PWS CT X-ray Tech.pdf

RADIOLOGY SERVICES

COMPUTED TOMOGRAPHY (CT) AND DIAGNOSTIC RADIOLOGY (X-RAY) TECHNOLOGIST

PERFORMANCE BASED

SECTION 1.0 – PERFORMANCE WORK STATEMENT (PWS)

1.1 Purpose

The purpose of this contract is to ensure continuous, accurate, and timely clinical Radiology Department to provide Computed Tomography (CT) and Diagnostic Radiology (X-Ray) Technologists support services that enable safe and effective patient care across Pine Ridge Indian Health Center, Outlying Clinics.

1.1.2 Period of Performance

To establish a multiple-option contract compromised of a Base Period of Ten Weeks; and 19 option periods each for Ten-week periods. For a total of a base plus 19 option periods to provide Computed Tomography

(CT) and Diagnostic Radiology (X-Ray) Technologists services to the IHS Pine Ridge Service Unit (PRSU)

Hospital for direct patient care to the Radiology Department at the Pine Ridge I H S Hospital and Outlying

Health Centers requires a minimum of one (1) and a maximum of six (6) Computed Tomography (CT) and three (3) Diagnostic Radiology (X-Ray) Technologists with skills in shall include independent performance of diagnostic imaging procedures, ensuring continuity of patient care, compliance with regulatory standards, and support to medical staff whose mission is to provide full-scope, quality Radiology services to patients of the Oglala Sioux Tribe.

Contract Delivery type will be a Firm Fixed Unit Price Performance Based Service contract. Staffing levels are determined by acuity and standards of care. This contract establishes a minimum level of support coverage that must be maintained during the life of the contract.

1.2 Performance Objectives and Outcomes

The Contractor shall deliver the following performance-based outcomes:

1.2.1 Objective/Outcome – Objective 1 – CT Imaging

The Contractor shall provide CT imaging services to support diagnostic and patient care operations.

Required duties include:

• Perform CT examinations in accordance with physician orders and established clinical protocols.

• Determine appropriate scan protocols, patient positioning, and technical parameters necessary to obtain diagnostic-quality images.

• Modify examination procedures as needed based on patient condition, clinical presentation, or findings observed during the study.

• Assist radiologists and other privileged providers with CT-guided and other interventional procedures, including biopsies, as required.

Outcome – Objective 1: CT Imaging

CT imaging services are delivered in a timely, accurate, and clinically effective manner, resulting in:

• Diagnostic-quality CT images that meet radiologist interpretation standards on the first acquisition, minimizing the need for repeat imaging.

• Timely completion of CT examinations in accordance with provider orders and facility turnaround expectations.

• Appropriate selection and adjustment of scan protocols based on patient condition, ensuring optimal image quality while maintaining radiation safety standards.

• Safe and effective support of interventional and CT-guided procedures without procedural delays or complications attributable to imaging support.

• Full compliance with facility policies, Indian Health Service standards, and accrediting body requirements (e.g., The Joint Commission).

• Complete, accurate, and timely documentation within the Electronic Health Record (EHR), supporting continuity of care and billing integrity.

Performance Standards:

The Contractor shall meet the following performance standards:

• Image Quality and Diagnostic Acceptability

≥ 95% of CT examinations shall be accepted by the radiologist as diagnostic quality on initial acquisition without the need for repeat imaging due to technologist error.

• Timeliness of Exam Completion

≥ 95% of CT examinations shall be completed within facility-established turnaround times from receipt of physician order, unless delayed due to patient condition or clinical priorities.

• Protocol Accuracy and Appropriateness

≥ 98% compliance in selecting and applying correct CT protocols, including proper positioning and technical parameters, in accordance with physician orders and facility guidelines.

• Procedure Modification and Clinical Judgment

≥ 95% of cases requiring adjustment (based on patient condition or intra-procedural findings) shall demonstrate appropriate modification consistent with accepted clinical standards and radiologist expectations.

• Support to Interventional Procedures

100% of CT-guided/interventional procedures shall be supported without delay attributable to

Contractor personnel, with proper preparation, equipment readiness, and technologist assistance.

