Standards for DoD Mortuary Facilities-PWS Drafting Standards-3 Feb 25.pdf

Feb 2025

Hill AFB Performance Work Statement (PWS) for DoD Contracted Mortuary Services ii

Contents

1. Introduction

2. General Information

2.1. Authorized Personnel

2.2. Licensed Embalmer

2.3. Unlicensed Assistant

2.3.1. Tasks authorized to be performed by unlicensed assistants

2.3.2. Tasks authorized to be performed by unlicensed assistants with required training

2.3.3. Tasks specifically not authorized to be performed by unlicensed assistants

2.4. Time Allotted for Services

2.4.1. Time allotted to initiate services

2.4.2. Time allotted to perform services

2.5. Hours of Operation

2.6. Area of Performance

2.7. Quality Control and Quality Assurance

2.7.1. Quality Control Plan

2.7.2. Quality Assurance Plan

2.8. Physical Security

3.1. General

3.1.1. Viewable

3.1.2. Viewable for identification

3.1.3. Nonviewable

4. Embalming Standards

4.1. General

4.1.1. Insect treatment

4.1.2. Disinfecting

4.1.3. Washing

4.1.4. Body positioning

4.1.5. Damaged tissue

4.1.6. Dressing remains

4.1.7. Grooming

4.1.8. Cosmetics

4.1.9. Setting features

4.2. Preparation of Unembalmed Remains

4.3. Preparation of Viewable Remains

4.3.1. General

iii

4.3.2. Treatment of scalp (viewable remains)

4.3.3. Mutilated hands (viewable remains)

4.3.4. Wounds, stains, and discolorations

4.4. Preparation of Nonviewable Remains

4.4.1. General

4.4.2. Nonviewable with full-body wrap

4.4.3. Full-body wrap procedure

4.4.4. Nonviewable head wrap

4.5. Preparation of Autopsied Remains

4.5.1. Internal organs (viscera)

4.5.2. Cranial cavity and scalp

4.6. Embalmer Evaluation

4.7. Quality Assurance Evaluation

4.7.1. Contracted facility

4.7.2. Corrective action

4.7.3. DoD mortuary facility

5. Casketing Standards

5.1. General

5.2. Placement in Casket

6. Transportation of Remains

6.1. General

6.1.1. Unembalmed remains

6.1.2. Embalmed remains

6.1.3. Remains movement and transportation vehicle

6.2. State, Territory, Local, or International Authority-issued Permits and Certificates

6.2.1. Transit, burial, cremation permits, and certificates

6.2.2. Death certificates

6.3. Removal

6.4. Employee Attire

6.5. Overland Transportation of Casketed Remains

6.5.1. Preparing for transport

6.6. Overland Transportation of Non-casketed Remains

6.7. Transportation of Casketed Remains on a Common Carrier

6.8. Sheltering of Remains

7. Cremation

7.1. Facility Pre-inspection

7.2. Payment for Cremation Services

7.3. Remains for Cremation

7.3.1. Subsequent remains – PADD/PAED disposition

iv

7.3.2. Subsequent remains – Military Service disposition

7.3.3. Cremation of unidentified subsequent portions

7.4. Crematorium and Cremation Procedures

7.4.1. Receipt and verification of remains within the cremation container at the crematorium 26

7.4.2. Sheltering of remains for cremation

7.4.3. Remains accountability

7.4.4. Processing cremated remains

7.4.5. Inurnment of cremated remains

7.4.6. Release of cremated remains

7.4.7. Release documentation

7.5. Crematory Operation

8. Facility Standards

8.1. General

8.1.1. Minimum requirements – General

8.1.2. Minimum requirements – Plumbing connections

8.1.3. Minimum requirements – Lighting and ventilation

8.1.4. Minimum requirements – Flooring, walls, ceiling, doors, and windows

8.1.5. Minimum requirements – Equipment and supplies

8.1.6. Minimum requirements – Access and privacy

8.1.7. Minimum requirements – Sanitary conditions and permitted use

8.1.8. Minimum requirements – Regulated waste disposal

8.1.9. Minimum requirements – Signage

8.1.10. Maintenance

9. Health and Safety Standards

9.1. General

9.2. Required Plans and Programs

9.3. Housekeeping Plans and Facility Maintenance

10. Records Management and Release of Information

10.1. General

10.1.1. Written policies and procedures

10.1.2. Functional records managers or custodians

11. Appendices

Appendix A – Commercial Item Descriptions

Appendix B – Classification of Defects

Appendix C – First-aid Kits and Required Supplies

Appendix D – Government and Contractor Furnished Items

References

Forms

Air force Contract Mortuary Inspection Checklist 11 June 2024 v

Military Community and Family Policy

Hill AFB Performance Work Statement (PWS) for DoD Contracted Mortuary Services 2025

1. Introduction

This PWS establishes the DoD standards for the operation of DoD facilities providing mortuary services, and funeral homes under contract for DoD mortuary services, and shall apply to all Military Service components.

The Defense Federal Acquisition Regulation Supplement (DFARS) includes clauses unique to the procurement of mortuary services (DFARS 252.237, Sections 7000 through 7009 and 7011). Contracting officers must utilize the standards contained herein and the PWS template in Appendix D when contracting for mortuary services. The standards contained herein do not apply to deaths where the person authorized to direct disposition (PADD), or where the person with authority to effect disposition (PAED), elects to make all arrangements for the disposition of remains.

