HomeMy Public PortalAbout007-2016 - Fire - Indiana University Health - LifelineService Agreement
This agreement ("Agreement') is entered by and between Richmond Fire Department (hereinafter,
"Contractor") and Indiana University Health, Inc. (hereinafter, "IU Health"). Any notices or
communications required or permitted to be given pursuant to this Agreement shall be sent to the parties set
forth on the signature page of this Agreement.
WHEREAS: IU Health desires to contract with the Contractor to provide courteous, quality, and
safe ambulance or wheel chair transport services for requested transport made by IU Health with a
preferred provider rate agreement.
WHEREAS: Contractor desires to provide requested services for IU Health.
NOW, THEREFORE: in consideration of the mutual promises and covenants herein, contained,
including the above stated recitals, it is mutually agreed as follows:
1. Term.
a. This Agreement shall commence on November 1, 2015 and shall expire on November 1,
2016, unless earlier terminated as provided herein.
b. At the end of the initial one-year term and each renewal term, this Agreement shall
automatically renew for a successive one year term each unless either party gives written
notice of non -renewal to the other party at least thirty (30) days prior to the expiration of
the then -current term.
2. Definitions.
a. "Retains control" means Indiana University Health maintains patient care control either
by providing clinical care crew members on board the "Contractors" vehicle or the
patient is transferred between Indiana University Health entities with the same provider
number.
Currently the following facilities are under the same provider number:
1. Indiana University Health Saxony
2. Indiana University Health University Hospital
3. Indiana University Health Methodist
4. Riley at Indiana University Health
3. Services.
a. Contractor acknowledges that it is not the exclusive provider of ambulance and/or wheel
chair transportation services for Indiana University Health or IUH LifeLine.
b. The relationship between the Contractor and IU Health will be as an independent
contractor and not as a partner or agent of IU Health. The Contractor will not act or hold
itself out to third parties as a partner, employee, joint venture, or agent of IU Health in the
provision of services under this Agreement.
c. The Contractor shall provide the services to IU Health, as set forth in Exhibit A.
4. Rates.
a. IU Health and Contractor agree that transportation services provided hereunder shall be at
the Centers for Medicare and Medicaid (CMS) rates ("Rates") set forth in Exhibit B. The
Contract No. 7-2016
parties agree to adjust the Rates each year in accordance with the Centers for Medicare
and Medicaid (CMS) fee schedule for medical care, as applicable.
Payment.
a. When a patient of IU Health is covered by Medicaid, Medicare, or private insurance
(`third party payor") which recognizes the Contractor as a provider eligible to bill for the
ambulance services, and the purpose of the ambulance transport makes the transport
eligible for payment by such third party payor, Contractor will invoice the third party
payor for the services directly. In cases when IU Health Retains Control during the
transport (as defined above) the Contractor shall invoice IU Health for the ambulance
services at the approved Rates.
b. In the event IU Health is required by the compensation provisions set forth in Exhibit B
to pay Contractor directly for the Services, IU Health shall pay Contractor within forty-
five (45) days of receipt of Contractor's accurate and complete invoice containing all
documentation required by IU Health, including a line item list of all Services provided
by Contractor for each patient to include Healthcare Common Procedures Coding System
(HCPCS) or applicable coding, service date(s), quantities and charges. Invoices
submitted later than one hundred twenty (120) days following the date the Service was
provided shall be deemed untimely and IU Health shall not be required to pay Contractor
for such Services unless the invoices were previously submitted to a Federal Health Care
Program and were denied by the Federal Health Care Program as appropriate for
Consolidated Billing rules of CMS.
c. IU Health agrees to assist the Contractor in obtaining the necessary billing information
for patients transported by the Contractor either to or from IU Health. IU Health is not
responsible for assisting the Contractor in obtaining payment or collecting any fees for
those services for which IU Health is not obligated to pay the Contractor.
d. Contractor shall invoice the insurance for patients transported, when such insurance
exists and covers ambulance transportation. For patients transported who either have no
insurance or their insurance does not cover ambulance transportation, the contractor shall
send an invoice for ambulance transportation to the patient or other responsible party. IU
Health shall only be responsible for payment of ambulance transports when required by
law or where IU Health is responsible, by law, for ambulance transportation of its
patient's in their CMS Part A stay. When the patient has insurance coverage, IU Health
shall obtain pre -authorization where required prior to requesting service by Contractor.
6. Termination. This Agreement may be terminated as follows:
a. Without Cause. Either party may terminate this Agreement without cause at any time by
providing at least thirty (30) days prior written notice to the other party.
b. Breach. Either party shall have the right to terminate this Agreement in the event of the
other parry's breach of this Agreement by providing at least thirty (30) days written
notice to the other party. Any such notice shall specify the cause upon which it is based.
The violating party shall have thirty (30) days notice period in which to rectify the cause
specified in the notice of termination, or, if such cause is not rectified to the satisfaction
of the non -breaching party within such thirty (30) day period, this Agreement shall
thereupon automatically terminate.
c. Immediate Termination. IL7 Health may immediately terminate this Agreement upon the
occurrence of any of the following events:
i. Conduct or misrepresentation by either parry's personnel who are considered by
the other party to be unethical, unprofessional, fraudulent, unlawful, or adverse
to the interest, reputation or business of the other party, including but not limited
to conduct which would be deemed by a reasonable person to be disruptive,
intimidating, coercive or harassing.
ii. Loss or suspension of any license of Contractor required for the provision of
Services pursuant to this Agreement or the imposition of any sanction against
Contractor under federal or state fraud and abuse laws and regulations or any
other federal or state or regulations relating to Contractor's participation in the
Medicare or state Medicaid programs;
iii. Appointment of a receiver for Contractor's assets, an assignment by Contractor
for the benefit of its creditors or any relief taken or suffered by Contractor under
any bankruptcy or insolvency act; or
iv. The dissolution, reorganization, or change in business of either party.
v. Any jeopardy to the health and safety of patients of I Health.
d. Automatic Termination. This Agreement shall automatically terminate in the event:
i. Either party has a sanction, suspension, exclusion or other ineligibility from
participation in any federally funded health care program, including but not
limited to Medicare or Medicaid, as of the effective date of such exclusion.
ii. A conviction of either party for a criminal offense related to healthcare or
conviction of either party for a felony whether or not the felony is related to
healthcare.
iii. A failure by the Contractor to maintain insurance coverage as required by this
Agreement.
iv. A loss of any licensure or certification required by the state in order for the
Provider to provide services contemplated by this Agreement
General Terms and Conditions.
a. The General Terms and Conditions set forth in Exhibit C attached hereto are incorporated
herein by reference as though fully set forth herein.
b. IU Health and Contractor shall comply with the General Terms and Conditions as part of
this Agreement.
Entire Agreement.
a. This Agreement, including the Exhibits attached hereto and referenced herein, contains
the sole and entire agreement between the parties regarding the subject matter hereof and
supersedes any and all prior written or oral agreements between the parties.
b. The Agreement will not be construed in favor of or against any party by reason of the
extent to which any party participated in the preparation of the Agreement.
c. If either party has made any change to the Agreement that said party did not bring to the
other party's attention in a way that is reasonably calculated to put the other party on
notice of the change, the change shall not become part of the Agreement.
