Southern Nevada Healthcare System Home Oxygen Las Vegas Schedule and Estimated Quantities .xlsx
XLSX spreadsheet 36 KB Posted
- Solicitation number
- 36C26124Q0072
About this file
This document outlines estimated quantities and pricing for home oxygen supplies and services required by the Southern Nevada Healthcare System over five ordering periods. Services include delivery and setup of oxygen concentrator systems, cylinder refills, preventative maintenance, home visits, clinical respiratory services, and ventilator rentals. Estimated annual quantities are provided for items such as concentrator rentals, cylinder refills in various sizes, supplies, and home visits. Pricing terms require the contractor to provide oxygen delivery equipment, maintenance, monitoring, training, and emergency response. The related federal contract opportunity is solicitation number 36C26124Q0072 for home oxygen supplies and services to be provided to the Southern Nevada Healthcare System located in Las Vegas, under the Department of Veterans Affairs Veterans Health Administration VISN 21.
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ORDERING PERIOD 1
| Southern Nevada Healthcare System Home Oxygen Services | Period of Performance | $s per each | Estimated Amount | ||
| No. of Months or Years | Qty Per Year | ||||
| Delivery, Initial set-up, and education of Government-Owned Oxygen Concentrator System with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask, humidifier, tubing, etc., when specified). Includes back up of minimum supply of oxygen which shall be equal to three times the maximum response time for use in case of system malfunction and/or power failure. Concentrator to be provided by VA with litter flow 0 to 5 and 0 to 10 liters per minute. One time charge for new set-up/new patient. Initial set-up is defined as those beneficiaries who have not been provided oxygen therapy delivery systems in the resident or nursing home on a previous occasion or have not used such a system continuously for the | |||||
| past sixty (60) days. Switch-out is defined as those beneficiaries who are presently using an oxygen delivery system or have used such a system continuously within the past sixty (60) days. | 12 | 72 | $ - 0 | ||
| If a request is received to deliver a Government owned concentrator and there is no Government inventory available, a vendor owned concentrator will be supplied at the vendor monthly rate (unit price). | 12 | 1 | $ - 0 | ||
| In the event a patient needs to have the Government owned concentrator switched out and there is no Government owned inventory available, a vendor owned concentrator will be supplied and billed the vendor owned monthly rate (unit price). | 12 | 1 | $ - 0 | ||
| In the event a patient needs to have a Government owned concentrator switched out with another Government owned concentrator, the vendor shall bill the PST delivery rate (unit price). | 12 | 1 | $ - 0 | ||
| Preventive Maintenance Services (PMI) for Government owned concentrators. (Includes all labor, tools, equipment, travel and materials necessary to perform PMI in accordance with | |||||
| manufactures instructions.) | 12 | 1 | $ - 0 | ||
| Monthly Rental of Oxygen Concentrator System with backup system consisting of compressed |
gas source, regulator, stand, (nasal cannula or mask humidifier, and tubing, etc., when specified).
(Includes delivery, setup, and education). Back up minimum supply of oxygen shall be equal to three times the maximum response time for use in case of system malfunction and/or power
| failure. With flow rate of 0 – 5 liters per minute. | 12 | 6696 |
| Monthly Rental of Oxygen Concentrator System with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask, humidifier, and tubing, etc., when |
specified). (Includes delivery, setup, and education). Back up minimum supply of oxygen shall be equal to three times the maximum response time for use in case of system malfunction
| and/or power failure. With a flow rate of 0-10 liters per minute. | 12 | 372 | |||
| Oxygen tubing as required/ordered, 6 foot in length | 12 | 1 | $ - 0 | ||
| Oxygen tubing as required/ordered, 50 foot in length. | 12 | 1 | $ - 0 | ||
| Face masks as required/ordered. | 12 | 1 | $ - 0 | ||
| Standard nasal cannulas as required/ordered. | 12 | 1 | $ - 0 | ||
| Disposable humidifiers as required/ordered. | 12 | 1 | $ - 0 | ||
| Cylinder, size M60 or H. Set-up consisting of regulator, flow meter, safety stand, humidifier and | |||||
| disposable supplies. Primary set-up only. Includes delivery, setup, and education. This is a one-time equipment setup charge, and not a recurring monthly expense. | 12 | 1 | $ - 0 | ||
| If a patient requires a cylinder refill, the vendor shall bill for the cylinder refill rate per cylinder | |||||
| (unit price) | 12 | 1 | $ - 0 | ||
| Cylinder, size M60 or H refill (Backup/Primary) E0443 | 12 | 1 | $ - 0 | ||
| #A012 *Portable system for new set ups consists of “E”, “D”, “C”, or “B” (M6) size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch and disposable supplies. Includes delivery, setup, and education. This is a one-time chargefor new set-ups. EXCEPTIONS: Oxygen conserving devices are Government supplied. | 12 | 396 | $ - 0 | ||
| Cylinder, size “E” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks required. E0443 | 12 | 2244 | $ - 0 | ||
| Cylinder, size “D” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks | |||||
| required. E0443 | 12 | 372 | $ - 0 | ||
| Cylinder, size “C” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks | |||||
| required. E0443 | 12 | 1908 | $ - 0 | ||
| Cylinder, size “M6) refill for #A012 above. Aluminum (or metal of equivalent weight) tanks required. E0443 | 12 | 912 | $ - 0 | ||
