Per diem Nrsg RN LPN SOW 2.4.21.doc

POLK CENTER PER DIEM NURSE

STATEMENT OF WORK

CONTRACT SCOPE/OVERVIEW

The selected Contractor will provide Per Diem Registered Nurses (RNs) and Per Diem Licensed Practical Nurses (LPNs) for the Department of Human Services (DHS) Polk Center (PC).

LOCATION

The location of services is PC, 1 Lakewood Circle, Polk, PA 16342, Venango County. PC is an Intermediate Care Facility for individuals with an intellectual or developmental disability. PC has a current census of 181 individuals.

SERVICE/HOURS

PC maintains 3 shifts (6:45 – 3:15, 2:45 – 11:15, and 10:45 – 7:15) for RNs and LPNs. PC will assign the Contractor staff based on the needs of PC. A ½ hour (30 min) unpaid lunch and two 15-minute breaks will be given to the RNs and LPNs performing duties under the contract. The time of break and lunch is dependent on shift assignment and PC’s needs.

BASIC JOB DUTIES Contractor RNs and LPNs will:

· Provide direct nursing care to individuals

· Make nursing diagnoses and develop nursing regimens (RNs only)

· Interpret oral and written instructions relating to individuals’ needs and assessments

· Assemble, analyze and Interpret data

· Receive, carry out and document verbal orders of physician

· Prepare medications according to orders of licensed physicians (RNs only)

· Administer oral medications, insulin therapy and topical ointments

· Monitor vital signs, administer first aid and oxygen therapy

· Perform emergency intervention, including CPR and Heimlich Maneuver

· Maintain healthcare documentation in individual’s chart

· Complete quarterly physical assessments (RNs only)

· Practice and teach safety principles

· Lift, position and transfer individuals

· Push medication carts, wheelchairs and other adaptive devices

· Make decisions regarding individual’s manual and cognitive abilities to administer medication

· Communicate effectively with self-advocates and staff

MANDATORY TRAINING

All contract RNs and LPNs must attend orientation for a period as determined by PC and will be required to attend training during the normal day time business hours. PC will provide the training. Contract RNs and LPNs must successfully complete of the required training.

PERFORMANCE STANDARDS

In its discretion, PC may reject or remove any contract staff if staff is unable or unwilling to perform their duties at a level acceptable to PC or necessary to meet the PC’s standards of care and practice. The Contractor shall replace the removed or rejected staff immediately or as directed by PC.

PC will provide all contract staff with an Identification Badge and key(s) that must be returned to PC upon completion of a shift unless otherwise approved by contract monitor. The Department may withhold payment to Contractor, charge Contractor for the replacement or rekeying, or both for a failure to return a key.

Each contract RN and LPN shall sign a statement regarding confidentiality of patient records and guaranteeing patient rights.

DRESS CODE

Contract staff must wear their PC ID at all times when on duty so that it is clearly visible and readable to other staff and consumers. All contract RNs and LPNs shall dress in a manner that displays professionalism at all times. PC shall instruct contract staff on the dress code.

SIGN IN/OUT

All contractor staff must sign in and out at an area designated by the contract monitor and have the Nurse Supervisor on duty verify by also signing.

Special Treatment Procedures

· PC is a restraint free facility. All Staff, including contract staff must utilize the least restrictive measures and follows PC policies and procedures in the care of consumer(s).

Emergency/Medical Interventions/Use of Medical Equipment Contract staff must:

· Adhere to infection control and Universal Precautions policies and procedures.

· Respond to medical emergencies, announce medical emergency, take appropriate actions for which specifically trained, including cardio-pulmonary resuscitation (CPR), first aid, foreign body airway obstruction management, or other emergency treatment procedures. Following the emergency, take appropriate action according to PC Policies and Procedures.

· Respond to disaster and emergencies, e.g., fires, earthquakes, floods, hazardous materials incidents, bomb threats, utility interruptions or transportation accidents; follow basic emergency procedures as contained in PC Policies and Procedures.

Competency Maintenance Activities Contract staff must:

· Attend and participate in ongoing mandatory DHS, and PC.

· Attend in-service training programs.

Oral and Written COMMUNICATIONS

Contractor staff must:

· Interact with individuals utilizing therapeutic communication skills.

· Write and print legibly.

· Document specific, accurate and complete information in the Medical Record.

· Report factual patient information.

· Provide accurate and legible written work and incident related statements as required.

· Maintain confidentiality of consumer information.

· Report problems accurately using the chain of command.

· Report and document consumer incidents.

· Keep conversations free from discriminatory, abusive or sexually harassing comments.

· Interact with physicians, interdisciplinary team members and families in a professional manner.

· Comply with documentation policies and procedures for the completion of all PC reports.

· Provide input and feedback for staff, committee, and improvement team meetings.

· Interact with colleagues in a cooperative manner to develop effective working relationships.

· Prepare and submit thorough and accurate reports in a timely manner as required.

Critical Thinking Contractor staff must:

· Prioritize work tasks to be accomplished.

· Utilize available staffing and equipment resources.

· Recognize and anticipate consumers’ medical needs.

· Anticipate and recognize patient safety needs.

Patient Rights Contractor staff must:

· Commit NO act of individual abuse or neglect.

· Cooperate with administrative investigations.

Professional Conduct Contractor staff must:

· Demonstrate professional conduct with coworkers and consumers.

· Demonstrate ethical behavior in the workplace.

· Maintain a non-discriminatory work environment.

· Abide by the Governor’s Code of Conduct and DHS Personnel Regulations, policies and procedures, and PC policies and procedures.

· Adhere to scheduled work hours.

· Comply with sign in/out procedures.

INVOICING

Payment Provision: The selected contractor will be reimbursed only for services actually accepted by the Commonwealth.

The selected contractor shall be paid upon satisfactory completion of work performed, and submission of an invoice on the contractor’s letterhead. The invoice should contain at minimum the information listed on the sample invoice provided at http://www.dgsweb.state.pa.us/comod/CurrentForms/SampleSupplierInvoice.doc ***Treasury is enforcing suppliers to have a single remit to address, which is their “901 extension” so please be sure to update if necessary, by following these instructions:

· If a supplier has a 901 extension but it’s not correct, they can change it by going into “Existing Supplier Registration” on the supplier portal.

· If a supplier doesn’t have a 901 extension, they will need to call VDMU (877-435-7363) to create one.

· There can only be one supplier number per tax ID.

The invoice for payment is to be mailed to:

Commonwealth of PA – PO Invoices

P.O. Box 69180

Harrisburg, PA 17106 A copy of the invoice should also be mailed to:

Polk Center

1 Lakewood Circle

Polk, PA 16342

Attn: Accounting

CONTRACT ADMINISTRATOR/MONITOR

The contract shall be administered on behalf of PC by the Nurse Manager or Facility Financial Manager:

Pat Nosko

-or-

Heath Kalac Phone:814-432-0259

Phone: 814-432-0221 Fax: 814-432-0187 e-mail: hkalac@pa.gov e-mail: pnosko@pa.gov All services provided by the contractor shall be subject to review and approval by the Contract Administrator.

PRICING

Pricing must be inclusive of all costs, including any overhead, travel and subsistence, training, supplies, and other expenses. Such items may not be billed separately. Estimated number of hours of service will be determined for the awarded vendor once the award is made.

NOTE: Only pricing for hourly rates should be submitted. Hourly holiday rate will be calculated at 1-1/2 times regular rates provided.

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