Sources Sought Notice – Q– VISN 16 Home Oxygen Contract 2017
Notice Type: Sources Sought Notice
Posted Date:
Office Address: NCO 16 Contracting Office;
Subject: Q-- VISN 16 Home Oxygen Contract 2017
Classification Code: Q - Medical services
Solicitation Number: VA25617R0994
Contact:
Description:
THIS IS A REQUEST FOR INFORMATION (RFI) ONLY. THIS IS NOT A REQUEST FOR PROPOSAL OR QUOTE. THE DEPARTMENT OF VETERANS AFFAIRS IS NOT SEEKING PRICING OR OFFERS OF ANY KIND.
1. The
2. VISN 16 currently serves an estimated 7,602 oxygen-using patients.
3. See the draft Performance Work Statement (PWS) below for the services to be provided.
4. The areas of responsibility/jurisdiction for each local
FAYETTVILLE, AR VAMC AND CBOC s: Contractor shall service any patients that are treated at the
COUNTIES IN
COUNTIES IN
COUNTIES IN
COUNTIES IN
COUNTIES IN
COUNTIES IN
PARISHES IN
COUNTIES IN
COUNTIES IN
PARISHES IN
5. The North American Industry Classification System (NAICS) code associated with this request for information is: 532291 which has a business size standard of
6. Responses to this
Business size
GSA/FSS schedule number (if applicable)
Identification of any socioeconomic categories (i.e. SDVOSB, VOSB, WOSB, 8(a), HUBZone, etc.) the company falls under
Capabilities
Please indicate if your company can provide services for the entire region specified above, or just portions of the region (specify which portions).
Any other pertinent information
7. Contracting Office Address:
Network Contracting Office 16 (NCO 16)
2575
8. Point of contact:
AJ Raiber
9. Performance Work Statement
Responders are encouraged to review the draft PWS shown below in determining their capability to meet VISN 16 requirements. If any responder should have questions about or suggestions to improve the draft PWS they are encouraged to return those with their response to this
PERFORMANCE WORK STATEMENT (PWS)
General:
The
Description of Services/Introduction:
The Contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to provide home oxygen equipment and services as defined in this Performance Work Statement (PWS). The services associated with this contract include: all logistical/administrative functions involved with the day to day operation of providing the service to the Veteran and their families, including furnishing warehouse space, surplus supplies, and quarterly in home respiratory therapy visits. This includes providing a Quality Control (QC) Plan about how the contractor will comply with the requirements of the contract to include coordinating and managing patient care, deliveries consisting of pickup and delivery of supplies, educate the patient and/or caregiver on proper use of equipment, documenting education and understanding, documenting use of supplies and inspection of home in relation to home oxygen in accordance with
Scope:
This PWS defines the effort required for the delivery, setup, education installation, and management of home oxygen services, in accordance with applicable TJC home care standards, to Veteran beneficiaries serviced by the VISN 16. All content contained herein regarding TJC standards shall be interpreted in the following manner. All issuing and follow-up care provided under this contract shall be provided in accordance with all current TJC standards. Contractor s facility(ies) may be inspected by the
Work Load Data:
The volumes or amounts shown in the Contract Line Item Numbers (CLINs) are estimates only and impose no obligation on the
VISN 16 Medical Centers
Per Month
Total per year
1
280
3,360
2
659
7,908
3
1,800
21,600
4
2,041
24,492
5
640
7,680
6
1,063
12,756
7
444
5,328
8
675
8,100
7,602
91,224
Ordering Process:
The COR or designee shall provide (via encrypted email and/or fax) the Contractor with notification to initiate individual patient service requirements, including the patient's oxygen prescription by authorized Licensed Independent Practitioner (LIP), equipment, supplies and services to be provided including date and place of delivery. The Contractor shall confirm receipt (via encrypted email and/or fax) of the request within one (1) working hour of notification to the ordering facility. The COR or designee shall also provide notification (via encrypted email and/or fax) to the Contractor of
Quality Control:
The Contractor shall develop a QC plan to ensure compliance with all applicable/current guidelines put forth by TJC standards and this PWS. The Contractor shall also develop and maintain an organization-wide planning structure and processes that focus on safety and quality to ensure services are performed in accordance with this PWS. The QC plan shall address at a minimum:
Patient satisfaction data.
Initial Patient Set-Ups within 24 hours from notification.
Documentation of Patient Set-ups.
Emergency Services with 4 hours of notification.