| Demand Nasal Cannula (e.g. Oximyzer). | 12 | 60 | $ - 0 | ||
| “E” cylinders (aluminum, each) complete portable system (e.g. tank, regulator, etc) for each | |||||
| Medical Center for availability to issue home oxygen beneficiaries who deplete their portable units during appointments or to send home with new start-up (e.g. discharged from inpatient). | 12 | 1 | $ - 0 | ||
| Monthly rental liquid oxygen system (90 –100 lbs) with stationary reservoir per beneficiary | |||||
| E0439 Includes delivery, setup, education, and supplies. | 12 | 1 | $ - 0 | ||
| Monthly rental portable liquid oxygen system per beneficiary. E0434 Includes delivery, setup, and education, and supplies. | 12 | 372 | $ - 0 | ||
| Liquid oxygen per pound for item #A019. E0444 | 12 | 1 | $ - 0 | ||
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence | |||||
| within Region. | 12 | 1 | $ - 0 | ||
| Home visit (non-clinical) by Respiratory Care Practitioner for reeducation. | 12 | 1 | $ - 0 | ||
| Home visit by Patient Services Technician for patients on Government-owned concentrators. | 12 | 24 | $ - 0 | ||
| All inclusive clinical Respiratory Services to include but not limited to: patient’s heart rate, blood pressure, breath sounds as well as pulse oximetry readings while on oxygen, room air at rest and while ambulating as tolerated. Periodic RT visits must address: prescribed liter flow compliance, equipment /patient safety (to include risk of open flames and smoking), and patient medication usage. Deficiencies shall be communicated to the COR or designee a t the time of home visit or within 24 hours, using COR designated form. (Initial setup or every 6 months). | 12 | 564 | $ - 0 | ||
| Fee for deliveries made for over 100 miles from the ordering VA facility, or from Contractors local facility, whichever is closer. | 12 | 1 | $ - 0 | ||
| Patient Safety Alert AL18-01 Use of Thermal Fuses on Home Oxygen Delivery Systems. Bidirectional oxygen thermal fuses. Sometimes referred to as fire-safe, oxy-safe, or fire-break valves. Two thermal fuses must be provided and installed in each home oxygen delivery system (one at the patient end and one at the oxygen source). This must be done for the patient’s primary oxygen therapy equipment as well as any portable oxygen therapy equipment. Thermal fuses are not required for portable pulse dose/intermittent oxygen therapy equipment when the equipment does not have a continuous flow setting. The fuses will be issued to all new patients that require them and replaced at the end of their expected life per manufacturer's guidelines. | 12 | 936 | $ - 0 | ||
| Labor Fee for reconditioning/repair of VA owned equipment per manufacturer’s requirements. Contractor is required to notify the COR to obtain approval prior to fixing/repairing of VA equipment under this line item. $ 20 per .25 hour | 12 | 1 | $ - 0 | ||
| Monthly equipment rental and management/monitoring of ventilators for continous ventilation patients, excludes scheduled preventatitve maintenance. Includes initial delivery, set-up, supplies, to include bag, value mask, education/training. Monthly Licensed Respitory Therapist (LRT) visits to inspect equipment and environment, re-educate, and/or re-train caregiver, provide supplies as neccesary and perform routine preventative maintainance to include support of 2 ventilators per patient: 1 primary and 1 backup. | 12 | 1 | $ - 0 | ||
| TOTAL | $ - 0 |
FOR OFFICIAL GOVERNMENT USE ONLY
Revision: 02 Effective Date: 06/14/2022 &F
ORDERING PERIOD 2
| Southern Nevada Healthcare System Home Oxygen Services | Period of Performance | $s per each | Estimated Amount | ||
| No. of Months or Years | Qty Per Year | ||||
| Delivery, Initial set-up, and education of Government-Owned Oxygen Concentrator System with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask, humidifier, tubing, etc., when specified). Includes back up of minimum supply of oxygen which shall be equal to three times the maximum response time for use in case of system malfunction and/or power failure. Concentrator to be provided by VA with litter flow 0 to 5 and 0 to 10 liters per minute. One time charge for new set-up/new patient. Initial set-up is defined as those beneficiaries who have not been provided oxygen therapy delivery systems in the resident or nursing home on a previous occasion or have not used such a system continuously for the | |||||
| past sixty (60) days. Switch-out is defined as those beneficiaries who are presently using an oxygen delivery system or have used such a system continuously within the past sixty (60) days. | 12 | 72 | $ - 0 | ||
| If a request is received to deliver a Government owned concentrator and there is no Government inventory available, a vendor owned concentrator will be supplied at the vendor monthly rate (unit price). | 12 | 1 | $ - 0 | ||
| In the event a patient needs to have the Government owned concentrator switched out and there is no Government owned inventory available, a vendor owned concentrator will be supplied and billed the vendor owned monthly rate (unit price). | 12 | 1 | $ - 0 | ||
| In the event a patient needs to have a Government owned concentrator switched out with another Government owned concentrator, the vendor shall bill the PST delivery rate (unit price). | 12 | 1 | $ - 0 | ||
| Preventive Maintenance Services (PMI) for Government owned concentrators. (Includes all labor, tools, equipment, travel and materials necessary to perform PMI in accordance with | |||||
| manufactures instructions.) | 12 | 1 | $ - 0 | ||
| Monthly Rental of Oxygen Concentrator System with backup system consisting of compressed |
gas source, regulator, stand, (nasal cannula or mask humidifier, and tubing, etc., when specified).
