Medical Gas System PM Service SOW.pdf

INDIAN HEALTH SERVICE

PHOENIX INDIAN MEDICAL CENTER

Statement of Work 1.Background The Phoenix Indian Medical Center (PIMC) is a 1.2M SF campus comprised of a hospital tower and numerous outpatient care and support buildings. The campus is located at 4212 North 16th Street, Phoenix, Arizona 85016. The PIMC hospital tower (Building 233) is a five-story, Joint Commission (TJC) accredited, 127-bed hospital employing 1,200 staff that primarily serves a patient population of 140,000 Native Americans in the Phoenix metropolitan area. The hospital tower was built in 1970 and is approximately 163,000 SF.

PIMC is required to follow NFPA 99 (2012) to install and maintain 244 items on its medical gas equipment inventory (Appendix A). The inventory contains two (2) BeaconMedaes Model MSV-020 vacuum pumps (serial numbers API851738 and API851739) and one (1) BeaconMedaes Model LPS-7D- SD80-DCY medical air dual scroll compressor system (serial number 150690-4). The vacuum pumps each run for appx 2,300 hours/year. Each compressor runs for appx 1,250 hours/year. PIMC policy dictates annual testing, inspection, and maintenance of components on its medical gas equipment inventory.

TJC Standard PE.04.01.01 Medical Gas and Vacuum Systems are Inspected and Tested, Element of Performance (EP) #3 states the following requirement:

Test, inspect and maintain critical components of piped medical gas and vacuum systems, waste anesthetic gas disposal (WAGD), and support gas systems on the inventory.

Inventory of critical components includes at least all source subsystems, control valves, alarms, manufactured assemblies containing patient gases, and inlets and outlets with activities, dates and results documented

No prescribed frequency; recommend risk assessment if < annual NFPA 99-2012: 5.1.14.2;

5.1.15; 5.2.14; 5.3.13

2.Objective The objective of this Scope of Work is to comply with all preventative maintenance, corrective maintenance, and emergency repairs, of items on the medical gas equipment inventory, in accordance with and as required by NFPA 99 (2012). All testing, inspection, and maintenance activities are to be documented in such a way as to comply with TJC Standard PE.04.01.01 EP #3, Medical Gas and Vacuum Systems are Inspected and Tested.

3. Contractor Responsibilities and Tasks

1) Perform preventative maintenance (PM) for the medical air compressor in accordance with the original manufactures recommendations (OEMs) and NFPA 99 (2012). If a conflict exists between the two, contractor shall perform the more conservative of the two. PM work includes but is not limited to:

a. Monthly service

b. Checking/adjusting cut in and cut out pressure

c. Changing the switching valve and tower pressure gauge as needed

d. 8,000 hour V-belt change (sooner if visual inspection indicates need)

e. 4,000 hour air intake filter change (sooner if visual inspection indicates need)

f. Six-Month service including recalibration of the CO monitor and flow check of the orifice for ceramic dew point monitor

g. Annual service including pre-filter change, after filter change, and purge muffler change

h. Two-Year Service including replacement of CO monitor sensor and sensor accuracy assessment of the ceramic dew point monitor

i. Five-Year service including changing of change Desiccant , check valve , tower o-ring, Canister o-ring, diaphragm, and poppet

2) Perform preventative maintenance (PM) for the medical vacuum pumps on the medical gas equipment inventory list (Appendix A) in accordance with the original manufactures recommendations (OEMs) and NFPA 99 (2012). If a conflict exists between the two, contractor shall perform the more conservative of the two. PM work includes but is not limited to:

a. Monthly Service

b. Annual Service including prescribed replacement parts including shipping charges

c. 1,000 Hour Service

d. 2,000 Hour Service

e. 4,000 Hour Service including vacuum control valve membrane replacement

f. 6,000 Hour Service including synthetic fluid and oil change

g. 24,000 Hour Service including motor overhaul, element overhaul, and replacement of vacuum control valve membrane.

3) Perform preventative maintenance (PM) for all other components of the medical gas system listed in the medical gas equipment inventory list (Appendix A) in accordance with the original manufactures recommendations (OEMs) and NFPA 99 (2012). If a conflict exists between the two, contractor shall perform the more conservative of the two.

4) Perform annual inspections in accordance with NFPA 99 (2012), see Appendix B, NFPA 99 annual medical gas system components inspection checklist

5) Contractor shall provide up to 20 hours of scheduled technician time during normal business hours per option year for corrective maintenance, repair, and installation of components on the medical gas equipment inventory list.

6) Contractor shall provide up to 20 hours of scheduled technician time outside of normal business hours per option year for corrective maintenance, repair, and installation of components on the medical gas equipment inventory list.

7) Contractor shall provide up to 60 hours of unscheduled emergency technician time per option year for corrective maintenance, repair, and installation of components on the medical gas equipment inventory list. Contractor is required to respond within 2 hours of being called regardless of when the call occurs

8) To provide parts necessary up to $25,000 per option year to correct deficiencies found during PM and service visits.

INDIAN HEALTH SERVICE

PHOENIX INDIAN MEDICAL CENTER

9) Technicians must have ASSE 6010, ASSE 6020, and ASSE 6040 certifications as appropriate for activity being performed.

4. Deliverables

1) Provide all PM and CM documentation at least annually (all documentation must show inspection dates within 12 months of previous year’s documented annual inspection dates) in such a way as to comply with TJC Standard PE.04.01.01 EP #3, Medical Gas and Vacuum Systems are Inspected and Tested. All documentation must include at a minimum: company performing inspection/testing, technician name, technician phone number, ASSE 6010/6020/6040 certification proof, pass/fail dates for each item inspected/tested/

5. Contracting Officer Authority Authority to negotiate changes in the terms, conditions, or amounts cited in this contract is reserved for the Contracting Officer.

6. Contracting Officer’s Representative (COR) The person identified below is hereby designated as the Contracting Officer's Representative (COR) for this contract.

Contacts: Douglas Barber 602-263-1539 TPOC: Ronald Allison douglas.barber@ihs.gov ronald.allison@ihs.gov

All service calls made by PIMC to be made by Ron Allison (Alternate COR) or Tyrone Sandoval.

7. Invoice Submission and Payment

1. Payment request means a bill, voucher, invoice, or request for contract financing payment with associated supporting documentation. The payment request must comply with the requirements identified in FAR 32.905(b), “Content of Invoices” and the applicable Payment clause included in this contract.

2. Except as provided in paragraph (c) of this clause, the Contractor shall submit payment requests electronically using the Department of Treasury Invoice Processing Platform (IPP) or successor system.

Information regarding IPP, including IPP Customer Support contact information, is available at www.ipp.gov or any successor site.

3. The Contractor may submit payment requests using other than IPP only when the Contracting Officer authorizes alternate procedures in writing in accordance with HHS procedures.

If alternate payment procedures are authorized, the Contractor shall include a copy of the Contracting Officer's written authorization with each payment request

APPENDIX A: See attached medical gas equipment inventory

APPENDIX B: See attached NFPA 99 annual medical gas system components inspection checklist mailto:douglas.barber@ihs.gov http://www.ipp.gov/