Attachment A - PWS- PIMC Hospitalist.pdf

HOSPITALIST SERVICES

PHOENIX INDIAN MEDICAL CENTER

Performance Work Statement (PWS)

PERFORMANCED-BASED SUMMARY:

This requirement is structured as a performance-based service acquisition. The Contractor is responsible for achieving the performance outcomes defined in this document, rather than adherence solely to prescribed processes.

INTRODUCTION:

This is a non-personal services contract. The Contractor shall be responsible for the management, supervision, and performance of all personnel. Contractor personnel shall not be supervised by Government personnel, and no employer-employee relationship exists between the Government and Contractor personnel.

It is the intent of the Phoenix Area Indian Health Service to acquire non-personal professional physician hospitalist services as described herein for the Phoenix Indian Medical Center (PIMC) located in Phoenix, Arizona. This contract solicitation contains two (2) elements:

1. Daytime hospitalist services, for which multiple awards may be made

2. Nighttime hospitalist services, for which a single award will be made

All responses to this solicitation shall contain a complete profile and current work history of the candidate(s) presented, including licensure and certifications. Additionally, responses must include a record of respondents’ successfully managing federal contracts of similar size and scope. Respondents may respond to one or both elements of this solicitation.

Selected candidates shall undergo the Indian Health Service mandated security clearance requirement prior to commencement of services at the PIMC. The security pre-clearance requirement must be adhered to; the process includes a fingerprint check and a screen check of the physician through the Office of the Inspector General's exclusion list at http://exclusions.oig.hhs.gov/. Documented evidence of the clearances shall be provided to the

Chief Contracting Officer at: Phoenix Area Indian Health Service, 40 North Central Avenue, Phoenix, AZ 85004.

1. SCHEDULES/LOCATION/SHIFTS/QUALIFICATIONS/CERTIFICATIONS:

SCHEDULE

The Contractor is requested to provide PHYSICIAN HOSPITALIST for a 12 month base year and four (4) 12-month option years. Shift times and schedules are subject to change based on the medical needs of the patient population and hospital/clinic operations.

All services shall be performed at the Phoenix Indian Medical Center (PIMC) located in Phoenix, Arizona.

A) Daytime Hospitalist:

SHIFTS: One (1) to two (2) Hospitalists will be needed to cover 8 and 11-hour day shifts (shift times are

7am to 3pm and 7am to 6pm) 7 days per week, including holidays. Estimated number of day shift coverage needs is variable, but may range from 10 to 30 shifts per month. On call service offsite is not required.

B) Nighttime Hospitalist:

SHIFTS: One (1) Hospitalist will be needed to cover a 13 - hour night shift (shift time is 6pm to 7am) for up to 30 nights per month. Estimated number of night shifts needed to be covered will vary, but will range from http://exclusions.oig.hhs.gov/

15 to 30 shifts per month. On call service offsite is not required.

The estimated quantities identified in this PWS represent the Government’s anticipated usage based on current operational requirements and available funding. Quantities are estimates only and do not guarantee maximum potential utilization scenarios. Services exceeding the funded estimated quantities shall require additional funding and appropriate contract action by the Contracting Officer prior to performance beyond the awarded level of effort.

LOCATION: Hospital Medicine Department

Hours Control/Preapproval:

All services shall be performed in accordance with the approved schedule. Any hours worked beyond the scheduled shift must be authorized in advance by the COR for the purpose of contract administration and payment approval. Such authorization does not constitute supervision or control over Contractor personnel.

In emergency situations requiring continuation of care, the Contractor may extend services beyond scheduled hours but must notify the COR within 24 hours and provide justification.

QUALIFICATIONS/CERTIFICATIONS

Daytime Hospitalist: The Contractor must have completed a residency in Internal Medicine or Family

Practice (if the specialty is Family Practice, sufficient inpatient hospitalist experience/training must be demonstrated and approved by the Chief, Hospital Medicine), and, have an active and unrestricted license to practice medicine in the USA, or the District of Columbia, or the Commonwealth of Puerto Rico. Contractor shall provide staff physician with experience in these areas. Current certification is required in BLS (Basic

Life Support) and ACLS (Advanced Cardiac Life Support). Board Certification or Board Eligibility is required for Internal Medicine or Family Medicine.

