VISN 23 HOME VENTALATION RENTAL AND O2 SUPPLY SCOPE OF WORK.docx

SERVICE SPECIFICATIONS:

A. VETERANS SERVED

VISN 23 currently serves an estimated 5,400 oxygen-using beneficiaries and 93 ventilator beneficiaries. The volumes or amounts shown in the Contract Line-Item Numbers (CLINS) are estimates only and impose no obligation on the VA. The contract shall be for the actual requirements of the VA as ordered by the VA during the life of the contract. The Contracting Officer’s Representative (COR) or designee shall provide (via encrypted email or fax) the contractor with notification to initiate individual patient service requirements, including the patient’s oxygen prescription, equipment, supplies, and services to be provided including date and place of delivery. The Contractor shall confirm receipt (via encrypted email or fax) of the request within one (1) hour of notification. The COR or designee shall provide notification (via encrypted email or fax) to the contractor of VA initiated discontinuation of service. The service discontinuation notifications shall be made (via encrypted email or fax) within 24 hours. The written documents shall include the authorizing official's signature, electronic or written.

B. The Joint Commission (TJC), VETERANS HEALTH ADMINISTRATION (VHA), AND OTHER STANDARDS The Contractor shall perform the required work in accordance with (TJC The Joint Commission or any other accrediting body’s with equivalent standards) standards for Homecare, and the VHA (Veterans Health Administration). The Contractor shall be in compliance with any updates that are issued. The Contractor shall meet all Federal, State, and local fire and life safety codes. Contractor agrees to meet or exceed JC, NCPS, VHA and all other applicable federal state or local standards of service, reporting systems and quality control as specified herein. Failure to comply with the specified terms and conditions and/or adverse reports from external monitoring agencies that indicate poor quality of care shall be grounds for termination of the contract. Immediate (within 24 hours) notification must be given to the Home Oxygen Coordinator ( HOC) regarding adverse action by a regulatory agency. The services specified in the Schedule of Supplies/Services may be changed by written modification to this contract with mutual written consent of both parties, providing the change is within the scope of the contract. The Contractor shall furnish the home oxygen and ventilator specified in this contract when authorized by the VA designee and/or HOC.

TERMS OF THE CONTRACT

The contract is effective for a base year and five (5) option periods. The resulting contract is subject to availability of VA funds for the ensuing option years. The contractor shall perform no services after September 30 of each year unless the Contracting Officer authorizes such services in writing.

A. CONTRACT ADMINISTRATION DATA

The Contracting Officer is the only person authorized to approve changes or modify any of the requirements under this contract. Only the Contracting Officer is authorized to make commitments or issue changes which shall affect price, quantity, or quality of performance of this contract. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered to have been made without authority and no adjustment shall be made in the contract price to cover any increase in costs incurred as a result thereof.

1) It is the intention of VISN 23 to award a single Firm-Fixed Price (FFP) Requirements contract for commercial items and services.

B. OFFEROR PRICING AND FEE SCHEDULE

All monthly fees for respiratory therapy equipment shall include: ventilators, stationary concentrator, portable oxygen contents-gas/liquid (all initial set-ups and refills required to meet the needs of the patient), conserving device as prescribed by VA, portable oxygen concentrator as prescribed by VA, delivery, set-up, education (quarterly), adjustments, equipment service, maintenance, emergency backup and replacements of devices and supplies, fire safety valves, consumables, cylinder carts, cylinder rack, cylinder carry bag (including shoulder or back pack style as requested by patient), labor (supervision, management, transportation), instructions/education to the patient and caregiver (if applicable) in the use and care of the equipment, no smoking signs, and instructional/educational material to be left with the patient/caregiver to facilitate the proper use and care of the equipment for all beneficiaries of VISN 23 and respective Outpatient Clinics including any VA Beneficiaries that travel into or out of the VISN 23 region (see Attachment A) for Medical Care or Vacation as requested by the COR or designee or other VA Medical Centers.

C. CONTRACT IMPLEMENTATION

Upon contract award, communication between the VA, the incumbent contractor and the newly awarded contractor is of the utmost importance. The Contracting Officers Representative (COR) or designee will provide the contractor with notification to initiate individual patient service requirements, including the patient’s oxygen/ventilator prescription and contact information (phone and address). The prescription will define the equipment, supplies, and services to be provided to the Patient. The new contractor will contact the Patient to schedule an appointment and will arrange for the exchange of equipment, and shall include notification to the incumbent when the Patient is set up on the new contract. The new contractor shall provide a daily (for up to 90 days, or until all patients have been transferred over to the new contract holder) notification electronically by encrypted e-mail (method must be approved by the VA prior to use) to the COR or designee, the incumbent contract holder and the Prosthetics Central Processing Unit identifying the name and last four social security numbers of beneficiaries who were set up on that day, indicating that the equipment has been delivered, the Patient has been set up and the incumbent contractor has been notified. In the event the COR or contractor’s encryption is not functioning, notification will be made by facsimile to the COR requesting confirmation of receipt. If confirmation isn’t received the contractor will contact the COR by telephone.