Description of services: The 75th Contracting Squadron is acquiring mortuary services for the embalming, restoration, other preparation, care, and disposition of remains of authorized personnel. The contractor shall provide licensed facilities, equipment, licensed funeral service practitioners, motor vehicles, professional services, supplies, death certificates, caskets, urns, outer shipping containers, transportation and perform hygienic practices as specified in this performance work statement (PWS). The contractor will comply with all existing federal, state, territory, and local licensing requirements and regulatory standards applicable in the area of performance of this contract.

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2. General Information

References: 5 CFR, Chapter 1, Part 430; 5 U.S.C. Section 2301-2302, Fair Labor Standards Act; Rehabilitation

Act of 1973 as amended by the Americans with Disabilities Act of 1990; EO 13548; DoD Performance

Management and Appraisal Program (DPMAP); 5 U.S.C., Chapters 43 and 75; DoDI 5000.72; DFARS 201.602-

2; DFARS PGI 201.602-2; DoDM 4715.20; DoDM 4715.05-G

This document describes services for use by both DoD mortuary facilities and funeral homes contracted by the DoD to provide mortuary services. This section also provides clear guidance on the tasks that may be performed by an unlicensed preparation room assistant or embalmer assistant and which tasks require a license within a DoD mortuary facility. Contracted facilities will work within their licensing authority or within the DoD PWS, whichever is more stringent. DoD facilities or DoD contracted facilities will comply with all existing, international, host nation, federal, state, territory, and local licensing requirements and regulatory standards applicable in the area of performance.

2.1. Authorized Personnel

Reference: DoDI 1400.25-V410

The preparation of human remains for final disposition shall be performed with regard to the confidentiality of the deceased and the wishes of the family. The following types of personnel may be authorized by management to be present in the preparation room while human remains are being embalmed, washed, or otherwise prepared for final disposition:

a. Licensed embalmers and unlicensed assistants as defined in this document;

b. Licensed and registered interns/apprentices/students as defined by state licensing boards;

c. Public officials or representatives in the discharge of their official duties; and

d. Licensed medical personnel.

Contracted licensed funeral homes may work with family and friends of the deceased to allow their participation in washing and dressing of the body in a private location other than the preparation room of the funeral home if their state law allows accommodating religious practices.

2.2. Licensed Embalmer

Reference: 10 U.S.C. Section 2015

For the purposes of this document, a licensed embalmer is a person licensed by a state board or certified by a funeral service board as an embalmer or as an embalmer intern or apprentice. A licensed embalmer is required for the application or injection of an embalming chemical solution. The application or injection of an embalming chemical solution is required for the following embalming procedures and requires a licensed embalmer: vascular embalming, cavity embalming, hypodermic embalming, and surface embalming, cleaning, dissection, and treatment of viscera. A licensed embalmer is also required when performing restorative arts for areas that are visible outside the decedent’s uniform or clothing (head, neck, and hands).

The licensed embalmer will also perform all tasks to temporarily preserve and sanitize the deceased and to restore the remains to an acceptable physical appearance. A licensed embalmer is required to complete all tasks associated with performing a head wrap. A licensed embalmer and a licensed intern or apprentice must follow the terms of the licensing authority or certification board of the state that issued the license or certificate. The Military Service is responsible for verifying the mortuary director and embalmers have valid licensure to perform the tasks required for their position. The licensure will be reviewed at least annually and upon initial assignment. The director and embalmers are responsible for maintaining current licenses per their state licensing authority. No DoD employee will perform embalming, to include the application of chemicals externally, internally, or both, unless they possess a current license to embalm from a state licensing authority.

2.3. Unlicensed Assistant

The use of unlicensed personnel to assist an embalmer or funeral director is only authorized as specified in this document.

Contract funeral homes must comply with applicable federal, state, local, or jurisdiction laws in which the contract funeral home is located when using unlicensed personnel to assist the embalmer or funeral director in the performance of their duties. Contracted facilities may use interns (apprentices) per applicable state regulations.

2.3.1. Tasks authorized to be performed by unlicensed assistants

The following tasks may be performed by an unlicensed assistant under the authority of a licensed embalmer after receiving the required Service or military occupation specialty training: stocking preparation rooms with supplies, sanitizing instruments and equipment, removing biohazardous waste, draping a closed casket with a flag, placing a closed casket into an air tray or other protective enclosure, securing documents necessary for shipment of remains overland or through the air, either inside the

Continental United States (CONUS) or Outside the Continental United States (OCONUS), and other administrative activities associated with the shipment of remains to the place designated by the PADD or

PAED.

2.3.2. Tasks authorized to be performed by unlicensed assistants with required training

The following tasks may be performed by an unlicensed assistant who has received the required training, as listed in Paragraph 2.3., when under the direct supervision of a licensed embalmer: removing remains from place of death and transporting to a mortuary facility; performing work as a remains handler to move remains throughout workstations in a mortuary; cleaning and dissecting viscera; suturing below the neck;

preparing remains for large- and small-scale cavity fluid packs for the application of chemicals by the licensed embalmer; removing large- and small-scale cavity fluid packs; cleaning and drying remains; placing protective barriers over wounds and/or sutures to prevent leakage; performing actions described in this document for a full-body wrap; dressing remains in protective garments, underclothes, and uniforms or other clothing as directed by the PADD or PAED; and placing remains in a casket. Additional activities that may be performed by an unlicensed assistant or person holding an appropriate license (e.g., cosmetologist, hairdresser, barber) include the application of cosmetics and the styling or cutting of hair to comply with

Military Service grooming standards or to meet styling preferences directed by the PADD or PAED.