Nighttime Hospitalist: The Contractor must have completed a residency in Internal Medicine or Family

Practice (if the specialty is Family Practice, sufficient inpatient hospitalist experience/training must be demonstrated and approved by the Chief, Hospital Medicine), and, have an active and unrestricted license to practice medicine in the USA, or the District of Columbia, or the Commonwealth of Puerto Rico. Contractor shall provide staff physician with experience in these areas. Current certification is required in BLS (Basic

Life Support) and ACLS (Advanced Cardiac Life Support). Board Certification or Board Eligibility is required for Internal Medicine or Family Medicine.

EXPERIENCE

Daytime/Nighttime Hospitalist: New residency graduates with significant hospitalist experience will be considered on a case by case basis; hospitalists with two (2) years or more experience in hospital medicine are preferred.

2. PRICING SCHEDULE:

The unit price paid to the Contractor shall be considered as payment in full for services provided under this award.

In no way, unless directed by the IHS, shall any provider attempt to bill or collect from any IHS patient, or from any alternate resource for which the patient may be eligible, any monies for services provided under this award.

Please see Attachment A for the Pricing Schedule to be completed.

Hourly fixed rate shall be inclusive of all other fees (holiday, nights, and weekend), including travel expenses, per diem, lodging, all city, state, federal and local taxes, and all miscellaneous costs associated with the provision of services. The government will pay one flat rate. On-Call and overtime rates will not be paid. If a shift is extended, the same hourly rate will be paid.

Contractor shall be paid only for actual time services are performed on site under the terms of the contract at the hourly fixed rate (one flat rate). There is no provision for holiday, nights, and weekend.

Additionally, Contractor shall be paid only for actual hours worked and approved. Hours exceeding scheduled shifts without prior approval (except in documented emergencies) may not be reimbursed.

*30-minute lunch breaks are included in the shift hours and will not be paid by the Government; the only exception is when there is a single physician on duty in which case a break would not be possible for patient safety reasons.

3. Performance Requirements:

Performance Objectives and Standards:

a. Coverage

• Standard: 100% of scheduled shifts filled

• Acceptable Quality Level (AQL): 98%

b. Patient Evaluation Timeliness

• Standard: Patients evaluated within 60 minutes of request (urgent/emergent)

• AQL: 95%

c. Documentation

• Standard: Charting completed within 24 hours

• AQL: 95%

d. Clinical Care Compliance

• Standard: Compliance with IHS, TJC, and CMS standards

• AQL: 100%

e. Responsiveness

• Standard: Response to Government communications within 1 hour (business hours)

• AQL: 95%

Performance Reporting:

The Contractor shall provide monthly performance reports summarizing compliance with performance standards, including documentation timeliness, response times, and staffing coverage.

Scope:

The overall scope of this contract is to provide qualified hospitalist services under a Government non-personal services contract. The Contractor shall ensure that personnel possess the education, training, licensure, experience, and competencies necessary to perform required services. All work shall be performed in accordance with the requirements and conditions of this Performance Work Statement (PWS).

The Contractor shall provide services necessary to support the normal operations of the department in accordance with this PWS. All services shall be performed consistent with applicable Indian Health Service (IHS) policies, procedures, and clinical standards. Performance shall be measured against the performance standards and acceptable quality levels defined in this PWS. Failure to meet these standards may result in corrective action, removal of personnel, or other remedies in accordance with contract terms.

The Contractor shall prepare and complete medical and other required records in a timely manner for all patients receiving care. Chart notes shall be completed within required timeframes as defined in this PWS. The Contractor shall ensure that patient care processes are performed in accordance with applicable standards, including The Joint

Commission (TJC) accreditation requirements and Centers for Medicare & Medicaid Services (CMS) standards.