D. TRANSITION PERIOD

At the end of the contract period a transition period shall be required during which incumbent Contractor shall continue to provide Home Oxygen/Ventilator services at the existing contract prices while the incoming Contractor is transitioning over. See FAR clause 52.237-3, Continuity of Services for additional information.

1) PHASE IN

The incoming Contractor shall replace all appropriate VA authorized (incumbent Contractor-owned) equipment presently located in residences of beneficiaries with the incoming Contractor’s equipment as soon as possible after award, but not to exceed 120 days from date of contract award. Incoming Contractor shall coordinate with the incumbent contractor during the transition period relating to the removal of the incumbent Contractor’s equipment from the Patient residences. The change shall include delivery, setup, and instruction as further specified herein, and shall be accomplished without disruption in ALL ENCOMPASSING services to the veteran or the VA. Transition date of each beneficiary shall be noted, to include the transfer of responsibility regarding Government Furnished Equipment (if applicable). The billing period shall begin on the noted transition date. Payments shall be assessed based on the providers established rate and prorated from setup date. Prorated monthly rates are based on a 30-day month.

2) PHASE OUT

In accordance with FAR 52.237-3 Continuity of Services, the Contractor realizes that the services being provided under this contract are vital and must be continued uninterrupted. The outgoing Contractor shall not remove any equipment from the beneficiary’s residence until replacement equipment has been installed. The outgoing Contractor shall coordinate transition of equipment / services with the incoming Contractor as soon as possible, but not to exceed 120 days from date of contract expiration. If additional transition time is required beyond contract expiration, the contractor shall be paid on a pro-rated basis at the prices established for the last period of performance. Prorated monthly rates are based on a 30-day month.

E. Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item unless the change is due to the defect in the item.

F. Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

G. Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

H. Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal, or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at Federal Acquisition Regulation (FAR) 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

I. Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

J. AUTHORIZED USERS

Authorized Users. refers to the clinical staff such as the Respiratory Care Practitioner or any other authorized medical professionals who are responsible for identifying the need of the patient and making the necessary recommendation in the form of a consult to the Prosthetics Department. The respective Prosthetic or Respiratory personnel will then be responsible for creating the PO (Task Order) which is then submitted to the vendor.

The below table provides the nine VISN-23 VA Medical Centers who may place orders.

Fargo, ND 58102

Iowa City, IA 52246-2208

Minneapolis VA Health Care System One Veterans Drive Minneapolis, MN 55417

Sioux Falls VA Health Care System 2501 West 22nd Street Sioux Falls, SD 57117

Saint Cloud, MN 56303

VA Black Hills Health Care System - Fort Meade Campus 113 Comanche Road Fort Meade, SD 57741

VA Black Hills Health Care System – Hot Springs Campus 500 North 5th Street Hot Springs, SD 57747

VA Central Iowa Health Care System 3600 30th Street Des Moines, IA 50310

VA Nebraska Western Iowa Health Care System 4101 Woolworth Avenue Omaha, NE 68105

SCOPE OF WORK

1. Overview of contract services: The contractor shall provide delivery, setup, oxygen supplies, ventilator supplies and education for all Veterans requiring invasive or non-invasive in-home ventilator and or oxygen service for the VISN 23 VA Health Care Systems and their service area (North Dakota, South Dakota, Minnesota, Iowa & Nebraska). See attachment list B complete with service area and estimated number of patients served. The Contractor agrees to set-up, assemble, the Ventilator/Oxygen system, and instruct the beneficiary and/or caregiver in the use and care of the equipment. The Contractor agrees to perform home visits in accordance with the statement of work. Contractor must be Joint Commission (JC) (or any other VA approved governing body’s with equivalent) for Home Care and must maintain the accredited standard for the duration of the contract. All initial and follow-up care provided under this contract shall be provided in accordance with all current Joint Commission (JC) and or any other VA Approved governing body’s equivalent standards for Home Care related to home oxygen/ventilator therapy. The contractor must follow alerts, advisories or notices related to home oxygen/ventilator use published by the Joint Commission/equivalent accrediting body and National Center for Patient Safety (NCPS). The contractor must complete patient safety assessment tools developed by the National Center for Patient Safety related to home respiratory care services and/or as requested by the facility patient safety program. The contractor must follow manufacturer recalls and/or National Center for Patient Safety recalls related to home respiratory care services including home oxygen. The COR will notify the contractor when the National Center for Patient Safety recall has been published in the Recall Software system as per the notice time frame/policy.

