contracting Office 6 Network Contracting Office 6 100 Emancipation Drive 100 Emancipation Drive Hampton VA 23667 Hampton VA 23667

2. CONTRACTOR REMITTANCE: All payments by the Government to the contractor will be made in accordance with:

[x] 52.232-33, Payment by Electronic Funds Transfer – System for Award Management, or

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly in Arrears

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests. Shall be submitted Electronically To:

Financial Services Center

PO BOX 149971

Austin TX 78714-9971

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

mailto:mario.santiago@va.gov mailto:mohamed.shakur@va.gov

B.2 SCHEDULE OF SERVICES

The Contractor shall provide on-site In-Patient Acute Care Hemodialysis Service to include Registered Nurses (RN’s) and ancillary equipment to perform all In-Patient Hemodialysis Service on-site at the Charles George Asheville VAMC (CGVAMC), in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Asheville VAMC.

The Government will issue a fixed price Indefinite Delivery Indefinite Quantity (IDIQ) type Contract for this requirement and the guaranteed minimum contract quantity, including the base year and any option year exercised, is 100 Procedures and the maximum quantity contract amount, including the base year and any option years exercised, shall not exceed 2,000 Procedures.

Pricing Instructions: The offeror is instructed to provide pricing corresponding for each contract line item number (CLIN). The offeror is instructed to include all other than price and cost information supporting the proposed price as directed in Instructions to Offerors addendum to 52.212-1.

The Contractor shall propose key personnel to be credentialed and be available for scheduling to meet the requirements of the contract. The minimum number of Registered Nurses to provide on-site Inpatient acute care Hemodialysis Services as defined in paragraph Hours of Operation in this section two (2) and the ancillary equipment. The Contractor shall propose a minimum of eight (8) Registered Nurses (RN’s) key personnel to be credentialed and be available for scheduling to meet the requirements of the contract

One (1) FTE is defined by VA as a minimum of eighty (80) hours every two (2) weeks per year and does not included holidays.

The VA will pay per procedure at the prevailing Medicare rate at the time of treatment.

BASE YEAR PERIOD OF PERFORMANCE: OCT 01, 2020 TO SEPT 30, 2021

CLIN DESCRIPTION OF

SERVICE

ESTIMATED

QTY.

UNIT OF

ISSUE

UNIT COST TOTAL

COST

HEMODIALYSIS

SERVICE &

PROCEDURE 350 EA $ $

CANCELLATION

AFTER SET-UP

(LABOR & SUPPLIES) 6 EA $ $

TREATMENT

CANCELLATION

(BEFORE SET-UP) 6 EA $ $

WAITING TIME

(AFTER 15 MINUETS

PER HOUR) 12 EA $ $

HOLIDAY

(DIFFERENIAL - PER

PROCEDURE) 10 EA $ $

BLOOD

ADMINISTRATION 24 EA $ $

0007 EXTRA DIALYZER 8 EA $ $

0008 EQUIPMENT CULTURE 12 EA $ $

SUPPLIES &

MAINTENANCE OF

EQUIPMENT PER

WEEK (0-5

TREATMENTS PER

WEEK) WK INCLUDED $0.00

SUPPLIES &

MAINTENANCE OF

EQUIPMENT PER

WEEK ( >5

TREATMENTS PER

WEEK) WK INCLUDED $0.00

BASE YEAR TOTAL

COST ESTIMATE $

OPTION YEAR – (1) PERIOD OF PERFORMANCE: OCT 01, 2021 TO SEPT 30, 2022

CLIN DESCRIPTION OF

SERVICE

ESTIMATED

QTY.

UNIT OF

ISSUE

UNIT COST TOTAL

COST

HEMODIALYSIS

SERVICE & PROCEDURE 360 EA $ $

CANCELLATION AFTER

SET-UP (LABOR &

SUPPLIES) 6 EA $ $

TREATMENT

CANCELLATION

(BEFORE SET-UP) 6 EA $ $

WAITING TIME (AFTER

15 MINUETS PER HOUR) 12 EA $ $

HOLIDAY (DIFFERENIAL

- PER PROCEDURE) 10 EA $ $

BLOOD

ADMINISTRATION 24 EA $ $

1007 EXTRA DIALYZER 8 EA $ $

1008 EQUIPMENT CULTURE 12 EA $ $

SUPPLIES &

MAINTENANCE OF

EQUIPMENT PER WEEK

(0-5 TREATMENTS PER

WEEK) WK INCLUDED $0.00

SUPPLIES &

MAINTENANCE OF

EQUIPMENT PER WEEK

( >5 TREATMENTS PER

OPTION YEAR - 1

TOTAL COST

ESTIMATE $

OPTION YEAR – (2) PERIOD OF PERFORMANCE: OCT 01, 2022 TO SEPT 30, 2023

SERVICE

ESTIMATED

QTY.

