SF1449 36C26324Q0751 SOLICITATION DOCUMENT MEDICAL OFFICER OF THE DAY.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C26324Q0751 09-10-2024

John Becker 605-585-3908 09-27-2024

11:00 AM CDT

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

2501 W. 22nd St.

Sioux Falls SD 57105 John Becker john.becker3@va.gov

X 100

X

621111

$16 Million

N/A

X

St Cloud VA Hospital 4801 Veterans Drive

St Cloud MN 56303

NETWORK 23 CONTRACTING OFFICE

2501 W. 22nd St.

Sioux Falls SD 57105

Electronic Invoicing Tungsten Support Website: https://us.tungsten-network.com Phone: 1-877-489-6135

See CONTINUATION Page

MEDICAL OFFICER OF THE DAY PHYSICIAN, PHYSICIAN ASSISTANTS,

AND/OR NURSE PRACTITIONER SERVICE

to support the St Cloud VA Hospital, 4801 Veterans Drive, St Cloud MN 56303.

See Price/Cost Schedule for specific information and requirements Period of Performance:

Base Period: 12/1/2024 to 11/30/2025 Option Period 1: 12/1/2025 to 11/30/2026 Option Period 2: 12/1/2026 to 11/30/2027 Option Period 3: 12/1/2027 to 11/30/2028 Option Period 3: 12/1/2028 to 11/30/2029

$0.00 See CONTINUATION Page

X one(1)

John Becker

VA-VHA-RPOC-2024-0074

36C26324Q0751

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

B.3 PERFORMANCE WORK STATEMENT (PWS)

B.4 IT CONTRACT SECURITY

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2023)

C.2 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.3 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR

PERSONNEL (JAN 2011)

C.4 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR

INFORMATION SYSTEMS (NOV 2021)

C.5 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.6 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) ... 45

C.7 52.228-5 INSURANCE—WORK ON A GOVERNMENT INSTALLATION (JAN 1997)

C.8 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.9 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.10 VAAR 852.219-73 VA NOTICE OF TOTAL SET-ASIDE FOR CERTIFIED

SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESSES (JAN 2023)

(DEVIATION)

C.11 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (JAN 2023)

(DEVIATION)

C.12 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.13 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.14 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019)

C.15 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.16 VAAR 852.239-76 INFORMATION AND COMMUNICATION TECHNOLOGY

ACCESSIBILITY (FEB 2023)

C.17 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) . 55

C.18 VAAR 852.211-76 LIQUIDATED DAMAGES – REIMBURSEMENT FOR DATA

BREACH COSTS (FEB 2023) ALTERNATE I (FEB 2023)

C.19 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.20 VAAR 852.204-70 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR

PERSONNEL (MAY 2020)

C.21 VAAR 852.204-71 INFORMATION AND INFORMATION SYSTEMS SECURITY

(FEB 2023)

C.22 VAAR 852.237-72 CRIME CONTROL ACT—REPORTING OF CHILD ABUSE

(OCT 2019)

C.23 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAY 2024)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 ATTACHMENT IMMIGATION CERTIFICATION

D.2 ATTACHMENT ORGANIZATIONAL CONFLICT CERTIFICATION

D.3 ATTACHMENT VA HANDBOOK 6500.6 CONTRACTOR RULES OF BEHAVIOR. 75

D.4 ATTACHMENT SUBCONTRACTING LIMITATION ACKNOWLEDGEMENT

D.5 ATTACHMENT QUALITY ASSURANCE SURVEILLANCE PLAN QASP

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (SEP 2023)

E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.4 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.5 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT

ORDERS—REPRESENTATION AND DISCLOSURES (DEC 2023)

E.6 52.216-1 TYPE OF CONTRACT (APR 1984)

E.7 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020) . 84

E.8 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.9 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.10 VAAR 852.239-75 INFORMATION AND COMMUNICATION TECHNOLOGY

ACCESSIBILITY NOTICE (FEB 2023)