Semi-annual TJC compliance self-assessment reports
Incident reports within 4 hours.
Quarterly Customer satisfaction reports.
Quarterly infection control reports.
Semi-annual performance improvement reports.
Preventative maintenance on equipment.
Preventative maintenance reports monthly.
Quarterly reassessment of patient after initial set-up/equipment installation and submit reports.
Quarterly Respiratory Therapist visits
Disaster Preparedness Plan.
Plan for prevention and control of infection
Patient Education Requirements:
The Contractor shall provide education or re-education to each Veteran and/or caregiver on all equipment which they are being used to include travel literature. This information is to be presented written and verbally on equipment, supplies, and services in the preference or learning style based on need. Education in demonstration and material covered shall be in written form to be left with the patient or care giver. The written material shall be in English as well as the foreign or preferred language of the patient; in the event the patient does not speak English. The Contractor provides information and instructions about infection control issues related to equipment and supplies it provides. The Contractor must evaluate the patient s and/or caregiver s understanding of the education and training it provided. Contractor provides education on how to communicate concerns about patient safety issues that occur before, during and after care is received. The Contractor, as directed by CO or COR shall implement any new or revised education material. The
The Contractor shall provide a copy of
Reports:
Incident: Reporting special incidents found or occurring during a home visit, to include finding patients in need of emergency medical assistance, 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 reasonable period of time, and any other incident meeting the Contractors written policy for incident reporting according to accreditation standards.
Customer Satisfaction: In accordance with TJC 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 each station s COR or designee in quarterly reports with an aggregate summary report to the VISN Prosthetics Rep or deginee.
Infection Control/Communicable Diseases: Quarterly Report shall include data related to the Contractor s ongoing Infection Control Program.
Performance Improvement: The Contractor shall collect data on important processes and outcomes related to patient care and organizational functions on a semi-annual basis.
Emergency Patient Safety: The Contractor shall provide the following emergency patient safety reports, within five (5) business days of the action, throughout the contract period.
Sentinel Events: The Contractor is required to inform the COR or designated person within four (4) hours of a sentinel event (as defined by TJC) that occurs during the performance of this contract that involves
Refusal of service: All beneficiaries have the right of refusal of service. In the event a beneficiary refuses service or orders the equipment to be removed from the home, the Contractor shall comply with the beneficiary s wishes, however in addition to a written report; the Contractor shall report the specifics of the refusal to the COR or designee by telephone within one (1) hour (follow up via encrypted email and/or fax, within 24 hours). The Contractor shall obtain signed Against Medical Advice (
Suspected incident: The Contractor shall report suspected incidents of abuse or neglect to the patient by family members or caregivers. Suspected incidents shall be reported immediately (within four (4) hours) to the COR or 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.
Meetings:
The Contractor shall meet, or participate in a conference call, with each station COR on a monthly basis to discuss the progress of the service being provided to
The Contractor shall meet with or participate in a conference call with the Contracting Officer and each of the station CORs on a quarterly basis to discuss the progress of the contract and to address any issues or complaints from the government, beneficiaries or contractor. All issues and complaints from the prior quarter will be addressed to ensure that all corrections have been made and a process is in place to help ensure corrections remain in effect. The COR will submit to the Contracting Officer each quarter a COR Quarterly Report that will address any issues or complaints.
Site Visits Periodic, unscheduled on-site contractor, home oxygen patient, and ventilator patient visits shall be made by COR or designee to monitor Contractor s under this contract. The Contractor shall make available all records and/or documentation necessary during the monitoring visit to the COR or designee. Other visits shall be made by the Joint Commission surveyors and/or the Home Respiratory Care Team for each facility.
Infection Control/Communicable Diseases Requirements:
Contractor shall have a QC plan for prevention and control of infection. The plan shall meet current TJC standards. Quarterly reports shall be provided to the CORs (see paragraph 10c).
Contractor shall provide a list of names to the COR or designee of all veteran patients exposed to communicable diseases by contracted staff during an identified incubation period. The type of exposure shall also be identified.
The COR or designee shall consult with
The Contractor shall report non-compliant reported or observed 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 their 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.
