SAMDaily.us | SRCSGT | W | VISN Wide Home Oxygen (VA-20-00015776)

SAMDAILY.US - ISSUE OF FEBRUARY 22, 2020 SAM #6659
SOURCES SOUGHT

W -- VISN Wide Home Oxygen (VA-20-00015776)

Notice Date: 2/20/2020 4:38:04 AM
Notice Type: Sources Sought
NAICS: 532283 — Home Health Equipment Rental
Contracting Office: 245-NETWORK CONTRACT OFFICE 5 (36C245) LINTHICUM MD 21090 USA
ZIP Code: 21090
Solicitation Number: 36C24520Q0233
Response Due: 2/26/2020 8:59:59 PM
Archive Date: 03/07/2020
Point of Contact: Crystal HintonContract specialist410-637-1530
E-Mail Address: crystal.hinton@va.gov
(crystal.hinton@va.gov)
Awardee: null
Description: 2 | Page SOURCES SOUGHT THIS IS A SOURCES SOUGHT ANNOUNCEMENT FOR INFORMATION, PLANNING PURPOSES AND MARKET RESEARCH TO MAKE APPROPRIATE ACQUISITION DECISIONS AND TO GAIN KNOWLEDGE OF POTENTIAL QUALIFIED SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESSES (SDVOSB), VETERAN-OWNED SMALL BUSINESSES (VOSB), 8(A), HUBZONE AND OTHER SMALL BUSINESSES INTERESTED AND CAPABLE OF PERFORMING THE REQUISITE WORK. IT IS NOT A REQUEST FOR PROPOSALS OR QUOTES NOR DOES IT OBLIGATE THE GOVERNMENT TO A CONTRACT AWARD. A CONTRACT MAY NOT BE AWARDED AS A RESULT OF THIS SOURCES SOUGHT ANNOUNCEMENT. A REQUEST FOR A SOLICITATION WILL NOT RECEIVE A RESPONSE. RESPONSES TO THIS SOURCES SOUGHT ANNOUNCEMENT MUST BE IN WRITING. DOCUMENTATION OF TECHNICAL EXPERTISE MUST BE PRESENTED IN SUFFICIENT DETAIL FOR THE GOVERNMENT TO DETERMINE WHETHER YOUR COMPANY POSSESSES THE NECESSARY FUNCTIONALITY, AREA EXPERTISE, AND EXPERIENCE TO COMPETE FOR THIS ACQUISITION. RESPONSES TO THIS NOTICE SHALL INCLUDE THE FOLLOWING: (A) COMPANY NAME (B) ADDRESS (C) POINT OF CONTACT (D) PHONE, FAX, AND EMAIL (E) DUNS NUMBER (F) CAGE CODE (G)TAX ID NUMBER (H) TYPE OF SMALL BUSINESS (E.G., SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS (SDVOSB), VETERAN-OWNED SMALL BUSINESS (VOSB), 8(A), HUBZONE, WOMEN-OWNED SMALL BUSINESS, SMALL DISADVANTAGED BUSINESS, OR SMALL BUSINESS HUBZONE BUSINESS) (I) MUST PROVIDE A CAPABILITY STATEMENT THAT ADDRESSES THE ORGANIZATIONS QUALIFICATIONS AND ABILITY TO PERFORM AS A CONTRACTOR FOR THE WORK DESCRIBED BELOW. PERFORMANCE WORK STATEMENT (PWS) Department of Veteran Affairs Medical Center (VAMC) has a requirement for providing Home Oxygen Services for the following facilities (Coverage Areas: DC, Virginia, West Virginia, Maryland): VA Medical Center 50 Irving Street, NW Washington, DC 20422 VA Medical Center VA Medical Center One Medical Center Drive 1540 spring Valley Drive Clarksburg, WV 26301 Huntington, MD 25704 1. SCOPE OF WORK 1.1 The intent of this Request for Proposal is to award a single or multiple Indefinite Delivery, Indefinite Quantity (IDIQ) contract to provide all the necessary labor, facilities, supplies, materials, equipment supervision, transportation, safety management, infection control, and management to perform home oxygen services, to include storage and management of both contractor owned and Government-owned home oxygen equipment, delivery, set-up, instruction and maintenance of equipment for VA beneficiaries as directed by the VISN 5 Department of Veteran Affairs Healthcare Systems (VAHCS) facilities listed herein. The Contractor shall maintain at the proposed servicing facilities adequate licensed registered respiratory therapy staff to provide instructions, safety management, perform respiratory evaluation (under the direction of the physician), and follow-up and/or emergency visits. The use of the terms beneficiary , Veteran , and Patient are used interchangeably and refer to the recipient of required supplies, equipment, and incidental services required under the contract. 1.2 The contract effective period shall be for a one (1) year Base Period and four (4) Option Year renewal periods. 1.3 All services will be performed in the Veteran s place of residence or in a nursing home housing and community living centers, if applicable. The area of service is depicted in Attachment 1. The equipment needs are subject to change as determined by the prescribing physician. The contractor shall have a facility or resources physically located in the area of service depicted in Attachment 1, in which they will provide service. The contractor s office location shall include the service office, warehouse, dispatch of vehicles and other functions related to the performance of services of this contract within a fifty (50) mile radius of the VA facilities in 5 to facilitate periodic inspections by VA and/or other accrediting agencies. 1.4 The geographical boundaries described herein (see Attachment 1) have been determined as the areas of responsibility/jurisdiction for each local VA Healthcare System. 1.5 Certain tasks described within this Statement of Work must be performed in accordance with the standards promulgated by The Joint Commission. These standards, available at www.jointcommission.org, form a part of this Statement of Work and are incorporated herein by reference. 2. SERVICE SPECIFICATIONS 2.1 VISN 5 currently serve an estimated 3,800 oxygen-using patients. The Contracting Officer s Representative (COR) or designee will provide (via encrypted email and 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 and fax) of the request within (2) two working hours of notification; the COR or designee will provide notification if VA owned equipment is to be provided; the COR or designee will also provide notification of VA initiated discontinuance of service. The notification may be made orally but will be confirmed in writing within one (1) working day. The written documents will include the authorizing official s signature, electronic or written. 2.2 BACKUP SYSTEM: The Contractor shall provide Veterans that have a prescription for an oxygen concentrator with a backup system consisting of a compressed gas source and regulator with stand, humidifiers and cannulas/mask for use during the event of a power failure or mechanical problem with non-electrical oxygen supply to last (3) three times the Contractor s response time. The Contractor shall provide documentation (via encrypted email and fax) if the Veteran declines the oxygen back-up system, to include the reason for declining backup system and the Veterans signature. Notification (via encrypted email and fax) shall be provided to the COR and VA Medical Center clinical point of contact within five (1) business day of the Veteran decline COR or designee within five (5) business days of the Veteran declining any prescribed equipment or contractor s inability to deliver the prescribed equipment. 2.3 In accordance with the prescription received from the VAMC, the contractor shall provide the patient with the following items at the time of set-up and when needed as re-supply. Any cost for shipping of the following items shall be borne by the Contractor: Humidifiers and water traps. The number of humidifiers provided must be sufficient to ensure that they are not depleted between re-supply visits.