IN WITNESS WHEREOF, the parties by their duty authorized representatives have entered into this Agreement as
of the _2^ day of 12016
Contractor: The City of Richmond, Indiana, by and through its Board of Public Works and Safety
Richmond Fire Department
ENTER CONTRACTOR INFORMATION HERE
50 North 5`° Street
Richmond, Indiana 47374
By:
Name: Vicki Robinson
Title: President
Address for Notices:
Richmond Fire Department
50 North 5`h Street
Richmond, IN 47374 Appri
Attn: Chief Jegy Purcell
IU Health:
Indiana University Health, Inc.
51 S. New Jjes Street
Indianapoli46204ByCZ
4; -----
Name: 9fte*y-MaeFssh Tit-)' C t'a-%--
Title: Executive Director b,cr-eetrst 1 Li Ce W r-k-
Address for Notices:
Indiana University Health, Inc.
51 S. New Jersey Street
Indianapolis, IN 46204
Attn: Shelly Maersch
4
Exhibit A
Services
Services. The Contractor shall provide emergency or non -emergency (ground ambulance and/or
wheel chair) transportation services to IU Health patients twenty-four (24) hours a day, seven (7)
days a week in accordance with medical necessity, regulations of responsible state regulatory
agencies and insurance programs and subject to medical director's protocols.
a. Contractor will supply Services in accordance with medical needs of the patient as
determined by the referring physician which has control of the patient care.
b. For all scheduled requests for Services, Contractor agrees to have its designated crew
arrive at the patient's designated pickup location promptly at the scheduled pick-up time.
c. For all unscheduled requests for non -emergency Services, Contractor agrees to have its
designated crew arrive at the patient's designated pick-up location as mutually agreed
upon between the applicable parties. In the event a request for an Emergency Services, it
will be provided as promptly as possible in accordance with applicable legal and
regulatory standards.
d. The Contractor shall provide equipment and/or supplies in the performance of the
Services. Contractor shall provide appropriately licensed and/or certified vehicles and
equipment to provide the Services hereunder and shall keep such vehicles and its
equipment and supplies in good order, conditions, and repair pursuant to applicable legal
and regulatory requirements. Contractor will maintain, and provide IU Health upon
request, written service records for all servicing of the vehicle(s) and/or medical devices
used by Contractor to provide Services under the terms of this Agreement.
e. The Contractor shall file a written report and provide documentation to IU Health with
respect to any known injuries occurring to patients during transportation (falls, etc.),
indicating the type of injury, the place and time that the injury occurred, and any other
information requested by IU Health.
f. The Contractor shall file a monthly written or electronic quality report to IU Health by
the fifth business day for the prior month. The quality report will include at a minimum:
the date of service, pick up location, drop off destination, level of care provided, invoiced
recipient, incident and /or run number, response time, reportable incident/issue, and if any
customer service follow up was completed. If the contractor is unable to provide the
requested transport service also include: reason for turndown, if it was referred, who it
was referred to. This is not an exclusive list and the Contractor should provide any other
information requested by IU Health within reason.
g. Contractor will provide a copy of current policies that pertain to procedures for
mandatory drug test after an incident, driver duty and rest time, inclement weather and
responsibility for aborting if there is a safety concern, speeding and other traffic
violations, vehicle tampering inspection.
Definitions.
a. "Scheduled pick-up time" means the Contractors personnel at the patient's bedside no
later than the requested time by IU Health designated medical transportation coordinator
(i.e. IU Health LifeLine Communications Center).
b. "Response time" means from the time the request is received by the Contractors
Communication Center and the time the Contractor's medical crew arrives at the patient's
bedside.
Exhibit B
Rates
1. Rates. The Contractor provides an ambulance or wheel chair van as requested by IU Health with
an appropriate Contractor crew providing the level of service:
a. The CMS 2015 ambulance schedule allowable for a one-way patient transport:
i. Basic Life Support:
1. Non -emergent (A0428) $213.56
2. Emergent (A0429) $341.70
3. Mileage (A0425) $7.27 per loaded mile
ii. Advanced Life Support:
1. ALS1 Non -emergent (A0426) $256.27
2. ALS1 Emergent (A0427) $405.77
3. ALS2 $587.29
4. Mileage (A0425) $7.27 per loaded mile
b. The Contractor provides an ambulance for patient transport with IU Health providing the
level of care crew and level of care equipment for service:
i. An advanced life support ambulance with mission appropriate gear would be
required as defined by the applicable state minimum guidelines (i.e. a
functioning electrical inverter, compressed oxygen with an adequate amount for
the patient condition, treatment and transport time, portable battery suction, on-
board suction, and patient compartment temperature monitoring device). It
would be expected for the Contractor medical crew to provide IU Health clinical
crew with the agreed upon completed pre -mission checklist and ground hazard
assessment tool prior to engaging in the mission.
1. Advanced Life Support charges and mileage should be billed to IU
Health for this service.
2. The vehicle type for this request will meet the current governmental
standards (KKK-A-1822-F type III style ambulance). Exceptions must
be approved by IU Health Medical Transport Service.
ii. In the event the IU Health level of care crew is returned to their base there will
not be a fee for such services, except for a mileage fee beginning at mile forty-
one (41) from the final patient destination to the crew final destination.
1. Mileage fee $1.75/mile after mile forty-one (41).
The Contractor provides a wheel chair transport.
i. Wheel chair charges:
1. Wheel chair transport $30.00
2. Loaded per mile $1.75
Exhibit C
General Terms and Conditions
Incorporation by Reference. These General Terms and Conditions are incorporated by reference
into the Agreement to which they are attached. Capitalized terms not defined herein shall have the
meaning set for in the Agreement.
Licenses, Permits, and Accreditations. lU Health, in accordance with applicable law, is
responsible for obtaining Services that meet professional standards and principles that apply to
professionals providing such Services in IU Health and for the timeliness of the Services.
Accordingly, Contractor hereby represents and warrants to IU Health that Contractor and each of
its employees, who perform Services on behalf of Contractor pursuant to this Agreement (the
"Contractor Personnel"):
a. Are, and will remain at all times throughout the term of this Agreement, authorized to
participate in the Medicare and state Medicaid programs and shall comply with all
conditions of participation or other requirements applicable to participation in such
programs;
b. Have, and will maintain at all times throughout the term of this Agreement, all the
necessary qualifications, certifications, licensures and/or accreditations required by
federal, state, and local laws and regulations to provide the Services covered by this
Agreement, including but not limited to state and federal department of transportation
(DOT) regulations applicable to operation of commercial vehicles providing healthcare
transportation (collectively, "Contractor Licenses");
c. Contractor is responsible to provide proof as request of vehicle driver's possessing a
current emergency vehicle operator course certification or its equivalent, which consist of
at least four hours of reviewed ambulance driving under emergency conditions.
d. Will provide the Services in accordance with the professional standards and principles
applicable to their profession; and
e. Are not, and at no time have been, excluded from participation in any federally funded
healthcare program, including Medicare or Medicaid, or sanctioned under any applicable
state or federal fraud and abuse statues.
