Common use of Reports and Requirements Clause in Contracts

Reports and Requirements. The Program will:  Prepare and submit patient services performance reports. Due January 31, 2018  Conduct quality assurance/performance measurement summary reports on Key Quality Indicators. Due February 28, 2018  Submit monthly CARS expense and revenue reports  Prepare and submit a Cost Analysis report using the Relative Value Unit methodology. Due August 31, 2018.  Conduct and maintain documentation of monthly internal Quality Control record audits and documentation review  Notify the ▇▇-▇▇/RH Program of staff changes and enroll new staff in the HCET “On-Boarding” program  Participate in on-site ▇▇-▇▇/RH program and telephone/video-conference reviews and consultation  Notify ▇▇-▇▇/RH Program staff in a timely manner of operational or service delivery problems and request consultation assistance as needed  Participate in ▇▇-▇▇/RH Program sponsored business and continuing educational offerings. Name of Person Submitting Application:  ▇▇▇▇▇▇ ▇▇▇▇▇▇ RN, BSN Date: 11/11/2016

Reports and Requirements. The Program will:  Prepare and submit patient services performance reports. Due January 31, 2018  Conduct quality assurance/performance measurement summary reports on Key Quality Indicators. Due February 28, 2018  Submit monthly CARS expense and revenue reports  Prepare and submit a Cost Analysis report using the Relative Value Unit methodology. Due August 31, 2018.  Conduct and maintain documentation of monthly internal Quality Control record audits and documentation review  Notify the ▇▇-▇▇/RH Program of staff changes and enroll new staff in the HCET “On-Boarding” program  Participate in on-site ▇▇-▇▇/RH program and telephone/video-conference reviews and consultation  Notify ▇▇-▇▇/RH Program staff in a timely manner of operational or service delivery problems and request consultation assistance as needed  Participate in ▇▇-▇▇/RH Program sponsored business and continuing educational offerings. Name of Person Submitting Application:  ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ RN, BSN Date: 11/11/201611/10/2016

Reports and Requirements. The Program will:  Prepare and submit patient services performance reports. Due January 31, 2018  Conduct quality assurance/performance measurement summary reports on Key Quality Indicators. Due February 28, 2018  Submit monthly CARS expense and revenue reports  Prepare and submit a Cost Analysis report using the Relative Value Unit methodology. Due August 31, 2018.  Conduct and maintain documentation of monthly internal Quality Control record audits and documentation review  Notify the ▇▇-▇▇/RH Program of staff changes and enroll new staff in the HCET “On-Boarding” program  Participate in on-site ▇▇-▇▇/RH program and telephone/video-conference reviews and consultation  Notify ▇▇-▇▇/RH Program staff in a timely manner of operational or service delivery problems and request consultation assistance as needed  Participate in ▇▇-▇▇/RH Program sponsored business and continuing educational offerings. Name of Person Submitting Application:  ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ RN, BSN Date: 11/11/2016November 11, 2016

Reports and Requirements. The Program will:  Prepare and submit patient services performance reports. Due January 31, 2018  Conduct quality assurance/performance measurement summary reports on Key Quality Indicators. Due February 28, 2018  Submit monthly CARS expense and revenue reports  Prepare and submit a Cost Analysis report using the Relative Value Unit methodology. Due August 31, 2018.  Conduct and maintain documentation of monthly internal Quality Control record audits and documentation review  Notify the ▇▇-▇▇/RH Program of staff changes and enroll new staff in the HCET “On-Boarding” program  Participate in on-site ▇▇-▇▇/RH program and telephone/video-conference reviews and consultation  Notify ▇▇-▇▇/RH Program staff in a timely manner of operational or service delivery problems and request consultation assistance as needed  Participate in ▇▇-▇▇/RH Program sponsored business and continuing educational offerings. Name of Person Submitting Application:  ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ RN, BSN Date: 11/11/2016