E.11 VAAR 852.252-70 SOLICITATION PROVISIONS OR CLAUSES

INCORPORATED BY REFERENCE (JAN 2008)

E.12 VAAR 852.273-70 LATE OFFERS (NOV 2021)

E.13 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.14 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2024)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

Business Name:

Unique SAM Entity:

Contact Person:

Email:

Phone:

b. GOVERNMENT:

Name: John Becker

Email: John.becker3@va.gov

Phone: 605-585-3908

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor should be mailed to the following address:

[X] 52.232-33, Payment by Electronic Funds Transfer—System for Award Management

3. INVOICES: Invoices shall be submitted in arrears:

• Monthly or Upon Completion of Individual Service or a period agreed upon between the Contractor and Government.

• Contractor shall submit final invoice on any services performed no later than 30 days after end of the period of performance of the purchase order or contract. This ensures timely closeout of purchase orders and/or contracts.

4. INVOICING: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Invoicing shall be in accordance with the requirements of The Department of Veterans Affairs (VA) Financial Services Center (VAFSC). The latest information shall be used for invoicing and payments and may change during the Period of Performance of this acquisition. Current Invoicing information is located at http://www.fsc.va.gov/einvoice.asp.

5. VETS-4212 REPORTING REQUIREMENTS (for contracts awarded over $150,000.00).

Contractor shall complete VETS-4212 reporting in accordance with FAR requirements.

Reference. Please refer to https://www.dol.gov/agencies/vets/programs/vets4212 for guidance on completing the required VETS-4212 report.

• FAR 52.222-35, Equal Opportunity for Veterans mailto:John.becker3@va.gov https://www.dol.gov/agencies/vets/programs/vets4212

• FAR 52.222-37, Employment Reports on Veterans

6. SECURE FAX. Please review VA Handbook 6500 that requires the following statement on all fax cover sheets be included: This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.”

7. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

SCHEDULE OF SERVICES

The Contractor shall furnish all key personnel to provide services necessary to perform On-site Medical Officer of the Day Physician Services (Physician, Physician Assistant, or Nurse Practitioner) to eligible beneficiaries of the Department of Veterans Affairs, St Cloud MN VA Hospital.

The services are accredited by The Joint Commission (TJC) and follow the standards & guidelines set forth by The American College of Physicians (encompassing all of internal medicine) and the Society of Hospital Medicine: https://www.hospitalmedicine.org. A contractor providing onsite Hospital Medicine physician services shall provide services that meet or exceed those guidelines.

Place of Performance: Services shall be provided on site, St Cloud MN VA Hospital, 4801 Veterans Drive, St Cloud, MN 56303.

Pricing Instructions:

The offeror is instructed to edit the number of Sub-Line Item Numbers (SLIN) to correspond with the number of key personnel submitted for the line item number (LIN). Identify the title/position or level of experience of the key personnel submitted. Also, renumber SLINs if adding or removing Key Personnel.

The Contractor shall propose a minimum of three (3) key personnel hospital medicine providers to be credentialed and be available for scheduling to meet the requirements of the contract.

B.2 PRICE/COST SCHEDULE

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 BASE PERIOD 7,660.00 HR ___________ ___________

Medical Officer of the Day Physician Services (Physician, Physician Assistant, or Nurse Practitioner) to support the St Cloud VA Hospital at 4801 Veterans Drive, St Cloud, MN 56303-2015.

Three (3) Full Time Equivalent (FTE) Employees Contract Period: Base POP Begin: 12-01-2024 POP End: 11-30-2025 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except Mental Health Specialists) PRODUCT/SERVICE CODE: Q201 - Medical - Managed Healthcare

0001AA

__________ HR ___________ ___________

Name: _____________________________________________________

Title: ______________________________________________________

Level of Experience: __________________________________________

0001AB

https://www.hospitalmedicine.org/

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001AC

1001 OPTION PERIOD 1 7,660.00 HR ___________ ___________

Medical Officer of the Day Physician Services (Physician, Physician Assistant, or Nurse Practitioner) to support the St Cloud VA Hospital at 4801 Veterans Drive, St Cloud, MN 56303-2015.