Contractor will provide IU Health with a copy of the Contractor Licenses, including any
temporary or permanent suspension or revocation of any Contractor License, or any sanction
or proposed sanction or exclusion against Contractor, or any officer, director or owner of
Contractor, in connection with participation in any federally funded healthcare program.
Quality Metrics. Both Contractor and IU Health shall mutually agree upon quality metric
measures within the first thirty days of the contract is signed. Failure to do so may result in
termination of the contract.
4. Compliance. Both Contractor and IU Health shall provide to the other, and shall ensure that the
Contractor Personnel provide, the Services to IU Health in accordance with:
a. All applicable requirements of federal, state or local laws, rules and /or regulations,
including official interpretations of those requirements by the entities charged with
implementing and enforcing them, including, without limitation, nondiscrimination on
the basis of race, color, national origin, handicap, age, or other protected class;
b. All aspects of traffic law which apply ambulance operations.
c. accepted professional standards of practice;
d. And all IU Health policies and procedures and any revisions thereto that are applicable to
the provision of Services to IU Health, copies of which shall be provided to Contractor.
e. Contractor shall participate, as reasonably requested, in quality monitoring programs
established by IU Health.
Corporate Compliance Program. Contractor acknowledges IU Health's Corporate Compliance
Program and receipt of IU Health's Standards of Service Commitment.
6. Patient Records. IU Health and Contractor shall each prepare and maintain records concerning
IU Health's patients receiving Services under this Agreement, in accordance with applicable
federal and state laws, regulations and program guidelines. Contractor shall provide to IU Health
documentation of the Services provided to, and any requested by Network. If the Services are
provided on the Network premises, such documentation shall be made in the patents' medical
record or chart, which shall be and remain the property of the IU Health. If the Services are
provided off of the IU Health premises, such documentation shall be on the forms and in the
format required by IU Health policies and procedures in accordance with applicable laws,
regulations, and program guidelines. Contractor hereby agrees to maintain the confidentiality of all
information and records relating to IU Health which it acquires in the course performing the
Services and to assure that such confidentiality is maintained by each of the Contractor Personnel
providing Services pursuant to this Agreement.
7. HIPPA Compliance. See Exhibit D.
Record Retention Requirements.
a. All records created by Contractor in connection with the provision of Services pursuant
to this Agreement including patient records and records related to billing and payment,
shall be retained by IU Health as required by law. IU Health shall be permitted to inspect
and/or duplicate any patient record, chart or other record of Contractor relating to the
provision of Services hereunder by Contractor for any business purpose, including
without limitation, determining Contractor's compliance with the terms of this
Agreement; ensuring safe, dependable and efficient patient care; satisfying IU Health's
obligations to any patient; or defending any allegation of malpractice or other liability
against IU Health.
b. The parties shall comply with all applicable state and federal statutes and regulations,
including Medicare, Medicaid and Internal Revenue Service requirements. The parties
further agree to comply with Section 952 of the Omnibus Reconciliation Act of 1980
providing for access to the books and records of subcontractors of Medicare providers by
the Center for Medicare and Medicaid Services and the Comptroller General. The parties
agree to provide such access to books and records and to require any of their respective
subcontractors to provide such access, when appropriate, for a period of four (4) years
after the provision of services.
This Section shall survive the expiration or termination of this Agreement.
9. Background Checks; Substance Abuse, Driver's License.
a. Contractor, at its sole cost and expense, shall conduct criminal background checks on the
Contractor Personnel that provide Services on behalf of the IU Health. Such background
checks:
i. Shall cover the previous seven (7) years;
ii. Shall be conducted in accordance with applicable state law;
iii. And must be based on information provided by the appropriate state or local law
enforcement agency, if so required by applicable state law.
b. Contractor shall not assign to the IU Health any Contractor Personnel who have been
convicted of or have pled guilty to the following crimes; theft; sexually deviant behavior,
assault and /or battery; abuse of the elderly, children or vulnerable individuals; heath care
fraud; or other criminal conviction related to the Services being provided to IU Health.
c. Contractor, at its sole cost and expense, shall conduct substance abuse testing and testing
pertaining to blood borne pathogens on the Contractor Personnel that provide Services on
behalf of the IU Health. Such substance abuse testing may be conducted by Contractor
but non -negative results shall be verified by a laboratory that is certified by the
Department of Health and Human Services. Contractor shall not assign to IU Health any
Contractor Personnel who are determined, after appropriate testing, to be engaged in
substance abuse.
d. The Contractor will review the driver's license checks shall be conducted initially and
then annually. Any associate with more than four points on the driving record will be
submitted to IU Health for further review. IU Health retains the right to prohibit the
associate from providing transport services for IU Health.
10. Insurance. Contractor shall, at its sole cost and expense, procure, keep and maintain throughout
the term of this Agreement, insurance coverage in the amount of statutory requirement for its
operations but no less than one million dollars ($1,000,000) per occurrence of the following:
a. Professional liability, negligence, errors and omissions.
b. Medical malpractice insurance sufficient to qualify under Indiana Medical Malpractice
Act.
c. Commercial auto liability insurance
i. With statutory limits for workers compensation.
ii. In addition, contractor shall maintain commercial auto liability insurance with
statutory limits for its specialty but no less than one million dollars ($1,000,000)
to include accidental death and disability.
d. Evidence of general liability.
e. Workers' compensation insurance per state guidelines.
Said insurance policies shall cover all services, Contractor, its directors, officers, employees,
agents. Contractor shall provide IU Health with evidence of such insurance promptly upon
request.
11. Indemnification. Each party shall indemnify, defend, and hold the other party harmless,
including its officers, directors, stockholders, employees and/or agents, from and against any and
all losses, claims, suits, damages, liabilities and expenses (including, without limitation,
reasonable attorneys' fees) of any nature or kind whatsoever arising out of or resulting from,
directly or indirectly:
a. A parry's breach of this Agreement, including, without limitation, breach of any
representation, warranty, or covenant of such party in this Agreement;
b. And any alleged negligent or intentional acts or omissions of a party, its agents or
employees, based upon, arising out of or attributable to the performance or non-
performance of their respective obligations under this Agreement. Upon notice, the other
party shall resist and defend, at its own expense, any such claim or action. Said indemnity
is in addition to any other rights the indemnified party may have against the indemnifying
party.
This Section shall survive the expiration or termination of the Agreement.
12. Independent Contractor. Nothing contained herein or any document executed in connection
herewith shall be deemed or construed by the parties hereto, nor by any third party, as creating the
relationship of principal and agent, employer and employee, partnership, or joint venture between
the parties. Each party hereby acknowledges that neither it nor its Agents shall have any right or
entitlement in or to any of the unemployment, workers compensation, health, pension, retirement,
or other benefit programs now or hereafter available to the other parry's employees.