If the Contractor is re-surveyed by the JC and/ or another accreditation entity as applicable during the contract term, the Contractor shall notify the Contracting Officer (CO) of survey dates, the outcome of the survey, and provide copies of new certificates as issued. Contract holder must submit survey results to CO no later than 15 days from the conclusion of the survey. Action plans consisting of remediation for any negative findings must be submitted no later than 30 days from the end survey date.

The Facility Contracting Officer’s Representative (FCOR) or Alternate Contracting Officer’s Representative (ACOR) shall be notified if a subcontractor is utilized. Any and all subcontractors must follow JC shall be monitored by the Contractor for compliance. Contractor facilities can/will be inspected by the respective Medical Center prior to the contract award. The Contractor’s comprehensive procedure manual shall become part of this contract. The manual shall include, but not be limited to:

· Delivery and Set-Up including the use of fire safe valves.

· Infection Control Safety

· Rights and Responsibilities

· Inventory

· Employee training (to include age specific) competency records and performance improvement

· Copy of the educational materials issued to patients at/during education.

· Patient training concerning home oxygen safety including fire prevention/safety, and smoking cessation.

· Environmental safety fire inspection procedures.

ADDITIONAL TERMS AND CONDITIONS

Copies of all relevant Respiratory Therapist licenses and certifications inclusive of any sanctions current or pending throughout the United States of America must be supplied to each VA Medical Center identified in this solicitation. These documents must be updated immediately by providing current certificates as they become available throughout the life of the contract. At the Government’s request, the Contractor shall participate in the kickoff meeting via teleconference within 10 days of issuance of a delivery order under this established contract.

CAPABILITY

The Contractor must be capable of performing contract compliant Home Respiratory Services, as stated in this PWS, to all Veteran beneficiaries located in, but not limited to, the Catchment Area Counties as outlined in this PWS and Attachment A “VISN 23 Catchment Areas”.

CONFORMANCE STANDARDS

Contractor shall provide services, supplies, and materials to ensure that the equipment functions in conformance with the latest requirements of Federal and VA specifications and requirements as applicable. The equipment shall be maintained such that it meets or exceeds the performance specifications as established in the OEM’s technical specifications. Additional performance specifications that exceed the OEM’s specifications shall be specified in writing by the VA.

MEETINGS

At the discretion of the VA, the Contractor shall attend and participate in all quarterly home oxygen committee meetings scheduled by the VA via teleconference with the contracted location. At the Government’s request, the Contractor shall be required to attend and participate in some meetings face-to-face with the VA facility rather than by teleconference.

These meetings shall be conducted at least on a quarterly basis. At the VA’s option, these meetings shall be conducted as frequently as monthly in the following circumstances:

1. The Contractor is JC accredited but not, yet JC accredited for the service location that he/she is performing from under the contract.

2. The Contractor’s JC accreditation status changes.

3. If negative trends in the Contractor’s performance are identified by the VA.

4. If the VA designee and/or HOC determines that more frequent meeting is appropriate because of the needs of the VA facility.

CONTRACTOR PERSONNEL

The Contractor must not employ persons for work on this contract if such employee is considered by the CO or FCOR to be a potential threat to the facility’s operational mission or the health, safety, security, general well-being of the VISN 23 VAMC’s employees, facility population, and all Veteran beneficiaries both in the facilities as well as in their respective home or place of residence.

Accessibility: Adherence to the VISN 23 Vendor Credentialing , Employee Background Checks and Facility Access Policy and visual identification requirements when visiting all VA facilities. The Contractor must comply with all registering, credentialing, and identification procedures when entering any VA owned or controlled property, to include but not limited to, pre-registering and submitting a fee for credentialing to any third-party vendor(s) used to register, schedule, and identify contracted service providers. To ensure compliance, the Contractor must obtain facility requirements from the FCOR prior to work commencement.

Attire: All employees must wear Contractor provided uniforms or comply with Contractor’s dress code which must include pants, shirts or blouses, and protective clothing when applicable. The dress code must be the same color or color combinations for all Contractor employees and distinguishable from VAMC staff and facility population. All apparel, whether uniform or dress code requirements, will be worn as designed by the manufacturer. Open toe shoes or sandals will not be worn. A leather shoe covering the entire foot is recommended. All personnel will display a Contractor provided identification badge while on station. The badge must indicate the employee’s name and the name of the Contractor and must be attached to employee clothing at chest level.

Appearance: Contractor personnel must be clean and present a neat appearance. Hair must be neatly trimmed and combed.

Employee Training: The Contractor is responsible for providing personnel of an adequate skill and educational level. Personnel must maintain their skill and education levels throughout contract life. Personnel selected by the Contractor must have the necessary education and training to perform the requirements of the contract prior to reporting to work under the contract. Contractor must provide documentation of employed individuals licensure and education requirements.