Holidays:
The Contractor is required to perform services 365 (366
Place of Performance:
Services shall be performed in the Veteran's place of residence, VA Medical or
Special Qualifications:
Each branch office or distribution point shall meet or exceed all applicable TJC standards. All documentation related to the patient record during the duration of this contract is the property of the
The Contractor shall have written policies and job descriptions that specify staff requirements to the specialized equipment, supplies and services it provides to patients such as; qualifications, experience, applicable certification, registration or license, training requirements and continuing education requirements. Contractor shall provide the CO/COR or designee with documented competency training to deliver prescribed supplies/oxygen concentrators/portable oxygen concentrators/cylinders/liquid oxygen (LOX) upon initiation of the contract and upon request thereafter.
The Contractor shall adhere to the provision of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI).
The Contractor shall internally maintain a patient account folder holding all documentation related to the supplies and services provided in compliance with the Privacy Act and Health Insurance Portability and Accountability Act (HIPAA). All patient files are subject to review by designated
The Contractor shall provide upon request all Contractor personnel files; which shall comport to Federal & State laws/regulations which shall contain information relative to the contract requirements for each individual providing services is support of this contract. Information should include experience, training records, performance reports and any certifications/licenses.
The Contractor shall provide CO/COR or their designee with a list of all employees currently competent to perform delivery/recovery and patient education services at the time the contract is awarded and through the life of the contract whenever there is a change to staffing. COR or their designee shall inspect employee files at the time of the inspection of Contractor premises and vehicles. Employee files shall be maintained at the local contract site.
The Contractor shall educate, evaluate and document employee education in a manner that meets or exceeds TJC accreditation standards.
Only employees that have been properly trained and who have demonstrated competency shall perform equipment deliveries, recoveries, and patient education on the equipment.
The contractor shall obtain PKI certification for all branch location managers to ensure secure communications.
Registration /Licensure/Accreditation requirements:
Contractor is responsible to comply with all applicable Federal & State laws/regulations in support of the contracted requirements.
Registration: National Provider Identification (NPI)
Distributor License:
Applicable State(s)
The Contractor's Respiratory Care Practitioner (RCP) shall be credentialed with the
All personnel servicing Veterans shall maintain a current valid driver s license.
Evidence of ability to meet or exceed TJC Accreditation Standards.
Certified Respiratory Therapists (CRT) or Registered Respiratory Therapist (RRT).
Service Transition (Phase In/Phase Out):
In the event award(s) are made to other than the incumbent Contractor, the new Contractor(s) shall arrange with the incumbent Contractor for exchange of equipment ensuring that there is no disruption of supplies/services to veteran beneficiaries. The Contractor recognizes that the services under this contract are vital to the Government and must be continued without interruption and that, upon contract expiration, a successor, either the Government or another contractor, may continue them. The Contractor agrees to furnish phase-in training; and exercise its best efforts and cooperation to effect an orderly and efficient transition to a successor. The Contractor shall, upon the Contracting Officer s written notice, furnish phase-in, phase-out services for up to 90 days prior to this contract expiration and negotiate in good faith a plan with a successor to determine the nature and extent of phase-in, phase-out services required. The plan shall specify a training program and a date for transferring responsibilities for each division of work described in the plan, and shall be subject to the Contracting Officer s approval. The Contractor shall provide sufficient experienced personnel during the phase-in, phase-out period to ensure that the services called for by this contract are maintained at the required level of proficiency. Successful Offeror shall provide a detailed contract change over plan that can be utilized upon contract award.
This transition period will be designated for the transfer of
The Contractor shall provide the facility COR by 12:00 noon each Friday, during the transition period, a detailed listing of all
Government Furnished Property
The Government will not provide any equipment to the contractor for use under this contract unless added through a contract modification.
Contractor Furnished Items And Responsibilities:
The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract. All electrically powered equipment used in performance of this contract shall be
Materials: The Contractor shall provide the Operation and Service manual to the patient and/or caregiver upon delivering any equipment. The manual shall contain information on operation, maintenance, and troubleshooting for clinicians, users, caregivers and service technicians. Contractor shall provide to the Government, one (1) copy of the Operation and Service manual for each type of equipment with any proposals regarding this contract.
Supplies: The Contractor shall be staffed and have sufficient supplies to render satisfactory and courteous service at all times to the patient as listed below. The Contractor shall be responsible for the acts and omissions of their employees. In accordance with the order/consult received from the Government, the Contractor shall provide the patient with the following disposable supplies:
Oxygen cannula (including low flow and high flow cannulas, special cannulas as requested by
Various interfaces and connectors, swivel adapter, oxygen bleed in adapter, to enhance oxygen delivery, washers, wrenches, oxygen nipple adaptors (Christmas trees), provided as needed.