• Radiation Safety Compliance

100% compliance with radiation safety standards, including ALARA principles, dose monitoring, and use of appropriate shielding and exposure techniques.

• Patient Safety and Care

100% adherence to patient identification protocols, infection control standards, and safe patient handling procedures; zero tolerance for preventable adverse events attributable to Contractor performance.

• EHR Documentation Compliance

100% of CT encounters shall be accurately documented in the facility Electronic Health Record

(EHR), including procedure details, technical notes, and required coding, within required timeframes.

• Regulatory and Accreditation Compliance

100% compliance with applicable policies, including Indian Health Service requirements and The

Joint Commission standards.

1.2.2 Objective – Diagnostic Radiology (X-Ray)

The Contractor shall provide diagnostic radiology (X-ray) services to support patient care and clinical operations. Required duties include:

• Perform routine to complex radiographic examinations in accordance with physician orders and established clinical protocols.

• Operate digital radiography (DR) and/or computed radiography (CR) systems independently to produce diagnostic-quality images.

• Ensure proper patient positioning, alignment, and exposure techniques to obtain accurate and high-quality radiographic images.

Outcome 2: Diagnostic Radiology (X-Ray)

Radiographic imaging services are delivered accurately, safely, and efficiently, resulting in:

• Diagnostic-quality X-ray images that meet radiologist interpretation standards on initial acquisition.

• Timely completion of radiographic exams in accordance with provider orders and clinical priorities.

• Proper positioning and exposure techniques that minimize repeat imaging and radiation exposure.

• Safe, patient-centered care with adherence to all safety and infection control protocols.

• Full compliance with facility policies, Indian Health Service standards, and accrediting body requirements such as The Joint Commission.

• Complete and accurate documentation within the Electronic Health Record (EHR), supporting continuity of care and billing integrity.

Performance Standards:

The Contractor shall meet the following performance standards:

• Image Quality and Diagnostic Acceptability

≥ 93% of radiographic images shall be accepted as diagnostic quality on first acquisition without repeat imaging due to technologist error.

• Timeliness of Exam Completion

≥ 95% of X-ray examinations shall be completed within facility-established turnaround times from receipt of physician order.

• Positioning and Technique Accuracy

≥ 93% compliance with correct positioning, alignment, and exposure techniques in accordance with established radiographic protocols.

• Equipment Operation

100% of imaging equipment shall be operated safely and in accordance with manufacturer guidelines and facility policy, with no preventable equipment misuse incidents.

• Radiation Safety Compliance

100% compliance with radiation safety standards, including ALARA principles, shielding, and dose minimization practices.

• Patient Safety and Identification

100% compliance with patient identification procedures, infection control protocols, and safe patient handling requirements.

• Repeat Rate

Repeat imaging rate due to technologist error shall not exceed 7%.

• EHR Documentation Compliance

100% of radiology encounters shall be documented accurately and timely in the EHR, including required technical notes and coding elements.

• Regulatory and Accreditation Compliance

100% compliance with applicable federal, facility, and accreditation standards, including Indian

Health Service and The Joint Commission requirements.

1.2.3 Objective 3 – Continuous Staffing Coverage

Outcome 3: Pine Ridge Service Unit operations remain fully supported with qualified personnel.

Performance Standards:

• 1.2.3.1 98% or greater shift coverage per month. The Contractor agree to provide services to patients as they are referred from the Outpatient Clinic, In-Patient locations such as Acute Care, Surgery, and Emergency Room, and any patient referrals needed for patients Purchased Referred

Care patient needs for a remote rural area. Work hours will be determined by department needs, but services will be provided on a scheduled basis but will include all shifts (days, evenings, nights, weekends and holidays).

• 1.2.3.2 No uncovered shifts without prior Government approval.

• 1.2.3.3 Present candidate submission packet with 100% accuracy ensuring all Pine Ridge Service

Unit Policies are adhered to.

1.2.4 Objective 4 – Safety and Regulatory Compliance

Outcome: Contract employees will know and follow all Pine Ridge Hospital and Clinic’s policy and procedures. Including but not limited to infection control, and facility safety standards.