2.3.3. Tasks specifically not authorized to be performed by unlicensed assistants

An unlicensed assistant may not perform any tasks identified in Paragraph 2.2. and any other tasks prohibited by the state of the licensee responsible for the preparation of the remains. The utilization of unlicensed assistants for the preparation of remains will be at the discretion of the licensee.

2.4. Time Allotted for Services

2.4.1. Time allotted to initiate services

The DoD mortuary facility or contracted facility will furnish the materials ordered and perform the services specified by the contracting officer or designee as promptly as possible. The DoD mortuary facility or contractor will initiate the services not later than 24 hours after: (1) receiving notification to remove the remains, or (2) after the remains have been released to U.S. Government control.

2.4.2. Time allotted to perform services

The time allotted to perform embalming and restoration work shall be based on the condition of the remains and procedures necessary to restore the remains to a condition that facilitates viewing and on the volume of work at the facility. At no time will preset time restrictions be placed on the amount of time a

DoD or contract embalmer can take to restore remains to a viewable state. NOTE: It is not unreasonable to expect an embalmer to spend several hours suturing extensive amounts of lacerations and wounds or working to restore the head/face to a condition that facilitates viewing. However, the contracted or DoD facility will notify the Military Service Mortuary Affairs Office if the procedure is expected to take more than

24 hours to complete (this does not include post-embalming surveillance). The Military Service Mortuary

Affairs Office will keep the PADD or PAED informed on the time required to prepare the remains. The mortuary case file will be updated to reflect when the time required to prepare the remains exceeds the 24-hour time limit.

2.5. Hours of Operation

DoD facilities must be able to receive remains 24 hours a day. The standard operating procedures or other documents must indicate procedures for receiving and securing remains outside normal operating hours.

The PWS for DoD contracted mortuary services must address the hours of operation and Government-initiated work outside normal hours.

2.6. Area of Performance

The area of performance is determined by geographic boundaries. The mortuary services contract applies to the resourced services required by the Military Services. The other determining factor is whether transportation charges for removal or delivery of the remains may be incurred. (See DFARS 252.237-7004.)

2.7. Quality Control and Quality Assurance

2.7.1. Quality Control Plan

The contractor shall have an effective Quality Control Plan (QCP) to ensure the facility meets approved standards and the services are performed per contract requirements. The contractor shall provide the

QCP to the contracting officer’s technical representative (COTR) for acceptance not later than 30 calendar days after award. The COTR will notify the contractor of acceptance or required modifications to the plan.

The contractor shall make appropriate modifications and obtain acceptance of the plan within 30 calendar days from the date of the award. The QCP shall include the following minimum requirements:

a. Contract and task order number;

b. Description of processes and controls used to verify acceptable performance;

c. The contractor-developed metrics used to verify the performance level of each task order objective;

d. The metrics reported as a quantitative value (%, ˃, ˂, etc.) and the definition and numerical figures used to calculate the percent or reportable outcome;

e. The task order objectives, associated standards, metrics, and quantitative values for each metric shall be reported per the PWS;

f. Description of the methods to be used for identifying and preventing defects in the quality of service performed;

g. Description of the records to be kept to document inspections and corrective or preventative actions taken; and

h. The frequency of surveillance and minimum acceptable defect rate(s).

2.7.2. Quality Assurance Plan

The Government will evaluate the contractor’s performance for the contract and task/delivery orders awarded. For those tasks listed in this PWS, Appendix D, the COTR or other designated evaluator will follow the method of surveillance specified. Government personnel will record all surveillance observations.

When an observation indicates defective performance, the COTR or other designated evaluator will require the contractor manager or representative at the site to initial the observation. The initialing of the observation does not necessarily constitute concurrence with the observation. It acknowledges that the contractor was made aware of the noncompliance. Government surveillance of tasks not listed in the PWS or by methods other than those listed in the PWS (such as provided in the inspection clause) may occur during the performance period of this task order. Such surveillance will be performed according to standard inspection procedures or other task order provisions. Any action taken by the contracting officer as a result of surveillance will be in accordance with the terms of the contract or task orders.

The Government reserves the right to perform inspections to ensure facilities, supplies, and services conform to approved and prescribed requirements as outlined in this document and the PWS. The goods and services purchased from the contracted facility or provided by a DoD mortuary facility will meet or exceed the standards contained within this document. Caskets and urns must meet the requirements of

DFARS 225.1.

DoD mortuary facilities will establish a Quality Assurance (QA) Plan to guide the implementation of quality assurance procedures outlined in this document. The QA Plan shall contain, at a minimum:

a. Description of processes and controls used to verify acceptable performance (specifically address the following areas: personnel, grounds, equipment, motor vehicles, facilities, and remains processing);

b. Review plan and schedule (frequency of surveillance and minimum acceptable defect rate(s));

c. Problem resolution and corrective action (procedures for reporting deficiencies, tracking, and providing feedback);

d. Tools, techniques, and methodologies (include maximum time to correct a noted deficiency);

e. Reporting requirements;

f. Metrics used for verifying that standards are met; and

g. Quality records (documentation requirements).