� The number of traps will be based on the patient s flow rate. Disposable oxygen cannulas on hand for change at a minimum of every two (2) weeks with a supply in reserve at all times until the contractor s next scheduled visit. Disposable masks for change/wash every two (2) weeks with a 30-day supply in reserve at all times until the contractor s next scheduled visit. Twenty-five (25) to fifty (50) feet of oxygen connection tubing shall be replaced every three (3) months with an equivalent section of tubing in reserve at all times (to be included in initial set-up) until the contractors next scheduled visit. Trachea collar and accessories (e.g. tubing and large volume nebulizer) with a supply on hand allowing for change every seven (7) days with a supply in reserve at all times until the contractors next scheduled visit. Oxysafe valves on every concentrator machine and portable oxygen system changed annually. Safety holders shall be provided for all patients with a prescription for four ��(4) or more cylinders. 2.4 INITIAL SETUPS: Initial set-ups are considered to be those patients who do not have a VA authorized oxygen therapy delivery system. The contractor shall provide the initial set-up within 24 hours of request from the COR or designee (dependent on Veteran s availability), to include weekends and holidays; this response time shall also apply to service calls. Initial setups may be provided by the contractor s Patient Service Technician; does not have to be a Respiratory Therapist. All patients receiving services under this contract shall be visited by a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT) within 24 hours after initial set up and at least annually thereafter. In the event a monthly visit will not occur, the COR will be notified and provided details of attempts to make contact with the veteran for service. The VISN 5 facilities reserves the right to obtain the initial set-up service from another source and to charge the contractor with any excess cost which may result there from, if the contractor is unable to meet the 24-hour response time. Initial set-up of Home Oxygen includes setting up and ensuring the appropriate oxygen system is operational, instruction and training of Patient, and/or caregiver, as well as performing a home environment safety check. The Contractor shall provide patients with a telephone number to contact with any questions or if additional information is required. All equipment shall contain an adhesive type label containing the vendor s name and emergency 24-hour toll-free phone number. This label shall be placed on the equipment in an area that is viewable to Patients and caregivers at all times. Patient shall be given a document listing a toll-free phone number for routine resupply of oxygen cylinders and supplies. 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 OSHA regulations. Specified sign shall be no smaller than 4 X 6 . 2.5 The Contractor shall provide the Operation manual for all equipment to the Patient and/or caregiver upon delivering any equipment. The manual shall contain information on operation, maintenance, and trouble- shooting. 2.6 HOME ASSESSMENT REQUIREMENTS: The Contractor shall perform an assessment of the patient s home and home environment in accordance with the Joint Commission accreditation standards and maintain documentation of assessments in the individual patient records. The Contractor shall notify the COR/designee or prescribing physician 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. Unsafe conditions may include, but are not limited to, fire safety hazards, oxygen safety hazards or any instance that places the patient or Contractor s staff in immediate danger. The Contractor shall contact the COR or designee by phone during the home visit and furnish (via encrypted email) written documentation of the safety hazard to the COR or designee within one (1) business day of the incident. The Contractor shall ensure the electrical outlets in the patient s home meet the requirements of the contractor s equipment standards and immediately report unsafe conditions to the COR or designee. Any alterations to the veteran s residence will be the responsibility of the veteran. The Contractor shall notify the COR or designee by telephone at time of set- up if any alteration to the Patient's home is necessary to accommodate the oxygen equipment, including electrical work. The Contractor shall verify the presence of working smoke alarms and instruct the Patient to test all smoke alarms on a monthly basis and include this verification in the documentation of assessment. The Contractor shall document any home where smoke alarms are not present and fully functional, the Contractor shall provide this notification to the COR or designee (via encrypted email) within five (5) business days of the service. 2.7 Every three (3) months the Contractor shall visit all patients on concentrators to reassess equipment compliance and educational needs. A qualified service technician may perform this service. A report shall be developed, signed and dated by the contract staff and the patient/care giver and a copy shall be left with the patient/care giver. The reports shall be legible and attached to the invoice. All reports shall be submitted to the COR or designee in alphabetical order, with the monthly bills by the 10th business day of the month following service. The written report shall include at a minimum the following data: Name and social security number (SSN) of patient using the equipment. Monitor compliance on prescription (LPM, hours per day). Type of concentrator and hours on concentrator. Inspection results of liter flow rate in monitoring patient compliance (as compared to prescription). Inspection compliance of filters (exchange or clean by patient) according to manufacturer s guidelines. Follow-up education and/or reinforcement of compliance documented. The Contractor's assessment form shall include the diagnosis of the veteran for the visiting respiratory therapist to provide ongoing education, assess equipment and supplies, and to submit a quarterly report, (for patients who are using oxygen therapy for cluster headaches, the respiratory therapist visit schedule will only require an annual visit. If the patient also has a concentrator, they will remain on the quarterly visit schedule. The Respiratory Therapist will document the average frequency of use of the therapy by the patient and remind the patient that the oxygen prescription needs to be renewed yearly by either the patient s primary care or the neurology doctor. The home oxygen prescription must be reviewed with the veteran. The quarterly report (used for all patients except for those stated above using oxygen therapy for cluster headaches) shall include the following data: Name and last four of the social security number (SSN) of beneficiary using the equipment. Review of prescription (Liters Per Minute, hours per day). Type, serial number, and hours on concentrator. Average usage of oxygen per day monitored through concentrator hour usage and actual observed setting of liter flow rate. Inspection results of liter flow rate in monitoring patient compliance (as compared to prescription). Inspection results of intake filters (exchange or clean). Inspection/change of bacterial filters. Fire safety issues Fall risks Inspection and replacement of disposable supplies Clinical assessment (if ordered, see below for requirements). A Clinical Assessment by credentialed Respiratory Therapist shall include the following: The patient s diagnosis. Vital signs to include blood pressure, heart rate, respiratory rate. Oxygen saturation by pulse oximetry (if ordered) on room air and on the oxygen liter flow prescribed at rest and w/patients normal activity Assessment of the lung sounds. Monitoring of respiratory medications All requirements for clinical assessments and documentation according to JC standards. 