Mais la polymyxine n'est pas du tout absorbée dans le sang du système gastro-intestinal et n'a d'effet que dans l'intestin et est utile pour le traitement des infections intestinales metronidazole prix Internet en y faisant des achats permettant d’économiser jusqu'à soixante-dix pour cent, tout en étant sûr de la qualité des produits pharmaceutiques.
The following items must be submitted to office in a sealed envelope:
1. Information as described in attached document. 2. Letter of Agreement (see below).
A. All proposals must be submitted in TRIPLICATE.
B. The Letter of Agreement must:
1. Be addressed to the Westmoreland County Commissioners.
2. Indicate specifically that the proposal is for Westmoreland Manor
3. Indicate that the company meets all specified standards and will
adhere to all relevant county, state, and federal regulations and
guidelines pertaining to the supply of medical products and the
4. Be signed by the company’s responsible official.
C. Failure of the bidder to submit and sign a letter of Agreement will be
cause for rejection of the proposal. Signature must be written in ink;
D. All proposals must be sealed in opaque envelopes and plainly marked on
the outside of the envelope “PROPOSAL FOR WESTMORELAND
MANOR PHARMACY SERVICES”. Sealed proposals will be received
at the office of Westmoreland County Controller, 2 North Main Street
Suite 111, Greensburg, Pennsylvania 15601, until 2:00 p.m. prevailing
time April 14, 2009. LATE PROPOSALS WILL NOT BE
ACCEPTED OR CONSIDERED.
E. Non-Discrimination Clause: The Successful Bidder shall execute the
F. Contractor Integrity: The Successful Bidder shall execute the attached
Contractor Integrity Agreement herein marked Attachment “B”.
E. HIPAA: The Successful Bidder shall execute the attached HIPAA
Agreement herein marked Attachment “C”.
F. DRA (Deficit Reduction Act of 2005): The Successful Bidder shall be
required to comply with the County’s Deficit Reduction Act Policy and
SECTION I - INSTRUCTIONS TO INTERESTED PARTIES A. There will be a mandatory pre-proposal meeting on April 1, 2009 at 10:00 a.m. at
Westmoreland Manor. The purpose of this meeting is to gain a better understanding of the services required under this Request for Proposal. If you need directions to Westmoreland Manor call (724) 830-4000.
B. All interested parties must submit with their completed proposal, a professional vita
of all individuals who will be involved with the program, and proof of the licensure in the Commonwealth of Pennsylvania.
C. The Pharmacy proposal must include the following:
1. Copy of all licenses, permits, etc. issued by federal, state or local government
agencies for the bidder to provide the types of services outlined herein.
2. Copy of all accreditation reports or certificates.
3. Names, resumes and licenses of the principals of the bidder’s company, and of
the registered pharmacist that is to be assigned to Westmoreland Manor should an award be made to the bidder.
4. Indicate the location, with address, phone number, fax number, email addresses,
and website of the vendor’s pharmacy that would service Westmoreland Manor.
5. Minimum of three references from long term care facilities, preferably of 400
beds or larger, and county owned in the Commonwealth of Pennsylvania with whom the bidder has or had a contract providing services similar to those detailed herein. List shall include the facility name, address, contact name with phone number and the number of years under contract.
6. Any exceptions to the terms, conditions or other requirements in any part of the
RFP (Request For Proposals). If none are listed, the Vendor will be responsible for full compliance with all terms, conditions and other requirements in the RFP and all stated proposals from the vendor.
7. Any and all rates, if applicable, for drugs, supplies, and services rendered in
D. All Pharmacies must provide documented evidence of the following: 1. The ability to provide all pharmacy services of any kind for Manor residents.
2. The ability to coordinate all services including clinical services, information
systems and billing in a cohesive, user friendly manner.
3. Contracts with all PDPs and if unable to contract with a PDP, must supply
E. All Pharmacies must be licensed by the Commonwealth of Pennsylvania and the DEA.
F. The Pharmacy shall maintain and retain all required reports and documents relating to the services provided under the contract that the Pharmacy would enter if their proposal is accepted, in such a manner and for such time periods as required by applicable law and administrative regulations, and agree that all such records shall be subject at all reasonable times to review and inspection and audit by the Commonwealth of Pennsylvania and the County or their contracted auditors or representatives to determine compliance with applicable law, regulations and policies. The County and Commonwealth shall also have the right to inspect the Pharmacy’s performance.