The Contractor shall ensure personnel possess appropriate professional medical education and maintain required licensure and certifications. Personnel shall demonstrate proficiency in documentation, communication, and use of electronic health record systems. The Contractor shall ensure personnel have the knowledge, experience, and professional behavior necessary to effectively perform services at PIMC and interact with patients, staff, and the community.

The Contractor shall ensure personnel maintain professional standards of conduct, appearance, and hygiene appropriate for a clinical healthcare environment while performing under this contract.

The Contractor shall utilize the electronic health record system for all required documentation, orders, and clinical communication.

The Contractor shall demonstrate sensitivity to the cultural and social factors of the patient population, including communication needs and cultural practices relevant to care delivery.

Services shall be performed during scheduled shifts. Any hours exceeding scheduled shifts must be preapproved in accordance with contract requirements, except in documented emergency situations.

Government housing is not provided.

MAJOR DUTIES:

The Contractor shall provide Medical Officer - Hospitalists for the Phoenix Indian Medical Center (PIMC)

Hospital Medicine Department:

A) CLN 0001- Daytime Hospitalist:

1) Admissions /Transfers - The contractor physician shall cover medical and surgical admissions on an "as needed" basis, to provide inpatient hospitalist services to support continuous coverage for up to 365 days per year. The contractor will be able to provide services on-site at PIMC. The contract personnel must be available for consultation at all times, available to admit any urgent/emergent patients, available to see patients who need on-site evaluation when requested by floor nurses, or, whenever a question about diagnosis or patient condition exists. The contract personnel will complete daily rounds on the patients in the ICU and Medical/Surgery wards.

2) The contractor physician will admit any appropriate urgent/emergent patients and will care for patients admitted to the Medical/Surgery and ICU wards as requested by the E.R. or other provider. Contractor personnel will also evaluate patients on the inpatient units when requested by floor nurses or whenever a question about diagnosis or patient condition exists.

3) The Contractor shall develop and provide staffing schedules at least 6 weeks in advance to meet

Government coverage requirements. Schedules shall be coordinated with the Chief, Hospital Medicine

(or designee) to ensure alignment with operational needs; however, the Contractor retains responsibility for staffing and assignment of its personnel. Contractor must demonstrate a history of excellent responsiveness on past federal hospitalist contracts of similar size and scope, including responses to email and phone calls from federal clients within one hour of contact. The contracting company must demonstrate success at responding to emergency schedule changes, including changes that occur during holidays, nights, and weekends.

4) Contract personnel provide hospitalist care as required, by interviewing (if possible) and examining patients with conditions potentially requiring hospital admission or urgent/timely evaluation, including difficult to diagnose illnesses. Contractor reviews past medical history and immediately requests and/or performs diagnostic tests and examinations deemed necessary to obtain all possible information related to each case. Makes preliminary diagnoses, directs, prescribes or provides treatment, or arranges for specialized care or patient referral as required. Bases decisions upon information obtained, professional medical knowledge and skills and prescribed policies and procedures. Makes notes of observations in patient's medical records. Provides definitive management in all medical categories for cases that do not require a referral. Gives total patient care including prevention, health maintenance, early diagnosis, treatment, and follow-up services to patients under his/her care.

5) Assure preparation and timely completion of appropriate medical records for all patients seen to ensure complete and comprehensive medical care. Completes all required entries in medical records before completing each assignment at Phoenix Indian Medical Center.

6) Primary assignment will be to provide inpatient care to individuals admitted to general adult medical units and the intensive care unit, as well as to evaluate patients for possible admission who present to the

Emergency Department. Contractor will work on an assigned schedule. Will also serve as a consultant to other providers at PIMC and in the field. Perform inpatient procedures when indicated, such as insertion of central venous catheters, insertions of arterial lines, thoracentesis, paracentesis, lumbar puncture, skin biopsies, when properly privileged. Appropriately admits and discharges patients to and from PIMC and transfers patients to other medical facilities for care if services are not available at PIMC.