13. Mediation/Arbitration. Any dispute or controversy arising under this Agreement or any
amendment hereof or the breach hereof may, by mutual agreement of the parties, be submitted to
mediation or arbitration proceedings in an attempt to resolve the dispute or controversy. If
arbitration proceedings are initiated, they shall be held in the county in which the IU Health is
located, in accordance with the rules of the American Health Lawyers Association Alternative
Dispute Resolution Service and applying the laws of the State parties, and judgment thereof may
be entered in any court having jurisdiction. During the pendency of any such arbitration and until
final judgment thereon has been entered, this Agreement shall remain in full force and effect
unless otherwise terminated as provided in this Agreement. Notwithstanding anything to the
contrary in this Section, any party may seek a temporary restraining order or other interim
injunctive or provisional relief from a court of proper jurisdiction without first reporting to the
arbitration procedures set forth in this Section. If any such relief is obtained the arbitrator(s) shall
address the continuance, modification or termination of such relief in the order and the parties
agree to abide by the arbitrator's decision regarding such relief. This Section shall survive the
expiration or termination of this Agreement.
14. Cumulation of Remedies; No Waiver. The various rights, options, elections, powers, and
remedies of the respective parties as provided in this Agreement are in addition to any others that
said parties may be entitled to by law, shall be construed as cumulative, and no one of them is
exclusive of any of the others, or of any right or priority allowed by law. The failure of a party to
exercise any of its rights or to give any notice with respect to any default by the other party or
otherwise to insist upon the strict performance of the other party's obligations hereunder shall not
be deemed a waiver of such parry's right with respect thereto in the future.
15. Attorney's Fees. If Contractor or IU Health brings any action to interpret or enforce this
Agreement, or for damages for any alleged breach hereof, whether by arbitration or otherwise, the
prevailing party in any such action shall be entitled to reasonable attorneys' fees and costs as
awarded by the arbitrator in addition to all other recovery, damages, and costs. This Section shall
survive the expiration or termination of this Agreement.
16. Governing Law; Statutory References. This Agreement shall be governed by and construed in
accordance with the laws of the State of Indiana, without regard to and regardless of the fact that
either IIJ Health or Contractor may become residents of a different state.
10
17. Force Majeure. Neither party hereto shall be liable for any delay or failure in the performance of
an obligation under this Agreement or for any loss or damage (including indirect or consequential
damage) to the extent that such nonperformance, delay, loss or damage results from any
contingency which is beyond the control of such party, provided such contingency is not caused
by the fault or negligence of such party. A contingency for the purposes of this Agreement shall
include Acts of God, fires, floods, earthquakes, explosions, storms, warms, hostilities, blockades,
public disorders, quarantine restrictions, embargoes, civil unrest, and compliance with any law,
order or control of, or insistence by any governmental or military authority.
18. Confidentiality. The parties hereto shall hold in confidence the information contained in this
Agreement or other information about a party, and each of them hereby acknowledges and agrees
that all information related to this Agreement or other information about a party, not otherwise
known to the public, is confidential and proprietary and is not to be disclosed to third persons
without the prior written consent of each of the parties except:
a. To the extent necessary to comply with any law, rule or regulation, including, without
limitation, any rule or regulation promulgated by the SEC, or the valid order of any
governmental agency or any court of competent jurisdiction;
b. To its auditors and its attorneys as part of its normal reporting or review procedure;
c. To its insurance agent to the extent necessary to obtain appropriate insurance;
d. Or as necessary to enforce its rights and perform its agreements and obligations under
this Agreement.
This Section shall survive the expiration or termination of this Agreement.
19. Modification and/or Assignment. This agreement may not be modified, amended or
supplemented, nor may any term or condition be waived, except by an agreement in writing signed
by both parties. Neither this Agreement nor any of the duties or obligations of Contractor
hereunder shall be assigned or delegated by Contractor except as contemplated in this Agreement
without prior written consent of IU Health. Subject to the restrictions against transfer or
assignment as herein set forth, the provisions of this Agreement shall inure to the benefit of, and
shall be binding on, the heirs, assigns, successors, personal representatives, estates, and legatees of
each of the parties hereto.
20. Entire Agreement. This Agreement shall constitute the entire agreement between the parties
hereto with respect to the transactions contemplated hereby and shall supersede all prior or
contemporaneous negotiations, understandings, and agreements applicable to the same Services.
There are no representations, agreements, arrangements or understandings, oral or written between
or among the parties hereto relating to the subject matter this Agreement that are not fully
expressed herein.
21. Severability. If any provision of this Agreement is found to be invalid or unenforceable by any
court or other lawful forum, such provision shall be ineffective only to the extent that it is in
contravention of applicable laws without invalidating the remaining provisions of this Agreement,
unless such invalidity or unenforceability would defeat an essential business purpose of this
Agreement.
11
22. Survival. Except as otherwise expressly provided in this Agreement, all covenants, agreements,
representations and warranties, express and implied, shall survive expiration or termination of this
Agreement.
23. Signatures. This Agreement may be executed in any number of counterparts, each of which shall
be deemed an original, but all of which shall constitute one and the same agreement. Facsimile
signatures shall be acceptable as originals. Any individual signing this Agreement on behalf of an
entity herby represents and warrants in his individual capacity that he has full authority to do so on
behalf of such entity.
12
Exhibit D
Business Associate Addendum
IU Health and Contractor are parties to a Services Agreement (the "Agreement"). While IU Health and
Contractor mutually agree that they are both Covered Entities in all respects as that status applies to HIPAA
and as such may freely and without precondition, except as specified by the Act and/or its implemented
regulations, exchange information between entities for the purposes of Treatment, Payment, or Health Care
Operations as those terms are defined under the Act or its regulations, IU Health and Contractor also agree
that under the Agreement, they may, can and will in part function in the capacity of Business Associates as
those terms are defined hereunder.
For purposes of complying with the Administrative Simplification provisions of the Health Insurance
Portability and Accountability Act of 1996, as amended, the implementing regulations promulgated
thereunder (collectively, "HIPAA") as well as the requirements of Subtitle D of the Health Information
Technology for Economic and Clinical Health Act and the implementing regulations promulgated
thereunder (collectively, "HITECH"), including the Final Omnibus Rule, when Business Associates is
acting as a "Business Associates" of Covered Entity as that term is defined in the HIPAA Privacy Rule, the
parties agree as follows:
Definitions. Capitalized terms used, but not otherwise defined in this Addendum, shall have the same
meaning as those terms in the HIPAA regulations and HITECH, and the following capitalized terms
shall be given the following meanings:
1.1. "Breach" means the acquisition, access, Use or Disclosure of Unsecured PHI in a manner not
permitted under the Privacy or Security Rule. Unless an exception applies, an impermissible Use
or Disclosure of PHI is presumed to be a Breach unless Business Associates demonstrate that
there is a low probability that the PHI has been compromised and whether breach notification is
necessary, Business Associates, must conduct a risk assessment that considers, at a minimum,
each of the following factors:
1.1.1. The nature and extent of the protected health information involved, including the types of
identifiers and the likelihood of re -identification;
1.1.2. The unauthorized person who used the protected health information or to whom the
disclosure was made;