2.8. Physical Security

The contracted facility providing mortuary services will be secure, and areas where remains are received, stored, or processed will not be accessible to the public. When a DoD mortuary facility or contracted facility has the ability for the family to view the remains, this area will be clean and orderly and will conform to Occupational Safety and Health Administration (OSHA) standards for viewing remains. DoD mortuary facilities and contracted facilities must have controlled access with appropriate signage posted on all entrances that complies with OSHA standards, applicable laws, regulations, ordinances, and codes.

3. Classification of Remains Standards

3.1. General

The embalmer will make a recommendation to the Military Service representative regarding the ability to view the deceased. Remains will be classified in one of three categories: viewable, viewable for identification, or nonviewable. Every attempt will be made to restore remains to a natural form and color that permits the PADD or PAED to decide whether the remains are to be viewed or not. The cultural and religious customs and traditions of the deceased, as well as the PADD’s or PAED’s preferences, should be taken into consideration for the remains preparation.

3.1.1. Viewable

Remains are considered viewable when the face and hands have only minor or no trauma, edema, dehydration, or discoloration. Remains may be fully restored to natural color and form. The condition of remains allows for dressing in uniform or other clothing selected by the PADD or PAED.

3.1.2. Viewable for identification

Remains may or may not be fully intact, and the face and hands may have trauma, edema, dehydration, or discoloration. Although remains may be missing limbs or may have received other trauma, the condition of remains allows for dressing in uniform or other clothing selected by the PADD or PAED. Remains may be restored to an appearance suitable for visual recognition.

3.1.3. Nonviewable

Remains may or may not be fully intact and may manifest extreme trauma, edema, dehydration, discoloration, or decomposition. Remains may not be able to be restored to an appearance suitable for visual recognition. The condition of remains may not allow for dressing in uniform or other clothing selected by the PADD or PAED.

3.1.3.1. Head wrap

Remains are categorized as nonviewable with the face or head having severe trauma, edema, dehydration, or discoloration such that restoration to a condition of viewable recognition is not possible. However, the condition of remains allows for dressing in uniform or other clothing selected by the PADD or PAED. The head wrap will be accomplished as directed by Paragraph 4.4.4.

3.1.3.2. Full-body wrap

Remains are categorized as nonviewable. Remains may not be intact or may have sustained severe trauma, edema, dehydration, advanced decomposition, or discoloration where restoration to a condition of viewable recognition is not possible and the remains cannot be dressed. In this situation, remains will be prepared using a full-body wrap. The full-body wrap will be accomplished as directed by Paragraphs 4.4.2.

and 4.4.3.

4. Embalming Standards

4.1. General

DoD mortuary facilities and facilities under contract to provide DoD mortuary services will prepare and embalm the remains of all entitled personnel per the written instructions of the PADD/PAED and per law.

The embalmer will verify PADD/PAED elections before beginning the preparation and embalming of the remains. No remains will be embalmed without written or oral instructions as outlined below. Oral instructions may be accepted if confirmed by the Military Service Casualty or Mortuary Affairs Office representative; however, follow-on written authorization must be obtained before the release of the remains, subsequent remains, or organ(s) collected at autopsy and released for disposition. The mortuary officer will note in the case file who provided the oral instructions and when (date and time) they were provided. The written authorization will be obtained at the first reasonable opportunity and uploaded into the case file. Predeath directives authorizing embalming, duly executed by the deceased, shall be given full legal effect and shall constitute an effective authorization to embalm. Human remains prepared at a DoD mortuary facility or contracted facility may not receive final disposition for an extended period (10 days or more) and may have been subjected to extreme trauma, weather conditions, or have been transported over long distances. Therefore, all remains, whether viewable or nonviewable, require variations in preservation techniques and procedures to accomplish maximum disinfection, preservation, and restoration of all body tissues. The following procedures will be accomplished in the course of processing or reprocessing all viewable remains, and to the extent possible for nonviewable remains. Please refer to DD Form 3045.

4.1.1. Insect treatment

Maggots and other insect larvae will be destroyed and removed, and their breeding sites in or on the remains thoroughly treated with an appropriate chemical.

4.1.2. Disinfecting

All body orifices will be treated with a non-astringent disinfectant chemical.

4.1.3. Washing

All body surfaces will be thoroughly washed with warm water and germicidal soap. Special attention will be given to the viewable surfaces, e.g., the face and hands.

4.1.4. Body positioning

The body will be positioned to appear comfortable and restful. The head will be positioned straight, without any turn, and hands will be positioned left over right. Deviation will be dependent upon the conditions of the remains and at the discretion of the embalmer.

4.1.5. Damaged tissue

The embalmer will determine when, during the preparation process, ulcerated, burned, and necrotic tissue, and/or bedsores, shall be excised and/or treated either by hypodermic injection or by cavity pack application of deodorizing/preserving chemicals. All excised tissues will be retained with the remains and not disposed of as medical waste. The excised tissue will be treated with the organs and placed in the body cavity.