UNIT

OF

ISSUE

UNIT

COST

TOTAL

COST

HEMODIALYSIS

SERVICE &

PROCEDURE 375 EA $ $

CANCELLATION

AFTER SET-UP

(LABOR & SUPPLIES) 6 EA $ $

TREATMENT

CANCELLATION

(BEFORE SET-UP) 6 EA $ $

WAITING TIME

(AFTER 15 MINUETS

PER HOUR) 12 EA $ $

HOLIDAY

(DIFFERENIAL - PER

PROCEDURE) 10 EA $ $

BLOOD

ADMINISTRATION 24 EA $ $

2007 EXTRA DIALYZER 8 EA $ $

EQUIPMENT

CULTURE 12 EA $ $

SUPPLIES &

MAINTENANCE OF

EQUIPMENT PER

WEEK (0-5

TREATMENTS PER

WEEK) WK INCLUDED $0.00

SUPPLIES &

MAINTENANCE OF

EQUIPMENT PER

WEEK ( >5

OPTION YEAR - 2

OPTION YEAR – (3) PERIOD OF PERFORMANCE: OCT 01, 2023 TO SEPT 30, 2024

SERVICE

ESTIMATED

QTY.

UNIT

OF

ISSUE

UNIT

COST

TOTAL

COST

HEMODIALYSIS

SERVICE &

PROCEDURE 385 EA $ $

CANCELLATION

AFTER SET-UP

(LABOR & SUPPLIES) 6 EA $ $

TREATMENT

CANCELLATION

(BEFORE SET-UP) 6 EA $ $

WAITING TIME

(AFTER 15 MINUETS

PER HOUR) 12 EA $ $

HOLIDAY

(DIFFERENIAL - PER

PROCEDURE) 10 EA $ $

BLOOD

ADMINISTRATION 24 EA $ $

3007 EXTRA DIALYZER 8 EA $ $

EQUIPMENT

CULTURE 12 EA $ $

SUPPLIES &

MAINTENANCE OF

EQUIPMENT PER

WEEK (0-5

TREATMENTS PER

WEEK) WK INCLUDED $0.00

SUPPLIES &

MAINTENANCE OF

EQUIPMENT PER

WEEK ( >5

OPTION YEAR - 3

OPTION YEAR – (4) PERIOD OF PERFORMANCE: OCT 01, 2024 TO SEPT 30, 2025

CLIN DESCRIPTION OF

SERVICE

ESTIMATED

QTY.

UNIT

OF

ISSUE

UNIT

COST

TOTAL

COST

HEMODIALYSIS

SERVICE &

PROCEDURE 400 EA $ $

CANCELLATION

AFTER SET-UP

(LABOR & SUPPLIES) 6 EA $ $

TREATMENT

CANCELLATION

(BEFORE SET-UP) 6 EA $ $

WAITING TIME

(AFTER 15 MINUETS

PER HOUR) 12 EA $ $

HOLIDAY

(DIFFERENIAL - PER

PROCEDURE) 10 EA $ $

BLOOD

ADMINISTRATION 24 EA $ $

4007 EXTRA DIALYZER 8 EA $ $

EQUIPMENT

CULTURE 12 EA $ $

SUPPLIES &

MAINTENANCE OF

EQUIPMENT PER

WEEK (0-5

TREATMENTS PER

WEEK) WK INCLUDED $0.00

SUPPLIES &

MAINTENANCE OF

EQUIPMENT PER

WEEK ( >5

OPTION YEAR - 4

TOTAL BASE YEAR AND ALL OPTION YEAR COST: $ _______________________

B.3 PERFORMANCE WORK STATEMENT

1. GENERAL

1.1. Services Provided: The Contractor shall provide on-site In-Patient Acute Care

Hemodialysis Service to include Registered Nurses (RN’s) and ancillary equipment to provide Inpatient Acute Care Hemodialysis Services at the bedside of acutely ill patients for continuous on call coverage 7 days per week, 24 hours per day. Emergent services are within 2 hours; immediate services are within 4 hours and Chronic routine hemodialysis treatments will be performed with 12 hours on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) at the Asheville Veteran Affairs Medical Center, NC.