Reports and Requirements. The Program will:  Prepare and submit patient services performance reports. Due January 31, 2018  Conduct quality assurance/performance measurement summary reports on Key Quality Indicators. Due February 28, 2018  Submit monthly CARS expense and revenue reports  Prepare and submit a Cost Analysis report using the Relative Value Unit methodology. Due August 31, 2018.  Conduct and maintain documentation of monthly internal Quality Control record audits and documentation review  Notify the ▇▇-▇▇/RH Program of staff changes and enroll new staff in the HCET “On-Boarding” program  Participate in on-site ▇▇-▇▇/RH program and telephone/video-conference reviews and consultation  Notify ▇▇-▇▇/RH Program staff in a timely manner of operational or service delivery problems and request consultation assistance as needed  Participate in ▇▇-▇▇/RH Program sponsored business and continuing educational offerings. Name of Person Submitting Application:  ▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇ ▇▇, RN, BSN M.Ed., Health Officer Date: 11/11/2016

Reports and Requirements. The Program will:  Prepare and submit patient services performance reports. Due January 31, 2018  Conduct quality assurance/performance measurement summary reports on Key Quality Indicators. Due February 28, 2018  Submit monthly CARS expense and revenue reports  Prepare and submit a Cost Analysis report using the Relative Value Unit methodology. Due August 31, 2018.  Conduct and maintain documentation of monthly internal Quality Control record audits and documentation review  Notify the ▇▇-▇▇/RH Program of staff changes and enroll new staff in the HCET “On-Boarding” program  Participate in on-site ▇▇-▇▇/RH program and telephone/video-conference reviews and consultation  Notify ▇▇-▇▇/RH Program staff in a timely manner of operational or service delivery problems and request consultation assistance as needed  Participate in ▇▇-▇▇/RH Program sponsored business and continuing educational offerings. Name of Person Submitting Application:  ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ , RN, BSN Date: 11/11/2016November 11, 2016

Reports and Requirements. The Program will:  Prepare and submit patient services performance reports. Due January 31, 2018  Conduct quality assurance/performance measurement summary reports on Key Quality Indicators. Due February 28, 2018  Submit monthly CARS expense and revenue reports  Prepare and submit a Cost Analysis report using the Relative Value Unit methodology. Due August 31, 2018.  Conduct and maintain documentation of monthly internal Quality Control record audits and documentation review  Notify the ▇▇-▇▇/RH Program of staff changes and enroll new staff in the HCET “On-Boarding” program  Participate in on-site ▇▇-▇▇/RH program and telephone/video-conference reviews and consultation  Notify ▇▇-▇▇/RH Program staff in a timely manner of operational or service delivery problems and request consultation assistance as needed  Participate in ▇▇-▇▇/RH Program sponsored business and continuing educational offerings. Name of Person Submitting Application:  ▇▇▇▇▇▇ ▇▇▇▇▇▇ RN▇, BSN Director/Health Officer Date: 11/11/201611/9/2016

Reports and Requirements. The Program will:  Prepare and submit patient services performance reports. Due January 31, 2018  Conduct quality assurance/performance measurement summary reports on Key Quality Indicators. Due February 28, 2018  Submit monthly CARS expense and revenue reports  Prepare and submit a Cost Analysis report using the Relative Value Unit methodology. Due August 31, 2018.  Conduct and maintain documentation of monthly internal Quality Control record audits and documentation review  Notify the ▇▇-▇▇/RH Program of staff changes and enroll new staff in the HCET “On-Boarding” program  Participate in on-site ▇▇-▇▇/RH program and telephone/video-conference reviews and consultation  Notify ▇▇-▇▇/RH Program staff in a timely manner of operational or service delivery problems and request consultation assistance as needed  Participate in ▇▇-▇▇/RH Program sponsored business and continuing educational offerings. Name of Person Submitting Application:  ▇▇▇▇▇▇ ▇▇▇▇▇▇ RN, BSN RN Date: 11/11/2016