7) The Contractor shall discuss possible incoming transfers to PIMC with the referring physician, to determine if level of service at PIMC is adequate for patient care.

8) The contractor shall discuss and co-manage with the surgeon on-call, any admissions for surgery. If surgery admits a patient, the Contractor may be asked to consult.

9) The contractor shall help find a bed when requested that would provide appropriate level of service for patient needing transfer out of PIMC from the ED or hospital. The Contractor would also provide this same assistance for patients needing placement in a nursing home, skilled nursing facility, or acute rehabilitation unit.

10) The Contractor shall ensure the availability of personnel to respond to urgent or emergent patient care needs during scheduled shifts in accordance with facility protocols.

11) The Contractor shall promote quality of care and patient safety. The Contractor agrees to work with the PIMC staff to eliminate barriers and ensure that patients are placed in the proper level of care to include transfer or discharge.

12) Current certification is recommended as noted below:

[X] BLS (Basic Life Support)

[X] ACLS (Advanced Cardiac Life Support)

[ ] PALS (Pediatric Advanced Life Support)

[ ] ATLS (Advanced Trauma Life Support) for Emergency Room Physicians

[X] Board Certification (or Eligibility) in Internal Medicine or Family Medicine

13) Contractor personnel will complete all required assigned training within the timeframe allowed.

B) CLN 0002-Nighttime Hospitalist: Duties are substantially similar to Daytime Hospitalist services, with adjustments for shift timing and coverage responsibilities as described below.

1) Nighttime hospitalist may be needed to cover a 13-hour night shift 7 nights per week, as needed.

2) Admissions /Transfers - The contractor shall cover medical and surgical admissions on an "as needed" basis, to assist in staffing the inpatient hospitalist coverage for up to 365 nights per year. The contractor will be able to provide services on-site at PIMC. The contract personnel must be available for consultation at all times, available to admit any urgent/emergent patients, available to see patients who need on-site evaluation when requested by floor nurses, or, whenever a question about diagnosis or patient condition exists. The contract personnel will complete nightly rounds on the patients in the ICU and Medical/Surgery wards as the clinical situation warrants.

3) The Contractor shall develop and provide staffing schedules at least 6 weeks in advance to meet

Government coverage requirements. Schedules shall be coordinated with the Chief, Hospital Medicine

(or designee) to ensure alignment with operational needs; however, the Contractor retains responsibility for staffing and assignment of its personnel. Contractor must demonstrate a history of excellent responsiveness on past federal hospitalist contracts of similar size and scope, including responses to email and phone calls from federal clients within one hour of contact during normal business hours.

Also, contracting company must demonstrate success at responding to emergency schedule changes, including changes that occur during holidays, nights, and weekends.

4) Contract personnel provide hospitalist care as required, by interviewing (unless clinical situation warrants otherwise) and examining patients with conditions potentially requiring hospital admission, including difficult to diagnose illnesses. Contractor physician reviews past medical history, and immediately requests and/or performs diagnostic tests and examinations deemed necessary to obtain all possible information related to each case. Makes preliminary diagnosis, directs, prescribes or provides treatment, or arranges for specialized care or patient referral as required. Bases decisions upon information obtained, professional medical knowledge and skills and prescribed policies and procedures. Makes notes of observations into patient's medical records. Provides definitive management in all medical categories for cases that do not require a referral. Gives total patient care including prevention, health maintenance, early diagnosis, treatment, and follow-up services to patients under his/her care.

5) Contractor physician is required to remain onsite at PIMC for the entire night shift.

6) Assure preparation and timely completion of appropriate medical records for all patients seen to ensure complete and comprehensive medical care. Completes all required entries in medical records before ending each shift at Phoenix Indian Medical Center.