G. The Pharmacy and the County, and their respective agents, employees, servants and
workmen shall perform their respective obligations, if an Agreement is entered, in such a manner as to insure that resident names and records shall remain confidential, except as disclosure is permitted by law. Pharmacy agrees that they will require all agents, employees, servants and workmen to act in compliance with all applicable statutes and regulations governing such confidentiality and right of privacy including HIPAA regulations. H. The Pharmacy agrees, that in performing the services as outlined in the specifications,
even if not written in final contract, to comply fully with all applicable provisions of law, and with all regulations promulgated by a governmental entity or agency, as well as with all guidelines and procedures required or recommended by such governmental entities or agencies, including but not limited to, criminal background checks, exclusion checks through the Office of Inspector General (OIG) and the office of General Services (GSA), and TB testing.
I. The Pharmacy shall maintain in effect an insurance policy or policies covering the
1) General Liability - $2,000,000 per occurrence of personal injury. 2) General Aggregate - $4,000,000 per occurrence. Proof of same to be provided within fifteen (15) days of award.
J. The Pharmacy shall indemnify, defend and hold the County harmless from and
against any and all losses, claims, actions, damages, liability and expenses occasioned wholly or in part by the Pharmacy’s negligent act or omission of the negligent act or omission of the negligent act or omission of Pharmacy’s employees, consultants or servants.
K. The Pharmacy shall have the ability to bill all insurance coverage applicable to the
L. The Pharmacy must have a reporting mechanism in place in order for the facility to
bill in compliance with the Federal and State regulations. Reports must be submitted to Westmoreland Manor within five (5) working days of the following month.
M. The Pharmacy must designate one (1) contact person to act as liaison with the Westmoreland Manor Administration and Nursing Department. SECTION II - RULES GOVERNING THE PROPOSAL A. Proposal Requirements and Conditions.
1. Acceptance or rejection of proposals:
The County will select a service provider within sixty (60) days after the date set for receipt of the proposals. The County reserves the right to reject any or all proposals. At the option of the County, the review period may be automatically extended for an additional sixty (60) days by delivering written notice of such extension to the proposed Pharmacies.
The County may make such investigations as it deems necessary to determine the ability of the Pharmacy to provide the services in the proposal. The County may request information from the Pharmacy as evidence to support their ability to provide the proposed services and may reject a proposal if the evidence fails to satisfy the County that the offeror is properly qualified to provide the services.
No offeror may withdraw their proposal during the sixty (60) days after submission, or during the sixty (60) day automatic extension, if the County so exercises its option to extend the review period.
The County may modify the Proposal Specification prior to the date fixed for submission of responses by issuance of an Addendum to all parties who have obtained the Request for Proposals from the Westmoreland County Controller.
5. Questions Regarding Clarification or Intent of the Request for Proposals:
The County shall determine if the questions and answers would be of value to all Request for Proposal recipients and, if so, will publish and distribute them to all recipients as Addenda to the Specifications.
1. The offeror selected by the County to perform the services shall be one whose
proposal is most advantageous to the County and most beneficial to the residents of Westmoreland Manor. See Section IV - Criteria for Selection of Proposal.
2. The contract shall be for a term of five (5) years beginning June 1, 2009 and
3. The County may terminate said contract upon thirty (30) day written notice to the
Pharmacy. The Pharmacy may terminate said contract upon ninety (90) day written notice to the County.
4. The contract shall be automatically terminated if either party loses its license as
set forth in these specifications or any finding of failure to comply with applicable laws and regulations.
5. The County reserves the right to reject any or all proposals.
6. Offerors whose proposals are not accepted will be notified.
SECTION III - PHARMACY SERVICE REQUIREMENTS A. Medication Delivery
The Pharmacy shall: 1. Deliver medications a minimum of two (2) times per day, Monday through Friday;
and one (1) time per day, weekends and holidays. Order cut off times for each delivery time must be defined.
2. Provide services on a seven (7) days per week, twenty-four (24) hours per day,
three hundred sixty-five (365) days per year (366 per leap year) basis. A pharmacist will be available at all times as needed.
3. Deliver medications in a blister pack, modified unit dose system, separated and
labeled by shift by resident on a thirty (30) day system or less often if facility requires.
4. Provide for a cassette exchange system including personnel for maintenance
medications on a mutually acceptable time (whether evening or night shift). Describe in detail.
5. Provide new medication carts for the duration of the contract. These carts shall be
purchased by the Pharmacy. They shall automatically lock and be approved by Manor Administration prior to selection. Time of purchase determined by Westmoreland Manor. The Pharmacy shall also be responsible for up keep of the carts for the length of the contract.
6. Develop a facility specific formulary in conjunction with the Medical Director.
7. Generic drugs will be used whenever possible. Labels on MAR and on blister
packs must list brand name if generic is substituted. Describe in detail how generics will be used and limited. Provide on label a physical description of generic medication (e.g. color).
