Table of Contents
Vendor Access Policy ................................................................................................................................... 3
Vendor Code Of Conduct .............................................................................................................................. 7
Vendor Access Guidelines ............................................................................................................................ 8
Vendor Identification Badges ...................................................................................................................... 12
Vendor Identification Badge Requirements ................................................................................................ 13
Vendor Procedure for Restricted Patient Care Areas ................................................................................. 14
Obtaining a Vendor Badge .......................................................................................................................... 16
Vendor Representative Sign-In/Sign-Out Procedure .................................................................................. 17
Vendor Profile Record ................................................................................................................................. 18
General Confidentiality Statement .............................................................................................................. 19
Vendor Gift Disclosure Form ....................................................................................................................... 20
Vendor Access Programs FAQs ................................................................................................................. 21
MedStar Health Hospitals ........................................................................................................................... 22
Effective Date of this Version: 9/1/14
Page 2 of 22
Vendor Access Policy
Purpose
To state MedStar Health’s specific rules for access and activities of all vendor representatives at MedStar
Health patient care facilities.
Policy
All vendor representatives doing business at a MedStar Health patient care facility will comply with the
established access requirements and policies associated with providing products, services or equipment.
Any product, service or equipment brought into a MedStar Health facility not meeting these requirements
will be considered a donation to MedStar Health for which there will be no remuneration. Badges are not
transferable and can be used only by the representative to whom they are issued.
Scope
This policy applies to any vendor representative providing educational support, service, products,
intraoperative blood salvage and/or equipment to any MedStar Health patient care facility. This policy
does not apply to temporary clinical or physician staff, volunteers, construction workers.
Definitions
1.
Vendor Representatives:
Vendor representatives are personnel employed by any company from whom MedStar Health
purchases or will purchase services, products and/or equipment.
2.
Vendor Access Program Administrator:
MedStar Health employee responsible for overall management of vendor access program.
3.
Vendor Photo Identification Badge:
Photo identification badges will be issued by MedStar Health Corporate Materials Management
Department to representatives having repeat business at MedStar Health facilities. Requirements
for these badges are listed in the Vendor Access Program packet.
4.
24-Hour Vendor Identification Badge:
24-hour badges will be issued at individual MedStar Health facilities for representatives needing
access to a MedStar Health facility two or fewer times annually. Authorization by a MedStar
Health department manager is required to enter patient care areas with a 24-hour badge.
5.
Vendor Access Program Packet
MedStar Health will provide online access to the requirements, forms, procedures and policies
related to the vendor access program.
Responsibilities
1. Vendor Program Administrator
1.1. Manage corporate vendor database or Business Outsourcing Partner
1.2. Provide Vendor Access Program Packets to any new vendor representative.
1.3. Communicate infractions of vendor policy to representative and their employer.
1.4. Communicate any infraction involving a breach of patient confidentiality to the Corporate
Privacy Officer.
Effective Date of this Version: 9/1/14
Page 3 of 22
2. Department Directors at MedStar Health Facility
2.1. Communicate as needed with representatives and the program administrator.
2.2. Coordinate and manage meetings with vendors.
2.3. In conjunction with the Product Standardization and Pharmacy and Therapeutics Committees
manage and facilitate product or equipment trials.
2.4. Provide information regarding infractions by vendor representative(s) to Program
Administrator for appropriate documentation and action.
2.5. Communicate any infraction involving a breach of patient confidentiality to the Corporate
Privacy Officer.
3. Hospital Departments-All Hospital Employees
3.1. MedStar Health employees should meet with vendor representative only if they have a
scheduled appointment.
3.2. All MedStar Health employees are responsible for identifying noncompliant vendor behavior
and reporting this to their manager.
4. Vendor Representatives
4.1. Complete all requirements as listed in the Vendor Access Information Packet. No vendor
representative badges will be issued until documentation has been completed. The Packet
includes:
4.1.1.
Vendor Access Policy
4.1.2.
Vendor Code of Conduct
4.1.3.
Vendor Access Guidelines
4.1.4.
