| Does the facility want the anesthesia group to have an Exclusive Contract? |
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| How many, "First Case of the Day Starts," are expected? |
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| Type of Anesthesia Providers desired |
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| If Medically Directed CRNAs, what level of Medical Direction is desired? MD: CRNA ratio |
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| Does the facility have Certified Nurse-Midwives (CNM) or Certified Professional Midwives (CPM)? |
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| Is an anesthesia provider needed at all times to be available for OB coverage? |
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Level of anesthesia call required?
(Check all that apply) |
| Beeper call from home | | 30 minute response time (Time called to arrival) |
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| If beeper call from home, what are the average number of hours in the facility? |
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| If 2nd call, what are are the average number of hours in the facility? |
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| Annual Number of surgical cases? |
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| Annual Number of OB deliveries (Vaginal & C-section)? |
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| Annual Number of Labor Epidurals? |
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| In the future, does the facility want more Natural Childbirths or Labor Epidurals? |
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| Do the nurse anesthetists place Labor Epidurals? |
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| Number of labor epidurals going to C-section |
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| Annual Number of C-sections? |
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| Who provides anesthesia for C-sections? |
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| Number of Operating rooms open after 3 PM? |
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| Number of Operating rooms going to 5 PM? |
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| Number of Operating rooms going to 7 PM? |
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| Annual Number of GI cases requiring anesthesia providers |
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| Percentage payors that are Medicare? |
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| Percentage of payors that are Medicaid? |
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| Percentage of payors that are billed as full charges ( Commercial/indemnity)? |
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| Percentage of payors that are Self Pay? |
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| Percentage of payors that are Tri-care? |
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| Percentage of payors that are Managed Care? |
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| Percentage of payors that are Worker's compensation? |
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| Percentage of payors that are Flat Fee (Cosmetics, GI)? |
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| Will the facility pay Anesthesia Group a Stipend? |
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| If a Stipend is paid, how much per year? |
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| Is the Stipend a: |
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| What is the current Stipend amount? |
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| What is the term of the Stipend? |
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| Is the Stipend renewable and transferable? |
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| Is the Stipend structured as a loan that has a "forgiveness” period? |
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| If Stipend loan has a forgiveness period, how long is the forgiveness period? |
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| Will Malpractice (professional liability ) insurance be provided to the new group by the hospital? |
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| If yes, then is the Malpractice Insurance Occurrence or Claims Made? |
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| What is the earliest implementation date? |
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| What is the latest implementation date? |
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| Is there an existing anesthesia department? |
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| The existing anesthesia department consists of: |
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| Does the facility have: Anesthesiologists, Nurse anesthetists, anesthesiologist assistants? |
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| Does the facility want to keep its existing anesthesia providers? |
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| Is Board Certification required of the anesthesiologists? |
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| Does the facility want the Nurse Anesthetists to be Medically Directed? |
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| Does the hospital want to employ the Nurse anesthetists? |
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| Does the hospital want to employ the anesthesiologists? |
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| Does the facility require mirror exclusivity? |
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| What is the term of the contract? |
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| What is the "Without cause" termination term? |
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| What is the "With Cause" termination term? |
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| Are there triggers for immediate termination? If yes, specify: |
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| Will the facility provide all anesthesia equipment (Anesthesia Machines, Laryngoscopes, etc)? |
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| Will the facility provide all anesthesia supplies (Anesthesia circuits, endotracheal tubes, etc.)? |
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| Will the facility provide all anesthesia drugs (Propofol, Fentanyl, etc)? |
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| Will the facility provide anesthesia technicians? If so, how many? |
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| What other services does the facility want the Anesthesia group to perform? (Check all that apply) |
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Does the faculty want or require a chronic pain service?
If so, would the service be hospital based, independent, an ASC, or no preference. |
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| Does the faculty want or require an acute pain service? |
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| How many out-of-OR (OOOR) sites require anesthesia coverage? |
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| What are the peak number of simultaneous locations expecting coverage? |
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| Does the facility want to do the billing for Anesthesia Services? |
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| Does the facility want temporary anesthesia coverage (Locum Tenens) for the time being? |
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High Priority Posting - Request for Proposal Job - (Facility: Hospital)