3. PATIENT EDUCATION 3.1 The Contractor shall provide education to each patient or caregiver at the time of set-up and assess the need for reinforcement during visits. This information is to be presented by demonstration and material covered shall be in written form to be left with the patient /care giver. The written material shall be in English as well as the foreign language of the patient, should the patient not speak English. The Contractor as directed by COR or designee will implement any new or revised education material. The VA will determine whether the contractor shall use their forms or forms supplied by the VA for documentation of education services provided to patients. The Contractor shall provide to each VA patient a copy of the approved Patient Instruction Booklet . This booklet shall be placed in a durable binder with emergency and routine contact information properly annotated before the booklet is give to the patient. Instructions shall cover the use of all equipment delivered. The contact information for the Joint Commission shall be provided in the booklet. The patient/caregiver and contract representative shall sign the approved Documentation of Set up/Periodic Maintenance and Patient Training checklist acknowledging that the written and oral instructions have been provided. A copy of the signed documents shall be submitted to the COR within five workdays of the initial set up. Instruction shall be in accordance with Joint Commission and CMS standards. The Patient Instruction Booklet shall include connection, removal, emergency procedures and toll free or collect phone number or contractor for emergency repair. The instructions shall be consistent with patient education provided by the VA to the patient. The Contractor must have the patient provide a return demonstration of appropriate use of the equipment. The contractor shall install NO SMOKING signs in each patient s residence. The Contractor shall test the smoke alarm battery by pressing the test button on the smoke detector to ensure proper function at the time of the initial set up. 3.2 The Contractor shall provide educational and warning information for patients, their families, and caregivers on the hazard of smoking while oxygen is in use. The education materials must be provided upon initial delivery and every six (6) month thereafter. Education materials shall instruct patients on oxygen that smoke to remove the cannula, shut-off the oxygen supply, stand a minimum of 25 feet away and wait for oxygen to dissipate prior to smoking. 3.3 Incidents where patients are reported as non-compliant with the guidelines set forth in the education and orientation material or whose behavior poses a risk of self-harm or harm to others shall be documented by the contractor and reported to the Home Oxygen Coordinator and/or the COR. 3.4 The Contractor shall provide patients a copy of VA Patient Rights & Responsibilities, and any information concerning advance directives during initial setup. VA Patient Rights & Responsibilities will be provided to the Contractor by the COR/HOC. The Contractor shall document that the patient/care giver is instructed in accordance with the Joint Commission standards to include how to contact the Joint Commission. 4. TRAVELING PATIENTS 4.1 The Contractor shall coordinate all oxygen services for patients who travel both within and outside the geographical area covered by this contract. Patients will be instructed by the Contractor and VA staff to notify the Contractor at least two (2) weeks before intent to travel and earlier if they are relocating. Accommodations shall be made for short notice in the event of a family emergency. 4.2 Patients receiving oxygen services under this contract are authorized a maximum of thirty (30) days travel, with a maximum of two (2) set-up charges within a one (1) year period from the latest prescription date. maximum of FOUR (4) set up charges within a one (1) year period from the latest prescription date instead of TWO (2). Subsequent to this, any other oxygen costs will be the patient s responsibility. It is the Contractor s responsibility to monitor usage and notify COR if the limits will be exceeded. we ourselves should track this as I don t like that idea of the next company alerting us and solely relying on that 4.3 The Contractor shall provide patients traveling within the geographical area covered by the contract all oxygen service hereunder at the contract rate utilizing Contractor furnished equipment only. The Contractor shall invoice the appropriate VA facility as established herein. 4.4 When the Veteran is temporarily traveling outside of the contracted area, the Contractor shall arrange for oxygen services at the same contract rate (billed to the Veteran s resident VAMC) if the Contractor has a subsidiary office located at the temporary destination. If not, the resident VAMC will coordinate with the VAMC nearest the Veteran s destination to arrange for oxygen services. 5. EMERGENCY SERVICES 5.1 Emergency services are for medical equipment provided to patients when an equipment malfunction or natural disaster may threaten a patient's health. The Contractor shall provide to the Contracting Officer a written emergency management plan, in compliance with Joint Commission standards. This emergency action plan shall address continuity of services for all patients in the affected region. 5.2 The contractor shall have a well-established communication system, providing 24-hour emergency services and shall provide services at the patient s place of residence within six (6) hours of a call. 5.3 The Contractor shall ensure all patients have a minimum of non-electrical oxygen supply to last three (3) times the Contractor s response time to be on-site at a patient s residence after receiving a call. The minimum supply shall take into account each patient s prescription flow-rate and distance from the Contractor s location; actual supply levels may differ from the patient to patient, as long as each patient has oxygen supply to last a minimum of three (3) times the Contractor s response time. If the Contractor is unable to respond to an emergency service call with six (6) hours, the contractor shall make arrangements with another supplier to provide oxygen at the patient s residence at the contractor s expense. Contractor shall provide a written explanation of Contractor s inability to provide emergency service to the COR or authorized personnel within two (2) business days. The cost of backup oxygen systems, backup oxygen, and backup equipment shall be borne by the contractor. If H or M tanks are used for backup, the contractor shall furnish an H or M tank stand for each tank. 5.4 The contractor shall notify the COR or designee immediately in the event of a disaster, natural or otherwise, that may affect the service covered under this contract. The Contractor shall provide patients with written instructions about what to do in case of a natural disaster or other emergency. 