Performance Standards:

• 1.2.4.1 Zero significant compliance violations.

• 1.2.4.2 Zero preventable safety incidents.

1.2.5 Objective 5 – Professional Conduct and Communication

Outcome: Personnel adhere to high standards of professionalism and confidentiality.

Performance Standards:

• 1.2.5.1 Zero substantiated incidents of unprofessional conduct.

1.3 Contractor Responsibilities

1.3.1 General Responsibilities

The Contractor shall:

• 1.3.1.1 Determine the methods and processes necessary to achieve all performance objectives.

• 1.3.1.2 Provide personnel who meet required qualifications.

• 1.3.1.3 Ensure supervision of all employees for all employer functions.

• 1.3.1.4 Adhere to radiation exposure standards.

1.3.2 Personnel Qualifications

Contractor personnel shall:

• 1.3.2.1 Hold current applicable registry/certification through the American Registry of Radiologic

Technologists (ARRT), or equivalent credential acceptable to the Government.

• 1.3.2.2 CT Technologists shall have documented competency and experience performing

Computed Tomography procedures, including appropriate CT registry/certification where required by facility policy.

• 1.3.2.3 Diagnostic Radiology/X-Ray Technologists shall have documented competency and experience performing routine and complex radiographic imaging procedures.

• 1.3.2.4 Meet all Government onboarding and security requirements. Including providing dosimeter badges to ensure Radiation Safety Requirements. Comply with all applicable radiation safety requirements, including ALARA principles, dosimetry monitoring, shielding, and exposure control practices.

1.3.2.5 Complete all required facility orientation, annual competencies, mandatory training, and policy acknowledgments.

1.4 Government Responsibilities

1.4.1 Government-Furnished Support

The Government will provide:

• 1.4.1.1 Radiology space, equipment, and materials.

• 1.4.1.2 PPE and supplies needed to perform tasks.

• 1.4.1.3 Access to systems necessary for task execution.

• 1.4.1.4 Orientation on facility-specific policies and adhere to Pine Ridge Service Unit Policy for completion deadlines.

SECTION 1.5 – DELIVERABLES

1.5.1 Timekeeping, Staffing, and Invoicing Report

Contractor shall submit a consolidated weekly report reflecting actual labor performance and billing support.

Includes:

• Actual hours worked by modality (CT / X-Ray)

• Shift coverage (scheduled vs. filled)

• Call-offs, replacements, and vacancies

• On call / callback utilization (if applicable)

• Invoice reconciliation (hours billed vs. worked)

Frequency: Weekly

Format: Electronic (Excel or system-generated report)

Performance Link: Supports staffing coverage ≥98% and invoice validation

1.5.2 Quality, Safety, and Adverse Event Report

Monthly performance report tied directly to imaging quality, patient safety, and compliance metrics.

Includes:

• CT and X-Ray image quality issues (non-diagnostic, repeats)

• Repeat imaging rate analysis (must remain ≤7%)

• Radiation safety compliance (ALARA adherence, dose concerns)

• Patient safety incidents (if any)

• Infection control issues

• Equipment performance or downtime impacting services

• Corrective actions implemented

Frequency: Monthly

Format: Electronic narrative + data summary

Performance Link: Image quality ≥93%, safety = 100% compliance

1.5.3 EHR Documentation Compliance Report

Verification that all imaging encounters are fully documented in the EHR in accordance with HIM and billing requirements. No invoices will be paid unless favorable Health Information

Documentation completed.

Includes:

• Completion of all CT and X-Ray encounter notes

• POV (Purpose of Visit) and coding accuracy

• Delinquent or incomplete records

• Turnaround time for documentation completion

Frequency: Monthly

Format: Electronic (audit report or summary)

Performance Link: 100% documentation compliance

1.5.4 Personnel Roster and Credentialing Package

Comprehensive staffing and compliance roster for all contract personnel.