7) Primary assignment will be to provide inpatient care to individuals admitted to general adult medical units and the intensive care unit. Contractor will work on an assigned schedule. Will serve as a consultant to other providers at PIMC and in the field. Will perform inpatient procedures when indicated, such as insertion of central venous catheters, insertions of arterial lines, thoracentesis, paracentesis, lumbar puncture, skin biopsies, when properly privileged. Appropriately admits and discharges patients to and from PIMC and transfers patients to other medical facilities for care if services are not available at PIMC.

8) The Contractor shall discuss possible incoming transfers to PIMC with the referring physician, to determine if level of service at PIMC is adequate for patient care.

9) The contractor shall discuss and co-manage with the surgeon on-call, any admissions for surgery. If surgery admits a patient, the Contractor may be asked to consult.

10) The contractor shall help find a bed that would provide appropriate level of service for patient needing transfer out of PIMC from the ED or hospital. The Contractor would also provide this same assistance for patients needing placement in a nursing home, skilled nursing facility, or acute rehabilitation unit.

11) The Contractor shall ensure the availability of personnel to respond to urgent or emergent patient care needs during scheduled shifts in accordance with facility protocols.

12) The Contractor shall promote quality of care and patient safety. The Contractor agrees to work with the PIMC staff to eliminate barriers and ensure that patients are placed in the proper level of care to include transfer or discharge.

13) Current certification is recommended as noted below:

[X] BLS (Basic Life Support)

[X] ACLS (Advanced Cardiac Life Support)

[ ] PALS (Pediatric Advanced Life Support)

[ ] ATLS (Advanced Trauma Life Support) for Emergency Room Physicians

[X] Board Certification (or Eligibility) in Internal Medicine or Family Medicine

14) Contractor physician will complete all required assigned trainings within the timeframe allowed.

4. CONDITIONS FOR REMOVAL/REPLACEMENT OF PHYSICIAN(S):

The Contracting Officer may require the Contractor to remove and replace any personnel who fail to meet contract requirements or performance standards

The Contractor’s employee shall be removed from an IHS facility if services are not performed in accordance with terms and conditions of this award, and/or the Contractor’s VA/FSS contract.

5. CONTRACTOR REQUIREMENTS:

For Medical & Professional Contractors, the contractor shall comply with all IHS facility infection control and safety procedures, and standards. During the performance of this contract, the Contractor shall provide for the consistent performance of patient care process according to the standards of The Joint Commission (TJC) and/or

Centers for Medicare Services (CMS) who supplies accreditation to the Phoenix Area Indian Health Service hospitals and health centers. These standards shall include: The Comprehensive Accreditation Manual for Critical

Access Hospitals, and the Laboratory Standards as they represent the scope of services of this contract.

For Medical& Professional Contractors, the contractor shall complete in a timely fashion, the medical and other required records for patients he/she admits or in any way provides treatment. Chart notes are to be completed on the day services are rendered. The contractor shall abide by the Service Unit Medical By-laws and rules and regulations and meet all credentialing requirements in accordance with the Service Unit Medical Staff By-laws.

Upon award, the selected physician(s) shall undergo Indian Health Service (IHS) mandated security clearance for work on-site for the PIMC. The security pre-clearance requirement must be adhered to; the process includes a fingerprint check and a screen check through the Office of the Inspector General's exclusion list at http://exclusions.oig.hhs.gov/. Documented evidence of the clearances shall be provided to the Chief Contracting

Officer at the Phoenix Area Indian Health Service, 40 North Central Avenue, Phoenix, AZ 85004.

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

6. MAJOR DUTIES REQUIRED BY THE POSITIONS:

Skill and knowledge of established concepts, principles and practices related to health care assignments and additional training or experience in assessing the conditions of patients, in providing medical care and in advising on health care needs, all with full consideration of mental, emotional and physical factors.

Knowledge of the diagnostic, preventive and therapeutic position related to a variety of medical health care fields to include Hospitalist Services.

Ability to collect, organize, record and communicate, in a meaningful way, data relevant to primary health assessments including the detailed family and medical history, a physical examination and selective laboratory tests.

