36C25719Q1296-013.xlsx

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Male-Only HCHV Services
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36C25719Q1296
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36C25719Q1296 HCHV Quality Assurance Surveillance Plan.xlsx

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Sheet1

TasksIDPerformance MeasuresAcceptable Quality Level (AQL)Remedies
Maintain Patient Privacy/Confidentiality1Daily100%Zero tolerance for violations
Maintain VA request for services , adult admission and consent form, medication/disposal form and self administration of medication forms on the patient's chart.2Daily100%All documentation will met or exceed standards, to include but not limited to accuracy, content and signature.
Adheres to all HIPPA requirements3Daily100%Zero tolerance for violations
Current Fire Drill and self inspection/business inspection forms on file.4Quarterly100%Provide documentation to Contracting Officer Technical Representative for review during Inspecton.
Maintain appropriate Federal, State licensure/certification requirements (mandatory prior to performance of duties).5Quarterly100%Provide documentation to Contracting Officer Technical Representative for review during inspection.

&"-,Bold"Residential Service for Homeless Veterans Contract General Quality Assurance

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