Contractor to Veteran training Education

a. Power failure

b. Equipment failure

c. Ventilator users and their caregivers must be prepared for equipment failure, disconnects, and power outages, especially if using 24-hour ventilation

d. Practicing regular safety drills to help prepare for emergencies

e. Home oxygen fire risks, use of fire safety valves, and safety concerning smoking, open flame, and other fire risks. This may involve the use of the VA home oxygen fire safety video as determined by the VA facility being serviced.

f. Fire safety plan/exit plan

g. Keeping a manual resuscitator, such as a bag valve mask (Ambu bag).

h. Infection control and patient supply storage

i. Cleaning or exchanging the oxygen tubing, ventilator tubing/circuits, and humidifier

j. Cleaning or exchange of the resuscitation bag and supplies

k. Cleaning or exchange of all equipment and accessories Provide continuing education in use as needed or directed by a licensed and privileged Department of Veteran Affairs Clinician. The Contractor will check for the presence and working order of smoke detectors and fire extinguishers in the patient’s home. The contractor will educate the patient about the need to have functional smoke detector(s) and fire extinguisher(s) in the home and if one is not present, inform the patient to purchase the equipment. The contractor will also, instruct the patient in how to properly test the smoke detector(s) and fire extinguisher equipment (including frequency of testing required) to ensure it is working properly. VA shall not be responsible or liable for any unsafe electrical conditions caused by the Contractor. Any alterations to the patient’s residence will be the responsibility of the patient

The contractor shall provide each beneficiary covered by this contract with the contractor's name, address, and telephone number to include numbers to be used during normal business hours and numbers for emergency requests during non-business hours. Contractor shall have a Toll-free contact number for patients to utilize 24 hours a day.

The Contractor shall provide the initial set-up within 24 hours of request from the COR or designee, to include weekends and holidays; this shall also apply to service calls. If the Contractor is unable to meet the 24-hour response time, the VA reserves the right to obtain the service from another source and to charge the contractor with any excess cost which may result therefrom. Contractors unable to provide services within designated time frame will notify the contracting officer for the affected facility.

The Contractor shall provide switch-outs by staff with documented competency training on the manufacturers recommended assembly, use, and maintenance of the equipment used under this contract. “Switch outs” refer to exchanging equipment per the facility guidelines or when following the prescription.

Perform home visits as stated in Initial Setup section, unless otherwise stated by VA Healthcare System Clinical CORs.

Provide documentation of all home visits to Home Respiratory Care Coordinator or Clinical COR within three (3) days of visit.

Provide continuing education/training in oxygen/ventilator use as needed. All education provided by Contractor's LRT shall be approved by the VA.

Assess the home environment for safety and suitability for ventilator use and submit a report within 24 hours in writing to the Home Respiratory Care Coordinator or clinical COR about required changes and recommendations.

The Contractor's Respiratory Therapist shall be competent in the use of invasive and noninvasive ventilation as designated by the VA, oxygen delivery, aerosol equipment, tracheotomies, airway care, and suction machines and cough assist devices. Competency assessment of the Contractor's therapists shall be provided to the VA at no cost to the Government. The Contractor shall inform the VA immediately of any change in Respiratory Therapist staff and have competent back up staff to service the beneficiaries. LRT should notify the Clinical COR in writing and/or by phone of any clinical changes noted during the visit. Critical changes in the patient's condition related to ventilation should be reported to the pulmonologist of record or patient may be advised to go to the closest Emergency Department for care.

The contractor shall provide one period of instruction in an individual setting on the proper use and care of Ventilator equipment and supplies. The Contractor's Respiratory Therapist shall provide instructions to the beneficiary and/or caregiver in the safe and appropriate use of equipment including basic home safety, storage, and handling of the involved equipment, required maintenance, electrical safety, whom to call in the event of an emergency, etc. Instructions to the beneficiary/caregiver shall include demonstrating the correct use and observing a return demonstration by the beneficiary/caregiver. Documentation of this demonstration signed by beneficiary/caregiver shall be sent to the VA within (1) one day of delivery or setup of services.

LRT's shall not provide any direct patient care that is not explicitly required by the resulting contract.

The contractor shall have on stock supplies available for issuing or mailing out. All items of supplies provided by the Contractor shall be approved, in writing by the COR. In the event that the contractor issues a non-approved supply item, the Government is not obligated to pay for such item. The COR shall provide in writing prior to contract start a compiled list of approved supplies and/or manufacturers.

The Contactor shall take phone orders for issued replacement supplies. Those orders shall be placed by either the COR or directly from the patient. Contractor shall monitor order frequency and report excessive orders to the COR.