All masks types (when prescribed) for change every two (2) weeks with a 30 day supply in reserve at all times until the Contractor s next scheduled visit.
25-50 feet of oxygen connecting tubing shall be replaced on a 90 day supply with an equivalent section of tubing in reserve at all times until Contractor s next scheduled visit.
Trachea collar or t-piece adapter and accessories (i.e. tubing, large volume nebulizer, drainage bag, oxygen bleed-in adapter when needed and any other supplies/equipment that is needed to carry out physician orders) allowing for change every three (3) days with a supply in reserve at all times until the Contractors next scheduled visit.
Humidifiers (disposable) and water traps as ordered by a
Safety holder(s), storage rack(s), and/or an e-cylinder cart shall be provided for all veterans with a prescription for tanks (cylinders) and for use with the back-up system.
NO SMOKING OXYGEN IN USE SIGNAGE and one backup. Visible and legible from the street.
Valved Fireproof Cannula shall be provided to all oxygen users.
The Contractor shall install the Valved Fireproof Cannula devices during contract start-up and during any initial equipment set-ups.
The Contractor shall replace the Valved Fireproof Cannula devices semi-annually (every six (6) months).
Equipment: The Contractor shall provide the following equipment to meet the requirements per the PWS. The following equipment is considered stationary and each unit shall have an attached sticker with a correct vendor name and emergency telephone number. The Contractor shall comply with all applicable Federal & State laws/regulations in support of the contracted requirements. The Contractor shall install and service all equipment and supplies ordered under this contract. All disposable supplies shall be new and unused. A label with the Contractor's name and emergency telephone number, where they can be reached 24 hours/day, shall be affixed to all equipment.
Oxygen Concentrators: The oxygen concentrators shall be
Alarms for the following failures required: Power Failure, 02 Concentration, and Irregular Pressure and Loss of Flow.
The oxygen concentrator shall not perform below the manufacturer's specification, at minimum delivers 93"-3% or higher concentration of oxygen at flow rates up to 10 liters per minute (LPM).
The oxygen concentrator shall contain an hour meter and oxygen concentration indicator (OCI). Should either of these components fail, the OCI must be removed from service and replaced with a working unit. Failed units cannot be put back into service until repairs have been made and the system successfully tested. Contractor shall maintain records of each unit that fails, the repairs done, and the successful testing of the unit.
Oxygen sensing devices.
The oxygen concentrator shall be grounded internally or plug into a three-prong wall outlet appropriate for the patient's home (outlet adaptors are not acceptable).
Be double insulated and have 3 prong plugs.
Be mounted on wheels for easy movement by patient/caregiver.
Shall meet
The portable oxygen concentrators shall be
The portable oxygen concentrator shall be electrically powered operate on 120 Volts Alternating Current (VAC), 60 hertz (Hz).
Types of Stationary Electrical Oxygen Concentrators.
Low-flow Concentrator ( 5 liter per minute (LPM)):
High-flow Concentrator (> 5 liter per minute (LPM)):
Low Decibel Concentrator 40 decibels or less
Stationary Oxygen Cylinders. The Contractor shall furnish cylinders in accordance with the Interstate Commerce Commission Regulations. Contractor shall transport cylinders in accordance with the Code of Federal Regulations (CFR) Part 49,
Types of cylinders G , H and M.
Shall have a safety stand.
Regulator flow gauge.
Cylinder wrench and consumables.
Stationary gas oxygen systems used as backup may only be charged for when backing up
Pulse dose regulator as prescribed by VA Physician
Reservoir shall have condensation collection tray.
Shall have quick release valve for easy refilling.
Flow meter range of 0 to 15 LPM.
Shall have electrical or mechanical content indicators.
Be mounted on wheels for easy movement by patient/caregiver.
Combined Stationary and Portable Units: Home Fill Stations: Concentrator base with compatibility for oxygen cylinder refill that allow a patient to fill their own high pressure cylinders from a concentrator. In addition to the requirements for a standard oxygen concentrator:
Oxygen Cylinder Refill Stations shall be a minimum of 5 LPM, fill any size cylinders with capability for continuous or pulse dose.
Oxygen provided shall be United States Pharmacopoeia (U.S.P.) oxygen.
Have a minimum four (4) compatible Post Valve Cylinders with integrated conserver (various sizes).
Gas cylinders have integral flow regulator.