Includes:

• Current roster of all CT and X-Ray technologists

• ARRT certifications and modality credentials

• State licensure (if applicable)

• BLS certification

• Competency validations

• Background clearance / PIV status

• Submission packet completeness (100%)

Frequency:

• At Award

• With each staffing change

• Monthly validation (recommended for Joint Commission readiness)

Format: Electronic

1.5.5 Staffing Coverage and Schedule Report

Forward-looking and retrospective staffing visibility.

Includes:

• Minium 30 day schedule provided

• Coverage gaps and mitigation plan

• Confirmation of filled shifts

• Upcoming risk periods (leave, rotations, vacancies)

Frequency: Weekly (minimum), real-time updates as needed

Format: Electronic (schedule format consistent with PRSU practice)

Performance Link: ≥98% coverage, zero unapproved gaps

1.5.6 Equipment and Operational Readiness Report

Ensures imaging operations are not degraded by equipment or workflow issues.

Includes:

• Equipment downtime impacting CT/X-Ray services

• Coordination with Biomedical/Facilities

• Workarounds or contingency measures

• Impact to patient care (if any delays occurred)

Frequency: Monthly or as incident occurs

Format: Electronic

1.5.7 COR Performance Review Support and QASP

Contractor shall provide all data necessary for COR surveillance and QASP validation.

Includes:

• Image quality rates

• Timeliness metrics

• Repeat rates

• Staffing compliance

• Safety compliance metrics

Frequency: Monthly (aligned to QASP review cycle)

Format: Data table + supporting narrative

1.5.8 Incident and Corrective Action Reports if applicable or needed

Formal reporting of any performance failure or compliance issue.

Includes:

• Description of issue

• Immediate corrective action

• Long-term prevention plan

• Timeline for resolution

Frequency: As Required (within 24–72 hours of incident)

1.6 Non-Personal Services Compliance

1.6.1 General Requirement

All services shall be provided strictly as non-personal services. No employer-employee relationship is created between the Government and Contractor personnel.

1.6.2 Contractor Responsibility for Personnel Management

Contractor staff shall:

• 1.6.2.1 Contractor personnel shall perform services independently under the general direction of the Contract Officer Representative. The Government shall not supervise contractor employees nor control the details of performance. Operate under the exclusive supervision and control of the

Contractor.

• 1.6.2.2 Receive all task assignments, direction, and supervision from the Contractor—not

Government staff.

• 1.6.2.3 Be hired, evaluated, paid, and disciplined solely by the Contractor.

• 1.6.2.4 Follow Contractor-established policies, except where Government rules are required for facility access or safety.

1.6.3 Government Role

Government staff shall:

• 1.6.3.1 Not supervise or direct Contractor personnel.

• 1.6.3.2 Not assign tasks directly to individual Contractor workers.

• 1.6.3.3 Communicate performance expectations and concerns only to the Contractor’s Program

Manager.

• 1.6.3.4 Provide outcome-oriented direction, department needs, not detailed task instructions.

1.6.4 Prohibited Government Actions

Government personnel should not:

• 1.6.4.1 Approve Contractor employee leave or schedules.

• 1.6.4.2 Conduct performance appraisals for Contractor staff.

• 1.6.4.3 Issue direct reprimands or corrective actions to Contractor employees.

• 1.6.4.4 Assign daily tasks to Contractor workers. Except for floating to needed areas of the hospital.

• 1.6.4.5 Involve Contractor personnel in inherently governmental functions. Oversight of the contract is managed by the COR designated for this contract. It is the vendor's responsibility to manage timecard information and submit it to the government. Timecards must be monitored by the vendor.

Vendor must offer an electronic time management program for the contract staff to utilize in documenting performance of contract. Government Program management will be given access to software programs to use for validation of services rendered and quality processes (concurrence).

1.6.5 Contractor Responsibilities to Maintain Non-Personal Status

The Contractor shall:

• 1.6.5.1 Provide a single management representative as a point of contact.

• 1.6.5.2 Conduct all HR functions independently.

• 1.6.5.3 Ensure personnel distinguish themselves from Federal employees.

• 1.6.5.4 Ensure personnel do not perform inherently governmental functions.