The contractor shall be required to mail out or issue supplies when requested by the VA beneficiary or COR. Replacement supplies mailed out shall be filled the same day and delivered no later than two (2) days after the initial order was placed. VA Beneficiaries or the COR may telephonically request supplies to be re-issued and picked-up at the contractor's facility. The contractor shall be prepared to issue replacement supplies within 48 hours after initial order is placed.

Deliveries in accordance with this section to the VA beneficiaries' place of residence or other authorized location shall be Free on Board (FOB) destination, within consignee's premises, pursuant to FAR Clause 52.247-35. Contractor may be requested to deliver Ventilator or oxygen delivery system to the local VA Healthcare System location.

Emergency Services

Emergencies/Pandemics; Contractor must comply with the applicable facility’s Infection Control Policy, Tuberculosis Surveillance Policy, and Infectious Disease Policy. Guidance and policy requirements will be provided by the FCOR and the facility’s Infection Prevention and Control Office. Costs incurred to establish and maintain Contractor compliance will be borne by the Contractor.

1) Emergency services are for medical equipment provided to VA beneficiaries when an equipment malfunction or natural disaster may threaten a patient’s health. The contractor shall have a well-established communication system as well as a disaster and emergency preparedness plan, providing 24-hour emergency services and the ability to provide services at the VA beneficiary’s home within a maximum of 4 hours of a call for patients using oxygen and 2 hours for patients using ventilators. The Contractor shall provide to the Contracting Officer a written emergency management plan, in compliance with National Accreditation standards. This emergency action plan shall address continuity of services for all patients in the affected region.

2) The Contractor shall provide to the Contracting Officer a written emergency management plan, in compliance with National Accreditation standards. This emergency action plan shall address continuity of services for all patients in the affected region.

3) The Contractor shall provide emergency maintenance 24 hours/7 days a week. A document listing the emergency telephone number shall be provided to the patient at the time of set up.

4) The patient shall first call the Contractor in an emergency equipment situation as described in the previous sentence. The Contractor shall have a well-established communication system, providing 24- hour emergency services and the ability to provide services at the patient’s home within four (4) hours of a call for patients using oxygen.

5) The Contractor shall ensure all VA beneficiaries have a minimum of 24 hours of oxygen supply.

6) Ventilator battery backup supply to last 3 times the response time to a call. If they are unable to respond to an emergency service call the contractor is responsible to make arrangements with another supplier to supply a ventilator at their cost. Emergency services shall be provided within 2 hours of notification for patients using Ventilators.

7) If the Contractor is unable to respond to an emergency service call within 2 hours, the contractor is responsible for making arrangements with another supplier to provide oxygen at the Contractor’s expense. A verbal notification to COR or COR designee shall be provided on same business day of this. A written explanation of why the Contractor was unable to respond to the emergency must be provided to the COR or designee within 2 business days. The cost of backup systems, backup oxygen, and backup equipment shall be borne by the Contractor. If H/M tanks are used for backup, the Contractor shall furnish an H/M tank stand for each H/M tank at no cost to the government. Liquid oxygen supply may be considered backup oxygen;

however, the oxygen supply must be maintained at the minimum three-times the Contractor’s response time, and the cost of any additional equipment such as extra stationary units used solely to maintain the minimum level of backup oxygen shall be borne by the Contractor. The cost of liquid oxygen used solely for backup purposes shall be borne by the Contractor.

8) The Contractor must notify the COR or designee immediately in the event of a disaster, natural or otherwise, that may affect the services covered under this contract.

9) The Contractor shall provide and post on all entrances into the residence, a sign stating "Warning Oxygen in Use, No Smoking" or other verbiage that NO Smoking is allowed due to oxygen being present and document that the beneficiary/care giver is instructed in the safe use of oxygen and equipment per U.S. Occupational Safety & Health Administration (OSHA). VA beneficiaries shall sign a statement about the safe use of oxygen and equipment during their use of the equipment. Reeducation on oxygen safety rules, and proper use of oxygen equipment shall be completed and documented during each quarterly follow-up visit by the contractor.

10) The Contractor shall provide educational and/or warning information for patients, their families, or caregivers on the hazards of smoking while oxygen is in use. The warning materials shall be provided upon initial delivery and every 90 days thereafter. The checklist used by the vendors for follow-up services shall, at minimum, include:

a) NO SMOKING SIGNAGE:

No Smoking signs provided and posted. Smoke alarm present, veteran instructed to test all smoke alarms monthly, and smoke alarm sounds when tested and provide how to obtain one. Veteran has been instructed to remove the cannula, shut off the oxygen supply, and wait for the oxygen to dissipate prior to smoking. Veteran, family or cohabitants shall be given educational material regarding the hazards of smoking and using an open flame near oxygen. Contractor shall check for fire extinguishers and/or provide guidance on how to obtain one.