Three (3) Full Time Equivalent (FTE) Employees Contract Period: Option 1 POP Begin: 12-01-2025 POP End: 11-30-2026 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except Mental

1001AA

1001AB

1001AC

2001 OPTION PERIOD 2 7,660.00 HR ___________ ___________

Assistant, or Nurse Practitioner) to support the St Cloud VA Hospital at 4801 Veterans Drive, St Cloud, MN 56303-2015.

Three (3) Full Time Equivalent (FTE) Employees Contract Period: Option 2 POP Begin: 12-01-2026 POP End: 11-30-2027 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except Mental

ITEM

NUMBER

DESCRIPTION OF

2001AA

2001AB

2001AC

3001 OPTION PERIOD 3 7,660.00 HR ___________ ___________

Assistant, or Nurse Practitioner) to support the St Cloud VA Hospital at 4801 Veterans Drive, St Cloud, MN 56303-2015.

Three (3) Full Time Equivalent (FTE) Employees Contract Period: Option 3 POP Begin: 12-01-2027 POP End: 11-30-2028 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except Mental

3001AA

3001AB

ITEM

NUMBER

DESCRIPTION OF

3001AC

4001 OPTION PERIOD 4 7,660.00 HR ___________ ___________

Assistant, or Nurse Practitioner) to support the St Cloud VA Hospital at 4801 Veterans Drive, St Cloud, MN 56303-2015.

Three (3) Full Time Equivalent (FTE) Employees Contract Period: Option 4 POP Begin: 12-01-2028 POP End: 11-30-2029 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except Mental

4001AA

4001AB

4001AC

GRAND TOTAL

B.3 PERFORMANCE WORK STATEMENT (PWS)

ON-SITE PHYSICIAN, NURSE PRACTITIONER, OR PHYSICIAN ASSISTANT SERVICE

1. GENERAL:

1.1 Services Provided: The Contractor shall provide a physician, nurse practitioner or physician assistant on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the St Cloud VA Hospital, 4801 Veterans Drive, St.

Cloud MN 56303.

1.2 Place of Performance: Contractor shall furnish services at the St Cloud VA Hospital, 4801 Veterans Drive, St. Cloud MN 56303.

1.3 Authority: Title 38 USC 8153, Health Care Resources (HCR) Sharing Authority and Federal Acquisition Regulation (FAR) parts FAR 12 in combination with 13.

1.4 Policy/Directives/Handbooks. The contractor shall be subject to the following policies, including any subsequent updates during the period of performance. The policies listed below can be accessed electronically at the following: VA Publications and/or VHA Publications

1.4.1 VA Directive 1663: Health Care Resources (HCR) Contracting – Buying Title 38 U.S.C.

1.4.2. VHA Directive 1003.04: VHA Patient Advocacy

1.4.3 VHA Directive 1065: Productivity and Staffing Guidance for Specialty Provider Group Practice

1.4.4 VHA Directive 1088(1): Communicating Test Results to Providers and Patients

1.4.5 VHA Directive 1100.18: Reporting and Responding to State Licensing Boards

1.4.6 VHA Directive 1100.20: Credentialing of Health Care Providers

1.4.7 VHA Directive 1100.21: Privileging

1.4.8 VHA Directive 1192.01: Seasonal Influenza Vaccination Program for VHA Health Care Personnel

1.4.9 VHA Directive 1220(1): Facility Procedure Complexity Designation Requirements to Perform Invasive Procedures in Any Clinical Setting

1.4.10 VHA Directive 1605.01: Privacy and Release of Information

1.4.11 VHA Directive 1907.01: VHA Health Information Management and Health Records

1.4.12 VHA Handbook 1100.17: National Practitioner Data Bank (NPDB) Reports

1.4.13 Privacy Act of 1974 (5 U.S.C. 552a) as amended:

http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5 Acronyms/Definitions: Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.5.1 ABIM: American Board of Internal Medicine http://www.abim.org/