Appropriate interlocking fill fitting for custom portable oxygen cylinders.
Indicator light when cylinder is full.
Audible alarm for compressor failure.
Carry bag (backpack, shoulder strap, waist pack) or wheeled cart for cylinders.
Oxygen provided shall be U.S.P. Oxygen.
Portable Oxygen Concentrator (POC): A concentrator that can be powered via AC or DC. It is like a stationary concentrator but is smaller and more mobile.
Must be Federal Aviation Administration Approved.
Shall be available for delivery within four (4) hours of a request.
Minimum continuous flow range of 0.5 LPM to 3 LPM.
Minimum pulse dose up to a setting of 6.
Minimum of 12 hours battery life or sufficient batteries for 12 hours of use based on patient s highest usage rate in the prescription.
Have continuous and pulse doses (40 ml or greater) flow option.
Portable Oxygen Systems.
Oxygen cylinders - The Contractor shall furnish aluminum cylinders that are in accordance with the Interstate Commerce Commission Regulations, and transport cylinders in accordance with Code of Federal Regulations (CFR) Part 49,
Types of Cylinders B , C , D , and E , M6 .
Shall have a safety stand for storage, Safety stands are provided at no additional charge to the Government.
Carrying case, shoulder/waist bag, backpack or cart.
Regulator flow gauge.
Cylinder wrench and consumables.
Patient shall be provided unlimited cylinders per month.
Liquid portable systems: The Liquid oxygen system consists of large reservoir and portable unit that is filled from a
Shall have carrying case (shoulder/waist bag, backpack or cart) or built in shoulder strap.
Easy to read contents gauge/scale.
Shall have flow setting of 1-6 for standard units or 1-15 high flow units.
Shall have quick release valve for easy refilling.
Shall have electrical or mechanical content indicators.
May have a built-in Demand Valve Regulator (DVR).
Oxygen Regulators: Device which regulates gas flow and pressure from a portable oxygen system.
Continuous flow regulator - Flow 0-8 LPM or 0-15 LPM based on prescription.
Demand Valve Regulator (DVR): A device that limits the oxygen flow to inspiration only and thereby increases the duration of the oxygen supply. The Contractor shall only provide a demand valve regulator upon a special request by the
Pneumatic powered DVR: Pneumatic units shall appropriately meet the following specifications based on patient needs:
Pulse dose from .25 to 6 or higher.
Have easy to read content gauge.
Conservation ratio of 3:1 or higher.
Have continuous flow setting.
Weigh less than 30 ounces.
Notes: Conserving ratios are based on a breathe rate of 20 breaths per minute (BPM).
Battery-Powered DVR: Battery units shall approximately meet the following specifications based on patient needs:
Pulse dose from .5 to 6 or higher
Have easy to read content gauge
Conservation ratio of 3:1 or higher
Bolus delivered per breath of at least 10cc per setting
Have continuous flow setting
Weigh less than 30 ounces
Contractor shall test and replace batteries as needed
Liquid System Conserving Device (DVR):
Electronic DVR built into portable unit.
Minimum flow setting 1 to 4 LPM on pulse (e.g. Helios)
May also have continuous flow setting up to 6 LPM (e.g. Marathon, Spirit)
Easy to read contents gauge/scale
Carrying case, shoulder/waist bag or backpack
Ventilator: Used to provide ventilation or ventilation assistance in patients with impaired ventilator drive. The Government must approve any ventilator suggested for use under this contract. The Contractor shall use the same ventilator for all patients covered under this contract unless there is a clinical justification approved by the Government on a patient by patient basis. Each unit shall have an attached sticker with an up to date vendor name and emergency telephone number. The type of ventilator used shall reflect the patient s prescription.
The Contractor shall provide a back-up ventilator in the home for all patients being ventilated via invasive ventilation.
The Contractor shall have back-up ventilator available for exchange within one hour of notification of ventilator failure for all patients being ventilated via non-invasive ventilation.
Contractor shall provide a self-inflating resuscitation bag with mask to all patients using a ventilator.
All ventilator set ups/follow-ups/education shall be performed by a trained CRT/RRT/RN.
All new requests for ventilator set-ups shall be completed within 24 hours, unless otherwise indicated by the
The Contractor shall ensure a local CRT/RRT/RN is on-call and available to respond to a patient s home within one hour of an emergency call.
The Contractor shall provide water chamber, large bore heated wire tubing, bacterial filters, sterile water and any other adapters, connectors or interface items necessary for a closed system based on the ventilator in use.