5.5 The Contractor shall provide phone numbers of supervisory staff who can be accessed twenty-four (24) hours a day, seven (7) days a week, during emergencies. Any changes to the emergency points of contacts or their contact information shall be communicated to VA within 3 business days. 6. DISCONTINUANCE OF SERVICE 6.1 The Government shall notify the Contractor in the event of an order to discontinue oxygen service to any patient covered under this contract. Notification shall be by telephone, facsimile and/or encrypted email. Payment will be pro-rated for the month in which service is terminated and will be terminated five (5) business days after notification to the Contractor to discontinue service. The Contractor shall notify the COR or authorized personnel within next business day if Contractor becomes aware of a patient death, or upon finding a patient has moved out of the service area. 6.2 After notification to discontinue service, the Contractor shall remove all equipment from the patient s residence at the earliest possible time, but no later than 5 business days after receiving notice unless approved by COR or designee. The date and time of equipment pickup shall be coordinated with the patient or next of kin. The Contractor shall make every effort to meet the patient s or patient s families requests for pickup times. The Contractor shall honor patient s or family s requests to pick up equipment before or after funerals or family gatherings relative to patient s funerals. The Contractor shall treat such requests with the utmost courtesy and give such requests the highest priority. 7. CONTRACTOR VISITS 7.1 The Contractor shall visit the patient s residence as needed for delivery of equipment in performance of this contract by appointment only, between the hours of 8:00 a.m. and 8:00 p.m., Monday through Friday; exceptions will be made in the cases of emergencies. The Contractor shall schedule the appointments to the patient s home 24-48 hours prior to the appointment. On each scheduled setup/delivery, the Contractor shall reassess the need to instruct the patient on the use and care of the equipment and supplies. All patients receiving services under this contract shall be visited by a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT) within 24 hours after initial set up and at least annually thereafter. In the event a monthly visit will not occur, the COR will be notified and provided details of attempts to make contact with the veteran for service. 7.2 The Contractor shall make every effort to establish appointments with patients when initiating set-ups and deliveries. Deliveries shall not be left unattended at the patient s home; physical acceptance of deliveries must take place between the Contractor and either the patient or caregiver. If the patient repeatedly fails to meet appointments, the Contractor shall notify the COR or designee. The COR or designee will contact the patient 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 patient for set ups and or deliveries the Government reserves the right to call in a third party to provide those services and bill the Contractor for any additional costs the Government incurs as a result of such action. 8. EXCESS DELIVERY: The VA will not pay for delivery of supplies or equipment in excess of those prescribed without prior authorization by VA. 9. REPORTS: The list of reports is included in Attachment 6. 9.1 Performance Review Report - The Contractor shall provide a written, quarterly report addressing all the Joint Commission Standards for improving organizational performance (The Joint Commission standards may be accessed at www.jointcommission.org) to the COR. The Contractor shall submit their Performance Review to the COR via encrypted email. The Contractor shall assess and score each Joint Commission standard and element of performance that is applicable to the contracted services by entering a self-assessed score. Any noncompliant finding or gaps in service identified on the self-assessment shall require a plan of action to correct the finding. 9.2 Incident Report - The Contractor shall report to the COR 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 Contractor s staff, inability to contact a Patient within a reasonable period of time, and any other incident meeting the Contractor s written policy for incident reporting according to Joint Commission accreditation standards. All reports, shall be provided to the COR via encrypted email within 24 hours. Contractor shall report all life threatening situations to the proper authorities immediately (e.g. 911, police, and any other emergency). 9.3 Patient Satisfaction Report - The Contractor shall collect satisfaction data from Patients and their families on a quarterly basis in accordance with Joint Commission standards. A copy of survey results shall be submitted to COR or designee in quarterly reports via encrypted email. The quarterly report is due to the COR within the 5th working day after the conclusion of the quarter. The reporting quarters are as follows: October 1st through December 31st, January 1st through March 31st, April 1st through June 30th and July 1st through September 30th 9.4 Infection Control Report - The Contractor shall collect, trend, and report on data related to the Contractor s Infection Control Program to the COR or designee on a quarterly basis for each contract performance period via encrypted email. The quarterly report is due to the COR within the 5th working day after the conclusion of the quarter. 9.5 Contract Usage Report Contractor shall provide a quarterly report via email detailing contract usage by each Medical Center. Contractor shall provide to each Facility s COR or designee their respective facility s report no later than 15 work days following the end of a quarter. The report shall include the total units per CLIN and total dollars invoiced by CLIN. Additionally, a composite report of each facility s usage, to include the total number of unique Patients, the total number of units used by CLIN, the total dollars invoiced by CLIN is required. 9.6 The Contractor shall provide the following emergent patient safety reports, within one (1) business day of the action, throughout the contract period. Sentinel Events - The contractor is required to inform the Home Oxygen Coordinator and/or COR within one (1) business day of a sentinel event via encrypted email that occurs during the performance of this contract that involves patients serviced under this contract. The Joint Commission defines a sentinel event as a patient safety event that reaches a patient and results in death, permanent harm or severe temporary harm. Refusal of service - All patients 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 comply with the patient s wishes. The Contractor shall report the specifics of the refusal to the COR by telephone within one (1) hour. If the refusal occurs during a home visit, the Contractor s staff shall make an attempt to notify the COR or designee of the refusal during the home visit. Non-compliant behavior - 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 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. The Contractor shall document noncompliant behavior and any follow-up actions (i.e. education). 10. EQUIPMENT AND SUPPLY REQUIREMENTS 10.1 The Contractor shall, install and service all equipment and supplies ordered under this contract. All disposable supplies are to 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. 