Surveillance Checklist - Non Emergent Patient Transportation - Ann Arbor VAMC.pdf
PDF 78 KB Posted
- Solicitation number
- 36C25024R0180
About this file
This document is a Surveillance Checklist for a non-emergent patient transportation contract at the LTC Charles S. Kettles VA Medical Center in Ann Arbor, Michigan. The checklist outlines the performance objectives and standards for the contractor providing wheelchair/ambulatory transportation services. Key requirements include ensuring passengers arrive 15-30 minutes prior to their appointment (95% compliance), picking up passengers within 30 minutes of a call (97% compliance), submitting injury reports within 24 hours (97% compliance), and maintaining a compliant fleet of vehicles (95% compliance). The performance standards and methods of surveillance are specified for each requirement. This checklist supports the related federal contract opportunity for a five-year IDIQ contract to provide non-emergent patient transportation services to the VA medical center and its clinics, with a NAICS code of 485991 and a size standard of $19 million.
View the file
Other files
Show all 11
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Surveillance Checklist
LTC Charles S. Kettles VAMC
Contract: Wheelchair/Ambulatory Non-emergent Transportation
Date/Time of Inspection:
Government POC Primary:
Government POC Alternate:
Organization:
LTC Charles S. Kettles VAMC
Location: 2215 Fuller RD, Ann Arbor, MI 48105
SS Performance Objective -Task PWS Para Standard Performance
Threshold Method of
Surveillance Met Not Met Remarks
SS 1
Provide on- time transportation service to appointments Section
XII
Shall ensure all passengers arrive at their designated appointment location 15 to 30 minutes prior to the appointment time.
95% Compliance
100% Surveillanc e of each patient pick-up.
Threshold Method of
Surveillance Met Not Met Remarks
SS 2
Provide on- time transportation service – return trips
Section X
Passenger picked up within 30 minutes of call from the
VTS/AOD.
97% Customer Feedback
SS 3
Incident Reporting
Section XIV.c
The Contractor shall submit all injury reports within 24 hours of incident to the VTS/COR and AOD for inclusion into the passenger’s administrative chart.
97% Compliance
Random Monitoring
SS4
Invoice Reports
VII
The Contractor shall submit all injury reports within 24 hours of incident to the VTS/COR and AOD for inclusion into the passenger’s administrative chart.
95% Compliance
100%
Surveillanc e
SS5
Vehicle Requirements accomplish all services under this contract.
Section
VII
Contractor to maintain fleet of vehicles in accordance with paragraph VII of
95% Compliance
Periodic Inspection
Threshold Method of
Surveillance Met Not Met Remarks the PWS to include providing reports upon request of the COR or CO.
SS6
Drivers shall complete training requirements outlined in this PWS V and
VI
Contractor to ensure drivers meet diver requirements of section V and training standards in section VI
95% Periodic
Inspection
File details come from the government source that posted it. Updated .