The Contractor shall provide the patient or caregiver with enough ventilator consumable supplies to change every seven (7) days with one complete set up in reserve.
Contractor shall provide a stand, carry case, and IV Pole for water bag.
All ventilator patients and equipment and prescription shall be assessed by CRT/RRT monthly.
Units shall be capable of invasive or non-invasive therapy.
The Contractor shall provide a 50/60 Hz, 12 Volt DC batteries with up to 3 hours of operations for use in the event of power failure.
Cylinders: The Contractor shall furnish aluminum cylinders that are in accordance with the Interstate Commerce Commission Regulations, and transport cylinders in accordance with Code of Federal Regulations (CFR) Part 49,
Heat Moisture Exchange (HME): Used to enhance humidification of inhaled gases by conserving moisture from exhaled gases.
The Contractor shall provide the patient or caregiver with enough supplies to change the humidification and moisture exchange device every 24 hours or as needed with two (2) in reserves at all times.
The Contractor shall be responsible for setup and education on use of equipment for patient and caregiver. Education shall be performed by a trained CRT/RRT/RN.
Resuscitation Bag: If patient has a bypassed or artificial airway one (1) self-inflating resuscitation bag with mask and oxygen tubing shall be provided by the Contractor.
Large Volume Nebulizer: Used for aerosolized particle delivery
Contractor shall supply large volume compressor, large bore tubing, drainage bags, aerosol bottle with sterile water and patient interface.
The Contractor shall provide the patient or caregiver with enough supplies to change every three (3) days with one complete set up in reserve. Education shall be performed by a trained CRT/RRT/RN.
High Flow Humidification System: Used for high flow heated molecular humidification.
Contractor shall supply the high flow humidification delivery system, heated breathing tube, patient interface and humidification chamber.
The Contractor shall provide the patient or caregiver with enough supplies to change every seven (7) days with one (1) complete set up in reserve.
The Contractor shall be responsible for setup and education on use of equipment for patient and caregiver. Education shall be performed by a trained CRT/RRT/RN.
Air Compressor: A high volume air compressor capable of producing 15 liters of compressed air per minute, supplies shall include trach collar, "T" piece or mask and disposable or reusable type aerosol corrugated home 6-inch tubing, large volume nebulizer with adapter, reservoir for humidification.
Stock Storage The contractor shall, upon request by the facility, stock portable set ups at the
Specific Tasks:
Oxygen therapy delivery system including but not limited to home oxygen and home respiratory equipment. Initial setup(s) for home oxygen at the patient s residence shall be performed by a certified respiratory therapist (CRT) or registered respiratory therapist (RRT) which is licensed in accordance with the governing standards of the location where the services are to be provided.
Patient or caregiver education shall be performed on the proper utilization for all issued equipment to include the following:
An explanation of the plan for care, treatment and services.
Procedures to follow in an event of an emergency.
Basic health practices and safety.
Infection prevention and control.
Basic home safety.
Safe and effective use of medical equipment or supplies.
Potential hazards and safety considerations related to the equipment.
Storage, handling and access to medical gases.
Proper equipment usage.
Equipment maintenance, function and operation system.
Equipment power source: electric, battery, compressor air, oxygen, and UL approved.
Notification to local power company of need for priority re-connection of power.
Proper utilization of oxygen with the prescribed ventilator.
Troubleshooting the equipment and system alarms.
Equipment and equipment settings that have been prescribed.
Emergency Procedures and how to respond to:
Power failure
Equipment failure
Infection control and patient supply storage:
Cleaning or replacement of the oxygen tubing, and humidifier.
Cleaning or replacement of the resuscitation bag and supplies.
Cleaning or replacement of all equipment and accessories.
Provide continuing education in use as needed or directed by a licensed and privileged
All education material provided by the Contractor shall be initially reviewed and approved by the
The Contractor shall provide a signed document (via encrypted disc) to the ordering facility COR verifying the following:
Patient has a safe home environment in accordance with TJC standards.
Patient received proper education and instructions.
Return demonstration has been accomplished with the patient and caregiver on the proper use of the oxygen equipment, and other home medical equipment upon initial set up.
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 patient/care giver is instructed in the safe use of oxygen and equipment per
The Contractor shall provide the initial set-up within four (4) hours of notification for continuous flow oxygen prescriptions and ventilator therapy or any other therapy as determined by the VA Clinical Staff to be urgent, to include weekends and holidays. All other requests shall be completed within 24 hours of receipt of the order to include weekends and holidays.