4.1.5.1. Prevent leakage

All lacerations, penetrating wounds, and autopsy incisions will be sutured closed to prevent leakage. In cases where there has been a significant loss of tissue due to dismemberment, blast damage, or charring and the tissue is unable to be closed, the embalmer will ensure exposed tissue is thoroughly embalmed, dried, and packed with drying powders, and secured with an absorbent material to prevent leakage and facilitate dressing in uniform or clothing provided by the PADD or PAED.

4.1.5.2. General full-body wrap guidance

The use of full-body wraps as prescribed in this document will be utilized as a last resort in cases where viewing is not recommended (e.g., severe charring of the upper torso and head, decapitation of the head, severe crushing of the head, uncontrolled odor caused by decomposition, etc.). The DoD facility or contractor cannot justify the use of full-body wrap to only prevent leakage or address missing limbs. There are procedures and supplies available for use by the preparing embalmer to prevent the leakage of bodily fluids onto the uniform and address missing limbs.

4.1.5.3. Communication required with full-body wrap

The recommendation for the use of a full-body wrap must be a collaborative effort between the embalmer and Service liaison or case manager. Whenever possible, the Service liaison/case manager must view the remains and discuss preparation procedures with the DoD or contract embalmer so they can effectively communicate the condition of remains and reason for the recommendation of a full-body wrap with the

PADD or PAED. The final decision for the use of the full-body wrap in circumstances as described in

Paragraph 4.1.5.2. rests with the most senior licensed embalmer with supervisory responsibilities over the embalmers at the DoD mortuary facility, or the signatory on the contract for DoD mortuary services provided by a civilian mortuary facility.

All communication among the preparing embalmer, Service liaison/case manager, and the PADD or PAED shall be documented in writing and entered in the appropriate mortuary case file.

4.1.6. Dressing remains

The PADD or PAED will be consulted and provided the opportunity to determine the clothing in which the deceased is to be dressed, or to be displayed upon the top of wrapped remains, as the situation dictates.

The contract funeral home or DoD facility providing mortuary services will be provided the clothing selected by the PADD or PAED or will be provided a uniform by the Military Service. Before dressing, all remains will be placed in a white, opaque, or clear leakproof protective undergarment (one-piece plastic garment used to cover the entire body from the neck down, including the feet). Drying powder and/or preservative powders will be placed inside the protective undergarment to absorb any possible leakage or odors.

4.1.7. Grooming

Military personnel who are dressed in their Service uniform will be groomed per Military Service regulations and standards. Male facial and scalp hair shall be washed and groomed to conform to military standards;

suitable hair preparation shall be accomplished for females to conform to military standards. If the PADD or

PAED requests other accommodations, the preparing mortuary will consult with the appropriate Military

Service to ensure compliance with Service standards. Fingernails shall be cleaned and trimmed. When the

PADD or PAED has requested that the Service member not be dressed in the Service uniform, the mortuary representative will check with the PADD or PAED to determine the correct attire. For nonmilitary personnel, the Military Service mortuary representative will check with the family to ascertain personal preferences.

4.1.8. Cosmetics

Cosmetics shall be applied only in the amount necessary to produce natural color and texture. For female

Service members, the cosmetics will conform to military standards unless expressly requested otherwise in writing by the PADD or PAED.

4.1.9. Setting features

The mouth will be securely closed by needle injector, or muscular or mandibular suture, where the lips abut to form a natural expression. The eyes will be securely closed by the use of eye caps or other appropriate means, with proper attention given to prevent wrinkling of the eyelids and a sunken appearance.

4.2. Preparation of Unembalmed Remains

When the PADD or PAED has requested the deceased be prepared for shipment to the receiving funeral home without embalming, the preparing mortuary will evaluate the condition of the remains and determine the feasibility of complying with the request based upon local and national regulations or laws at the place of origin and destination and any restrictions imposed by available transportation methods, such as air, train, or hearse. Unless prohibited by law, regulation, or the availability of transportation options, the preparing mortuary will prepare Unembalmed remains per Paragraphs 4.1.1. through 4.1.9., above, and to the extent possible, will adhere to religious preparation practices or other preferences as directed by the

PADD or PAED. This section applies to subsequent remains recovered and identified after mortuary processing or interment or inurnment has occurred.

4.3. Preparation of Viewable Remains

4.3.1. General

To obtain optimum results, a thorough pre-embalming case analysis will be completed by the embalmer utilizing the number of arterial injection sites necessary to ensure proper distribution of fluid. Case analysis is an iterative process that continues throughout the embalming operation. The embalmer will adjust the embalming treatment as case analysis dictates to include multiple site injection, if necessary, to ensure maximum disinfection and preservation. Post-embalming surveillance is crucial to ensure all areas are disinfected and preserved, or, if deficiencies are discovered, treated with further chemical treatment to ensure disinfection and preservation. The arterial chemical solution injected into the remains shall contain a minimum 5 percent concentration, by volume, of formaldehyde or isomer of formaldehyde derivative preservative agent(s). The total volume of arterial solution injected shall not be less than 1 gallon per 50 pounds of body weight. Unless the decedent is edematous, a humectant must be added in equal volume to the arterial chemical in the total fluid solution injected into the head and arms. It is permissible for a humectant-based arterial chemical to be used in place of humectant additive being incorporated into the total fluid solution. For non-autopsied cases, the thoracic, abdominal, male genitals, and cranial cavities shall be thoroughly aspirated and injected with full-strength cavity chemicals having a 36-index (percent) or greater. A minimum of 16 ounces of cavity chemical must be injected into the thoracic cavity, and a minimum of 16 ounces in the abdominal cavity and male genitals, and a minimum of

2 ounces of cavity chemical to ensure the preservation of contents of the cranial cavity, having a 36-index

(percent) or greater. Hypodermic injections, packs, or other special treatments shall be accomplished, as required, to ensure the disinfection and preservation of all body tissues. A suitable cream or lotion shall be applied on the face and hands to prevent dehydration.