b) HIGH RISK SMOKERS:

The facility shall notify the Contractor of all identified High Risk Smokers. The Contractor shall notify the COR or designee of High-Risk Smokers that they identify in the home via encrypted email or fax within one (1) day of the home visit. Contractor notification to each COR or designee shall consist of contractor’s written report/form and shall contain at a minimum Veteran’s name, birth date, and social security number shall be clearly documented, and what precautions were provided to the patient. High-risk patients are patients who exhibit unsafe clinical or behavioral traits involving oxygen and smoking, such as attempting to hide their smoking materials or activities from staff, having a history of noncompliance with smoking rules; or smoking in a patient sleeping room or other areas designated as non-smoking areas.

c) FALL PREVENTION:

The Contractor shall provide patient education or re-education on how to prevent falls in the home related to oxygen equipment and supplies (i.e. oxygen tubing is a fall hazard) on initial set up and every 90 days thereafter. The Contractor shall provide documentation (via encrypted email or fax) if it becomes known to the Contractor that the patient has recently fallen.

11) FAILURE TO RESPOND

Failure of the contractor to respond to intervening service calls (i.e. oxygen concentrator failure) within four (4) hours after notification by the VA and/or patient shall result in a reduction in payment equal to the contract unit price for the specific machine for each day that the machine is inoperable. Further, failure to perform within 3 attempts any of the services as set forth in this contract shall be considered grounds for invoking provisions of FAR 52.212-4(m) "Termination for Cause

REPORTS

a. The Contractor will maintain an incident reporting system for reporting and documenting all accidents, injuries, abuse, or neglect of beneficiaries, and safety hazards. All incidents regarding this VISN contract will be sent via encrypted e-mail in an incident report to the Medical Center Home Oxygen Coordinator and the COR within 24-hours after the occurrence. In the event the COR or Contractor’s encryption is not functioning, notification will be made by telephone to the COR and overnight mail within one business day of the occurrence. In addition, the contractor will provide a monthly and annual report (October 1st through September 30th) summarizing the incidents by number, type, station, and VISN. The report will include a chart by facility and VISN showing the number and type of incidents. The annual report will show the data by month for the annual period.

b. The monthly report will be provided electronically via encrypted e-mail to the COR or designee by the second Friday of each month. The annual summary report will be provided by the second Friday in November, each year. The Contactor will have a policy for handling incidents in accordance with Joint Commission or any other equivalent accrediting body’s standards. The Contractor must have a VA reviewed and approved written policy that addresses emergency situations that may be encountered at the patient’s home. The Contractor is responsible for ensuring they take appropriate actions so that patient is able to receive oxygen and/or safeguard the patient’s health and well-being.

c. The Contractor shall provide a written, quarterly report (Periodic Performance Review) meeting all Joint Commission or any other equivalent VA approved accrediting body’s standards for improving organizational performance (The Joint Commission standards may be accessed at www.Joint Commission.org). Annually, contractor will submit to the COR their Periodic Performance Review for contracted services within 90 days of the end of each Year. Contractor shall assess and score each Joint Commission or any other equivalent accrediting body standards and element of performance that is applicable to the contracted services by entering a self-assessed score. Any noncompliant findings or gaps in service identified on the self-assessment shall require a plan of action to correct as part of the Periodic Performance Review submitted to the COR. Periodic Performance Review for home care is based upon Joint Commission’s home care standards that can be accessed at www.jointcommission.org This can also be made available by COR upon Contractor’s request.

d. Report will also include data related to the contractors on-going Infection Control Program.

e. JOINT COMMISSION or equivalent accrediting body’s COMPLIANCE REPORT; Contractors will be required to provide comprehensive monthly reports, approved by the VA, throughout the duration of the contract with specific documentation for each JC standard showing their level of compliance with each applicable JC standard. A written action plan must be provided for every standard that is not met. This report will be provided electronically via e-mail to the COR or designee by the second Friday of each month.

f. Respiratory Therapy VISITS REPORT The contractor shall provide a monthly report (October 1st through September 30th) showing by VA facility, the number of active patients at the end of the month, number of new start-up patients, the number of patients discontinued, number of patients deceased still on active list, the number of RT visits due that month, number of RT visits completed that month, number of delinquent visits that month, with any additional subcategories required by the COR or designee. The report will contain a graph showing the percentage of visits completed on time by facility and VISN and the % completed on time.

g. The monthly report will be provided electronically via e-mail to the COR or designee by the second Friday of each month. To support the monthly report, VA will provide the contractor a monthly Active Patient Report on the first working day of the month and a monthly RT visit notes entered report on the 4th working day of the month. The contractor will review the list to ensure data is correct and up-to-date and communicate any discrepancies back to the VA within one week.