(Includes delivery, setup, and education). Back up minimum supply of oxygen shall be equal to three times the maximum response time for use in case of system malfunction and/or power
| failure. With flow rate of 0 – 5 liters per minute. | 12 | 6696 |
| Monthly Rental of Oxygen Concentrator System with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask, humidifier, and tubing, etc., when |
specified). (Includes delivery, setup, and education). Back up minimum supply of oxygen shall be equal to three times the maximum response time for use in case of system malfunction
| and/or power failure. With a flow rate of 0-10 liters per minute. | 12 | 372 | |||
| Oxygen tubing as required/ordered, 6 foot in length | 12 | 1 | $ - 0 | ||
| Oxygen tubing as required/ordered, 50 foot in length. | 12 | 1 | $ - 0 | ||
| Face masks as required/ordered. | 12 | 1 | $ - 0 | ||
| Standard nasal cannulas as required/ordered. | 12 | 1 | $ - 0 | ||
| Disposable humidifiers as required/ordered. | 12 | 1 | $ - 0 | ||
| Cylinder, size M60 or H. Set-up consisting of regulator, flow meter, safety stand, humidifier and | |||||
| disposable supplies. Primary set-up only. Includes delivery, setup, and education. This is a one-time equipment setup charge, and not a recurring monthly expense. | 12 | 1 | $ - 0 | ||
| If a patient requires a cylinder refill, the vendor shall bill for the cylinder refill rate per cylinder | |||||
| (unit price) | 12 | 1 | $ - 0 | ||
| Cylinder, size M60 or H refill (Backup/Primary) E0443 | 12 | 1 | $ - 0 | ||
| #A012 *Portable system for new set ups consists of “E”, “D”, “C”, or “B” (M6) size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch and disposable supplies. Includes delivery, setup, and education. This is a one-time chargefor new set-ups. EXCEPTIONS: Oxygen conserving devices are Government supplied. | 12 | 396 | $ - 0 | ||
| Cylinder, size “E” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks required. E0443 | 12 | 2244 | $ - 0 | ||
| Cylinder, size “D” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks | |||||
| required. E0443 | 12 | 372 | $ - 0 | ||
| Cylinder, size “C” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks | |||||
| required. E0443 | 12 | 1908 | $ - 0 | ||
| Cylinder, size “M6) refill for #A012 above. Aluminum (or metal of equivalent weight) tanks required. E0443 | 12 | 912 | $ - 0 | ||
| Demand Nasal Cannula (e.g. Oximyzer). | 12 | 60 | $ - 0 | ||
| “E” cylinders (aluminum, each) complete portable system (e.g. tank, regulator, etc) for each | |||||
| Medical Center for availability to issue home oxygen beneficiaries who deplete their portable units during appointments or to send home with new start-up (e.g. discharged from inpatient). | 12 | 1 | $ - 0 | ||
| Monthly rental liquid oxygen system (90 –100 lbs) with stationary reservoir per beneficiary | |||||
| E0439 Includes delivery, setup, education, and supplies. | 12 | 1 | $ - 0 | ||
| Monthly rental portable liquid oxygen system per beneficiary. E0434 Includes delivery, setup, and education, and supplies. | 12 | 372 | $ - 0 | ||
| Liquid oxygen per pound for item #A019. E0444 | 12 | 1 | $ - 0 | ||
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence | |||||
| within Region. | 12 | 1 | $ - 0 | ||
| Home visit (non-clinical) by Respiratory Care Practitioner for reeducation. | 12 | 1 | $ - 0 | ||
| Home visit by Patient Services Technician for patients on Government-owned concentrators. | 12 | 24 | $ - 0 | ||
| All inclusive clinical Respiratory Services to include but not limited to: patient’s heart rate, blood pressure, breath sounds as well as pulse oximetry readings while on oxygen, room air at rest and while ambulating as tolerated. Periodic RT visits must address: prescribed liter flow compliance, equipment /patient safety (to include risk of open flames and smoking), and patient medication usage. Deficiencies shall be communicated to the COR or designee a t the time of home visit or within 24 hours, using COR designated form. (Initial setup or every 6 months). | 12 | 564 | $ - 0 | ||
| Fee for deliveries made for over 100 miles from the ordering VA facility, or from Contractors local facility, whichever is closer. | 12 | 1 | $ - 0 | ||
| Patient Safety Alert AL18-01 Use of Thermal Fuses on Home Oxygen Delivery Systems. Bidirectional oxygen thermal fuses. Sometimes referred to as fire-safe, oxy-safe, or fire-break valves. Two thermal fuses must be provided and installed in each home oxygen delivery system (one at the patient end and one at the oxygen source). This must be done for the patient’s primary oxygen therapy equipment as well as any portable oxygen therapy equipment. Thermal fuses are not required for portable pulse dose/intermittent oxygen therapy equipment when the equipment does not have a continuous flow setting. The fuses will be issued to all new patients that require them and replaced at the end of their expected life per manufacturer's guidelines. | 12 | 936 | $ - 0 | ||
| Labor Fee for reconditioning/repair of VA owned equipment per manufacturer’s requirements. Contractor is required to notify the COR to obtain approval prior to fixing/repairing of VA equipment under this line item. $ 20 per .25 hour | 12 | 1 | $ - 0 | ||
| Monthly equipment rental and management/monitoring of ventilators for continous ventilation patients, excludes scheduled preventatitve maintenance. Includes initial delivery, set-up, supplies, to include bag, value mask, education/training. Monthly Licensed Respitory Therapist (LRT) visits to inspect equipment and environment, re-educate, and/or re-train caregiver, provide supplies as neccesary and perform routine preventative maintainance to include support of 2 ventilators per patient: 1 primary and 1 backup. | 12 | 1 | $ - 0 | ||
| TOTAL | $ - 0 |
ORDERING PERIOD 3
| Southern Nevada Healthcare System Home Oxygen Services | Period of Performance | $s per each | Estimated Amount | ||
| No. of Months or Years | Qty Per Year | ||||
| Delivery, Initial set-up, and education of Government-Owned Oxygen Concentrator System with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask, humidifier, tubing, etc., when specified). Includes back up of minimum supply of oxygen which shall be equal to three times the maximum response time for use in case of system malfunction and/or power failure. Concentrator to be provided by VA with litter flow 0 to 5 and 0 to 10 liters per minute. One time charge for new set-up/new patient. Initial set-up is defined as those beneficiaries who have not been provided oxygen therapy delivery systems in the resident or nursing home on a previous occasion or have not used such a system continuously for the | |||||
| past sixty (60) days. Switch-out is defined as those beneficiaries who are presently using an oxygen delivery system or have used such a system continuously within the past sixty (60) days. | 12 | 72 | $ - 0 | ||
| If a request is received to deliver a Government owned concentrator and there is no Government inventory available, a vendor owned concentrator will be supplied at the vendor monthly rate (unit price). | 12 | 1 | $ - 0 | ||
| In the event a patient needs to have the Government owned concentrator switched out and there is no Government owned inventory available, a vendor owned concentrator will be supplied and billed the vendor owned monthly rate (unit price). | 12 | 1 | $ - 0 | ||
| In the event a patient needs to have a Government owned concentrator switched out with another Government owned concentrator, the vendor shall bill the PST delivery rate (unit price). | 12 | 1 | $ - 0 | ||
| Preventive Maintenance Services (PMI) for Government owned concentrators. (Includes all labor, tools, equipment, travel and materials necessary to perform PMI in accordance with | |||||
| manufactures instructions.) | 12 | 1 | $ - 0 | ||
| Monthly Rental of Oxygen Concentrator System with backup system consisting of compressed |
gas source, regulator, stand, (nasal cannula or mask humidifier, and tubing, etc., when specified).