4.3.2. Treatment of scalp (viewable remains)

If the scalp was shaved because of medical treatment or surgery, processing or reprocessing shall be accomplished as specified for viewable remains, after which the cranium shall be neatly and professionally wrapped with gauze or equivalent. The Military Service retains the ability to use an authorized uniform hat or beret instead of gauze wrap. For remains requiring a partial head wrap, the remains will be prepared per

Paragraph 4.4.4. The embalmer will ensure the tissue is firm, dry, and thoroughly preserved. The wrapping will be accomplished per Paragraph 4.4.4. but will be limited to covering the affected area of trauma, providing the possibility of viewing if desired by the PADD or PAED.

4.3.3. Mutilated hands (viewable remains)

When the hands are mutilated to the point that restoration is not possible, or discolorations are present that cannot be cleared, the hands shall be treated in a manner that shall render all tissue firm, dry, and thoroughly preserved. The hands, regardless of condition, will then be placed in opaque, leakproof gloves followed by white (military) cloth gloves.

4.3.4. Wounds, stains, and discolorations

All lacerations, abrasions, incisions, excisions, and burn wounds shall be sealed and/or sutured to prevent leakage. Swollen or distorted features shall be reduced, if possible, to the normal contours. Applying packs and/or needle injection may be used to chemically bleach antemortem or postmortem stains. On viewable areas, masking cosmetics may be used to render stains/discolorations nondetectable.

4.4. Preparation of Nonviewable Remains

4.4.1. General

To obtain optimum results, a thorough pre-embalming case analysis will be completed. Case analysis is an iterative process that continues throughout the embalming operation. The embalmer will adjust the embalming treatment as case analysis dictates to include multiple site injection, if necessary, to ensure maximum disinfection and preservation. Post-embalming surveillance is crucial to ensure all areas are disinfected and preserved, or, if deficiencies are discovered, treated with further chemical treatment to ensure disinfection and preservation. Each gallon of arterial fluid shall contain a minimum 10 percent concentration, by volume, of formaldehyde or isomer of formaldehyde derivative preservative agent(s).

4.4.1.1. Preservation treatment

The total volume of arterial solution injected shall not be less than 1 gallon per 50 pounds of body weight.

All body areas shall be further treated utilizing a hypodermic injection using undiluted cavity chemicals having a 36-index (percent) or greater concentration. In addition, packs, special gels, and/or dry sanitizers shall be used, as required, to ensure preservation, prevent leakage, and eliminate all offensive odors.

4.4.1.2. Cavity and genital treatment

The thoracic, abdominal, male genitals, and cranial cavities shall be thoroughly aspirated and injected with full-strength cavity chemicals having a 36-index (percent) or greater concentration. A minimum of 16 ounces of cavity chemical must be injected into the thoracic cavity, a minimum of 16 ounces in the abdominal cavity and male genitals, and a minimum of 2 ounces of cavity chemical in the cranial cavity to ensure the preservation of contents of the cranial cavity. Injected cavity chemical must have a 36-index

(percent) or greater concentration.

4.4.1.3. Procedure when arterial injection and/or cavity treatment is not possible

When arterial injection and/or cavity treatment is not possible, all articulated and disarticulated anatomical portions shall be thoroughly disinfected and preserved via hypodermic injection and accessory chemical embalming techniques. Immersion and/or hypodermic injection with a trocar and/or syringe and needle, using full-strength cavity chemicals of a 36-index (percent) or greater concentration, is acceptable. Surface application of liquid, gel, or dry sanitizers and preservatives is also required to supplement primary needle and/or hypodermic injection techniques.

4.4.2. Nonviewable with full-body wrap

Remains that have been processed or reprocessed as outlined in Paragraph 4.3. or 4.4. and are mutilated, decomposed or have physical trauma to the extent that the remains cannot be dressed shall be wrapped.

4.4.2.1. Preparation for full-body wrap

Wrapping shall be accomplished as follows: Polyethylene sheeting (5 millimeters or greater) and a wool blanket shall be furnished by the Military Service’s mortuary representative. The military wool blanket shall be spread on the dressing table with opposing corners at the head and foot ends of the table. The blanket is then covered with a white cotton sheet followed by a sheet of polyethylene. Cotton strips are laid down the center of the plastic sheet and liberally coated with a preservative/drying compound

(hardening compound).

4.4.2.2. Dorsal side preparation

The dorsal side of the remains shall be liberally coated with a gel preservative followed by a liberal coating of drying compound (hardening compound), and then laid on top of the prepared wrapping material on the dressing table.

4.4.2.3. Ventral side preparation

The ventral side of the remains shall be liberally coated with a gel preservative followed by a liberal coating of drying compound (hardening compound).