10.2 The installation/maintenance of all machines and equipment by the Contractor shall be performed by a competent professional familiar with nature of the equipment involved and fully qualified under the laws of the State in which the services are being rendered. Installation shall be consistent with local Fire and Safety Codes in the respective area of the State and shall conform to National Fire Protection Association (NFPA) 99/101 (Life Safety Codes) NFPA (Oxygen Cylinder Requirements) which are incorporated herein by reference. The Contractor shall provide a safety/emergency checklist to be completed, then signed by the patient or his/her caregiver and retained in the patient s account records. The Contractor shall service all equipment at manufacturer recommended intervals. The Contractor shall conduct a check of the concentrator using a certified oxygen analyzer that is calibrated according to the manufacturer standards. The Contractor shall perform maintenance on all equipment according to the equipment manufacturer's guidelines. The Contractor shall change compressor inlet pre-filters and compressor inlet bacteria filters according to the manufacturer recommendations. The Contractor shall test the alarm battery at each maintenance check; the Contractor shall change the alarm battery as indicated, but at least annually. The Contractor shall track and document maintenance of equipment in accordance with manufacturer specifications and provide these records to the COR for review upon request. Contractor shall furnish parts and labor for routine maintenance. The Contractor shall have recall procedures for equipment and supplies that have been identified for recall. 10.3 The Contractor shall not change or alter a patient s oxygen prescription or equipment requirements without a new prescription from the patient s VA physician. 10.4 The VISN 5 facilities will not pay for the Contractor s lost or damaged equipment provided under this contract unless circumstances as reviewed by the Contracting Officer are concluded to be the result of willful negligence on behalf of patients or VAHCS employees. Accordingly, this is considered to be the cost of doing business and is the requirement of the Contractor to pay for this type of equipment. Contractor may request payment for lost or damaged equipment by submitting a written summary of the circumstances of lost or damaged equipment to the contracting officer within 30 calendar days of the occurrence of the incident in question. The Contracting Officer will review the summary, and a written determination will be made to the Contractor as to the liability. The VISN 5 facilities will not pay for rental on equipment not being used by an authorized patient during the performance of this contract or for equipment that cannot be found. 10.5 Contractor shall provide service and preventive maintenance on all equipment (contractor-furnished equipment and government-owned equipment) as recommended by the manufacturer. Preventive maintenance shall only be performed by a certified service technician that has received the approved training. Contractor shall provide all documentation to the COR with signatures and dates on the contract inception date and upon the COR s request. The Contractor shall ensure that every concentrator has a label or pouch that indicates the most recent service date, service hours and technician s name. 10.6 OXYGEN CONCENTRATORS: The Contractor shall provide oxygen concentrators that are Underwriter Laboratory (UL) approved and must at a minimum meet the following specifications: Electrically powered (115 volts) Shall include a battery-operated audible alarm to indicate a power failure The oxygen concentrator shall not perform below the manufacturer s specification The oxygen concentrator shall contain an hour meter and oxygen concentration indicator (OCI) 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). 10.7 FIVE (5) LPM (LITERS PER MINUTE) CONCENTRATOR: The Contractor shall provide 5 LPM Concentrators that meet the following specifications: Deliver 90% oxygen at flow rates up to 5LPM. Operate on 120 VAC, 60 Hz Have thermal protector for compressor Be double insulated and have two prong plug Have pressure compensated flow meter Have high-low pressure alarm Have power failure alarm Weight 60 pounds or less Be mounted on wheels for easy movement by patient/caregiver Must meet FDA QSR standards Minimum of three-year warranty on concentrator and compressor Sound level of 60db or less Note: Concentrators shall have oxygen sensing devices. 10.8 TEN (10) LPM CONCENTRATOR: The Contractor shall provide 10 LPM Concentrators that meet the following specifications: Deliver oxygen flow rates: (I) 95% to 92% @ 1/2 - 7 LPM flow (II) 95% to 90% @ 7-10 LPM flow (O2 Pressure: 7 PSIG (48 KPA) normal) Alarms for the following failures are required: Power Failure, 02 Concentration (Optional), and Irregular Pressure Size: shall vary Weight: shall vary (light as possible/easily maneuverable) Be double insulated and have two prong plugs Have power failure alarm Be mounted on wheels for easy movement by patient/caregiver. Must meet FDA QSR standards Minimum of two-year warranty on concentrator and compressor. Sound level of 60 db or less Note: Concentrators shall have oxygen sensing devices. 10.9 PNEUMATIC POWERED OXYGEN CONSERVING DEVICES: The Contractor shall provide Oxygen Conserving Devices that are battery-powered or pneumatic powered devices that limits oxygen flow to inspiration only and thereby increase the duration of the supply. Pneumatic units must meet the following specifications: Flow settings from .25 to 6 or higher Have easy to read content gauge Conservation ratio of 3:1 or higher Have at least 2-year warranty Weight less than 30 oz. Notes: 1) Pneumatic conservers may use double lumen cannula. 2) Conserving ratios are based on a breath rate of 20 bpm. Battery-powered Oxygen Conserving Devices must meet the following specifications: Minimum flow settings from 1 to 5 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 Have at least 2-year warranty Weight less than 30 oz. 10.10 LIQUID OXYGEN SYSTEM: Liquid oxygen system consists of large reservoir and portable unit that is filled from the reservoir. Standard reservoir holds 110 pounds of liquid oxygen and portable unit holds 3-5 pounds of liquid oxygen. The Contractor shall provide liquid oxygen systems that meet the following specifications: Reservoir must have condensation collection tray Must have quick release valve for easy refilling Flow meter range of � to 6 LPM, or 1-15LPM for high flow systems Portable unit must come with shoulder strap Shall have electrical or mechanical content indicators Shall have a portable cart or vented backpack bag for portability 10.11 LIQUID OXYGEN SYSTEM WITH CONSERVING DEVICE: Liquid oxygen system with conserving device consists of large reservoir and portable unit that is filled from the reservoir. Standard reservoir holds 110 pounds of liquid oxygen and portable unit holds 0.9 pounds of liquid oxygen. The standard reservoir weighs 165 pounds full and the portable unit weighs 4 to 8 pounds full. The Contractor shall provide liquid oxygen systems with conserving devices that meet the following specifications: Reservoir must have condensation collection tray Must have quick release valve for easy refilling Must have flow settings of 1-6 or 1-15 Portable unit must come with shoulder strap and belt loop holder Shall have electrical or mechanical content indicators 10.12 SELF-FILL OXYGEN SYSTEM: The Contractor shall provide self-fill oxygen systems to include 4 self-fill compatible oxygen tanks (sizes M6, C, D or E), carrying cart, conserving device, fill station and self-fill compatible concentrator. 