Ability to perform special screening and developmental tests and assess routine and specialized laboratory and radiological services.

Skill in making diagnosis and in choosing, initiating and modifying selected therapies; and ability to provide emergency treatment.

Ability to assess the physical-psychosocial health status of patients and family based upon the knowledge of growth and development patterns and health condition is that require medical management.

Knowledge of pharmaceuticals in order to recognize their desired effects, side effects and complications of their use.

Knowledge of human behavior during stressful situations in order to exercise emotional control, tact, patience and reliability in carrying out patient care.

Knowledge of the availability and use of resources designated as primary care and referral services.

Ability to provide individual and family counseling, guidance and health instruction to help patients to understand how to prevent disease and maintain good physical and mental health.

Knowledge of quality assurance and evaluation process to improve care and facilitate monitoring and program planning.

Knowledge of health record aspects of patient care and ability to accurately and completely document related clinical data.

Ability to provide guidance and leadership to other healthcare providers.

A license to practice in the United States is required. Compliance with Indian Health Service – Service Unit

Medical Staff/Governing Body By-laws, Rules and Regulations and compliance with requirements for credentialing/privileging as an active member of the medical staff.

Skill in diplomacy and tact while working in stressful situations.

Skill in working with people from a wide variety of backgrounds and different cultures.

7. CONTRACTOR PHYSICIAN CREDENTIALS:

The contractor shall provide a list of qualified candidates and the following documents per candidate:

a) Current Resume or CV

b) OMB NO 0917-0028, Addendum to Declaration of Federal Employment (OF-306)

c) College Transcripts; conferred degrees and certified training in the field.

d) Two (2) letter of reference from current or previous employers.

e) Past Work Performance Statement, applicants must describe their present/previous experiences in this field.

f) Credentialing documents and degree conferred.

g) Copy of active unrestricted License to Practice Medicine.

h) Copy of Board Certification or Board Eligibility

i) License Certification Statement

j) Current Health Status Report.

k) Certificate of Immunization.

l) Child Care Form, Addendum OMB Approved Form-2012

8. SUPERVISORY CONTROLS

The Government, through the Chief of the Department or designee, will provide technical direction, clinical coordination, and oversight of services to ensure performance in accordance with this PWS and applicable IHS policies and standards.

The Government will establish overall clinical objectives, policies, and available resources applicable to patient care within the facility. Contractor personnel shall perform services in accordance with these established standards and within the scope of their granted privileges.

The Contractor shall be responsible for the supervision, management, and performance of its personnel. The

Government will not exercise direct supervision or control over Contractor personnel.

Notwithstanding the non-personal nature of this contract, Contractor personnel shall integrate into the clinical environment of the facility and adhere to established medical staff bylaws, clinical protocols, and standards of care. The Chief of Hospital Medicine (or designee) may provide clinical direction related to patient care, including prioritization of clinical activities, coordination of care, and compliance with facility policies necessary to ensure patient safety and quality of care. Such clinical direction is limited to the delivery of healthcare services and does not constitute supervision, management, or control of Contractor personnel. The Contractor retains full responsibility and accountability for the professional performance, supervision, and conduct of its employees.

The Government may review Contractor performance periodically to ensure compliance with contract requirements, applicable policies, and accepted standards of medical practice, including participation in quality assurance and performance improvement activities.

Contractor personnel shall collaborate and coordinate with Government medical staff regarding patient care, including consultation on complex or unusual cases, in accordance with standard medical practice and facility protocols. Such coordination does not constitute Government supervision or control over Contractor personnel.

All services shall be subject to review for conformance with IHS policies, procedures, accepted professional standards, and the Quality Assurance/Performance Improvement programs of the Service Unit.

Within established guidelines, contractor(s) exercise latitude in planning and carrying out health care assignments and in undertaking new procedures, practices and approaches to extend both services provided and increase individual proficiency. The Government may evaluate overall contract performance for effectiveness in meeting requirements for healthcare services.