i. Incident Report – Reporting special incidents found or occurring during a home visit, to include finding patients in need of emergency medical assistance, evidence of home oxygen fires or fires unrelated to the VA beneficiaries oxygen delivery system, Sentinel events, observed/reported falls, patient abuse/neglect, safety hazards that do not fall into the category of presenting immediate life-threatening danger to the patient or Contractors staff, inability to contact a patient within a 24 hour period of time, and any other incident meeting the Contractors written policy for incident reporting according to accreditation standards.

ii. Customer Satisfaction - In accordance with Joint Commission or any other equivalent accrediting body’s standards the contractor shall collect data on service satisfaction from contracted patients and their families from each facility on a quarterly basis. A copy of survey results shall be submitted to COR’s or designee in Quarterly reports.

iii. Infection Control/Communicable Diseases/Hand Hygiene Monitoring – Report will include data related to the Contractor’s ongoing Infection Control Program. The summary will include at a minimum result from data collected including the analysis of the data and actions taken to improve services. Quarters begin on October 1; January 1; April 1; and July 1 of each year.

iv. Delivery Ticket/Billing Audit Report – The contractor shall provide a report providing information auditing the VA order with the delivery ticket and home O2 billing. This report will be provided to the VA on a quarterly basis.

v. Performance improvement – The contractor shall collect data important processes and outcomes related to patient care and organizational functions. This will include but not be limited to number, type, and frequency of equipment repairs and replacement by facility. The contractor shall have an on-going Quality Improvement (QI) Program specific to VA Patients ONLY, designed to objectively and systematically monitor and evaluate the quality and appropriateness of patient care, resolve, and identify problems, and pursue opportunities to improve patient care. A quarterly summary of the QI Program will be sent electronically via e-mail to the COR or designee by the second Friday of each quarter following the previous quarter (October, January, April, and July).

vi. Oxygen Cylinder Summary- The contractor will provide a monthly and annual report (October 1st through September 30th) by VA facility listing the types and number of cylinders provided to each patient monthly for each VA facility and a summary total by VISN for the type and number of tanks issued. This report will be provided electronically via encrypted e-mail to the COR or designee by the second Friday of each month. The annual summary report will be provided by the second Friday in November, each year.

INCIDENT REPORTING

h. The Contractor shall provide the following emergent patient safety reports throughout the contract period (initial notification shall be within 24 hours of when the Contractor is aware of the event or issues) with a follow-up official report within 5 business days unless specified below. The Contractor shall inform the COR or their designee of a sentinel event (as defined by Joint Commission) via encrypted email or fax that occurs during the performance of this contract that involves the patients serviced under this contract.

i. Sentinel Events - The contractor is required to inform the COR or their designee of a sentinel event, as defined by Joint Commission in the sentinel event policy under the home care designation (Sentinel events are a subcategory of adverse events. A sentinel event is a patient safety event (not primarily related to the natural course of a patient’s illness or underlying condition) that reaches a patient and results in death, severe harm (regardless of duration of harm), or permanent harm (regardless of severity of harm) (See Reference 2). Sentinel events are not only events that occur during the care and treatment of individuals. Physical and verbal violence, abductions, and power failures are all potential sentinel events that can affect the health care organization and its patients. This can include all sentinel events as defined by Joint Commission (See Reference 1) and includes but is not limited to * Fire, flame, or unanticipated smoke, heat, or flashes occurring during an episode of patient care. This includes but not limited to any fire in the patient’s home that is related to care or treatment ordered by a provider, including home oxygen administration, as part of the home care services, regardless of whether a home care staff member was present or the most current version of the Joint Commission definition of a sentinel event) via encrypted email or fax that occurs during the performance of this contract that involves the patients serviced under this contract within 24 hours of the event. The contractor is required to complete a mandatory root cause analysis, or the equivalent of a comprehensive systematic analysis with corrective action plans as defined by Joint Commission or equivalent accrediting body within 45 business days of date of aware. The contractor is required to report to the COR or their designee of the corrective action plan/actions and outcome measures for remediation within 30 days of the completion of the analysis.

ii. Refusal of service - All beneficiaries shall have the right of refusal of service. In the event a patient refuses service or orders the equipment to be removed from the home, the Contractor shall notify the COR or designee by phone. The Contractor shall also report the specifics of the refusal to the COR or designee within 5 business days via encrypted e-mail. If the refusal occurs during a home visit, the Contractor's staff shall notify the COR or their designee of the refusal during the home visit. If a VA beneficiary refuses services, the contractor shall be required to complete a client refusal of service form with the patient’s signature. If the patient refuses to sign the form, the contractor will make note of this refusal on the form.