1.5.2 ACGME: Accreditation Council for Graduate Medical Education

1.5.3 ACLS: Advanced Cardiac Life Support

https://www.va.gov/vapubs/ https://www.va.gov/vhapublications/index.cfm http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm http://www.abim.org/

1.5.4 BLS: Basic Life Support

1.5.5 CDC: Centers for Disease Control and Prevention

1.5.6 CEU: Certified Education Unit

1.5.7 Clinical Privileging: Clinical Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific, and within available resources.

1.5.8 CME: Continuing Medical Education

1.5.9 CMS: Centers for Medicare and Medicaid Services

1.5.10 CO: Contracting Officer: The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

1.5.11 COR: Contracting Officer’s Representative: A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government.

The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.5.12 COS: Chief of Staff

1.5.13 CPARS: Contractor Performance Assessment Reporting System

1.5.14 CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.5.15 Credentialing: Credentialing is the process of obtaining, verifying, and assessing the qualifications of a health care provider to provide care or services in or for the VA health care system. Credentials are documented evidence of licensure, education, training, experience or other qualifications.

1.5.16 DEA: Drug Enforcement Agency

1.5.17 FSMB: Federation of State Medical Boards

1.5.18 FTE: Full Time Equivalent. VA’s standard definition is for full time working the equivalent of 80 hours every two weeks, 2080 hours per year. However, providers may propose using their standard FTE definition.

1.5.19 HHS: Department of Health and Human Services

1.5.20 HIPAA: Health Insurance Portability and Accountability Act

1.5.21 Hospital Medicine: A medical specialty dealing with the care of hospitalized patients.

1.5.22 ISO: Information Security Officer

1.5.23 Key Personnel: The individuals specified in this contract who are essential to work performance.

1.5.25 Medical Emergency: A sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part.

1.5.26 NPI: National Provider Identifier. NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.5.27 POP: Period of Performance

1.5.28 PPD: Purified Protein Derivative

1.5.29 PWS: Performance Work Statement

1.5.30 QA/QI: Quality Assurance/Quality Improvement

1.5.31 QASP: Quality Assurance Surveillance Plan

1.5.32 QM/PI: Quality Management/Performance Improvement

1.5.33 VETPro: is VHA’s mandatory credentialing software platform to document the credentialing of VHA health care providers. This system facilitates completion of a uniform, accurate, and complete credentials file.

1.5.34 VHA: Veterans Health Administration

1.5.35 VISN: Veterans Integrated Services Network

1.5.36 VistA: Veterans Integrated Systems Technology Architecture

2. QUALIFICATIONS:

2.1 Staff/Facility:

2.1.1 License: The Contractor’s physician(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia) when services are performed onsite on VA property.

All licenses held by the key personnel working on this contract shall be full and unrestricted licenses. Contractor’s physician(s) who have current, full, and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2 Board Certification and Experience: All contractor’s physician(s) shall be Board Certified/Board Eligible in Internal Medicine, have experience in providing scope of care as described herein and be currently certified in VHA-approved Basic Life Support (BLS) and/or Advanced Cardiac Life Support (ACLS) or equivalency. All continuing education courses required for maintaining certification must be kept up to date at all times.

Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.3 Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Directive 1100.20 and VHA Directive 1100.21 referenced above. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any Contractor’s physician(s) prior to obtaining approval by the Facility Medical Executive Board and Medical Center Director.

2.1.3.1 If a Contractor’s physician(s) and/or other contract provider(s) are not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.4 Technical Proficiency: Contractor’s physician(s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read, and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed.

Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor’s physician(s) and contractor’s physician(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.5 Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements:

Contractor shall provide the COR copies of current CMEs as required or requested by the facility. Contractor’s physician(s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credential’s office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract physician(s).