1.1.3. Whether the protected health information was actually acquired or viewed; and
1.1.4. The extent to which the risk to the protected health information has been mitigated.
Business Associates must evaluate the overall possibility that the PHI has been compromised by
considering all of the above, and any other relevant factors, in combination. Such risk assessment must be
thorough and completed in good faith and the conclusions must be reasonable under the law. Breach does
notinclude:
1) Use or Disclosure of Protected Health Information (PHI) that does not include the identifiers listed at
45 C.F.R./ 164.514 (e)(2), date of birth, and zip code;
13
2) Any unintentional acquisition, access, or Use of PHI by a member of Business Associates' Workforce
or a person acting under the authority of Business Associates, if such acquisition, access or Use was
made in good faith and within the person's scope of authority and does not result in further Use or
Disclosure in a manner not permitted under the Privacy Rule;
3) Any inadvertent Disclosure by a person who is authorized to access PHI at Business Associates to
another person authorized to access PHI at Business Associate, provided the information received as a
result of such Disclosure is not further Used or Disclosed in a manner not permitted under the Privacy
Rule;
4) Ora Disclosure of PHI where Business Associate has a good faith belief that an unauthorized person to
whom the Disclosure was made would not reasonably have been able to retain such information.
1.2. "Compliance Date" means, in each case, the date by which compliance is required under the
referenced provision of HITECH.
1.3. "Disclose" and "Disclosure" mean, with respect to Protected Health Information, the release,
transfer, provision, of access to, or divulging in any other manner of Protected Health Information
outside Business Associate's internal operations or to other than its employees.
1.4. "Final Omnibus Rule" means the modifications to the HIPAA Privacy, Security, Enforcement, and
Breach Notification Rules Under the Health Information Technology for Economic and Clinical
Health Act and the Genetic Information Nondiscrimination Act; Other Modifications so the
HIPAA Rules, as published at 78 FR 5565 on January 25, 2013, when and as effective.
1.5. "HITECH" means the Health Information Technology for Economic and Clinical health Act,
enacted as part of the American Recovery and Reinvestment Act of 2009, Pub. Law No. 11 1-5,
and any regulations promulgated thereunder. References in this Addendum to a section or
subsection of title 42 of the United States Code are references to provisions of HITECH. Any
reference to provisions of HITECH in this Addendum shall be deemed a reference to that
provision and its existing and future implementing regulations, when and as each is effective.
1.6. "Privacy Rule" means the Standards for Privacy of Individually Identifiable Health Information at
45 C.F.R Part 160 and Part 164, Subparts A and E.
1.7. "Protected Health Information" or "PHI" means information, including demographic information
that (a) relates to the past, present or future physical or mental health or condition of an
individual, the provision of health care to an individual, or the past, present or future payment for
the provision of health care to an individual; (b) identifies the individual (or for which there is a
reasonable basis for believing that the information can be used to identify the individual); and (c)
is received by Business Associate from or on behalf of a Covered Entity, or is created by
Business Associate for Covered Entity, or is made accessible to Business Associate by Covered
Entity. "ePHI" means "Electronic Protected health Information," as that term is defined in the
Privacy and Security Rules. PHI includes PHI that is ePHI as well as PHI that does not constitute
ePHI.
1.8. "Security Rule" means the Security Standards for the Protection of Electronic Protected Health
Information at 45 C.F.R Part 164, Subpart C.
1.9. Unsecured Protected Health Information" or "unsecured PHI" means Protected Health Information
that is not rendered unusable, unreadable, or indecipherable to unauthorized individuals through
the use of a technology or methodology specified by the Secretary in the guidance issued under
section 1340 (h)(2) of Public Law 111-5, those being: (1) encryption for ePHI in accordance with
the appropriate NIST standards; or (2) destruction for other forms of PHI.
1.10. "Use" or "Uses" mean, with respect to Protected Health Information, the sharing, employment,
application, utilization, examination or analysis of such Protected Health Information within
Business Associate's internal operations.
14
Confidentiality Obligation. Business Associates will not Use or Disclose PHI other than as permitted
by the Agreement or this Addendum, or as Required by Law.
Permitted Uses and Disclosures of PHI. Business Associates shall Use or Disclose PHI only as
necessary to perform functions, activities, or services under the Agreement or as Required by Law,
provided such Use or Disclosure would not: (i) violate the Privacy Rule, Security Rule, other
applicable provisions of HIPAA or HITECH if done by Covered Entity; or (ii) violate the minimum
necessary policies and procedures of Covered Entity or Business Associate.
4. Uses and Disclosures by Business Associates.
4.1. Use of PHI. Except as otherwise limited in this Addendum or by law, Business Associate may use
PHI for the proper management and administration of Business Associate or to carry out the legal
responsibilities of Business Associate.
4.2. Disclosure of PHI. Except as otherwise limited in this Addendum or by law, Business Associate
may disclose PHI for the proper management and administration of Business Associate or to
carry out the legal responsibilities of Business Associate, provided that disclosures are required
by law, or Business Associate obtains reasonable assurances, in writing, from the person to whom
the information is disclosed that it will remain confidential and be used or further disclosed only
as required by law or for the purpose for which it was disclosed to the person, and the person
notifies Business Associate, in writing within five (5) business days, of any instances of which it
is aware in which the confidentiality of the information has been breached.
4.3. Limitation on Use and Disclosure of PHI. With regard to its Use and/or Disclosure of PHI
necessary to perform its obligations to Covered Entity, Business Associate agrees to limit
Disclosures of PHI to the Minimum Necessary (as defined in the Privacy Rule, as modified by
HITECH and implementing regulations) to accomplish the intended purpose of the Use,
Disclosure or request, respectively, whenever the Privacy Rule limits the Use or Disclosure in
question to the Minimum Necessary.
4.4. Limitation on Remuneration for PHI. With regard to its Use and/or Disclosure of PHI necessary
to perform its obligations to Covered Entity and to comply with HITECH, Business Associate
agrees not receive direct or indirect remuneration for any exchange of PHI not otherwise
authorized under HITECH without individual authorization, unless (i) specifically required for
the provision of services under the Agreement (ii) for treatment purposes; (iii) providing the
individual with a copy of his or her PHI; or (iv) otherwise determined by the Secretary in
regulations.
4.5. Reporting Violation of Law. Business Associate may use PHI to report a violation of law to
appropriate Federal and/or State authorities, consistent with 45 CFR/ 164.502 0)(1).
5. Safeguards. Business Associate shall use reasonable and appropriate safeguards to protect PHI from
any improper oral or written Use or Disclosure other than is permitted by this Agreement. Such
safeguards shall include administrative, physical, and technical safeguards that reasonably and
appropriately protect the confidentiality, integrity, and availability of any electronic PHI that it creates,
receives, maintains, or transmits on behalf of Covered Entity. As of the Compliance Date for 42
15
U.S.C./ 17931, Business Associate shall comply with the Security Rule requirements set forth at 45
C.F.R // 164.308, 164.310, 164.312, and 164.316, as well as additional requirements of HITECH that
relate to security and are applicable to Covered Entity. Business Associate acknowledges that
provisions apply to Business Associate in the same manner that they apply to Covered Entity. Business
Associate shall also comply with the requirements of Subtitle D of HITECH that relate to privacy and
are applicable to Covered Entity. Such safeguards shall at also include: (i) a comprehensive written
information privacy and security policy addressing the requirements of the Privacy and Security Rules,
as amended by HITECH, that are directly applicable to Business Associate; and (ii) periodic and
mandatory privacy and security training and awareness for members of Business Associate's
Workforce.