(Includes delivery, setup, and education). Back up minimum supply of oxygen shall be equal to three times the maximum response time for use in case of system malfunction and/or power
| failure. With flow rate of 0 – 5 liters per minute. | 12 | 6696 |
| Monthly Rental of Oxygen Concentrator System with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask, humidifier, and tubing, etc., when |
specified). (Includes delivery, setup, and education). Back up minimum supply of oxygen shall be equal to three times the maximum response time for use in case of system malfunction
| and/or power failure. With a flow rate of 0-10 liters per minute. | 12 | 372 | |||
| Oxygen tubing as required/ordered, 6 foot in length | 12 | 1 | $ - 0 | ||
| Oxygen tubing as required/ordered, 50 foot in length. | 12 | 1 | $ - 0 | ||
| Face masks as required/ordered. | 12 | 1 | $ - 0 | ||
| Standard nasal cannulas as required/ordered. | 12 | 1 | $ - 0 | ||
| Disposable humidifiers as required/ordered. | 12 | 1 | $ - 0 | ||
| Cylinder, size M60 or H. Set-up consisting of regulator, flow meter, safety stand, humidifier and | |||||
| disposable supplies. Primary set-up only. Includes delivery, setup, and education. This is a one-time equipment setup charge, and not a recurring monthly expense. | 12 | 1 | $ - 0 | ||
| If a patient requires a cylinder refill, the vendor shall bill for the cylinder refill rate per cylinder | |||||
| (unit price) | 12 | 1 | $ - 0 | ||
| Cylinder, size M60 or H refill (Backup/Primary) E0443 | 12 | 1 | $ - 0 | ||
| #A012 *Portable system for new set ups consists of “E”, “D”, “C”, or “B” (M6) size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch and disposable supplies. Includes delivery, setup, and education. This is a one-time chargefor new set-ups. EXCEPTIONS: Oxygen conserving devices are Government supplied. | 12 | 396 | $ - 0 | ||
| Cylinder, size “E” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks required. E0443 | 12 | 2244 | $ - 0 | ||
| Cylinder, size “D” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks | |||||
| required. E0443 | 12 | 372 | $ - 0 | ||
| Cylinder, size “C” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks | |||||
| required. E0443 | 12 | 1908 | $ - 0 | ||
| Cylinder, size “M6) refill for #A012 above. Aluminum (or metal of equivalent weight) tanks required. E0443 | 12 | 912 | $ - 0 | ||
| Demand Nasal Cannula (e.g. Oximyzer). | 12 | 60 | $ - 0 | ||
| “E” cylinders (aluminum, each) complete portable system (e.g. tank, regulator, etc) for each | |||||
| Medical Center for availability to issue home oxygen beneficiaries who deplete their portable units during appointments or to send home with new start-up (e.g. discharged from inpatient). | 12 | 1 | $ - 0 | ||
| Monthly rental liquid oxygen system (90 –100 lbs) with stationary reservoir per beneficiary | |||||
| E0439 Includes delivery, setup, education, and supplies. | 12 | 1 | $ - 0 | ||
| Monthly rental portable liquid oxygen system per beneficiary. E0434 Includes delivery, setup, and education, and supplies. | 12 | 372 | $ - 0 | ||
| Liquid oxygen per pound for item #A019. E0444 | 12 | 1 | $ - 0 | ||
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence | |||||
| within Region. | 12 | 1 | $ - 0 | ||
| Home visit (non-clinical) by Respiratory Care Practitioner for reeducation. | 12 | 1 | $ - 0 | ||
| Home visit by Patient Services Technician for patients on Government-owned concentrators. | 12 | 24 | $ - 0 | ||
| All inclusive clinical Respiratory Services to include but not limited to: patient’s heart rate, blood pressure, breath sounds as well as pulse oximetry readings while on oxygen, room air at rest and while ambulating as tolerated. Periodic RT visits must address: prescribed liter flow compliance, equipment /patient safety (to include risk of open flames and smoking), and patient medication usage. Deficiencies shall be communicated to the COR or designee a t the time of home visit or within 24 hours, using COR designated form. (Initial setup or every 6 months). | 12 | 564 | $ - 0 | ||
