36C24820Q0208-005.docx

Contractor Performance Standards or QASP (Quality Assurance Surveillance Plan):

Measure: Timeliness of Service – Delivery made within 24 hours or receipt of order Numerator and Denominator: Number of VA patients delivered.

Quantity of Surveillance: Randomly pull 5% of files. results quarterly Acceptable Quality Level: 97% Method of Surveillance: Random Sampling

Measure: Timeliness of Service – quarterly and monthly visits Numerator and Denominator: Number of VA patients delivered.

Quantity of Surveillance: Randomly pull 5% of files. results quarterly Acceptable Quality Level: 97% Method of Surveillance: Random Sampling

Measure: Patient Customer Satisfaction Numerator and Denominator: Number of VA patients satisfied with contractor’s service.

Quantity of Surveillance: Random. Contractor Surveys results quarterly Acceptable Quality Level: 98% Method of Surveillance: Random Sampling

Measure: Vendor Audit Numerator and Denominator: On site review of vendor contract regulatory requirements, on-call response, employee records, warehouse inspection – equipment tracking and management, patient record review and vehicle inspection.

Quantity of Surveillance: Random survey results quarterly.

Acceptable Quality Level: 95% Method of Surveillance: Random Sampling

Measure: Home Visit Findings Numerator and Denominator: Number of VA patients receiving service, Equipment as ordered, Home Safety, Prescription compliance Quantity of Surveillance: Random. home visits by PSAS & Home Oxygen Coordinator results quarterly Acceptable Quality Level: 95% Method of Surveillance: Random Sampling Measure: Unsafe Conditions Numerator and Denominator: Number of VA patients who had an incident related to oxygen Equipment to include; accidents, malfunctions, injuries, deaths, and sentinel events.

Number of VA patients receiving oxygen equipment Quantity of Surveillance: PSAS, Home Oxygen Coordinator and Contractor – identification of at Risk for Fire, Falls, etc.

Acceptable Quality Level: 100% Method of Surveillance: Random Sampling reported quarterly