1.2. Place of Performance – On-site, within Nursing Services at the Charles George VA

Medical Center, 1100 Tunnel Road, Asheville, NC 28805.

1.3. Authority: Health Care Resources (HCR) Title 38 USC 8153 procurement.

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

1.4.1. VHA Handbook 1100.17: National Practitioner Data Bank Reports https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.2. VHA Handbook 1100.18: Reporting and Responding to State Licensing Boards https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.4.3. VHA Handbook 1100.19: Credentialing and Privileging

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.4.4. VHA Directive 1192: Seasonal Influenza Prevention Program https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5472

1.4.5. VA Directive 1663: Health Care Resources Contracting - Buying https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

1.4.6. VHA Handbook 1907.01: Health Information Management and Health Records:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088

1.4.7. Privacy Act of 1974 (5 U.S.C. 552a) as amended

http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5. Definitions/Acronyms- Terms used in this contract 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.

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5472 https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5.1. BLS: Basic Life Support

1.5.2. CDC/HICPAC: Center for Disease Control / Health Care Infection Control Practice Advisory Committee

1.5.3. CFR: Code of Federal Regulations

1.5.4. 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.

1.5.5. 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.

1.5.6. COS: Chief of Staff

1.5.7. CPARS: Contractor Performance Assessment Reporting System.

1.5.8. EHR: Electronic Health Record – electronic health record system used by the VA

1.5.9. HIPAA: Health Insurance Portability and Accountability Act

1.5.10. HR: Human Resources

1.5.11. ISO: Information Security Officer

1.5.12. 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.

1.5.13. MOD: Medical Officer of the Day.

1.5.14. 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).

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

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

1.5.17. NP: Nurse Practitioner

http://www.nlnac.org/

1.5.18. POP: Period of Performance

1.5.19. PPD: Purified Protein Derivative

1.5.20. PWS: Performance Work Statement

1.5.21. QA/QI: Quality Assurance/Quality Improvement

1.5.22. QM/PI: Quality Management/Performance Improvement

1.5.23. QASP: Quality Assurance Surveillance Plan

1.5.24. RN: Registered Nurse

1.5.25. TJC: The Joint Commission

1.5.26. TMS: Talent Management System

1.5.27. 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.

1.5.28. Veterans Integrated Services Network (VISN): The regional oversight for the VA Medical Centers.

1.5.29. 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.

1.5.30. VETPRO: Veteran’s health Administration Credentialing System (a federal web-based credentialing program for healthcare providers).

1.5.31. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the Asheville VA Medical Center.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1 License – Personnel assigned by the Contractor to perform the services covered by this contract shall be licensed as a Registered Nurse (RN) in the state of North Carolina. The license must be active, current and unrestricted by the North Carolina Board of Nursing.

2.1.2. Credentialing and Privileging – VETPRO credentialing must be completed and verified before commencing work at the Asheville VA Medical Center.

2.1.3. Technical Proficiency - Applicants must provide evidence of at least one full, active, current and unrestricted licensure, registration, certification, and/or other relevant credentials for verification prior to appointment and throughout the employment process as requested. They are responsible for keeping the Department of Veterans Affairs appraised of anything that would adversely affect or otherwise limit their clinical privileges. Note: Failure to keep VA fully informed on these matters may result in administrative or disciplinary action.

2.1.4. Training (BLS and VA MANDATORY – Personnel performing these services shall be a licensed as a Registered Nurse (RN). All contract RN’s will complete mandatory and yearly educational requirements at the Asheville VA Medical Center in the Talent Management System (TMS). All Contract RN’s must have current yearly hemodialysis competencies and BLS certification on file.

Training (The following training is mandatory per VHACO for Contracted Registered Nurses)

Frequency (once a year, etc.) Annual Hours

Active Threat Training Every 1 Year 1 Hour Government Ethics Every 1 Year 1 Hour Prevention of Workplace Harassment/No Fear Act

Every 1 Year 1 Hour

VA Core Values Training (ICARE Recommitment)

Every 1 Year 1 Hour

VA Privacy and Information Security Awareness and Rules of Behavior

Every 1 Year 1 Hour

Privacy and HIPAA Training Every 1 Year 1 Hour AHA BLS Every 2 Years 3 to 8 Hours Prevention/Management of Disruptive Behavior/Violence Prevention

Every 2 Years 8 Hours

Suicide Prevention: Suicide Risk Management Training for Clinicians

Every 1 Year 1 Hour

OPIOID Training Initial Onboarding 30 Minutes Service Connection Initial Onboarding 30 Minutes CBI Every 1 Year 1 Hour List other Training per local facility

Courses to be assigned in TMS as required.