| Fee for deliveries made for over 100 miles from the ordering VA facility, or from Contractors local facility, whichever is closer. | 12 | 1 | $ - 0 | ||
| Patient Safety Alert AL18-01 Use of Thermal Fuses on Home Oxygen Delivery Systems. Bidirectional oxygen thermal fuses. Sometimes referred to as fire-safe, oxy-safe, or fire-break valves. Two thermal fuses must be provided and installed in each home oxygen delivery system (one at the patient end and one at the oxygen source). This must be done for the patient’s primary oxygen therapy equipment as well as any portable oxygen therapy equipment. Thermal fuses are not required for portable pulse dose/intermittent oxygen therapy equipment when the equipment does not have a continuous flow setting. The fuses will be issued to all new patients that require them and replaced at the end of their expected life per manufacturer's guidelines. | 12 | 936 | $ - 0 | ||
| Labor Fee for reconditioning/repair of VA owned equipment per manufacturer’s requirements. Contractor is required to notify the COR to obtain approval prior to fixing/repairing of VA equipment under this line item. $ 20 per .25 hour | 12 | 1 | $ - 0 | ||
| Monthly equipment rental and management/monitoring of ventilators for continous ventilation patients, excludes scheduled preventatitve maintenance. Includes initial delivery, set-up, supplies, to include bag, value mask, education/training. Monthly Licensed Respitory Therapist (LRT) visits to inspect equipment and environment, re-educate, and/or re-train caregiver, provide supplies as neccesary and perform routine preventative maintainance to include support of 2 ventilators per patient: 1 primary and 1 backup. | 12 | 1 | $ - 0 | ||
| TOTAL | $ - 0 |
ORDERING PERIOD 4
| Southern Nevada Healthcare System Home Oxygen Services | Period of Performance | $s per each | Estimated Amount | ||
| No. of Months or Years | Qty Per Year | ||||
| Delivery, Initial set-up, and education of Government-Owned Oxygen Concentrator System with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask, humidifier, tubing, etc., when specified). Includes back up of minimum supply of oxygen which shall be equal to three times the maximum response time for use in case of system malfunction and/or power failure. Concentrator to be provided by VA with litter flow 0 to 5 and 0 to 10 liters per minute. One time charge for new set-up/new patient. Initial set-up is defined as those beneficiaries who have not been provided oxygen therapy delivery systems in the resident or nursing home on a previous occasion or have not used such a system continuously for the | |||||
| past sixty (60) days. Switch-out is defined as those beneficiaries who are presently using an oxygen delivery system or have used such a system continuously within the past sixty (60) days. | 12 | 72 | $ - 0 | ||
| If a request is received to deliver a Government owned concentrator and there is no Government inventory available, a vendor owned concentrator will be supplied at the vendor monthly rate (unit price). | 12 | 1 | $ - 0 | ||
| In the event a patient needs to have the Government owned concentrator switched out and there is no Government owned inventory available, a vendor owned concentrator will be supplied and billed the vendor owned monthly rate (unit price). | 12 | 1 | $ - 0 | ||
| In the event a patient needs to have a Government owned concentrator switched out with another Government owned concentrator, the vendor shall bill the PST delivery rate (unit price). | 12 | 1 | $ - 0 | ||
| Preventive Maintenance Services (PMI) for Government owned concentrators. (Includes all labor, tools, equipment, travel and materials necessary to perform PMI in accordance with | |||||
| manufactures instructions.) | 12 | 1 | $ - 0 | ||
| Monthly Rental of Oxygen Concentrator System with backup system consisting of compressed |
gas source, regulator, stand, (nasal cannula or mask humidifier, and tubing, etc., when specified).