Vendor Procedure for Restricted Patient Care Areas
4.1.5.
Vendor Badging Procedure
4.1.6
Vendor Sign-in/Sign-out Procedure
4.1.7
Vendor Profile Record
4.1.8
Confidentiality Statement
4.1.9.
Vendor Gift Disclosure Form
4.2. Display vendor representative identification badge at all times while in any MedStar Health
facility.
4.3. Comply with all MedStar Health policies regarding patient safety, confidentiality, infection
control and risk management.
Exceptions
This policy does not apply to physician offices. Application to outpatient settings will be made by local
administrators. Other exceptions may be made by authorized MedStar Health employees in emergent
situations.
What Constitutes Noncompliance
Noncompliance includes but is not limited to violation of any of the requirements cited in the MedStar
Health Vendor Access Information Packet:



Vendor Code of Conduct
Vendor Access Guidelines
Vendor Badge Procedure
Effective Date of this Version: 9/1/14
Page 4 of 22



Vendor Sign-in/Sign-Out Procedure
Confidentiality Statement
Vendor Gift Disclosure Form
Any violation of federal, state or other regulatory laws may lead to the termination of the contract or
business relationship. MedStar Health may report these violations to the appropriate agency, which could
lead to consequences under the appropriate law.
Explanations and Details/Examples
Badges are valid for as long as services are authorized and requirements are met. The representative
must submit documentation of compliance or surrender their badge to MedStar Health Corporate
Materials Management. If an event occurs that is in violation of the badge requirements, it is the
responsibility of the representative’s employer to notify Corporate Materials Management in writing. The
badge must be surrendered. The company is required to surrender the badge on the transfer or
termination of a representative.
1. Vendor Identification Badge
Photo identification badge will be issued by the MedStar Health Corporate Materials Management
Department to representatives having business at MedStar Health patient care facilities. The badge color
will denote the level of access allowed to the representative. The badge contains: the company name,
vendor representative’s name, vendor representative identification number and picture. Badge colors
reflect the following access levels:
1.1. Green Vendor Badge – Level I:
Allows access to non-patient care areas only, i.e. Lab area, offices, etc
1.2. Blue Vendor Badge – Level II:
Allows access to limited patient care areas, i.e. patient care units, Pharmacy
1.3. Red Vendor Badge – Level III:
Allows access to restricted patient care areas, i.e. Inpatient and Outpatient Perioperative units,
Imaging Departments, Emergency Department, etc.
All access is limited to an appointment confirmed by an authorized MedStar Health
Representative.
2. 24-Hour Vendor Identification Badge
Badge issued at individual MedStar Health patient care facilities for representatives who occasionally
need access to a MedStar Health facility.
If a Representative needs access more than two times annually, they need to meet all of the
requirements for a Vendor Representative Identification Badge.
24-hour badges can be obtained from the facility’s security department or desk.
Requirements and Guidelines for Implementing the Policy
Corporate Materials Management and Hospital Department Directors will be responsible for managing
and enforcing the Vendor Representative Access Policy.
Guidelines for Vendor Representatives
No product, service, equipment, drug or information will be introduced to a MedStar Health facility until it
has met all of the approval criteria from MedStar Health or other applicable government agencies.
No drug samples will be distributed in any MedStar Health facility without the approval of that facility's
Director of Pharmacy.
Effective Date of this Version: 9/1/14
Page 5 of 22
Representatives will abide by all HIPAA regulations and restrictions regarding patient confidentiality.
In case of a lost badge, Corporate Materials Management must be notified by the representative within 24
hours. During non-business hours, hospital security may be notified.
Reference to Laws or Regulations of Outside Bodies
HIPAA
Right to Change or Terminate Policy
Proposed changes to this policy will be discussed with all affected parties at both MedStar Health entities
and corporate levels of the organization.
The corporation’s policies are the purview of the Chief Executive Officer (CEO) and the CEO’s
management team.
The CEO has the final sign-off authority on all corporate policies.