iii. The Contractor shall report suspected incidents of patient abuse or neglect. Suspected incidents shall be reported to the COR or their designee, as well as to the adult protective agency. The Contractor shall follow all state and local laws in reporting suspected incidents of abuse or neglect.

iv. The Contractor shall report non-compliant behavior with fire safety guidelines set forth in the patient education and re-assessment material and/or behaviors which pose a risk of self-harm or harm to others. Such behavior shall be reported to the COR or designee during the home visit if the Contractor's staff determines the patient’s non-compliant behavior, within the home environment, is not improving after education on the fire hazard of smoking when on oxygen treatment is provided. Noncompliant behavior and any follow-up actions (i.e. educations) shall be documented and forwarded to the COR or designee within 5 business days via encrypted email.

v. The contractor shall report non-compliant behavior with fire safety guidelines set forth in the patient education and re-assessment material and/or behaviors which pose a risk of self-harm or harm to others to the Home Oxygen Coordinator or designee during the home visit if the contractor’s staff determines the beneficiary’s non-compliant behavior, within the home environment, is not improving after education on the fire hazard of smoking or other hazardous activities when oxygen is in use. Noncompliant behavior and any follow-up actions (e.g. educations) will be documented and reported to the applicable VA Medical Center (VAMC) in the Veteran beneficiaries’ service area.

ADMINISTRATION REQUIREMENTS

a. The Contractor makes every effort to establish appointments with VA beneficiaries when initiating set ups and deliveries. Deliveries will not be left unattended at the beneficiary’s home unless other arrangements have been made. If the VA beneficiary chronically fails to meet appointments, the Contractor is to notify the COR or COR designee. The COR or COR designee shall contact the VA beneficiary and a corrective action plan will be implemented; the COR will notify the Contractor of any changes. If the Contractor has not made valid and documented attempts to contact the VA beneficiaries for set ups and or deliveries the Government reserves the right to call in a third party and bill the Contractor if the Contractor fails to perform.

b. Data Security: The contractor shall comply with applicable VA Information Security requirements, shall abide by all applicable security/confidentiality requirements as set forth by HIPAA. All VA Contractors shall complete and return the signed Rules of Behavior (ROB) prior to handling any patient’s sensitive information. All VA contractors will comply with Privacy and HIPPA training, as well as any other additional required training (as needed).

VA BENEFICIARY RECORDS

An individual beneficiary account record shall be maintained by the Contractor in compliance with the Privacy Act and maintain the Health Insurance Portability and Accountability Act of 1996 (HIPPA) compliance. Copies of these beneficiary records may be maintained on a computer and shall be provided to the FCOR upon request. The individual patient medical records shall be maintained and housed at the Contractor’s individual branch providing the oxygen service. At a minimum, the record shall include the following:

· Beneficiary identifying information (full name, complete SSN, home address, phone number of beneficiary caregiver, serial number, and type of VA owned equipment)

· Emergency contact phone number at a separate residence other than the beneficiary

· Copy of physician’s prescription (original or renewal)

· Plan of Care as developed by Contractor

· Documentation of the initial and monthly visits, assessments, patient education, and Home Oxygen/Vent supplied

· Initial and continuing verbal and written instructions to the beneficiary and/or caregiver (to include, but not limited to basic home safety, safe and appropriate use of equipment, handling, cleaning, precautions on smoking, and storage-universal precautions)

· Patient complaints, accidents, injuries, and safety hazards identified, and corrective actions taken

· Documentation of all beneficiary education to include course of action in emergency situations

· Infection control- Contractor will comply with standard precautions in the handling, storing, cleaning, delivery of home oxygen/ventilator equipment, and shall maintain a system for reporting, documenting, and evaluating records of infection among beneficiaries and Contractor staff

BILLING, INVOICING PROCEDURES AND PAYMENTS:

All payments made under this contract will be made monthly in arrears. No advance payments will be authorized. All draft invoices and related supporting documentation must be received by the 3rd business day of the month following the period they are for. (March bills must be received 3 business days into April). Payment shall be net-30 calendar days made monthly in arrears upon certification by the COR of a properly prepared invoice. Failure to submit properly prepared invoices shall result in delayed payment. All payments made to the contractor shall be made electronically. (Additional Information shall be provided if award is made to contractor that accepts the Government Purchase Card for payments).

It shall be considered fraudulent for the contractor to bill other third-party insurance sources for supplies and services rendered to veteran enrollees under this contract. The contractor shall not submit bills to any other State, Federal, or third-party agency for reimbursement during the period the beneficiary is covered under this contract.

The invoice shall include the total number of patients, total amount due and the contract number. The invoice shall be accompanied by an easily read, alphabetical listing of each veteran, with each supply or service itemized and shall contain the following information.

· Veteran’s last name, first name and last 4 digits of the social security number

· Description of supplies…