Contractor shall provide to the COR a copy of the training certificates for each applicable employee within one (1) week of the initiation of the contract and annually thereafter, as required. These online courses listed above are located at the following web site: https://www.tms.va.gov/plateau/user/login.jsp. Detail instructions on account setup will be provided to the successful offeror upon contract award. Failure to complete this mandatory training listed above within the timeframe required shall be grounds for suspension or termination of all physical https://www.tms.va.gov/plateau/user/login.jsp and/or electronic access privileges and removal from work on the contract until such time as the training is completed.

2.1.5. Standard Personnel Testing (PPD, etc.): Contractor shall provide initial evidence of health certification to include the following tests for Registered Nurses (RN’s) within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year initially and annually.

2.1.5.1.TUBERCULOSIS TESTING: Contractor shall provide proof of a negative

Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractors Registered Nurses (s) {This is applicable to all health care workers}. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. The TST or IGRA testing shall be repeated annually.

2.1.5.2.MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}.

2.1.5.3.VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}.

2.1.5.4.ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians {This is applicable to all health care

2.1.5.5.INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine, they shall be required to wear a mask during the Influenza season. {This is applicable to all health care

2.1.5.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO

BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractors Registered Nurses (s) {This is applicable to all health care workers}; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.1.5.7. 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.

http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

2.1.6. Conflict of Interest - The Contractor and all contractor’s Registered Nurses are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of Quotes and during the entirety of contract performance. At the time of Quotes, 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) and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.7. Citizenship related Requirements

2.1.7.1. 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;

2.1.7.2. 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.

2.1.7.3. 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.

2.1.7.4. 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.

2.1.7.5. 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.

2.1.7.6. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offeror’s response to the RFQ using the subject attachment in Section D of the solicitation document.

2.2. 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) Office of Inspector General (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.

2.2.1. 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 contractors Registered Nurses (s) 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.

2.2.2. By submitting their Quotes, 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.

2.3. Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19.

Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the VAMC COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.4. Non-Personal Healthcare Services: The parties agree that the Contractor and all contractors Registered Nurses (s) shall not be considered VA employees for any purpose.

2.5. 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.

2.6. Prohibition Against Self-Referral: Contractors Registered Nurses are prohibited from referring VA patients to contractor’s or their own practice(s).

http://oig.hhs.gov/exclusions/index.asp

2.7. Inherent Government Functions: Contractor and Contractors Registered Nurses (s) 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.

2.7.1. Technical Direction: Provide services under the direction of the Associate

Director, Patient Care Services.

2.8. No Employee status: The Contractor shall be responsible for protecting Contractors Registered Nurses (s) 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:

2.8.1 Workers’ compensation

2.8.2 Professional liability insurance

2.8.3 Health examinations

2.8.4 Income tax withholding, and

2.8.5 Social security payments.

2.9. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract physician(s). When a Contractor or contractors Registered Nurses (s) 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 contract physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.10. Key Personnel:

2.10.1. The minimum number of Registered Nurses to provide on-site Inpatient acute care

Hemodialysis Services as defined in paragraph Hours of Operation in this section is two (2) and the ancillary equipment. The Contractor shall propose a minimum of eight (8) Registered Nurses (RN’s) key personnel to be credentialed and be available for scheduling to meet the requirements of the contract

2.10.2. One (1) FTE is defined by VA as a minimum of eighty (80) hours every two (2) weeks per year and does not included holidays.

Name:________________________

Name:________________________

Name:________________________

Name:________________________

Name:________________________

Name:________________________

2.10.3. It is essential that continuity of services is maintained to the maximum degree possible hence, substitution of contractor provided Registered Nurses shall be limited to urgent/emergent absences of approved, assigned providers. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required.

In the event a scheduled Registered Nurse is unable to begin or complete an assigned shift, the contractor shall provide replacement physician coverage within 2 hours and notify the Contracting Office Representative (COR) at the (Asheville VAMC) immediately of the schedule change.