Effective Date of this Version: 9/1/14
Page 6 of 22
Vendor Code Of Conduct
MedStar Health requires all vendors to adhere to the MedStar Health Code of Conduct (see attachment)
and related policies and procedures.
MedStar Health strives to exercise the highest standards of conduct in working with vendors. We expect
that our vendors will also use these same high standards when conducting business with MedStar Health.









Vendors will keep patient and business information confidential.
No vendor will seek the attention or time of MedStar personnel without an appointment.
Vendors will not request anyone other than a designated member of Materials Management,
Perioperative Services, Facilities or Pharmacy Departments to sign any type of purchasing
agreement or contract. Agreements or contracts signed by a non-authorized MedStar agent will
be considered non-binding. No agreement will be deemed valid until all MedStar Health contract
conditions are met.
All contract negotiations and interactions between MedStar Health and vendors/suppliers shall be
conducted in a manner that avoids the violation of any law or regulation and the appearance of
impropriety.
Vendors will observe the general hours of operation of each facility. Access shall be limited to
9:00 AM to 5:00 PM unless other arrangements have been made through Materials Management,
Perioperative Services, Pharmacy or other involved department.
Vendors will not demonstrate any supplies, equipment or pharmaceuticals to staff on site without
approval by that department manager.
On each visit, vendors will be required to register upon arrival and sign out upon departure at a
designated site(s) in each facility. (See Vendor Representative Sign-in/Sign-out Procedure in
Vendor Information Packet.) During the visit, representatives will be required to display the
appropriate MedStar Health-issued photo ID or 24-hour badge.
Gifts or inducements of any kind are subject to the limitations of the MedStar Health Code of
Conduct. Any violation could negatively impact future business. Violation of federal or state laws
or other regulator agencies may result in MedStar Health reporting these violations to the
appropriate agency.
Vendors not compliant with MedStar Health Corporate and Hospital policies, procedures,
including, Department Dress Code, Fire and Safety, etc. and Code of Business Conduct will lose
their opportunity to access MedStar Health facilities.
Signature
Date
Print Name
Effective Date of this Version: 9/1/14
Page 7 of 22
Vendor Access Guidelines
MedStar Health views vendor representatives as partners in support of our mission to provide the highest
quality patient care in the safest environment. Our staff recognizes vendor representatives as a key
resource in supporting high quality, cost-effective solutions and technologies.
Supply Chain Strategy
In support of the MedStar Health’s “patient first” core philosophy, the supply chain strategy is to create an
effective supply chain operating model that will produce sustainable cost reductions, support high
customer service standards, consolidate the supply chain infrastructure and standardize business
practices. Vendors are expected to be in compliance with all applicable laws and regulations.
Materials Management Goals of Service
1. Provide optimum support to our caregivers by providing them with timely accessibility of
appropriate, clean, safe, user-friendly products, equipment, and services.
2. Have a clear understanding of and maximum influence over all elements of supply chain cost.
3. Maximize understanding of and support for current and emerging technology.
4. Work with trading partners to enhance each other’s quality of service and cost profile.
Participation in the Vendor Program
MedStar Health will institute specific vendor requirements to participate in MedStar Health’s Vendor
Representative Program. Areas of access levels are:
Level I Access – Green Badge

All non-patient care areas, i.e., Laboratory, offices, etc.
Level II Access – Blue Badge

Inpatient and Outpatient Nursing units
Level III Access – Red Badge






Inpatient and Outpatient Perioperative areas
Labor and Delivery departments
GI Endoscopy areas
Cardiac Catheterization and EP labs
All Imaging areas to include Interventional, Diagnostic and Nuclear Medicine
Emergency departments
No vendor may access a patient care facility without making prior arrangements per MedStar Health’s
Vendor Access Policy.
Visitation Rules
Authorized MedStar Health employees in emergent situations may grant exceptions.
Visitation to a MedStar Health facility is by invitation only and will require a scheduled appointment. Under
no circumstances will a vendor representative be permitted to visit MedStar Health staff without a
scheduled appointment.