8. Provide for urgent (as defined by facility) medication delivery within two (2)
hours of notice. The Pharmacy will provide and maintain an automatic dispensing system for facility defined stock and IV supplies at the facility to minimize frequency of urgent calls. Describe system that would be used.
9. Provide and maintain a module emergency box.
10. Provide IV fluids and IV medications prepared and labeled for each resident individually every day (24 hour supply).
11. Provide IV pumps on a per diem basis. Type of pump must be approved by the
12. Provide automatic drug interaction program for all prescriptions filled. 13. Dispose of unused or outdated medications including narcotics. Describe system. 14. Provide IV starts if needed to back up facility. (Price to be stated in proposal according to type, midline, PICC and peripheral.)
15. Provide individualized Westmoreland County policy and procedure manuals (and updates) in accordance with all State and Federal laws and regulations. 16. Provide a generic drug identification book for each unit and for the Nursing Supervisor’s Office. . 17. Describe in detail how you manage non-formulary drugs and the prior authorization process under the Medicare – Part D program. 18. Describe PDP contracts and how the pharmacy assures the most advantageous position for the facility.
1. Provide consultation services in accordance with federal, state and local laws.
2. Supervise, review and coordinate all pharmaceutical services.
3. Review each resident’s drug regimen, with staff, at least monthly to evaluate
available PDPs and plan the best medical management of residents.
4. Submit monthly written reports to administration, attending physician, the
Director of Nursing and Medical Director outlining the status of resident’s drug regimen and any recommendations to ensure the County’s compliance with all state and federal regulations.
5. Screen for unnecessary drugs, duplicative therapy, and overuse of medications for patients.
1. Orient all pertinent facility staff to proposed system / services if selected. Updates
of any changes will occur in a timely manner. Appropriate scheduling including live presentations on all three shifts will be decided by the facility.
2. Education will be provided as needed (at least quarterly) to all appropriate staff,
all shifts. Topics will be mutually decided by Pharmacy and facility.
3. Provide IV education, including certification, to Registered Nurses and Licensed
Practical Nurses. Price to be included in proposal.
1. IS must be sufficient to meet the needs of the facility. Please describe in detail
and include ordering, delivery, inventory and billing. Provide samples of all forms that would be used. Billing forms must be categorized by payor source.
2. The Pharmacy shall provide computer generated documentation forms as needed
by the facility. Provide sample forms. Include (but not limited to) the following:
Include costs: a. MAR b. TAR c. Insulin MAR d. Coumadin MAR e. Controlled substance proof of use record f. Psychotropic monitoring sheet g. ADL Flow Sheet h. NA Flow Sheet i. Restorative Nursing Flow Sheet j. Physician orders and Progress Notes (MD orders are recapped every 30 days or 60 days). Describe how the Pharmacy ensures accuracy of printed information and the system used to gather the needed information. (provide sheets to view). Pharmacy must input physician orders. k. Pre-printed Admission/Return from hospital sheets.
3. System for generation of reorders and kardex if resident is readmitted from
4. Computer generated lists must be available in a timely manner for facility use.
Please describe in detail lists available and time availability.
5. The ability to check all medication orders against resident prescription drug plan
(formulary) as prescription is filled. Describe system for notifying facility and physician of any non-coverage and recommended substitutes.
1. The Consultant Pharmacist shall attend bimonthly Pharmacy QA meetings and
other meetings as requested by the Administrator.
2. The Consultant Pharmacist or designee shall review the monthly environmental
issues related to Pharmacy services that shall be part of Pharmacy QA review, including but not limited to the following: a. med rooms b. med and RX carts c. emergency boxes
This review must be done immediately when DOH starts annual survey.
3. The Pharmacy shall provide a Quality Assurance Program to document quality of
services provided to the County and the residents. This shall include a program to oversee the use of psychoactive drugs and inappropriate medication use by the elderly as outlined in CMS survey guidelines. Narcotic audits will be conducted by the Pharmacy on a schedule determined by the facility. This shall also include a Corporate Compliance Program.
SECTION IV - CRITERIA FOR SELECTION OF PROPOSAL A. The County shall review all proposals and evaluate each according to the following
criteria (criteria are listed in alphabetical order not in order of importance):
5. Proposed Scope of Services (including services available in addition to those requested) 6. Understanding of Requirements
Proposals should respond to specifications as indicated. Marketing materials are not necessary nor will they be considered if not directly relevant to the specifications.
Chorale Trip to Vancouver, British Columbia RULES AND REGULATIONS – KEEP AT HOME! We are looking forward to a pleasant trip together! We will be doing loads of singing and sightseeing, so getting plenty of rest prior to and during our trip is highly encouraged, pleasant moods are deeply appreciated, and kindness is absolutely mandatory. Here are a few common sense rules that MUST be fol
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