1.6.6 Inherently Governmental Functions

Contractor personnel shall not perform tasks defined as inherently governmental

Examples include:

• 1.6.6.1 Supervising Federal employees.

• 1.6.6.2 Making policy decisions.

• 1.6.6.3 Directing Federal staff.

• 1.6.6.4 Binding the Government contractually.

2.0 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

(CT and Diagnostic Radiology (X-Ray) Services – PRSU)

2.1 Purpose

The QASP defines the systematic methods the Government will use to monitor, evaluate, and document

Contractor performance to ensure all Performance Work Statement (PWS) requirements are met.

Surveillance focuses on outcomes, not processes, in accordance with non-personal services requirements.

2.2 Performance Metrics and Surveillance Plan

Objective Performance

Standard

Acceptable

Quality Level

(AQL)

Surveillance

Method Frequency Data Source

2.2.1 Image

Quality (CT & X-

Ray)

Images meet diagnostic standards on first acquisition

≥ 93% acceptable (≤

7% repeat rate due to technologist error)

Random sampling of studies;

Radiologist feedback

Monthly

PACS review;

Radiology QA logs

Objective Performance

Standard

Acceptable

Quality Level

(AQL)

Surveillance

Method Frequency Data Source

2.2.2 Timeliness

Exams completed within facility-established turnaround times

≥ 95% on time EHR/PACS time stamp review Monthly EHR, RIS/PACS

2.2.3 Protocol

Accuracy (CT)

Correct protocol, positioning, and technique applied

≥ 98% compliance

Random chart/study audit Monthly Imaging records

2.2.4 Positioning

& Technique (X-

Ray)

Proper positioning and exposure techniques

≥ 93% compliance

Observation;

image review Monthly PACS

2.2.5 Staffing

Coverage

Scheduled shifts fully staffed

≥ 98% coverage;

no unapproved gaps

Timekeeping and schedule reconciliation

Weekly

Contractor reports;

schedules

2.2.6 Radiation

Safety

Compliance

Adherence to

ALARA, shielding, dose practices

100% compliance

Safety audits;

badge monitoring review

Monthly Radiation safety logs

2.2.7 Patient

Safety &

Infection Control

Compliance with patient ID, infection control, safety protocols

100% compliance; zero preventable events

Direct observation;

incident review

Ongoing Incident reports

2.2.8 EHR

Documentation

Complete, accurate, timely documentation

100% compliance EHR audit Monthly HIM reports

2.2.9 Equipment

Use

Equipment used per manufacturer and policy

100% compliance

Observation;

maintenance logs

Monthly Biomed logs

2.2.10

Professional

Conduct

No substantiated complaints Zero incidents

COR

observation;

staff feedback

Ongoing Complaint logs

Objective Performance

Standard

Acceptable

Quality Level

(AQL)

Surveillance

Method Frequency Data Source

2.2.11

Credentialing &

Compliance

All staff are fully credentialed and cleared

100% compliance

Credentialing file review Monthly

HR/credentialing records

2.3 Surveillance Methods

2.3.1 Random Sampling

• Review of CT and X-Ray imaging studies to validate diagnostic quality and protocol adherence

• Sampling size determined by COR based on workload volume

2.3.2 100% Inspection (Critical Areas)

Applied to:

• Patient safety incidents

• Radiation safety compliance

• Credentialing and background clearance

• EHR documentation

2.3.3 Direct Observation

• Real-time observation of technologist performance

• Verification of patient interaction, positioning, safety practices

2.3.4 Data Review and Trend Analysis

• Review of Contractor-submitted deliverables

• Analysis of:

o Repeat rates o Timeliness trends o Staffing gaps o Documentation compliance

2.3.5 Customer Feedback

• Input from:

o Radiologists o Providers o Nursing staff

• Used to validate image quality and responsiveness

2.3.6 COR–Contractor Performance Meetings

• Monthly (minimum) performance review meetings

• Discuss:

o QASP metrics o Deficiencies o Corrective actions o Staffing and operational risks

2.4 Remedies and Corrective Actions

If Contractor performance does not meet established standards, the Government may implement the following remedies:

2.4.1 Corrective Action Request

• Issued for any failure to meet performance standards

• Contractor must respond with:

o Root cause analysis o Corrective action plan o Timeline for resolution

2.4.2 Increased Surveillance

• Applied when performance trends downward

• May include:

o Increased sampling rates o Daily monitoring o Additional reporting requirements

2.4.3 Personnel Removal

The Government may require removal and replacement of Contractor personnel for:

• Failure to meet qualifications

• Repeated performance deficiencies

• Safety violations

• Unprofessional conduct

• Failure to maintain required credentialing or clearance

2.4.4 Invoice Withholding

• Payment may be delayed or adjusted for:

o Non-performance o Incomplete documentation – Health Information Documentation o Unverified hours

2.4.5 Non-Exercise of Option Periods

• Continued poor performance may result in:

o Non-renewal of option periods o Contract termination considerations

3.0 EVALUATION FACTORS LOWEST PRICE ACCEPTATBLE EVALUATION FACTORS

3.1 Evaluation Approach

The Government will award a contract to the responsible Offeror whose proposal:

• Is Technically Acceptable,

• Is determined Responsible in accordance with FAR Part 9, and

• Submits the Lowest Evaluated Price

This acquisition will be conducted using Lowest Price Technically Acceptable (LPTA) procedures in accordance with FAR 15.101-2.

Proposals will be evaluated on a pass/fail basis only. The Government will not assign strengths, weaknesses, or ratings beyond Acceptable or Unacceptable, and no tradeoffs will be conducted.

The Government intends to evaluate proposals in the following order:

1. Technical Acceptability

2. Price

3.2 Technical Acceptability (Pass/Fail)

Technical acceptability will be determined based on the Offeror’s demonstrated ability to meet all requirements of the Performance Work Statement (PWS).

Failure to clearly demonstrate compliance with any requirement may result in a rating of Unacceptable.

3.2.1 Staffing and Coverage Capability

The Offeror shall demonstrate the ability to:

• Provide qualified CT and Diagnostic Radiology (X-Ray) Technologists

• Maintain ≥ 98% staffing coverage

• Ensure no unapproved uncovered shifts

• Provide contingency coverage for absences, turnover, and surge needs

Rating:

• Acceptable = Meets all requirements

• Unacceptable = Fails to demonstrate capability

3.2.2 Personnel Qualifications

The Offeror shall demonstrate that proposed personnel:

• Meet all PWS credentialing requirements

• Hold required ARRT certifications and modality competencies

• Meet background, credentialing, and onboarding requirements prior to performance

• Provide complete candidate submission packets

Rating:

• Acceptable = All requirements met

• Unacceptable = Any requirement missing or not demonstrated

3.2.3 Technical Capability

The Offeror shall demonstrate capability to:

• Perform CT and X-Ray imaging in accordance with clinical standards

• Produce diagnostic-quality images on first acquisition

• Apply correct protocols, positioning, and techniques

• Comply with radiation safety (ALARA) and infection control requirements

Rating:

• Acceptable = Meets all PWS clinical requirements

• Unacceptable = Does not demonstrate required capability

3.2.4 EHR Documentation and Regulatory Compliance

The Offeror shall demonstrate ability to:

• Utilize the facility Electronic Health Record (EHR) system

• Complete 100% required documentation (encounters, coding, POV, technical notes)

• Meet Health Information Management (HIM) standards

• Comply with IHS, facility, and Joint Commission requirements

Rating:

• Acceptable = Demonstrates full compliance capability

• Unacceptable = Does not demonstrate compliance

Technical Acceptability Determination

A rating of Unacceptable in any subfactor will result in the proposal being rated Technically Unacceptable overall and removed from further consideration for award.

3.3 Price Evaluation

The Government will evaluate price for:

• Fairness and reasonableness in accordance with FAR 15.404-1

• Completeness

Award will be made to the Lowest Evaluated Price among Technically Acceptable Offerors.

3.4 Past Performance

Past performance will not be evaluated as a separate factor but may be considered as part of the responsibility determination in accordance with FAR Part 9.