All vendor representatives are required to register at the Security Department or desk prior to conducting
business at MedStar Health. All vendor representatives are required to check out of the site on
completion of business. See Sign-in/Sign-out Procedure.
After checking in, vendor representatives are authorized to visit only the areas designated by their badge
for their scheduled appointment. Vendor representatives may be present in common areas of the
Effective Date of this Version: 9/1/14
Page 8 of 22
facilities; however, initiating unsolicited contact with clinicians or other employees is prohibited. At the
completion of the scheduled appointment, vendor representatives are expected to leave the facility.
Vendor Identification Badges are not transferable. At no time may a representative allow the use of
his/her badge by another individual. To do so will result in the loss of access to any MedStar Health
facility.
Vendor representatives are prohibited from access to confidential patient or product information unless it
has been authorized as part of the information needed to complete their project. Only vendor
representatives with appropriate clearance (Red or Blue Badge) may visit patient care areas and only
when an appointment has been scheduled.
Vendor representatives are required to wear a MedStar Health-issued Vendor Identification Badge at all
times while in a MedStar Health facility.
Vendor Identification Badges do not grant permission to provide direct patient care or indicate that
MedStar Health or its facilities have approved the representative to provide such care. Only individuals
who have met all applicable MedStar Health/facility requirements regarding credentialing, clinical
privileges and/or other qualifications are permitted to provide direct patient care. Vendor representatives
who are present while patient care is being rendered must always follow the direction, when given, of the
attending physician or other MedStar Health/facility clinician involved in the procedure.
Vendor representatives are prohibited from displaying company information or advertisements without
prior permission from the appropriate facility leadership, i.e., the Director of Materials Management or
Pharmacy.
Vendor representatives are not permitted to park in areas designated for patients. Representatives must
park in designated visitor parking areas and pay the appropriate parking fees. Some facilities may have
additional parking restrictions, which the representative should observe. Vehicles parked in unauthorized
areas will be towed at the driver’s expense.
Product Standardization/Utilization
Vendor representatives may only deliver or install products, equipment or services that have been preapproved for use by MedStar Health authorized personnel as determined by the facility. Vendors will not
encourage clinicians or hospital staff to bring in any product outside of the established MedStar Health
product process. All purchases of products and services must be approved by appropriate department
head, i.e., Materials Management, Pharmacy, Laboratory Department, and supported by a valid purchase
order.
Products and equipment for all trials or evaluations will be provided to MedStar Health at no charge and
supported with a “no charge” purchase order. If a patient charge is generated, a Purchase Order will be
required.
Products, equipment, or services provided without prior approval or a valid purchase order will be
considered a donation to MedStar Health or may be returned at the supplier’s expense.
Equipment
All equipment coming into a MedStar Health patient care facility for demonstration, evaluation,
clinical/workplace application or purchase must be inspected before delivery to a unit. Equipment
categories and inspection departments are:



Patient care equipment inspected by Clinical Engineering
Non-patient care equipment inspected by Facilities Management
Computer equipment inspected by Information Services
Any questions concerning equipment should be directed to the involved department manager.
Prior to removal, any equipment that might contain patient information, e.g., computers, fax machines,
must have the approval of Information Services.
Effective Date of this Version: 9/1/14
Page 9 of 22
Business Standards
Gifts or gratuities of any kind are subject to the MedStar Health Code of Conduct and any violation of this
could negatively impact future business, as well as, be subject to fines or imprisonment if in violation of
federal, state or other laws. Vendors will promptly and accurately complete and return any annual (or
other) disclosure form regarding compliance with these standards requested by MedStar Health or its
facilities/hospitals.
Compliance
MedStar Health is committed to full compliance with all federal, state and local laws, and ordinances. It is
MedStar Health’s expectation that their vendors will also be in compliance with all federal, state and local
laws, and ordinances.
Environmental Commitment
MedStar Health strives to maintain an environment that is free from health and safety hazards. Vendor
representatives are required to follow all of MedStar’s health and safety policies.
Vendors providing hazardous material to MedStar Health must provide Material Safety Data Sheets
(MSDS) at the time of the materials delivery and must provide for appropriate hazardous waste disposal.