2.1.6 Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s employees as required by the VA. There may other trainings assigned to meet the mission of the VHA.

Training Frequency Annual Hours

BLS at a minimum Annually 1.0 Hour

Active Threat Training Annually 1.0 Hour

Blood Administration: Complications Annually 1.0 Hour

Blood Administration: Administration (all contract employees who administer blood components)

Annually 1.0 Hour

CPRS and EDIS One Time 1.0 Hour

EHR One Time 1.0 Hour

General Infection Control Annually 1.0 Hour

Government Ethics Annually 1.0 Hour

Hospice and Palliative Care for VA Clinicians

One Time 1.0 Hour

Joint Patient Safety Reporting (JPSR) One Time 1.0 Hour

Military Sexual Trauma (MST) for Medical Providers

One Time 1.0 Hour

Moderate Sedation In-Service Training Annually 1.0 Hour

Training Frequency Annual Hours

PACT Act 2022 Toxic Exposure Screening

(TES)

One Time 1.0 Hour

Patient Abuse Annually 1.0 Hour

Patient Rights Annually 1.0 Hour

Patient Safety Annually 1.0 Hour

Prevention/Management of Disruptive Behavior/Violence Prevention Level I

Annually 1.0 Hour

Prevention of Workplace Harassment/No Fear Act

Annually 1.0 Hour

Suicide prevention: Suicide Risk Management Training for Clinicians

Annually 1.0 Hour

SUX Infection Control and Blood Borne Pathogens

Annually 1.0 Hour

VA Core Values Training (ICARE Recommitment)

Annually 1.0 Hour

VA Privacy and Information Security Awareness and Rules of Behavior

Annually 1.0 Hour

VHA Privacy and HIPAA Focused Training Annually 1.0 Hour

VISTA Imaging One Time 1.0 Hour

2.1.7 STANDARD INFECTION CONTROL MEASURES (PPD, IMMUNIZATIONS, ETC.):

Contractor shall provide proof of the following for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer.

Tests shall be current within the past year.

2.1.7.1 TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s physician(s) upon hire in accordance with CDC guidance. (This is applicable to all health care workers). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results.

2.1.7.2 MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor physicians.

2.1.7.3 VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}.

2.1.7.4 ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians {This is applicable to all health care workers}.

2.1.7.5 INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

2.1.7.6 OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO

BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s physician(s) {This is applicable to all health care workers}; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.1.7.7 The facility shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel ( as published in American Journal for Infection Control- AJIC 1998; 26:289-354 (https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/index.html) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.8 National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical facilities). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

2.1.9 DEA Contractor shall provide copy of current DEA certificate.

2.1.10 Conflict of Interest: The Contractor and all contractor’s physician(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.11 Citizenship related Requirements:

2.1.11.1 The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals;

2.1.11.2 While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Finfectioncontrol%2Fguidelines%2Fhealthcare-personnel%2Findex.html&data=05%7C01%7C%7Cd7680a2a6e804141d0cb08da3dc81d55%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637890226930302569%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=tVJJoWuHL1TL2cTHqFwOw%2F4DalpjL2163AL8MHWeiMQ%3D&reserved=0 to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.1.11.3 If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.1.11.4 This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.1.11.5 The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document.

2.1.12 Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.12.1 Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contractor’s physician(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.12.2 By submitting their proposal, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.2 Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by VA Medical Facility COS or his/her clinical designee and approval by the Medical Facility Director as provided in VHA Directive 1100.20 and VHA Directive 1100.21.

Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the facility COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3 Non Personal Healthcare Services: The parties agree that the Contractor and all contractor’s physician(s) shall not be considered VA employees for any purpose.

http://oig.hhs.gov/exclusions/index.asp

2.4 Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees.

2.5 Prohibition Against Self-Referral: Contractor’s physicians are prohibited from referring VA patients to contractor’s or their own practice(s).