(Includes delivery, setup, and education). Back up minimum supply of oxygen shall be equal to three times the maximum response time for use in case of system malfunction and/or power
| failure. With flow rate of 0 – 5 liters per minute. | 12 | 6696 |
| Monthly Rental of Oxygen Concentrator System with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask, humidifier, and tubing, etc., when |
specified). (Includes delivery, setup, and education). Back up minimum supply of oxygen shall be equal to three times the maximum response time for use in case of system malfunction
| and/or power failure. With a flow rate of 0-10 liters per minute. | 12 | 372 | |||
| Oxygen tubing as required/ordered, 6 foot in length | 12 | 1 | $ - 0 | ||
| Oxygen tubing as required/ordered, 50 foot in length. | 12 | 1 | $ - 0 | ||
| Face masks as required/ordered. | 12 | 1 | $ - 0 | ||
| Standard nasal cannulas as required/ordered. | 12 | 1 | $ - 0 | ||
| Disposable humidifiers as required/ordered. | 12 | 1 | $ - 0 | ||
| Cylinder, size M60 or H. Set-up consisting of regulator, flow meter, safety stand, humidifier and | |||||
| disposable supplies. Primary set-up only. Includes delivery, setup, and education. This is a one-time equipment setup charge, and not a recurring monthly expense. | 12 | 1 | $ - 0 | ||
| If a patient requires a cylinder refill, the vendor shall bill for the cylinder refill rate per cylinder | |||||
| (unit price) | 12 | 1 | $ - 0 | ||
| Cylinder, size M60 or H refill (Backup/Primary) E0443 | 12 | 1 | $ - 0 | ||
| #A012 *Portable system for new set ups consists of “E”, “D”, “C”, or “B” (M6) size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch and disposable supplies. Includes delivery, setup, and education. This is a one-time chargefor new set-ups. EXCEPTIONS: Oxygen conserving devices are Government supplied. | 12 | 396 | $ - 0 | ||
| Cylinder, size “E” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks required. E0443 | 12 | 2244 | $ - 0 | ||
| Cylinder, size “D” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks | |||||
| required. E0443 | 12 | 372 | $ - 0 | ||
| Cylinder, size “C” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks | |||||
| required. E0443 | 12 | 1908 | $ - 0 | ||
| Cylinder, size “M6) refill for #A012 above. Aluminum (or metal of equivalent weight) tanks required. E0443 | 12 | 912 | $ - 0 | ||
| Demand Nasal Cannula (e.g. Oximyzer). | 12 | 60 | $ - 0 | ||
| “E” cylinders (aluminum, each) complete portable system (e.g. tank, regulator, etc) for each | |||||
| Medical Center for availability to issue home oxygen beneficiaries who deplete their portable units during appointments or to send home with new start-up (e.g. discharged from inpatient). | 12 | 1 | $ - 0 | ||
| Monthly rental liquid oxygen system (90 –100 lbs) with stationary reservoir per beneficiary | |||||
| E0439 Includes delivery, setup, education, and supplies. | 12 | 1 | $ - 0 | ||
| Monthly rental portable liquid oxygen system per beneficiary. E0434 Includes delivery, setup, and education, and supplies. | 12 | 372 | $ - 0 | ||
| Liquid oxygen per pound for item #A019. E0444 | 12 | 1 | $ - 0 | ||
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence | |||||
| within Region. | 12 | 1 | $ - 0 | ||
| Home visit (non-clinical) by Respiratory Care Practitioner for reeducation. | 12 | 1 | $ - 0 | ||
| Home visit by Patient Services Technician for patients on Government-owned concentrators. | 12 | 24 | $ - 0 | ||
| All inclusive clinical Respiratory Services to include but not limited to: patient’s heart rate, blood pressure, breath sounds as well as pulse oximetry readings while on oxygen, room air at rest and while ambulating as tolerated. Periodic RT visits must address: prescribed liter flow compliance, equipment /patient safety (to include risk of open flames and smoking), and patient medication usage. Deficiencies shall be communicated to the COR or designee a t the time of home visit or within 24 hours, using COR designated form. (Initial setup or every 6 months). | 12 | 564 | $ - 0 | ||
