Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee CPSA; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 1
Appears in 5 contracts
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client Information / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 0 AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee CPSA; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.638.4494 Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or AHS: Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 Xxxxxxxx 0 AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.638.4494 Documented evidence of patient satisfaction program, Annually Facility AHS: Contract Manager NHSF Contracts including documented evidence of Client Concerns Resolution Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.638.4494 Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.638.4494 Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 1
Appears in 3 contracts
Samples: www.albertahealthservices.ca, www.albertahealthservices.ca, www.albertahealthservices.ca
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting Classification System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee CPSA; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Committee, AH, CPSA Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical ContractsAH, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Documented evidence of patient satisfaction program, including Annually Facility Contract Manager documented evidence of Client Concerns Resolution Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Non-Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 AH Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 AH Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 11 National Ambulatory Care Reporting System (NACRS) For Mandatory Reporting to Alberta Health Clinic Identifying Information Delivery organization Program number As defined by AHS Client Identifying Information Client name Optional – Not Reported beyond AHS AB Personal Health Number (PHN) 9 digit number Unique Lifetime Identifier (ULI) Assigned by Alberta Health Clinic chart number Unique identifier established by clinic Postal code Birth date YYYYMMDD Gender
Appears in 2 contracts
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting Classification System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee CPSA; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Committee, AH, CPSA Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical ContractsAH, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Documented evidence of patient satisfaction program, including Annually Facility Contract Manager documented evidence of Client Concerns Resolution Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Non-Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 AH Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 AH Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional Zone standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 11 National Ambulatory Care Reporting System (NACRS) For Mandatory Reporting to Alberta Health Clinic Identifying Information Delivery organization Program number As defined by AHS Client Identifying Information Client name Optional – Not Reported beyond AHS AB Personal Health Number (PHN) 9 digit number Unique Lifetime Identifier (ULI) Assigned by Alberta Health Clinic chart number Unique identifier established by clinic Postal code Birth date YYYYMMDD Gender
Appears in 2 contracts
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting Classification System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee CPSA; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Committee, AH, CPSA Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Contract Manager, AH, Appendix 4 Schedule “D”, Appendix 4 AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Non-Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 AH Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 AH Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 11 National Ambulatory Care Reporting System (NACRS) For Mandatory Reporting to Alberta Health Clinic Identifying Information Delivery organization Program number As defined by AHS Client Identifying Information Client name Optional – Not Reported beyond AHS AB Personal Health Number (PHN) 9 digit number Unique Lifetime Identifier (ULI) Assigned by Alberta Health Clinic chart number Unique identifier established by clinic Postal code Birth date YYYYMMDD Gender
Appears in 1 contract
Samples: www.albertahealthservices.ca
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 • AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee • CPSA; and • AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.634.4494 Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or AHS: Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 • AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and • AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.634.4494 Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) • AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and • AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.634.4494 Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) • AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and • AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.634.4494 Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 1
Appears in 1 contract
Samples: www.albertahealthservices.ca
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting Classification System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee CPSA; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Committee, AH&W, CPSA Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical ContractsAH&W, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Annually Facility Contract Manager Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Non-Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 11 National Ambulatory Care Reporting System (NACRS) For Mandatory Reporting to Alberta Health Clinic Identifying Information Delivery organization Program number As defined by AHS Client Identifying Information Client name Optional – Not Reported beyond AHS AB Personal Health Number (PHN) 9 digit number Unique Lifetime Identifier (ULI) Assigned by Alberta Health Clinic chart number Unique identifier established by clinic Postal code Birth date YYYYMMDD Gender
Appears in 1 contract
Samples: Agreement
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS and in any event, no less than 30 days of each Fiscal Year of the Term. The IPC related indicators will be developed in consultation with the Operator within six (6) months from the Effective Date of this Agreement and will be subject to revision from time to time during the Term, at AHS’ sole discretion. Schedule “D” D” Operator Reporting Requirements National Ambulatory Care Reporting Classification System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 2 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting Classification System (NACRSACCS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRSACCS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee CPSA; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Committee, AH&W, CPSA Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical ContractsAH&W, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Annually Facility Contract Manager Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Non-Medical Goods or Services Within thirty (3060) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 1.
Appears in 1 contract
Samples: Agreement
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client Information / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 0 AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee CPSA; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.634.4494 Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or AHS: Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 Xxxxxxxx 0 AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.634.4494 Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.634.4494 Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.634.4494 Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 1
Appears in 1 contract
Samples: www.albertahealthservices.ca
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting Classification System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting Classification System (NACRSACCS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRSACCS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee CPSA; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Committee, AH&W, CPSA Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical ContractsAH&W, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Annually Facility Contract Manager Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Non-Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year fiscal year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 11 Ambulatory Care Classification System Requirements (ACCS) For Mandatory Reporting to Alberta Health and Wellness Clinic Identifying Information Delivery organization Program number As defined by AHS Client Identifying Information Client name Optional – Not Reported beyond AHS AB Personal Health Number (PHN) 9 digit number Unique Lifetime Identifier (ULI) Assigned by Alberta Health & Wellness Clinic chart number Unique identifier established by clinic Postal code Birth date YYYYMMDD Gender
Appears in 1 contract
Samples: Agreement
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 • AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee • CPSA; and • AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan Xxxxxxx 780.422.6489 Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 • AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and • AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan Xxxxxxx 780.422.6489 Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) • AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and • AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan Xxxxxxx 780.422.6489 Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) • AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and • AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan Xxxxxxx 780.422.6489 Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 1
Appears in 1 contract
Samples: Agreement
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 • AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee • CPSA; and • AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.638.4494 Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or AHS: Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 • AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and • AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.638.4494 Documented evidence of patient satisfaction program, Annually Facility AHS: Contract Manager NHSF Contracts including documented evidence of Client Concerns Resolution Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) • AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and • AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.638.4494 Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) • AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and • AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 HCPA Manager 780.638.4494 Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 1
Appears in 1 contract
Samples: www.albertahealthservices.ca
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting Classification System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee CPSA; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Committee, AH&W, CPSA Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary ZoneInfection Prevention and Control, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: LeadContract Manager, Surgical ContractsAH&W, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Process and follow-up; linked to AHS Annually Facility Contract Manager internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Non-Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: LeadContract Manager, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 11 National Ambulatory Care Reporting System (NACRS) For Mandatory Reporting to Alberta Health Clinic Identifying Information Delivery organization Program number As defined by AHS Client Identifying Information Client name Optional – Not Reported beyond AHS AB Personal Health Number (PHN) 9 digit number Unique Lifetime Identifier (ULI) Assigned by Alberta Health Clinic chart number Unique identifier established by clinic Postal code Birth date YYYYMMDD Gender
Appears in 1 contract
Samples: Agreement
Infection Prevention and Control (IPC) Reporting. The Operator shall provide AHS with a report on IPC related indicators from time to time upon request by AHS. Schedule “D” Operator Reporting Requirements National Ambulatory Care Reporting System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts and AHS Incident Review Committee CPSA; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Lead, Surgical Contracts, Calgary Zone or Contract Manager NHSF Contracts Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Process and follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non- Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Financial Reports Annually Facility AHS Finance Director (BAS) Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule D, Appendix 2) AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts; and AH&W attention to: Xxxxxxxx X. Xxxxxxxx- Shinnan 780.422.6489 Volume of Insured Services provided, by category Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Change of Ownership or Control Immediately Facility AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Conflicts of Interest Immediately Written Notification AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records AHS: Lead, Surgical Contracts, Calgary Zone, Contract Manager NHSF Contracts Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 1
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Samples: Agreement