6. Mitigation. Business Associate shall mitigate any harmful effect that is known to Business Associate
of a Use or Disclosure of PHI by Business Associate that violates the requirements of the Agreement
or applicable law.
Access and Amendment. Upon the request of Covered Entity, and within ten (10) business days of
any such request, Business Associate shall: (a) make the PHI specified by Covered Entity available to
Covered Entity or to the Individual(s) identified by Covered Entity as being entitled to access in order
to meet the requirements under 45 C.F.R./ 164.524; and (b) make PHI available to Covered Entity for
the purpose of amendment and incorporate changes or amendments to PHI when notified to do so by
Covered Entity. If PHI is maintained in an Electronic Health Record, Business Associate shall provide
access electronically, upon reasonable request of Covered Entity, when and as required by HITECH.
Accounting. Upon Covered Entity's request, and within five (5) business days of any such request,
Business Associate shall provide to Covered Entity or, when directed in writing by Covered Entity
directly to an Individual in a time and manner specified by Covered Entity, an accounting of each
Disclosure of PHI made by Business Associate or its employees, agents, representatives or
subcontractors as would be necessary to permit Covered Entity to respond to a request by an Individual
for an accounting of Disclosures of PHI in accordance with 45 CFR/ 164.528. Any accounting
provided by Business Associate under this subsection shall include: (a) the date of the Disclosure; (b)
the name, and address if known, of the entity or person who received the PHI; (c) a brief description of
PHI disclosed; and (d) a brief statement of the purpose of the Disclosure. For each Disclosure that
could require an accounting under this subsection, Business Associate shall document the information
specified in (a) through (d), above, and shall securely retain this documentation for six (6) years from
the date of the Disclosure. If PHI is maintained in an Electronic Health Record ("HER"), Business
Associate shall comply with Business Associate shall document and maintain documentation of such
disclosures as would be required for Covered Entity to respond to a request by an Individual for an
accounting of disclosures in an HER, when and as required by HITECH.
Access to Books and Records. Business Associate shall make its internal practices, books, and
records relating to the Use and Disclosure of PHI pursuant to this Addendum available to the Secretary
of the Department of Health and Human Services for purposes of determining compliance with
HIPAA. Covered Entity shall have the right to access and examine ("Audit") the books, records, and
other information of Business Associate related to this Addendum. Such Audit rights shall be in
addition to and notwithstanding any audit provisions set forth in the Agreement. Business Associate
shall cooperate fully with any such Audit(s) and shall provide all books, records, data, and other
documentation reasonably requested by Covered Entity. Covered Entity may make copies of such
documentation. To the extent possible, Covered Entity will provide Business Associate reasonable
16
notice of the need for an Audit and will conduct the Audit at a reasonable time and place.
Notwithstanding the foregoing, covered Entity will not have access to any books, records, data and/or
documentation related to any of Business Associate's other clients.
10. Agents and Subcontractors. Business Associate shall require al subcontractors and agents to which it
provides PHI received from, or created or received on behalf of Covered Entity, to agree in writing to
all of the same restrictions and conditions concerning such PHI to which Business Associate is bound
in this Addendum, as amended by HITECH, to the same extent Business Associate is required to
comply.
11. Civil and Criminal Liability. Business Associate acknowledges, that it shall be liable under the civil
and criminal enforcement provisions set forth at 42 USC // 1320d-5 and 1320d-6, as amended from
time to time, for failure to comply with any Use or Disclosure requirements of this Agreement with
respect to PHI and for failure to comply with its direct obligations under the Privacy and Security
Rules and HITECH.
12. Reporting of Violations. Business Associate shall report to Covered Entity any Use or Disclosure of
PHI not authorized by this Addendum immediately upon becoming aware of it and, in no case longer
than five (5) business days following discovery. This reporting obligation includes, without limitation,
the obligation to report any Security Incident, as that term is defined in 45 C.F.R./ 164.304.
12.1. Breach Notification. Business Associate also shall immediately notify Covered Entity of any
actual or suspected Security Incident or Breach of Unsecured PHI. Such notification shall occur
without unreasonable delay and in no case later than five (5) business days after Business
Associate discovers the Breach in accordance with 45 C.F.R. / 164.410. The notification shall
comply with the Breach notification requirements set forth at 42 U.S.C. / 17832 and its
implementing regulations at 45 C.F.R. / 164.410 and shall include: (a) the identification of each
person whose Unsecured PHI has been, or is reasonably believed by Business Associate to have
been, accessed, acquired, or Disclosed during such Breach; and (b) any other available
information about the Breach, including: (i) a description of what happened, including the dates
of the Breach an discovery of the Breach, if known; (ii) a description of the types of Unsecured
PHI involved in the Breach; (iii) any steps affected persons should take to protect themselves
from potential harm resulting from the Breach; and (iv) the steps Business Associate is taking to
investigate the Breach, mitigate harm to individuals, and to protect against any further Breaches.
Business Associate shall provide Covered Entity with such additional information about the
Breach either at the time of its initial notification to Covered Entity or as promptly thereafter as
the information becomes available to Business Associate. Business Associate shall provide any
additional information reasonably requested by Covered Entity for purposes of investigating a
Breach of Unsecure PHI. A Breach shall be treated as discovered by Business Associate as of the
first day o which the Breach is known to Business Associate (including any person, other than the
Individual committing the Breach, that is an employee, officer, or other agent of business
Associate) or should reasonably have been known to Business Associate to have occurred.
Covered Entity shall have the sole right to determine, with respect to a Breach: (i) whether notice
is to be provided to Individuals, regulators, law enforcement agencies, consumer reporting
agencies, media outlets and/or the Department of Health and Human Services, or others as
required by law or regulation, in Covered Entity's discretion; and (ii) the contents of such
Services, whether any type f remediation may be offered to Individuals affected, and the nature
and extent of any such remediation. The provision of the notices to affected Individuals, and any
17
remediation which Covered Entity determines is required or reasonably necessary, shall be at
Business Associates sole cost and expense.
13. Terms and Termination.
13.1. This Addendum begins on the Effective Date and remains in effect for the entire term of the
Agreement unless otherwise terminated as provided below.
13.2. In addition to and notwithstanding the termination provisions set forth in the Agreement, both
this Addendum and the Agreement may be terminated by Covered Entity in the event that
Covered Entity determines Business Associate has violated a material term of this Addendum and
such violation has not been remedied within fifteen (15) days following written notice to
Business Associate.