| Fee for deliveries made for over 100 miles from the ordering VA facility, or from Contractors local facility, whichever is closer. | 12 | 1 | $ - 0 | ||
| Patient Safety Alert AL18-01 Use of Thermal Fuses on Home Oxygen Delivery Systems. Bidirectional oxygen thermal fuses. Sometimes referred to as fire-safe, oxy-safe, or fire-break valves. Two thermal fuses must be provided and installed in each home oxygen delivery system (one at the patient end and one at the oxygen source). This must be done for the patient’s primary oxygen therapy equipment as well as any portable oxygen therapy equipment. Thermal fuses are not required for portable pulse dose/intermittent oxygen therapy equipment when the equipment does not have a continuous flow setting. The fuses will be issued to all new patients that require them and replaced at the end of their expected life per manufacturer's guidelines. | 12 | 936 | $ - 0 | ||
| Labor Fee for reconditioning/repair of VA owned equipment per manufacturer’s requirements. Contractor is required to notify the COR to obtain approval prior to fixing/repairing of VA equipment under this line item. $ 20 per .25 hour | 12 | 1 | $ - 0 | ||
| Monthly equipment rental and management/monitoring of ventilators for continous ventilation patients, excludes scheduled preventatitve maintenance. Includes initial delivery, set-up, supplies, to include bag, value mask, education/training. Monthly Licensed Respitory Therapist (LRT) visits to inspect equipment and environment, re-educate, and/or re-train caregiver, provide supplies as neccesary and perform routine preventative maintainance to include support of 2 ventilators per patient: 1 primary and 1 backup. | 12 | 1 | $ - 0 | ||
| TOTAL | $ - 0 |
ORDERING PERIOD 5
| Southern Nevada Healthcare System Home Oxygen Services | Period of Performance | $s per each | Estimated Amount | ||
| No. of Months or Years | Qty Per Year | ||||
| Delivery, Initial set-up, and education of Government-Owned Oxygen Concentrator System with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask, humidifier, tubing, etc., when specified). Includes back up of minimum supply of oxygen which shall be equal to three times the maximum response time for use in case of system malfunction and/or power failure. Concentrator to be provided by VA with litter flow 0 to 5 and 0 to 10 liters per minute. One time charge for new set-up/new patient. Initial set-up is defined as those beneficiaries who have not been provided oxygen therapy delivery systems in the resident or nursing home on a previous occasion or have not used such a system continuously for the | |||||
| past sixty (60) days. Switch-out is defined as those beneficiaries who are presently using an oxygen delivery system or have used such a system continuously within the past sixty (60) days. | 12 | 72 | $ - 0 | ||
| If a request is received to deliver a Government owned concentrator and there is no Government inventory available, a vendor owned concentrator will be supplied at the vendor monthly rate (unit price). | 12 | 1 | $ - 0 | ||
| In the event a patient needs to have the Government owned concentrator switched out and there is no Government owned inventory available, a vendor owned concentrator will be supplied and billed the vendor owned monthly rate (unit price). | 12 | 1 | $ - 0 | ||
| In the event a patient needs to have a Government owned concentrator switched out with another Government owned concentrator, the vendor shall bill the PST delivery rate (unit price). | 12 | 1 | $ - 0 | ||
| Preventive Maintenance Services (PMI) for Government owned concentrators. (Includes all labor, tools, equipment, travel and materials necessary to perform PMI in accordance with | |||||
| manufactures instructions.) | 12 | 1 | $ - 0 | ||
| Monthly Rental of Oxygen Concentrator System with backup system consisting of compressed |
gas source, regulator, stand, (nasal cannula or mask humidifier, and tubing, etc., when specified).