4.4.2.4. Strips, sheeting, and blanket preparation

Additional cotton strips shall completely cover the remains. The polyethylene sheet is then folded around the remains per Paragraph 4.4.2.1. The folding of the polyethylene sheeting, white cotton sheet, and wool blanket shall be uniform, with the head and foot ends folded in first.

4.4.3. Full-body wrap procedure

The wrapping material on the left side of the remains shall be folded to the right. The right side, then folded to the left side of the remains, shall be secured with tape or pins, as applicable and described below.

All seams in the polyethylene sheeting shall be sealed with nylon filament packing tape to ensure no odor and/or fluid is emitted from the wrapping. When necessary, in extreme cases, duplicate layers of polyethylene sheets may be used. The white cotton sheet is then wrapped around the polyethylene-sheathed remains and secured with large safety pins (silver in color, 2 to 3 inches) placed no more than

4 inches apart. The wool blanket is then wrapped around the white cotton sheet, which shall have as few creases as possible, and secured with large safety pins (silver in color, 2 to 3 inches) placed no more than

4 inches apart. A tag identifying the deceased shall be attached to the foot end of the wrapped remains bearing the deceased’s name, rank, last four of the Social Security number or DoD identification number, and date of death.

Remains that have been processed or reprocessed as outlined in Paragraph 4.4.2. will be draped in the clothing provided by the Military Service mortuary representative.

4.4.4. Nonviewable head wrap

Before beginning the wrapping process, all tissue and hair shall be rendered as dry as possible. During the embalming process, the tissue shall be prepared to present as natural a head shape as possible once the head wrap process is complete.

4.4.4.1. Materials

Required materials to accomplish the head wrap process include: two clear or semitransparent plastic

(0.78 millimeter or greater) liner bags approximately 24 inches by 23 inches; 2-inch white surgical tape or

2-inch clear strapping tape; 12 yards of 4.5-inch (sterile or nonsterile) gauze bandage (approximately three rolls); cotton prep towels (sterile or nonsterile); and absorbent cotton or an absorbent sheet product.

4.4.4.2. Procedure

Wrapping shall be completed as follows: The embalmer will place one clear or semitransparent bag over the head and tuck it down into the full-body plastic garment, as required in Paragraph 4.1.6.

The embalmer will ensure all air is removed from the bag before securing the bag at the base of the neck with tape. Taping the bag around the forehead, over the nose, and over the chin may provide a more aesthetically pleasing shape. The embalmer will place a second clear or semitransparent bag over the head and repeat the above steps, taking care not to lose the shape of the facial features if present.

A minimum of three strips of gauze bandage will be prepared, side by side, overlapping one-quarter inch and centered over the crown of the head extending to the base of the skull and the base of the chin.

The bandage will be tightly stretched and unobtrusively secured by tape. Beginning at the natural hairline on the left side of the head, the embalmer will secure the end of the gauze bandage roll.

Once secure, the gauze bandage will be wrapped around the head, overlapping the previous row of bandages by one-half the width of the gauze bandage. This ensures no visibility of the underlying plastic bag and presents a neat and professional appearance.

The gauze bandage will continue to be wrapped around the head, down the neck until it reaches the base of the neck and will be secured with white surgical tape. The remains will then be dressed as described in

Paragraph 4.1.6., ensuring no tape is visible above the collar of the shirt or blouse. Trauma that is isolated to a specific area will be neatly and professionally wrapped with gauze or equivalent.

4.5. Preparation of Autopsied Remains

If a partial or complete autopsy is performed, chemical injection and application with multisite drainage shall be accomplished, using the arterial chemical solutions requirements as specified in Paragraph 4.3.

or 4.4. Hypodermic injection of the thoracic and abdominal walls, back, buttocks, male genitals, shoulders, and the vertebral column with an undiluted cavity chemical having a 36-index (percent) or greater concentration is required. The scalp will be injected by syringe and needle with the chemical solution used for the arterial injection.

4.5.1. Internal organs (viscera)

Under no circumstances will the service provider dispose of or destroy any internal organs (viscera) or partial remains. The viscera from remains that have had a cranial, thoracic, and/or abdominal examination shall be removed, cut into sections not greater than 2 by 2 inches, and immersed in an undiluted cavity chemical having a 36-index (percent) or greater concentration, for an appropriate amount of time but typically a minimum of two hours.

The inner surfaces of the body cavities shall be given a liberal application of gel formaldehyde or isomer of formaldehyde derivative preservative agent(s).

The preserved organs are to be liberally coated with formaldehyde or isomer of formaldehyde derivative preservative agent(s) and drying compound (hardening compound) and placed directly (not in a bio-bag or other plastic bag) into the thoracic or abdominal cavities.

4.5.2. Cranial cavity and scalp

When a cranial autopsy is performed, the vertebral and internal carotid arteries must be sealed. The cranial cavity shall be packed with cotton and drying compound, both in the cranium and in the calvarium, and secured by cranial clamps or wiring. The scalp shall be replaced over the calvarium, and the incision will be coated with drying compound and tightly and neatly sutured to avoid leakage and unnatural appearance.

The color of the suture cord should blend with the deceased’s hair.