2.6 Inherent Government Functions: Contractor and Contractor’s physician(s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.7 No Employee status: The Contractor shall be responsible for protecting Contractor’s physician(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.7.1 Workers’ compensation

2.7.2 Professional liability insurance

2.7.4 Health examinations

2.7.4 Income tax withholding, and

2.7.5 Social security payments.

2.8 Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract physician(s).

When a Contractor or contractor’s physician(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contract physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9 Key Personnel:

2.9.1 The VA Full Time Equivalency (FTE) for the services required is three (3) VA FTE (3.6827 FTE for 7,660 annual hours) that the resultant contract will provide hours of service coverage for example 2080 hours = 1.0 VA FTE.

2.9.2 The minimum number of Board Certified /Board Eligible Hospital Medicine physicians required to be on site daily is one (1) physician as defined in paragraph Hours of Operation in this section.

2.9.3 It is essential that continuity of services is maintained to the maximum degree possible, hence, substitution of contractor provided Physicians shall be limited to urgent/emergent absences of approved, assigned providers. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations, and additional coverage as required. In the event a scheduled physician is unable to begin or complete an assigned shift, the contractor shall provide replacement physician coverage within 2 hours and notify the Contracting Office Representative (COR) immediately of the schedule change.

2.9.4 Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. The Contractor shall notify the CO, in writing, within thirty (30) calendar day (s) after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least thirty (30) calendar days prior to making any permanent substitutions.

2.9.4.1 The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within thirty (30) calendar days after receipt of all required information of the decision on the proposed substitutes.

The contract will be modified to reflect any approved changes of key personnel.

2.9.4.2 For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive work days or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.9.4.3 The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives.

Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor’s physician(s), s/he may request, without cause, immediate replacement of said Contractor’s physician(s). The CO and COR shall deal with issues raised concerning Contractor’s physician(s) conduct. The final arbiter on questions of acceptability is the CO.

2.9.4.4 Contingency Plan: Because continuity of care is an essential part of the facility’s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractor’s physician(s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA HOURS OF OPERATION/SCHEDULING:

3.1 VA Business Hours: The hospital operates 24 hours a day, 7 days a week, 365 days a year including Federal Holidays.

Schedule: Contractor shall provide a PA, NP, or MD to cover from 4:00p.m. – 8:00a.m., Monday through Friday, including Federal Holidays (24 hours), 24-hour or 48-hour weekend coverage, and any other mutually agreed upon hours. This will include day shifts on holidays, day or evening shifts on weekends, and coverage in UC on occasion.

Care coverage will be provided at 80 to 136 hours per week (depending on weekend coverage) plus up to five (5) hours weekly beyond normal tour of duty for approved activity (i.e. trainings, patient care activities and administrative duties).

Patient care appointments are not scheduled. Average workload is two patient transfers and three program admissions per tour. Assessment of in-house patients varies in workload but is the primary responsibility of the MOD on duty. MOD tours on evenings, weekends, and holidays to include patient care rounding in the CLC, RRTP, and Acute Psych, as necessary, are included in this coverage. On occasion, the heavy workload in the UC area may necessitate the MOD to assist the UC provider when such assistance does not affect MOD in-house patient care duties.

3.1.1 Patients must be seen by a contractor’s physician(s) on-site at the facility in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.1.2 Contractor’s Physician(s) shall be available to be scheduled to work during all hours of operation of the facility or as required by the facility Chief of Staff or designee.

4. CONTRACTOR RESPONSIBILITIES:

4.1 Clinical Personnel Required: The Contractor shall provide contractor’s physician(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

Contractor’s physician(s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices.

4.2 Standards of Care: The contractor’s physician(s)’ care shall cover the range of Hospital Medicine Physician services as would be provided in a state-of-the-art health care treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

4.2.1 The Society of Hospital Medicine (http://www.hospitalmedicine.org ) would be the most reasonable replacements.

4.2.3 The American Board of Internal Medicine http://www.abim.org/

4.2.3 The professional standards of the The Joint Commission (TJC) http://www.jointcommission.org/

4.2.4 The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

4.2.5 The requirements contained in this PWS.

4.3 Medical Records:

4.4.1 Authorities: Contractor’s physician(s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the 5 U.S.C.552a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C.