2.10.4. Personnel Substitutions: For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive workdays or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.10.5. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractors Registered Nurses (s), s/he may request, without cause, immediate replacement of said Contractors Registered Nurses (s).

The CO and COR shall deal with issues raised concerning Contractors Registered Nurses (s) conduct. The final arbiter on questions of acceptability is the CO.

2.10.6. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractors Registered Nurses (s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA HOURS OF OPERATION / SCHEDULING:

3.1. VA Business Hours: Seven (7) days per week, twenty-four (24) hours per day on call:

3.1.1. Work Schedule: Seven (7) days per week, twenty-four (24) hours per day on call. The Charles George Asheville VA Medical Center will only pay for qualified services received by the In-patient requiring Hemodialysis. Pay will be per procedure.

3.1.2. 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.

4. CONTRACTOR RESPONSIBILITIES:

4.1. SERVICES REQUIRED: The Contractor shall provide Inpatient Acute Care On-Site Hemodialysis service to include Registered Nurses (RN’s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties and the ancillary equipment.

4.1.1. Contractors Registered Nurses (s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices.

4.1.2. The Contractor’s staff shall be responsible for provision of the ordered services to include set-up and safety check of equipment and water treatment system.

4.1.3. The contract staff shall notify the Nurse Manager & Charge Nurse of their arrival and departure from the location of the procedure.

4.1.4. Initiating treatment, monitoring of treatment and termination of treatment.

4.1.5. Documentation of treatment on Asheville VAMC approved forms.

4.1.6. Clean-up of dialysis equipment and proper storage of machine and supplies.

4.1.7. Contract RN’s will be available to provide continuing education and training to assure current technical and clinical knowledge of the Asheville VAMC staff.

4.1.8. Contract staff shall provide education to patients and families as needed regarding hemodialysis procedures.

4.1.9. Contractor shall report quarterly on established clinical indicators for all Asheville VAMC patients who received hemodialysis treatments. Clinical Indicators include vascular access site, dialysis prescriptions, patient assessments, patient education and communication and safety.

4.1.10. Contractor shall maintain records of the equipment culture results and supply copies to the Asheville VAMC quarterly.

4.1.11. Contractor shall supply a quarterly infection control summary to the Asheville

VAMC.

4.1.12. Contractor shall supply preventive maintenance records in accordance with TJC requirements.

4.1.13. Contractor shall supply: Commercially available dialysis solutions, tubing sets for provider equipment, dialyzers, all filters required for contractor equipment, fistula needles and water quality analysis supplies.

4.2. Standards of Practice and Care: The contractors shall be responsible for meeting or exceeding VA standards in providing Registered Nurses (s)’ in providing Inpatient Acute Care Hemodialysis services and the standards of care shall be of a quality, meeting or exceedingly currently recognized national standards as established by:

4.2.1. The professional standards of The Joint Commission (TJC) http://www.jointcommission.org/emergency_department/.

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

4.2.3. The requirements contained in this PWS.

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contractors Registered Nurses (s) 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).

http://www.jointcommission.org/emergency_department/ http://www.hpoe.org/resources?show=100&type=8

4.3.2. HIPAA: Health Insurance Portability and Accountability Act of 1996. 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.

4.3.2. Disclosure: Contractors Registered Nurses (s) 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.

4.3.3. 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.

4.3.4. 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.

http://www.rms.oit.va.gov/SOR_Records/24VA19.asp http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://www4.va.gov/vaforms/va/pdf/VA3288.pdf http://www4.va.gov/vaforms/va/pdf/VA3288.pdf http://www4.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf http://www4.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf

Completed Release of Information requests will be forwarded to the VA Privacy Officer at the following address: ATTN: Asheville VAMC Information Security Officer or Privacy Officer, 1100 Tunnel Road, Asheville, NC 28805.

4.4. DIRECT PATIENT CARE: Estimated 100% of the time involved in direct patient care.

4.4.1. Contractor shall be responsible for each of the following areas stated in the PWS and the section below:

4.4.2. Patient Safety: Patient safety incidents must be reported immediately (maximum within 24 hours) using the Patient Safety Report at the Asheville VAMC.

