Exhibit A - Proposed Scope of Work.docx

Exhibit A Scope of Work

I. Duties and Responsibilities of the Contractor A. The Contractor shall provide oxygen services, equipment of high quality and in good working condition to facility residents as ordered by attending physicians in accordance with applicable Federal, Veteran Administration (Fitzsimons) , State and Local laws, rules and regulations.

1. The Contractor shall provide as a rental and deliver to Fitzsimons/WRRC durable medical equipment that is in good working condition as needed within 2 hours of notification by Fitzsimons/WRRC authorized personnel. Delivery services must be available 24-hours/per day and can be performed by technicians.

a) Room concentrators for all residents using oxygen, including high flow concentrators when necessary.

b) Centralized liquid tanks for refilling portable liquid tanks.

c) Portable tanks that meet the individual needs of each patient, including high flow portables when necessary.

d) Portable tanks that meet the individual needs of each patient, including nebulizer kits.

e) C-Pap machines and Bi-Pap machines.

f) Oxygen tubing and connectors as needed by the particular machine and tank(s) for the resident.

g) Tracheostomy supplies that meet the individual needs of each patient.

h) Respiratory therapy services available 24 hours/per day to meet the individual needs of each patient.

2. The Contractor shall provide the following oxygen services by appropriately qualified and licensed personnel:

a) Change oxygen tubing a minimum of every 2 weeks or more frequently as needed.

b) Clean and change concentrator filters every 2 weeks or more frequently as needed.

c) Must provide mesh or other cloth bags to contain excess oxygen tubing.

d) Instruct and demonstrate the use, precautions, and safety measures of medical oxygen (liquid and gas) and medical oxygen equipment to nursing staff as needed.

e) Ensure all oxygen equipment delivered to Fitzsimons/WRRC has been inspected and meets the manufacturer’s operational standards for use.

f) Documentation of the operational inspection shall be indicated on the equipment by a tag at the time of delivery to Fitzsimons/WRRC.

g) Provide documentation when requested that all equipment used in the delivery of oxygen to a patient meets any federal, state, and local requirements, and facility policies and procedures.

h) Work with Fitzsimons/WRRC to ensure compliance with the Veteran Administration standards (for Fitzsimons), and Medicare and Medicaid rules and regulations.

3. Responsibilities of the Contractor for oxygen services:

a) The Contractor shall be able to provide oxygen that meets airline quality standards within 24 hours of being contacted by a representative at Fitzsimons/WRRC on an as needed basis.

b) The Contractor shall maintain and produce upon request all necessary federal, state, and local licenses and certifications required by law to provide specified durable medical equipment.

c) The Contractor shall submit to Fitzsimons/WRRC proof of insurance effective for each year of the contract prior to contract execution.

B. Qualifications, duties, and responsibilities of the respiratory therapist:

1. Assess respiratory conditions of the resident(s) as needed. This may include but is not limited to:

a) Initial respiratory assessment of any new admissions.

b) Availability PRN for respiratory consulting services.

c) Teach nursing staff on the use of respiratory equipment.

d) Educate nursing staff on clinical parameters to adhere to for monitoring patient clinical status.

2. Tracheostomy services shall be provided by the respiratory therapist as needed.

a) The respiratory therapist shall educate the facility nursing staff on how to clean, remove, re-insert and manage tracheostomies.

b) The respiratory therapist shall also provide direction and guidance to the facility clinical staff regarding patient care needs pertaining to tracheostomies, including but not limited to: types of equipment required, and frequency of care.

3. Physically assess all oxygen patients a minimum of once a week.

4. Meet with the Director of Nursing or designee at Fitzsimons/WRRC as needed to ensure appropriateness of oxygen and respiratory care given to patients.

5. Provide in servicing to facility nurses PRN as it pertains to tracheostomy care and treatment, normal and adventitious lung sound, use of emergency suction equipment, etc. as directed by the Director of Nursing or designee.

6. Provide licensed respiratory therapist coverage and emergency services by a qualified respiratory therapist on an “on call” basis 24 hours a day, 7 days a week, to assist in setting up and treating residents with a tracheotomy with no more than a 2 hours response time, should Fitzsimons/WRRC require a respiratory therapist. Due to the fact that it is patient specific, it is difficult to mandate a set number of hours, but estimated hours are 5 hours per month. Additional hours must be subject to approval by the Director of Nursing or designee. Therefore, an “on-call” status would be appropriate and sufficient.