13.3. Except as provided below, upon termination of this Addendum, Business Associate shall either
return or destroy all PHI. However, if Covered Entity determines that neither return nor
destruction of PHI is feasible, Business Associate may retain PHI provided that it extends the
protections of this Addendum to the PHI and limits further Uses and Disclosures to those
purposes that make the return or destruction of the PHI infeasible, for so long as Business
Associate maintains such PHI.
14. Inconsistent Terms; Interpretation. If any portion of this Addendum is inconsistent with the terms
of the Agreement, the terms of this Addendum shall prevail. Except as set forth above, the remaining
provisions of the Agreement are ratified in their entirety. Any ambiguity in this Addendum shall be
resolved to permit Covered Entity to comply with the Privacy Rule, Security Rule, other applicable
provisions of HIPAA, and HITECH and any regulations promulgated thereunder.
15. Regulatory References. A reference in this Addendum to a section in the Privacy Rule, Security
Rule, other applicable provisions of HIPAA or HITECH or any regulations promulgated thereunder
means the section as in effect or as amended.
16. Amendment. Covered Entity and Business Associate agree to take such action as is necessary to
amend this Addendum from time to time as is necessary for the parties to comply with the
requirements of the Privacy Rule, Security Rule, other applicable provisions of HIPAA, or HITECH
and any regulations promulgated thereunder. Notwithstanding the foregoing, Covered Entity may
unilaterally amend this Addendum as is necessary to comply with applicable laws and regulations and
the requirements of applicable state and federal regulatory authorities. Covered Entity will provide
written notice to Business Associate of such amendment and its effective date. Unless such laws,
regulations or regulatory authorities require otherwise, the signature of Business Associate will not be
required in order for the amendment to take effect.
17. Indemnification. Business Associate shall defend, indemnify and hold harmless Covered Entity and
its directors, officers, employees, and agents (collectively, the "Indemnities") from and against any and
all claims, losses, damages, suits, fees, judgments, costs and expenses, including reasonable attorneys'
fees, that the Indemnities may suffer or incur arising out of or in connection with Business Associate's
breach, non-performance, non-compliance, or failure to observe any term of this Addendum or any
negligence or wrongful acts or omissions (including failure to perform its obligations under the Privacy
and Security Rules and HITECH).
18. Survival. The respective rights and obligations of Business Associate under section 9, subsection 13.3
and section 17 of this Addendum shall survive the termination of this Addendum and the Agreement.
18
IU Health Standards of Service Acknowledgement
We acknowledge that we have received the IU Health Standards of Service. Our organization will comply
with its terms to the extent applicable and relevant to our business duties or responsibilities, throughout
our association with the ICJ Health. We understand the Standards of Service represents IU Health culture
and violation may result in termination of our business relationship with IU Health.
Contractor/ Business/ Organization Name: City of Richmond Fire Department by and through the
Richmond Board of Public Works and Safety
Name (Print): Vicki Robinson
Title (Print): President
OX
Signature:. W
(I� A&� Date:
Name (Print): Anthony L. Foster, II
Title (Print): Member
Signature:
Name (Print): Richard Foore
Title (Print): Mem
Date: a ! c
Signature: Date: t b
APPROVED:
By: ( ayor
avid M. now
19
Standards of Service
Respect, Commitment, Communications, Customer Waiting, Customer
Complaints, and Safety Excellence
Introduction
At IU Health, we are partners in the delivery of compassionate service and exceptional
care. We trust and depend upon one another to get the job done right for our patients
and celebrate the gifts each of us brings. Our work gives us the opportunity to learn,
develop, and contribute as whole persons — mind, body, spirit.
We "go to work" to take care of things that are important to us. These things range from
the basics like food, shelter, family and financial responsibilities to the sense of personal
achievement, contribution, and satisfaction from a "job well done".
IU Health's mission is to improve the health of our patients and community through
innovation and excellence. As a place of healing and service we can give and receive
the very special gift of human compassion. This is the "Gift of CareGiving". At IU Health
we are all caregivers no matter what our role. And as caregivers we both give and
receive the gift of human kindness and compassion.
At IU Health our intention is to be the health care provider and employer of choice. We
believe participating in the care and service of others is a privilege. It is a privilege that
requires a special commitment and it brings special responsibility. This includes having
clear and high service expectations for ourselves and for others.
In joining the IU Health team we make a commitment to ourselves and to one another
that we will work hard to see that nothing gets in the way of serving our patients. This
includes caring for ourselves, for one another, and for the resources entrusted to us to
deliver care.
These service standards are one expression of this commitment.
K1
The lU Health Mission:
Improve the health of
our patients and community through
innovation and excellence in
care, education, research
and service.
I am committed to serving my patients, families, and other customers with respect
and compassion, therefore I will ....
... demonstrate respect and appreciate the differences of others.
... show commitment by taking pride in what I do and recognizing my work as a
reflection of myself.
... value all individuals by practicing effective communication skills.
... respect the time of others by minimizing the wait and keeping my patients,
families, and other customers informed.
... view complaints as an opportunity to take action to improve the service I
provide.
As a member of the IU Health team we commit to meet and exceed these standards of
service. We will provide feedback and support to our team members as we serve one
another and our patients.
Supervisor's signature Date Employee's signature
Date
21
Respect: I will demonstrate respect and appreciate the differences of others.
1 make a good impression by:
• Wearing my nametag above my waist where it can be easily seen.
• Attempting to make eye contact when greeting a person, smiling, saying hello,
addressing him or her by name (if possible), and expressing a willingness to
help.
• Introducing myself by name and explaining in simple terms what I will be doing
and why.
• Closely listening to customers and giving my full attention.
• Anticipating information the customer will need before they ask.
• Knowing my resources, facility, and how I can help my customers. If I don't know,
I'll find out and then follow through.
• Working with my supervisor and co-workers to improve the service.
l take time to be courteous and considerate by:
• Taking the time to stop and help someone.
• Directing people, always giving simple directions, and when possible, escorting
them to their destination or an information desk.
• Showing appreciation by using the words "please" and "thank you."
• Keeping the noise level to a minimum.
• Never being rude.
i embrace diversity and inclusion by:
• Valuing and embracing the differences as well as similarities of others.
• Recognizing and appreciating the rights, opinions, and/or practices of co-
workers.
• Maintaining professional courtesy among co-workers, especially if a conflict
develops.
• Taking advantage of educational opportunities to learn more about my culture
and the many diverse cultures at IU Health.
• Contacting an interpreter when needed.
I protect privacy and confidentiality by:
• Not discussing in public areas information dealing with other departments, co-
workers, or patients.
• Maintaining an individual's privacy by knocking before entering a room and
closing a patient's bedside curtains before an examination.
• Preserving a person's dignity. Treating others, as I would like to be treated.
I maintain integrity by:
• Up holding the ethics of the organization by following the Standards of Conduct
for Business Practices as outlined by Corporate Compliance.
22
Commitment: I will show commitment to my patients, families, and other
customers by taking pride in what I do and recognize my work as a reflection of
myself.
I show ownership in the facility and work space by:
• Keeping my work area and surrounding environment clean and safe.