4.6. Embalmer Evaluation

The DoD or contracted facility embalmer processing or reprocessing the remains shall critically evaluate the completed treatment to ensure all remains are effectively disinfected, uniformly preserved, and will arrive at their destination in excellent condition. The Military Service mortuary representative will authorize delivery or shipment of remains from a contracted facility when assured that the services and supplies furnished by the contractor, including the signed DD Form 2062 (Record of Preparation and Disposition of

Remains Outside CONUS) or the signed DD Form 2063 (Record of Preparation and Disposition of Remains, Contracted Mortuary Facility), meet the PWS, DoD standards within this document, and commercial item descriptions in their entirety.

4.7. Quality Assurance Evaluation

4.7.1. Contracted facility

Remains will be inspected after embalming, after dressing, and after placement of remains in a casket.

Failure to pass these inspections will require the contractor to remove the remains from the casket and perform one or more of the following services as directed by the contracting officer or designee: additional disinfectant or preservative treatment, re-dressing or rewrapping, or placement of remains in a new casket when the original casket is defective.

4.7.2. Corrective action

When the Military Service mortuary representative directs corrective action under this paragraph, the contractor shall perform the corrective measures and other required services again at no additional cost to the Government.

4.7.3. DoD mortuary facility

Remains will be inspected after embalming, after dressing, and after placement of remains in a casket. If the remains do not pass inspection at any point in the process, corrective action will be taken to correct the deficiency, and it will be documented in the case file. Additional actions that may be required to correct a deficiency may include any of the following: additional disinfectant or preservative treatment, re-dressing or rewrapping, or placement of remains in a new casket when the original casket is defective.

5. Casketing Standards

5.1. General

Casket specifications are provided in Appendix A. Caskets will meet the specifications outlined and will be checked for defects (Appendix B) before casketing of remains. Defective caskets will not be used by a DoD mortuary facility or a contracted facility providing DoD mortuary services.

5.2. Placement in Casket

Remains shall be placed in the casket in a manner that will create an appearance of rest and repose. When remains are prepared for transit or shipping, body positioning devices may be placed around the remains to prevent shifting. Only positioning devices available from funeral service suppliers are authorized. A piece of plastic will be placed between the decedent’s head and the pillow. A piece of plastic will be placed under the hands and folded over the top of the hands, for transit, to ensure cosmetics are not transferred onto the uniform or clothing, or casket interior. When white gloves are utilized, no plastic is required for the hands.

A clean piece of tissue will be placed over the face. The casket shall be of sufficient size to prevent the appearance of crowding and cramping. When an “oversize” casket is used, the preparing facility will notify the Military Service mortuary representative.

6. Transportation of Remains

References: DoDI 1300.18; 37 U.S.C. Section 453(f); 10 U.S.C. Sections 1036, 1482, 1484, 1485, 1486, 1490;

Public Law 109-364, Section 562, “John Warner National Defense Authorization Act for Fiscal Year 2007”

6.1. General

6.1.1. Unembalmed remains

When unembalmed remains are transported, they shall be wrapped in a polyethylene sheet that is impervious to liquids, covered in such a manner that the body cannot be viewed, encased in a secure pouch, and placed on a cot, stretcher, or rigid tray and carried feet first. When unembalmed remains are transported by air, the remains will be placed in a transfer case after being placed in a secure pouch.

6.1.2. Embalmed remains

When embalmed remains are transported, they must be enclosed in a casket or alternative container and an appropriate outside shipping container (as applicable). All applicable regulations and policies of the jurisdiction and carrier must be followed.

6.1.3. Remains movement and transportation vehicle

The deceased must be transported in a funeral coach or other appropriate vehicle authorized by the

Military Service Casualty and Mortuary Affairs Office in a manner that promotes respect for and preserves the dignity of the deceased and shields the remains from being viewed from outside of the conveyance.

The capacity of the transportation vehicle must be sufficient to permit loading and unloading of the remains without excessive tilting of the cot, stretcher, rigid tray, casket, alternative container, or cremation container, and to allow the remains to remain in a horizontal position during transport. The remains will be secured to prevent the remains or container from excessive movement within the conveyance during transport.

6.2. State, Territory, Local, or International Authority-issued Permits and Certificates

6.2.1. Transit, burial, cremation permits, and certificates

The preparing contracted facility representative will obtain the necessary permits, licenses, and documentation, issued by the appropriate authority, to remove, inter, cremate, or transport remains

(e.g., burial/transit permits, a medical examiner cremation authorization certificate, or a cremation certificate), and provide two copies to the Military Service mortuary representative at the time the remains are inspected and accepted by the Military Service mortuary representative.

DoD mortuary facilities will obtain the necessary permits, licenses, and documentation, issued by the appropriate authority, to remove and transport remains. The mortuary facility will work with the applicable

Service casualty office on any other documents required. In addition to the above requirements, DoD mortuary facilities will comply with DoD policy regarding the transportation of human remains, use of contract airlift, military airlift, special assignment airlift mission, or commercial air support.

6.2.2. Death certificates

The preparing facility representative will submit the necessary information and documents to the appropriate authority authorized to issue death certificates.

The DoD mortuary facility will obtain one certified copy of the death certificate from the issuing authority and will upload this document into the Defense Casualty Information Processing System (DCIPS).

The contracted facility representative will obtain 15 certified copies of the final death certificate from…