9. SECURITY CLEARANCES:

The contractor shall ensure their employees have been properly screened prior to presenting to PIMC for employment under this contract. The contractor shall inform their employees to obtain Fingerprint cards or electronically submit their fingerprints through the PIMC Human Resources Department and complete the appropriate background investigation form which will be submitted for processing. No performance under this contract shall be allowed until the contractor’s employee is cleared through the PIMC Human Resources

Department and issued a badge.

10. CREDENTIALING AND PRIVILEGING:

The contractor will participate in the credentialing and privileging process in accordance with existing procedure.

Contractor shall provide no services prior to obtaining approval by the Government Medical Executive and

Governing Board. The Contractor will be provided copies of current requirements and updates as they are published. Privileges will require renewal at least every one - two years in accordance with Government credentialing privileging policy and JCAHO requirements.

11. DELIVERABLES:

A. The Contractor is required to provide a copy of each Contractor’s employee profile to the COR prior to providing services at the PIMC.

B. Timesheet (preferably electronic) shall be submitted to the Chief or Supervisor of the Department, or designee.

The timesheets shall be reviewed for accuracy and certified by signature as accurate and acceptable for payment, then forwarded to the receiving official for further processing of receipt of services through UFMS.

C. The Contractor shall provide a monthly report detailing hours worked, total billed hours, and cumulative expenditures against the contract value.

12. PERFORMANCE CONDITIONS:

A) The Government will identify required coverage needs and communicate them to the Contractor. The Contractor shall be responsible for developing staffing schedules to meet those requirements. The Government’s preference is for coverage schedules to be developed and coordinated at least three (3) to four (4) months in advance to support continuity of operations; however, the Contractor retains responsibility for staffing and assignment of its personnel.

B) In the event the Contractor’s employee is unable to render service on a previously agreed schedule, the

Contractor shall provide a minimum seventy-two (72) hour notification to the COR. The Contractor shall then make a full, good-faith effort to provide coverage with a replacement.

C) The Contractor shall maintain sufficient staffing capability to accommodate routine personnel leave, vacancies, credentialing delays, and short-term staffing fluctuations while maintaining required coverage levels. The Contractor shall coordinate anticipated coverage impacts with the COR and make reasonable efforts to avoid disruption of services.

D) Both parties recognize that on occasion there shall be a need to fill coverage requests with less than a 15-day notice. In such an emergency scheduling situation, The Contractor shall maintain the capability to respond to emergent staffing needs and make a good-faith effort to provide coverage. Failure to provide coverage shall be communicated promptly to the COR.

E) As relates to the single award of a nighttime hospitalist contract, the contractor must seek and recruit a sufficient number of physicians to fill staffing needs up to 365 nights per year. This involves a significant amount of planning on the part of the contractor company to be able to anticipate surges of need at short notice. Contractor must submit weekly schedule updates to the Chief, Hospital Medicine. The Contractor shall submit proposed schedules for Government review and coordination to ensure alignment with coverage requirements and funding constraints. The Contractor retains full responsibility for staffing and assignment of its personnel. Contractor must demonstrate a successful history of managing staffing needs of this magnitude.

F) As relates to the hospitalist contracts, the contractor must have in place a mechanism to respond to emergency staffing needs that may occur at any time, including at night and on the weekends or other off duty times. Contractor must also demonstrate a history of timely responses to communication from contracted sites. Acceptable response times during normal business hours (Monday to Friday 7a to 330 p) are one hour for urgent emails and phone calls. During off hours, a 24/7 emergency response system must be provided.

13. Quality Assurance Surveillance Plan (QASP):

Performance Objective Surveillance Method Frequency AQL

Shift Coverage Schedule review Monthly 98%

Patient Evaluation Chart review Monthly 95%

Documentation EHR audit Monthly 95%

Responsiveness Communication logs Monthly 95%

END OF STATEMENT OF WORK