4.4.3. Provide Hemodialysis treatment.

4.4.4. Properly evaluate patient prior to, during and after the Hemodialysis treatment.

4.5. ADMINISTRATIVE: (0)% of time not involved in direct patient care.

4.5.1. The Contractor will not be responsible for administrative task.

4.6. PERFORMANCE STANDARDS, QUALITY ASSURANCE AND QUALITY

IMPROVEMENT

4.6.1. Methods of Surveillance: Random Inspections, Direct Observation, Periodic

Sampling and Random Sampling.

4.6.2. Performance Standards: The Quality Assurance Surveillance Plan (QASP) outlines required standards and will be a part of the resultant contract.

4.6.3. Required Registration with Contractor Performance Assessment Reporting System

(CPARS).

4.7. Government Responsibility

4.7.1. Oversight of Service / Performance Monitoring / Contract Administration.

4.7.2. VA Support Personnel, Services or Equipment.

4.8. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY

IMPROVEMENT(QI)

4.8.1. Quality Management/Quality Assurance Surveillance: Contract personnel shall be subject to Quality Management measures, such as patient satisfaction surveys, timely completion of medical records, proper utilization of the Emergency Department Integration Software (EDIS) used for patient tracking and Peer Reviews. Methods of Surveillance: Focused Provider Practice Evaluation (FPPE) and Ongoing Provider Practice Evaluation (OPPE). Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

4.8.2. Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. In the event that the Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

4.8.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

4.8.4. Performance Standards:

4.8.4.1 Measure: Registered Nurse Quality Performance

Performance Requirement: All contractors Registered Nurses(s) shall perform in accordance with clinical standards.

Standard: (100%) of care provided within clinical standards of care.

Acceptable Quality Level: 100% meet Standards

Surveillance Method: Ongoing Provider Performance Evaluation (OPPE) data pertinent to care performed for each provider working under this contract. OPPE data will review the following elements:

Frequency: Quarterly A. Patient Care Performance B. Medical/Clinical knowledge C. Practiced Based Learning and Improvement D. Interpersonal and Communication Skills E. Professionalism F. System Based Practice

4.8.4.2. Measure: Qualifications of Key Personnel

Performance Requirement: All contractors Registered Nurses (s) shall be certified in providing Hemodialysis Services.

Standard: All (100%) contract nurses are Registered Nurses certified and experienced in providing Hemodialysis Services.

Acceptable Quality Level: 100%.

Surveillance Method: Random Inspection of qualification documents.

Frequency: Quarterly

4.8.4.3. Measure: Scope of Practice/Privileging

Performance Requirement: Contractors Registered Nurses (s) shall perform within their individual scopes of practice/privileging.

Standard: All (100%) contractors Registered Nurses (s) perform within their scope of practice/privileges 100% of the time.

Acceptable Quality Level: 100%.

Surveillance Method: Random Inspection of records.

4.8.4.4. Measure: Patient Access

Performance Requirement: The Contractor shall provide contractor’s Registered Nurses in accordance with the operating hours and VA clinical schedule outlined in this PWS.

Standard: All (100%) contractors Registered Nurses (s) are on time and available to perform services.

Acceptable Quality Level: Contractors Registered Nurses (s) is on-time and available to perform services 100% of the time.

Surveillance Method: Periodic Sampling of Time and Attendance Sheets

4.8.4.5. Measure: Patient Safety

Performance Requirement: Patient safety incidents shall be reported using Patient Safety Report. All incidents reported immediately (within 24 hours.)

Standard: All (100%) of patient safety incidents are reported using Patient Safety Report within 24 hours of incident.

Acceptable Quality Level: 100% Surveillance Method: Direct Observation

4.8.4.6. Measure: Maintains licensing, registration, and certification Performance Requirement: Updated Licensing, registration and certification shall be provided as they are renewed. Licensing and registration information shall be kept current.

Standard: All (100%) licensing, registration(s) and certification(s) for contractors Registered Nurses (s) must be provided as they are renewed.

Licensing and registration information must be kept current.

Acceptable Quality Level: 100%

Surveillance Method: Periodic Sampling and Random Sampling

4.8.4.7.Measure: Mandatory Training Performance Requirement: Contractor shall complete all required training on time per VAMC policy

Standard: All (100%) of required training is complete on time by contractors Registered Nurses (s)

Acceptable Quality Level: 100%

Surveillance Method: Absence of Delinquent TMS reports.

4.8.4.8. Measure: Privacy, Confidentiality and HIPAA

Performance Requirement: Contractor is aware of all laws, regulations, policies and…