The Contractor shall provide initial setup at the patient s residence the same day of discharge regardless of what time the order was received.
If any modifications or preparations need to be made to equipment, these changes shall be coordinated with Patient caregiver and made before the patient arrives home from the hospital. Other items that shall be prepared ahead of time include:
The Contractor shall establish designated Customer Service support phone line for Patients to call for in home assistance.
Provide the Patient or caregiver with all emergency numbers.
Quarterly RT visits shall be performed by the RRT/CRT for all Patients that utilize home oxygen services.
Documentation shall be provided to the ordering facility s COR documenting a thorough review of the patient's equipment, to include all equipment records, and any re-education of the patient and/or caregiver, if necessary, documentation shall be provided to the ordering facility s COR for all home visits with the monthly bill.
Preventive Maintenance/Home Assessment: The Contractor shall perform routine maintenance every quarter and preventative maintenance according to manufactures guidelines with documentation of these checks. Preventive maintenance shall only be performed by a certified service technician that has received the approved training. The Contractor shall provide all documentation to the COR or designee with signatures and dates on the contract inception date and monthly thereafter. If the patient does not receive a reassessment of equipment per manufacturers guidelines or a quarterly RT home visit, documentation shall be provided (via encrypted email and/or fax) to the COR or designee identifying the reason preventative maintenance was not done.
The contractor shall provide the initial set-up the same day when the prescription is received by
The contractor shall provide initial setup within 24 hours when prescription is received after
Segregation of Items: The Contractor shall clearly segregate
Backup System:
Veterans with a prescription for an oxygen concentrator shall be provided with a backup system consisting of a compressed gas source and regulator with stand, humidifiers, and cannulas/masks for use during the event of a power failure or mechanical problem with electrical home oxygen equipment. The Contractor shall provide documentation (via encrypted email and/or fax) if the patient declines the oxygen back-up system, to include the reason for declining backup system and the veterans signature. Notification (via encrypted email and/or fax) shall be provided to COR or designee within five (5) business days of the veteran declining any prescribed equipment or Contractor s inability to deliver the prescribed equipment.
Home Assessment Requirements:
The Contractor shall perform an assessment of the beneficiary s home and environment in accordance with TJC standards, and maintain documentation of assessments in the individual patient file or folder. Assessments shall be done upon initial set-up and quarterly thereafter.
The Contractor shall verbally notify the COR or designee during the home visit if the Contractor s staff determines that the presence of oxygen in the home presents such a danger that the oxygen must be removed, or in the case of an initial set-up, not placed in the home. All verbal notification shall be documented in the patient folder and with the monthly billing.
The Contractor shall verbally notify the COR or designee of any unsafe conditions observed in the
The Contractor shall check the adequacy of the electrical outlets in the patient s home which are being used for oxygen equipment and immediately report unsafe conditions to the COR or designee.
The Contractor shall verify the presence or absence of a working smoke detector and the presence of functional fire extinguisher with a full gauge. The Contractor shall document this verification in the patient file, incident report.
Expectations for Compliance:
Inquire about the presence or absence of a functional smoke detector and fire extinguisher when oxygen is delivered, as well as with subsequent encounters.
When smoke detectors, and fire extinguishers are present:
Ask the patient during each service check visit if they have tested their smoke detectors and checked the condition (charge level) of their fire extinguishers in the last 30 days.
Check all medical equipment provided to home oxygen patients on each service visit to ensure its fire safety. Document in the home care record that this check has occurred.
In homes where there is evidence of smoking or there is a potential for open flames such as in heating devices, cooking surfaces, or fireplaces the Contractor shall verify the following:
That no smoking signage is properly posted.
Patient and/or caregiver understand and confirm understanding verbalizing the dangers of smoking and open flames.
Patient and/or caregiver shall avoid smoking or the presence flames anywhere near oxygen.
COR or designee has been notified if patient/caregiver persists in using open flame devices in the vicinity of oxygen home care record the occurrence of items listed above.
High Risk 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 non-compliance with smoking rules; or smoking in a patient s bedroom or other areas designated as non-smoking areas.