552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

4.4.2 HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to:

a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA10A7 ). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that http://www.hospitalmedicine.org/ http://www.abim.org/ http://www.jointcommission.org/ http://www.hpoe.org/resources?show=100&type=8 http://www.rms.oit.va.gov/SOR_Records/24VA19.asp all records pertaining to medical care and services provided to VA patients are captured in the VA electronic health record system as required by VA policy as discussed in 4.4.4.

4.4.3 Disclosure: Contractor’s physician(s) may have access to patient medical records for the purpose of providing medical care and services to VA patients and performing services under the contract; however, Contractor shall obtain permission from the VA before disclosing any patient information outside VA. VA authorizes the Contractor to discuss patient health information for coordination of care with community health care providers in compliance with VA regulations, HIPAA and VHA Directive 1605.01, Privacy and Release of Information. The VA will provide the Contractor with a copy of VHA Directive 1907.01, Health Information Management and Health Records and VHA Directive 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.4.4 Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Directive 1907.01 Health Information Management and Health Records and all guidelines provided by the facility.

4.4.5 Release of Information: The VA shall maintain control of releasing any copies of patient health information or health records and will follow policies and standards as defined, but not limited to Privacy Act requirements. Contractor will not release or disclose copies of records and will refer all such requests to the Release of Information Department at the VA facility were assigned.

4.4.6 Management for Medical Records: National Archives and Records Administration record disposition requirements are found in RCS 10-1 Chapter 6, 6000 series.

4.5 Direct Patient Care: estimated 95% of the time involved in direct patient care.

Scope of Care: Contractor’s physician(s) (as appropriate and within scope of practice/privileging) shall be responsible for providing Hospital Medicine Physician care, including, but not limited to:

Evaluation, Treatment and Management: Contractor’s physicians shall admit and coordinate all aspects of care for hospitalized medical patients including:

Admission, including history and physical examinations

Appropriate placement within the Hospital

Evaluation and treatment, including the ordering and interpretation of diagnostic studies, including laboratory, diagnostic imaging, and electrocardiographic examinations, and the administration of medications normally considered part of the practice of hospital medicine.

Discussion of end of life preferences/advanced care planning

Consultations with sub-specialists

Timely and proactive discharge planning

Coordination of care with primary care physician

Discharge including ensuring appropriate follow-up is arranged

Perioperative care

Contractor’s physicians shall provide care to patients in critical/acute care settings in conformance with VA policies. Contractor’s physicians shall assess, stabilize, and determine the disposition of inpatients with emergent conditions consistent with medical staff policy regarding emergency and consultative call services. This includes running code teams and rapid response teams.

The core privileges in this specialty include the procedures on the procedures list (below) and such other procedures that are extensions of the same techniques and skills. This is not intended to be an all-encompassing procedures list. It defines the types of activities/procedures/privileges that the majority of practitioners in this specialty perform at the VA and inherent activities/procedures/privileges requiring similar skill sets and techniques.

Abscess incision and drainage

Thoracentesis

Nasogastric tube insertion

Reinsertion of gastric tube

Fecal occult blood testing

Paracentesis

Placement of transurethral catheter

Aspiration and injection of joints except ankle and hip Injection of lateral epicondyle (tennis elbow)

Removal of lines and tubes

Lumbar Puncture

Clinic: Contractor’s physician(s) shall be present on time for any scheduled clinics as documented by physical presence in the clinic at the scheduled start time.

Inpatient Admissions: Contractor’s physician(s) shall review all admissions to inpatient hospital care recommended by Physician Assistant or Nurse Practitioner providers. Every admission to inpatient care shall have a person-to-person hand-off/hand-over from the admitting Provider to a responsible member of the admitting team.

Consultation and Referral…