10.13 PORTABLE OXYGEN CONCENTRATOR: The Contractor shall provide portable oxygen concentrators that can provide continuous flow (FAA Approved) and shall be able to provide a minimum of 2 LPM and a pulse setting of 5, weigh 20 pounds or less, AC/DC capability, up to 12 hours battery life, continuous and pulse doses (40 ml or greater) flow option. pulse dose to 5 lpm on the smaller POC s and a continuous flow of 3lpm and pulse dose of�6 lpm on the continuous machine s on the larger POC s Portable Concentrator (FAA Approved) shall be 1-6 LPM flow capability, weight 10 pounds or less, AC/DC capability, 12 hours battery life, continuous and pulse doses (40 ml or greater) flow option, carry bag and strap, Intelligent Oxygen Delivery-(daytime and nighttime delivery), Auto Oxygen Delivery(Automatically delivers oxygen if breath not detected), overseas power (converts to proper voltage) and easy-to-read Lighted LCD Display(Constant Oxygen Purity Monitoring). BACKUP SYSTEM:� Veterans with a prescription for an oxygen concentrator and/or portable oxygen concentrators 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 cost of replacement for the above-mentioned backup system shall be borne by the Contractor.� The cost of replacement of equipment damaged, lost or misplaced not through Patient's negligence shall be borne by the Contractor.� The Contractor shall provide documentation (via encrypted email and 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 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. 10.14 Any H or M size oxygen cylinder furnished by the Contractor shall include an H or M size oxygen cylinder safety stand. This stand shall remain contractor-owned. Cylinders shall be clean (free of dust, insects, rodent residue or other soil) when delivered to patient s residence. 10.15 The Contractor agrees to provide cylinders without assessing demurrage charges on the Government. 10.16 Oxygen provided meet United States Pharmacopoeia (USP) standards. 11. REQUIREMENTS AND STANDARDS 11.1 Periodic, unscheduled on-site contractor and home oxygen patient visits will be made by the COR or designee to monitor the Contractor s performance under this contract. The contractor shall make available all records and documentation necessary during the monitoring visits. Other visits shall be made by the Joint Commission surveyors and the Home Oxygen Coordinator for each facility 11.2 The Contractor shall develop and maintain a patient account record no more than five (5) days after the initial oxygen set-up and maintain it in compliance with the Privacy Act and Health Insurance Portability and Accountability Act (HIPPA). All patient records are subject to review by designated VISN 5 officials and accreditation surveyors on the behalf of VISN 5 during accreditation surveys or consultation. These records shall include prescription, plan of care, patient education documentation, reports of infections, safety inspection, initial setup with safety check, invoices/delivery slips, equipment list w/serial numbers, changes in patient care and family support system and any other documentation required by Joint Commission. All signed deliveries and maintenance documentation shall be filed in the patient s record. 11.3 The Contractor shall provide its staff with documented competency training to deliver prescribed supplies/cylinders/liquid oxygen (LOX) as required. The Contractor shall provide and document employee orientation, ongoing employee education, and ongoing assessment of employee competence for all employees involved with the delivery/recovery of equipment covered under this contract according to Joint Commission standards. 11.4 The Contractor shall develop and maintain personnel records for all employees providing services under this contract, to include items in 11.3 and make available for review upon request of the Contracting Office or COR. 11.5 The Contractor shall provide the COR or authorized personnel with a list of all employees currently qualified to perform delivery/recovery and patient education services no more than five (5) days after contract award. The COR or designee will inspect employee records at the time of the inspection of Contract premises and vehicles. Employee files shall be maintained at the local contract site. 11.6 The Contractor shall ensure that only Contractor employees that have been properly trained and who have demonstrated competency perform equipment deliveries, recoveries, and patient education on the equipment provided under this contract. 11.7 The Contractor shall be sufficiently staffed to render satisfactory and courteous service at all times to patients. The Contractor shall be responsible for the acts and omissions of its employees, its sub-contractors or satellite office and their employees. Sub-contractors are required to adhere to the requirements of this contract; the Contractor shall ensure its subcontractors adhere to the requirements of this contract. 11.8 The Contractor shall require that its employees wear a uniform when providing on-site services to patients under this contract and that employees present and maintain a professional appearance during the performance of this contract. 11.9 The Contractor s employees shall conform to all regulations, Federal, State and local, governing the performance of contracted services in each state in which performance occurs. VAMC facilities have been designated NO SMOKING areas in their entirety. Individuals found in violation of this no smoking policy may be subject to a federal citation for disregarding posted safety rules and regulations. Furthermore, Contractor may be directed to stop work. Contractor shall notify all of its employees and sub-contractors of this strict enforcement policy. 11.10 INFECTION CONTROL REQUIREMENTS: The Contractor shall take the following precautions to prevent exposure to blood-borne diseases: Gloves shall be worn when handling items soiled with blood or body fluids. Hands shall be washed before and after visiting each patient and when gloves are removed. Contaminated equipment shall be separated from clean equipment. The contractor s warehouse shall have clean demarcation between contaminated and clean storage areas. If contaminated and clean items are transported in the same vehicle, the vehicle shall have clearly demarcated areas for contaminated and clean items. The contractor s procedure for handling the pick-up of contaminated equipment shall meet Joint Commission Standards Contractor shall have a current plan for surveillance, prevention and control of infection. The plan must meet or exceed current Joint Commission standards. Contractor shall provide a list of names to the Home Oxygen Coordinator or designee of all patients exposed to communicable diseases by contracted staff during an identified incubation period within 24 hours of identifying this exposure. The type of exposure shall also be identified. The Home Oxygen Coordinator or designee will consult with VA infection control staff regarding the need to contact exposed patients and/or complete any needed medical follow-up. 11.11 EQUIPMENT CHANGE OUT FROM PREVIOUS CONTRACTOR(S): At the end of the contract period, a transition period shall be required during which the incumbent Contractor shall continue to provide home oxygen supplies and