D.3 Quality Assurance Surveillance Plan 02.docx

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Attached to
6515--FY26 North Florida-South Georgia Home Oxygen Base Plus 4
Solicitation number
36C24825R0029
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About this file

The document is a Quality Assurance Surveillance Plan (QASP) for a Home Oxygen service contract for North Florida/South Georgia VA patients. The QASP outlines six key performance measures with 95% acceptable quality levels, including service delivery timeliness, quarterly vendor audits, home visits, and critical safety monitoring for patient falls and fire risks. Surveillance methods involve random sampling of 5% of patient files and on-site reviews, with quarterly reporting focused on verifying service quality, equipment compliance, home safety, and patient care standards.

The associated federal contract opportunity (Solicitation 36C24825R0029) is a Service-Disabled Veteran Owned Small Business (SVOSB) set-aside procurement for home oxygen supplies and services through the VA Veterans Health Administration. The contract is structured as a base year with four 12-month option periods, using NAICS code 532283 with a $41M small business size standard. Quotations are due by 07/07/2025 at 4:00 PM EST, with questions accepted until 06/18/2025. The procurement will use a trade-off evaluation process, and all offerors must be verified in the SBA system and registered in SAM.

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Other files

File Type Posted
D.2 PAST PERFORMANCE QUESTIONNAIRE_NFSG Home Oxygen 02.docx DOCX document
D.1 Business Associate Agreement.docx DOCX document
D.5 Handbook_6500.6_Appendix C.pdf PDF
36C24825R0029_3.docx DOCX document
D.4 WAGE DETERMINATION_NFSG Home Oxygen.docx DOCX document

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North Florida/South Georgia Home Oxygen Quality Assurance Surveillance Plan

1. 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: 95% Method of Surveillance: Random Sampling

2. 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: 95% Method of Surveillance: Random Sampling

3. 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

4. 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 RRTs results quarterly Acceptable Quality Level: 95% Method of Surveillance: Random Sampling

5. Measure: Falls per JC NPSG 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: Home Visits by RRTS, Contractor, HBPC and Home Oxygen Clinical Staff identification of at Risk for Falls Acceptable Quality Level: 0% Method of Surveillance: Random Sampling reported quarterly

6. Measure: Fires per JC NPSG 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: Home Visits by RRTS, Contractor, HBPC and Home Oxygen Clinical Staff identification of at Risk for Fire Acceptable Quality Level: 0% Method of Surveillance: Random Sampling reported quarterly

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