(Includes delivery, setup, and education). Back up minimum supply of oxygen shall be equal to three times the maximum response time for use in case of system malfunction and/or power
| failure. With flow rate of 0 – 5 liters per minute. | 12 | 6696 |
| Monthly Rental of Oxygen Concentrator System with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask, humidifier, and tubing, etc., when |
specified). (Includes delivery, setup, and education). Back up minimum supply of oxygen shall be equal to three times the maximum response time for use in case of system malfunction
| and/or power failure. With a flow rate of 0-10 liters per minute. | 12 | 372 | |||
| Oxygen tubing as required/ordered, 6 foot in length | 12 | 1 | $ - 0 | ||
| Oxygen tubing as required/ordered, 50 foot in length. | 12 | 1 | $ - 0 | ||
| Face masks as required/ordered. | 12 | 1 | $ - 0 | ||
| Standard nasal cannulas as required/ordered. | 12 | 1 | $ - 0 | ||
| Disposable humidifiers as required/ordered. | 12 | 1 | $ - 0 | ||
| Cylinder, size M60 or H. Set-up consisting of regulator, flow meter, safety stand, humidifier and | |||||
| disposable supplies. Primary set-up only. Includes delivery, setup, and education. This is a one-time equipment setup charge, and not a recurring monthly expense. | 12 | 1 | $ - 0 | ||
| If a patient requires a cylinder refill, the vendor shall bill for the cylinder refill rate per cylinder | |||||
| (unit price) | 12 | 1 | $ - 0 | ||
| Cylinder, size M60 or H refill (Backup/Primary) E0443 | 12 | 1 | $ - 0 | ||
| #A012 *Portable system for new set ups consists of “E”, “D”, “C”, or “B” (M6) size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch and disposable supplies. Includes delivery, setup, and education. This is a one-time chargefor new set-ups. EXCEPTIONS: Oxygen conserving devices are Government supplied. | 12 | 396 | $ - 0 | ||
| Cylinder, size “E” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks required. E0443 | 12 | 2244 | $ - 0 | ||
| Cylinder, size “D” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks | |||||
| required. E0443 | 12 | 372 | $ - 0 | ||
| Cylinder, size “C” refill for #A012 above. Aluminum (or metal of equivalent weight) tanks | |||||
| required. E0443 | 12 | 1908 | $ - 0 | ||
| Cylinder, size “M6) refill for #A012 above. Aluminum (or metal of equivalent weight) tanks required. E0443 | 12 | 912 | $ - 0 | ||
| Demand Nasal Cannula (e.g. Oximyzer). | 12 | 60 | $ - 0 | ||
| “E” cylinders (aluminum, each) complete portable system (e.g. tank, regulator, etc) for each | |||||
| Medical Center for availability to issue home oxygen beneficiaries who deplete their portable units during appointments or to send home with new start-up (e.g. discharged from inpatient). | 12 | 1 | $ - 0 | ||
| Monthly rental liquid oxygen system (90 –100 lbs) with stationary reservoir per beneficiary | |||||
| E0439 Includes delivery, setup, education, and supplies. | 12 | 1 | $ - 0 | ||
| Monthly rental portable liquid oxygen system per beneficiary. E0434 Includes delivery, setup, and education, and supplies. | 12 | 372 | $ - 0 | ||
| Liquid oxygen per pound for item #A019. E0444 | 12 | 1 | $ - 0 | ||
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence | |||||
| within Region. | 12 | 1 | $ - 0 | ||
| Home visit (non-clinical) by Respiratory Care Practitioner for reeducation. | 12 | 1 | $ - 0 | ||
| Home visit by Patient Services Technician for patients on Government-owned concentrators. | 12 | 24 | $ - 0 | ||
| All inclusive clinical Respiratory Services to include but not limited to: patient’s heart rate, blood pressure, breath sounds as well as pulse oximetry readings while on oxygen, room air at rest and while ambulating as tolerated. Periodic RT visits must address: prescribed liter flow compliance, equipment /patient safety (to include risk of open flames and smoking), and patient medication usage. Deficiencies shall be communicated to the COR or designee a t the time of home visit or within 24 hours, using COR designated form. (Initial setup or every 6 months). | 12 | 564 | $ - 0 | ||
| Fee for deliveries made for over 100 miles from the ordering VA facility, or from Contractors local facility, whichever is closer. | 12 | 1 | $ - 0 | ||
| Patient Safety Alert AL18-01 Use of Thermal Fuses on Home Oxygen Delivery Systems. Bidirectional oxygen thermal fuses. Sometimes referred to as fire-safe, oxy-safe, or fire-break valves. Two thermal fuses must be provided and installed in each home oxygen delivery system (one at the patient end and one at the oxygen source). This must be done for the patient’s primary oxygen therapy equipment as well as any portable oxygen therapy equipment. Thermal fuses are not required for portable pulse dose/intermittent oxygen therapy equipment when the equipment does not have a continuous flow setting. The fuses will be issued to all new patients that require them and replaced at the end of their expected life per manufacturer's guidelines. | 12 | 936 | $ - 0 | ||
| Labor Fee for reconditioning/repair of VA owned equipment per manufacturer’s requirements. Contractor is required to notify the COR to obtain approval prior to fixing/repairing of VA equipment under this line item. $ 20 per .25 hour | 12 | 1 | $ - 0 | ||
| Monthly equipment rental and management/monitoring of ventilators for continous ventilation patients, excludes scheduled preventatitve maintenance. Includes initial delivery, set-up, supplies, to include bag, value mask, education/training. Monthly Licensed Respitory Therapist (LRT) visits to inspect equipment and environment, re-educate, and/or re-train caregiver, provide supplies as neccesary and perform routine preventative maintainance to include support of 2 ventilators per patient: 1 primary and 1 backup. | 12 | 1 | $ - 0 | ||
| TOTAL | $ - 0 |
File details come from the government source that posted it. Updated .