services at the existing contract prices while the incoming Contractor is transitioning over When there is a change in the Contractor, the new Contractor shall pick-up all Government-owned equipment from the previous contractor and shall store that equipment until it is ready to be issued to patients. A mutually acceptable relocation date shall be coordinated by the Contracting Officer s Representative (COR) with the new and prior contractors to facilitate a smooth transition without disrupting the provisions of services to patients. The transition shall include the transfer of all inventory records. Phase In: The Contractor shall replace all prior contractor-owned equipment presently located in the residences of patients with current Contractor-owned equipment as soon as possible after award, but not to exceed ninety (90) days from date of contract award. The incoming Contractor shall coordinate with the incumbent contractor during the transition period relating to the removal of the incumbent contractor s equipment from the patients residences. The change shall include delivery, setup and instructions, and shall be accomplished with the least disruption in service to the patient as possible. The Contractor shall note the transition date of each patient, to include the transfer of responsibility regarding Government Furnished Equipment. The billing period will begin on the noted transition date and the cost will be prorated from setup date. The Contractor is required to issue Government-owned equipment prior to issuing contractor-owned equipment. Phase Out: In accordance with FAR 52.237-3 Continuity of Services, the Contractor agrees that the services being provided under this contract are vital and must be continued uninterrupted. At the end of this contract, the Contractor shall not remove any equipment from the patient s residence until replacement equipment has been installed. The Contractor shall coordinate transition of equipment / services with the incoming contractor as soon as possible, but not to exceed ninety (90) 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. 11.12 SAFETY REQUIREMENTS: In the performance of this contract, the Contractor shall take such safety precautions as the Contractor determines to be reasonably necessary to protect the lives and health of all persons affected by this contract. In addition, the Contracting Officer or the COR may require that the Contractor take additional safety precautions if the Contracting Officer or COR determine the Contractor s safety precautions are inadequate. The Contracting Officer or COR will notify the Contractor of any noncompliance with the foregoing provisions and the action to be taken. The Contractor shall, after receipt of such notice, immediately correct the conditions to which attention has been directed. Such notice, when served on the Contractor or his/her representative at the site of the work, shall be deemed sufficient for the purposes aforesaid. If the Contractor fails or refuses to comply promptly, the Contracting Officer may issue an order stopping all or any part of the work and hold the Contractor in default. 11.13 VEHICLES: The Contractor shall ensure that the vehicles used in the performance of this contract are licensed and meet the minimum requirements as mandated by each state/county/city in which performance occurs. All vehicles shall be clearly identified with the company name. 11.14 EVIDENCE OF COVERAGE: Contractors are required to have Property Damage Liability insurance coverage of at least $500,000. Before commencing work under the contract, the Contractor shall furnish the Contracting Officer with a certification from its insurance companies indicating the coverages for this contract have been obtained and that it may not be changed or canceled without thirty (30) days prior written notice to the Contracting Officer. 12. SPECIAL CONTRACT REQUIREMENTS 12.1 Each Contractor branch office and distribution point must be nationally accredited by The Joint Commission or meet or exceed Joint Commission standards. Contractor must maintain accreditation, or meet or exceed Joint Commission standards throughout the duration of the contract. 12.2 Any and all documentation related to the patient record during the duration of this contract is the property of the VA and will be returned to VA by the contractor upon the termination or non-renewal of this contract. 12.3 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. 12.4 The contractor shall perform the required work in accordance with The Joint Commission (TJC) standards. The contractor shall comply with all annual updates as issued. 12.5 Contractor agrees to maintain the minimum acceptable service, reporting systems and quality control as specified herein. Failure to comply with the specified terms and conditions or adverse reports from external monitoring agencies that indicate poor quality of care may be grounds for termination of the contract. The Contractor shall provide immediate (within 24 hours) notification to the VA COR regarding any adverse action by an external monitoring agency. 12.6 CONTRACTING OFFICER S REPRESENTATIVE (COR): The Contracting Officer reserves the right to designate a representative to act for him/her in furnishing technical guidance regarding the work to be performed under this contract. Such designation will be in writing and will define the scope and limitation of the designee s authority. A copy of the designation will be furnished to the Contractor no more than five (5) days after notice of award. 13. PAYMENTS AND INVOICING 13.1 Payments shall be made monthly in arrears based upon the VAMC s certification of properly submitted invoices.� Invoices shall be sent to the appropriate site as listed in Attachment 1 according to the patients under those sites. 13.2 Invoices shall be submitted monthly in arrears and received no later than the 10th of the following month. All documents containing signatures, i.e. delivery slips, patient s service reports, shall be provided in a searchable PDF format and shall contain at a minimum the following: Name and business concern and the invoice date Invoice control number Contract Number Patient s full name/address, last 4 of social security number Patient Education documentation (when prescribed) Description of Supplies and/or services Cylinder sizes Serial Numbers of equipment that is provided initially, returned and/or exchanged.� Equipment includes the following but not limited to:� concentrator, conserving device, ventilator, and oxygen refill system defined as new or refurbished. Concentrator Hours Patient s Signature on all required documents NOTE: Failure to obtain a signature from the patient for deliveries shall result in suspension of payment for these invoices. 