• Eating only in designated areas for employees, away from where patients and
their families will see.
• Paying attention to details. It is the details that separate satisfactory and
excellent.
• Being sure I know and understand the responsibilities of my job. I take charge
and accept my responsibilities.
• Following the organization and department policies regarding tardiness, breaks,
and time clocks.
1 keep up my appearance — personal and physical by:
• Practicing good personal hygiene.
• Wearing my I.D. nametag above my waist where it can be easily seen.
Adhering to the I Health Dress Code Policy and department -specific dress code
policy (where applicable).
1 demonstrate teamwork by:
• Pitching in and helping others. By helping colleagues, staff, and physicians, I
ultimately help a patient.
• Partnering with other departments to meet and exceed the needs of my
customers.
• Treating every co-worker as a professional, recognizing that we each have areas
of expertise.
• Showing consideration by being sensitive to a fellow employee's inconvenience.
Avoiding last minute requests and consider others' priorities in addition to my
own.
23
Communications at IU Health: I will value all individuals by practicing effective
communication skills.
1 use good telephone habits by:
• Answering calls within three rings.
• Asking permission before I put someone on hold and waiting for their response.
• If I have put someone on hold, I check back with him or her within one minute and offer
to take a message. I don't leave them on hold.
• Always giving the caller options, even if I can't directly answer a question. This
empowers the caller and makes him or her feel like I really care about the call.
• If I don't know the answer to a question, I offer to look into it and call the person back, or
I offer to transfer the person to someone who has the answer.
• When transferring a call, I give the caller the phone number to where I am transferring in
case they are accidentally disconnected.
• When transferring a call, I tell the person accepting the call as much as possible so the
caller doesn't have to repeat the information.
• When voicemail is an option, I ask the caller if they would like to leave a message on
voicemail.
• When I am in the office and I have a visitor, I use the forward option.
I use good voicemail habits by:
• When you record a greeting, provide your name and your department. If you wish,
include your pager number for emergencies.
• Keep your message short and to the point.
• Let callers know when you are unavailable and when you will return if you are gone for
more than one business day during the work week.
• Respond to calls within the same business day but no longer than 24 hours, even to say
that you are still working on a request.
• When leaving a message, always provide your phone number and your name.
1 use good E-mail habits by:
• Using email for professional use only.
• Writing a message that is concise and summarizes.
• Responding to a -mails within the same business day but no longer than 24 hours after
receiving the e-mail.
• Always ask myself: Is a face-to-face meeting or a phone call a better way to
communicate the message?
• Using manners:
• I say a greeting and my name.
• I say thanks.
• I use the subject line to clarify the message.
• I use spell check and proper grammar.
24
I use good pager habits by:
• Putting my pager on vibrate instead of a loud alert when possible.
• Carrying my pager and responding as necessary.
• Not paging someone if it isn't urgent.
1 use good cell phone habits by:
• Using low tones or vibrate mode so I won't disturb others (when I can)
• Not answering my cell phone in the middle of a meeting or begin a conversation on my
cell phone in the meeting.
• If I absolutely must take a call that cannot wait, excuse myself and quietly leave the
room.
• Never using cell phones in patient care areas. Cell phones can disrupt essential
equipment.
• 1 use cell phones within the hospitals as outlined in the Employee Occupational Health
Services (EONS) policy.
1 use good elevator etiquette habits by:
• Pausing briefly before I get on the elevator so that I don't block the way of someone
getting off.
• If I am escorting someone, I let the person enter and exit first.
• Letting the patients and family members get on the elevator first, even if I have to wait
for the next elevator.
• Making room for others, and holding the "open" button while people get on the elevator.
• Allowing those with disabilities to be in the front of the elevator.
• Not discussing patients, their care, or hospital business on the elevator. I preserve
patient confidentiality and the organization's integrity.
• Not discussing personal matters in the elevator or other public places.
Customer Waiting: I will respect the time of others by minimizing the wait and keeping my
patients, families, and other customers informed.
1 help patient/family waiting by,
• Providing a clean and neat atmosphere for waiting customers, I know it is every
employee's job.
• Always looking for creative ways to eliminate the need for waiting.
• Telling patients and their families an honest estimate about how long they will need to
wait — even if it is longer than they expected.
• Reconnecting with waiting customers every 15 minutes, either with new information or
thanking them for continuing to wait.
• If appropriate, offering to reschedule their appointment.
• Apologizing for their inconvenience.
• Using the Service Recovery program when relevant (see the Service Recovery Guide for
details).
25
I help internal customers by:
• Always communicating an expected time of service delivery.
• If I cannot meet my deadline, I apologize and communicate the new expected time of
service delivery.
• Working with other departments to minimize service waits.
1 help with call lights by: (if applicable)
Ensuring the nurse's station is never left unattended, so that at least one hospital
employee is available to answer call lights and telephones.
Visiting my patients at least once every hour to ensure their needs are being met.
Responding to a co-workers call lights if he/she is not able. I know that all direct patient
care providers are responsible for answering call lights promptly to meet the patient's
request, even if it's not my assigned patient.
Handling Customer Complaints: I will view complaints as an opportunity to take action to
improve the service I provide.
I will handle complaints by:
• Thanking the customer for giving us the opportunity to correct the situation.
• Dealing with a complaint in an honest and straightforward manner.
• Acknowledging a customer's complaint by listening carefully, without interrupting. I'll let
the customer voice his or her concern completely.
• Attempting eye contact, and apologizing for their inconvenience.
• Not arguing with the customer or becoming defensive.
• Making sure I understand the problem, restating what the customer says and asking if
my statement is accurate.
• Identifying the problem and determining whether I can help. If I can help, I will. If I
cannot, I'll check with my supervisor for assistance in finding someone who can help.
• I'll use the Service Recovery program in the clinical settings if appropriate. (See the
Service Recovery Guide for details.)
26
Safety Excellence: I will practice safety in every situation and at all times.
1 will practice safety by:
• Being responsible for maintaining a safe work environment, whether it is by following
Environment of Care (EOC) policies and procedures, infection control standards or using
equipment safely. I won't take unnecessary chances.
• Reporting incidents immediately when they do occur.
• If I am hurt on the job, I'll follow Employee Occupational Health Services (EOHS),
Infection Control, and Human Resources policies for reporting and treatment. (Call
Methodist EOHS at 962-8494 or IU EOHS at 274-8214.)
• Referring to the Employee Handbook for specific safety policies or referring to the
policies located in the EOHS Policy and Procedure Manual. [[Call the IU Health Safety
and Security Department [Methodist, 962-8000; Wile Hall, 962-3501 (non -emergencies);
IU/Riley campus, 274-7270; IU Hospital, non -emergencies, 274-0400]].
• Reporting a condition or hazard that poses a definite danger to the life or health of
people in our facilities or risk of major damage to IU Health Buildings and/or property to
the IU Health Safety and Security Department.
• If I have been trained to respond to a hazard (such as a chemical spill), I'll follow the
proper IU Health procedure for cleanup, under the appropriate level of supervision. I'll be
efficient and calm in my work.
27