The Contractor shall be responsible for arranging and coordinating all home oxygen for Veterans who travel both within and outside their respective contracted jurisdiction. The
The Contractor shall arrange for home oxygen for Veterans traveling outside the areas covered by the respective
The Contractor shall arrange for home oxygen for Veterans requiring emergency travel. (Emergency travel is defined as any travel with 48 hours or less notice). The Contractor shall contact Veteran to coordinate travel within 1 hour of receipt of
Authorized Veteran Travel Areas: The Contractor shall be responsible for arranging and coordinating all
Contractor Visits:
The Contractor s schedule for visits to beneficiaries' residences in performance of this contract shall be by appointment. Typical scheduled hours are
Emergency Services and Protocol:
Emergency services are for medical equipment provided to Patients when an equipment malfunction, low/zero balance of oxygen back up, or natural disaster may threaten a patient's health. The Contractor shall provide to the Contracting Officer, and COR a written emergency management plan within 10 days of contract award. This emergency action plan shall addresses continuity of services for all patients in the affected region.
The Contractor shall provide emergency maintenance assistance 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.
The patient shall first call the Contractor in an emergency equipment situation. 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 (or present location) within two (2) hours of a call, but in no case to exceed six (6) hours of a call.
The Contractor shall provide a backup oxygen supply that shall last a minimum of three times the organization s maximum response time and function at the prescribed flow rate, frequency, and duration. If the Contractor is unable to respond to an emergency service call within six (6) hours, the Contractor shall be responsible for making arrangements with another supplier, who meets all TJC standards, to provide oxygen at the Contractor's expense. A written explanation (via encrypted email and/or fax) of why the Contractor was unable to respond to the emergency shall be provided to the COR or designee within two (2) business days. The cost of backup systems, backup oxygen, and backup equipment shall be borne by the Contractor. If H or M size oxygen cylinder is used for backup, the Contractor shall furnish an H or M size oxygen cylinder stand for each H or M size oxygen cylinder. Liquid oxygen supply shall be considered backup oxygen; however the oxygen supply shall be maintained at the minimum three (3) times the maximum response time.
In the event of disaster, natural or otherwise, the Contractor shall notify the CO, COR or their designee within four (4) hours if services covered under this contract may be affected.
Emergency calls made to the Contractor shall be considered life threatening with an immediate response to the site of the veteran beneficiary s domicile, no matter the distance from the Contractor's place of business. An emergency exists if the
As a minimum, the backup system shall provide continuing equipment function for forty eight (48) hours. In addition to the ventilators, the Contractor shall provide a backup system equal to three (3) times the maximum response rate for all other Primary Oxygen Systems, including Government owned equipment. Contractor shall have a Clinician (RT/RN) available to provide after-hours education and equipment management for Patients with a bypassed upper airway, or receiving ventilator therapy.
In the event the Contractor is unable to meet the appropriate response times for emergencies, the Government has the right to obtain the services from another source and to charge the Contractor any costs incurred over and above the contract price. A mandatory written justification detailing why emergency service was not available shall be provided by the Contractor to the facility COR and the Contracting Officer within twelve (12) hours from the original time the Contractor was called to provide the service.
Termination of Oxygen Services:
Upon termination of oxygen service to the beneficiary, the Contractor shall pickup all oxygen equipment and supplies no later than forty eight (48) hours after receipt of notification from the
Upon the death of a beneficiary the
In the event the Contractor gains knowledge of the patient s death, or change in requirement status, prior to the servicing
Performance Objectives:
The Performance Objectives and Performance Thresholds will be verified by Government personnel IAW the Quality Assurance Surveillance Plan. Each Performance Objective represents a significant task as identified in the PWS by the Government at the time of contract award. The Performance Threshold represents the minimum acceptable level of performance. The Performance Objectives and Performance Thresholds represent the most significant tasks of this contract and do not excuse the Contractor from performance of other responsibilities identified in this PWS.
Performance Objectives
PWS Reference
Performance Threshold
Initial Setups and Education
Para 21
98% of all initial home oxygen setups are completed within 24 hours of notification.
Preventive Maintenance/RT Home Visits
Para 21(g) and (i)
98% of patient shall receive 90 day routine maintenance and preventative maintenance in accordance with manufacturer guidelines.
Para 26
98% of patient travel shall comply with the PWS.
Emergency Services
Para 29
100% of all emergency maintenance services shall be provided to all patients.
Reports
Para 10
98% of reports shall provide timely reports IAW their respective due dates.
Link/URL: https://www.fbo.gov/spg/VA/FaVAMC564/FaVAMC564/VA25617R0994/listing.html
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