13.3 The Contractor shall provide an invoice summary in a spreadsheet in a format compatible with Microsoft Excel. The summary shall include: Patient s name Servicing VAMC site The last 4 digits of the patient s social security number Item HCPC code Contract line item number Dates of service Item price for each item on that service date Subtotal for the item on that service date A grand total for all items for each patient for the month billed 13.4 Billing shall be submitted via encrypted email or CD. Contractor must have current VA compatible email encryption and is responsible for costs associated with obtaining this capability. Overall documentation must be correct, complete, timely and legible; failure to do so shall result in delay of payment for these invoices. Corrections to previous billing shall include the information outlined in 13.2 and shall be submitted in the same manner as the monthly bill. 13.5 VA shall review the invoice against its record. VA will notify the contractor of invoice discrepancies. Upon receipt of corrected invoice, VA will approve the invoice and make payment to the contractor by Government Credit Card. If discrepancies cannot be resolved between the COR and the contractor, contractor shall refer the matter to the Contracting Officer for resolution. 13.6 Contractor shall provide with the monthly invoice, a list of discontinued patients for that month to include patients full name, last SSN, date of equipment pick up, type, quantity and serial numbers of equipment picked up. 13.7 Contractor shall bear all costs associated with recovering from a patient, contractor-owned and government-owned equipment that is no longer needed by the patient. 13.8 Contractor shall not bill other third-party insurance sources for services rendered to Veteran enrollees under this contract. 14. INVENTORY 14.1 The VA will purchase Concentrators for drop-shipment directly to the Contractor for storage. It is the Contractor s responsibility to: 1) properly receive Concentrators, 2) check for damage before accepting receipt from shipper, 3) document receipt, 4) tag appropriately as Government-owned Equipment, 5) place in storage area, 6) immediately EMAIL and/or FAX shipping documents along with purchase order information and acceptance certification to the appropriate VA ordering facility's COR. The Contractor may provide acceptance certification on the packing list/shipping document provided by the supplier. All invoices, receiving documents, and acceptance certification shall be forwarded to the COR no later than five (5) calendar days of receipt of Concentrators. 14.2 In the event overages, shortages, or damages are discovered upon receipt of Government-owned Concentrators, the Contractor shall provide a statement of the condition and apparent causes to the COR immediately, no later than twenty-four (24) hours after occurrence. Only that quantity actually received shall be recorded in the official records. 14.3 The Contractor shall maintain inventory controls and prepare a perpetual inventory control record of all Government-owned equipment, new and retrieved, held in storage under the terms of this contract. The Contractor shall perform monthly inventory counts in order to maintain the required inventory levels and to ensure that proper inventory procedures are operating effectively. A copy of the monthly inventory report shall be provided via email and/or FAX (FAX Numbers will be provided upon contract award) as determined by the appropriate COR by last business day of each month. The monthly inventory report shall be accompanied by the Contractor s certification that all equipment stored in the clean storage area has been cleaned, serviced, and stored in accordance with the provisions of this contract. The contractor shall provide a listing of all inventory awaiting repairs and item status. Failure to provide an accurate monthly inventory report may result in forfeiture of payment for new set ups placed on Contractor-owned equipment. 14.4 Contractor and each facility COR shall establish procedures to notify COR if inventory of a particular item reaches a point that an emergency order for that item needs to be completed. 14.5 The Contractor's inventory control record shall contain the following basic information for every item of Government-owned Equipment in the Contractor's possession: HME Description Model Number Serial Number New or Used Location (clean storage, temporary storage or patients homes) 14.6 The Contractor shall also maintain a cumulative log of equipment issued during the contract period. The log shall contain the following information: Date issued Patient s initials and SSN Make, Model and Serial Numbers 14.7 The Contractor shall ensure equipment is marked appropriately for identification as Government-owned property and identify the VA facility accountable for the equipment. All tags shall be marked in bold lettering 'VA' along with the following information: Date picked up Patients initials and last four of social Make & Model Serial Number Date Cleaned Date assessed or inspected Date of last preventive maintenance Status: To be repaired Ready to issue Cannot be repaired 14.8 Discrepancies in inventory shall be investigated by the Contractor and a written explanation provided to the appropriate facility's COR via email and/or FAX. Resolution of discrepancies must be completed before the next inventory reporting period. 14.9 Immediately upon termination or completion of the contract, the Contractor shall perform a physical inventory, adequate for disposal purposes, of all Government-owned Equipment applicable to the contract and provide the CORs with the Inventory Control Record document within seventy-two (72) hours after termination or completion. 15. HOURS OF SERVICE The Contractor shall perform the services as specified herein twenty-four (24) hours per day seven (7) days per week.�Set-ups will normally be requested during normal business hours. Normal business hours are 7:30 a.m. to 5:00 p.m. Monday through Friday.�Contractor must present the COR with a plan for handling emergency requests.� Delivery Areas: The geographical area for service will encompass the following areas associated with each medical center listed below.: VA Medical Center VA Medical Center 10 North Greene Street 50 Irving Street, NW Baltimore, MD 21201 Washington, DC 20422 VA Medical Center VA Medical Center One Medical Center Drive 1540 spring Valley Drive Clarksburg, WV 26301 Huntington, MD 25704 DC VAMC Zones: Washington (DC) Zone 1 Alexandria (VA), Arlington (VA), Fairfax (VA), Fall s Church (VA), Anne Arundel (MD), Charles (MD), College Park (MD), Howard (MD), Montgomery (MD), Prince George s (MD) Zone 2 King George (VA), Lancaster (VA), Loudoun (VA), Manassas (VA), Prince William (VA), Stafford (VA), Westmoreland (VA), Calvert (MD), St. Mary s (MD) Zone 3 Huntington VAMC Zones: West Virginia Counties-Cabell, Wayne, Lincoln, Mingo, Logan, Jackson, Mason, Putnam, Kanawha, Boone (Zone 1) Ohio Counties-Lawrence, Gallia, Scioto, Pike, Jackson, Meigs, Athens, Vinton (Zone 2) Kentucky Counties- Lewis, Wolfe, Pike, Floyd, Rowan, Morgan, Boyd, Greenup, Carter, Elliot, Lawrence, Breathitt, Martin, Fleming, Johnson (Zone 3) Clarksburg VAMC Zones: West Virginia Counties: Harrison, Barbour, Taylor, Upshur, Lewis, Doddridge, Tyler, Wetzel, Monongalia, Marion, Preston, Pleasants, Ritchie, Gilmer, Marshall, Nicholas, Tucker, Randolph, Webster, Braxton, Calhoun, Wirt, Wood, Roane, Jackson and Clay (Zone 1) Ohio Counties: Washington, Athens, Belmont, Morgan, Monroe, and Noble (Zone 2) Pennsylvania Counties: Fayette, Greene and Washington (Zone 3) Maryland Counties: Garrett (Zone 4) A coordinated effort between the VA, the patient and the contractor will be necessary to accomplish this task.
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Place of Performance: Address: USA; Country: USA
Record: SN05567550-F 20200222/200220230152 (samdaily.us)
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W -- VISN Wide Home Oxygen (VA-20-00015776)