Equal Opportunity
MedStar Health is committed to maintaining an efficient and productive work environment that is free from
discrimination and harassment. Vendor representatives doing business with MedStar Health are required
to conduct themselves in a manner that upholds this commitment.
Effective Date of this Version: 9/1/14
Page 10 of 22
Invoices
All purchase order-related invoices and statements should be mailed to the following billing address:
MedStar Health/Accounts Payable
MedStar Franklin Square Medical Center – PO Box 44200
MedStar Good Samaritan Hospital – PO Box 44260
MedStar Georgetown University Hospital – PO Box 44500
MedStar Harbor Hospital – PO Box 44550
MedStar Union Memorial Hospital – PO Box 44560
MedStar Washington Hospital Center – PO Box 43910
MedStar Health Corporate – PO Box 44250
MedStar Diversified Business – PO Box 44310
Baltimore, MD 21236
 Choose appropriate PO Box
Erin, Mike, Tony: Will vendors know
what “Diversified” means? Should we
list the business names there?
MedStar Health/Accounts Payable
MedStar National Rehabilitation Hospital
102 Irving St. NW
Washington, DC 20010
To be processed, all invoices must contain:







Company name
Company division and Tax ID number
Item description
Item order number
Cost/each
Extended Cost
MedStar Health-assigned PO
Inquiries or questions regarding invoices should be directed to the Accounts Payable Department at
410-933-2501 or faxed to 410-993-2357
Questions
Direct all questions relating to procurement policy, purchase order management, or the vendor access
policy to MedStar Health Corporate Materials Management at 410-933-8044.
Effective Date of this Version: 9/1/14
Page 11 of 22
Vendor Identification Badges
MedStar Health-issued identification badges are to be worn by vendor representatives at all times while in
MedStar Health patient care facilities.
Vendor Identification Badges will consist of two categories:
Vendor Photo Identification Badge
The Corporate Materials Management Department will issue a Photo Identification Badge to vendor
representatives who have met the necessary requirements. Vendor badges will display the company
name, vendor representative’s name, vendor representative’s picture, and vendor representative’s
identification number. These badges are required to access any MedStar Health patient care facility.
24-Hour Vendor Identification Badge
24-Hour Vendor Badges will be available in Security within each MedStar Health acute care facility.
Vendor representatives needing a 24-hour badge will be required to log in prior to receiving a badge and
log out at the close of business. The 24-Hour Vendor Badge will serve as a pass for the time period of the
scheduled appointment or work requirement, not to exceed 24 hours. If a representative requests a 24hour badge more than two times annually, they will be required to fulfill all the requirements for a Vendor
Identification Badge. Authorization by a MedStar Health manager is required to access patient care areas
with a 24-hour badge.
Confidentiality Statement must be completed at time of sign-in at facility security desk.
Badge Display
Vendor Identification Badges must be prominently displayed by the representative, with the photo visible
and above the waist, and will be worn at all times while in a patient care facility.
Lost Badges
Lost badges must be reported to the Corporate Materials Management Office within 24 hours. If this
occurs outside of normal business hours, hospital security may be notified. Corporate Materials
Management will replace lost badges for a fee of $75.00 per badge.
Effective Date of this Version: 9/1/14
Page 12 of 22
Vendor Identification Badge Requirements
The following requirements must be completed with appropriate documentation on file in the Corporate
Materials Management Department prior to the issuance of a vendor representative identification badge
for access to MedStar Health patient care facilities.
GREEN VENDOR BADGE
BLUE VENDOR BADGE
RED VENDOR BADGE
Level I Access
Level II Access
Level III Access
Non Patient Care Areas
Patient Care Areas
Restricted Patient Care Areas
Read and sign MedStar Health’s
Vendor Code of Conduct
Read and sign MedStar Health’s
Vendor Code of Conduct
Read and sign MedStar Health’s
Vendor Code of Conduct
Provide documentation of
substance abuse testing
Provide documentation of
substance abuse testing
Provide documentation of
substance abuse testing
Completed Vendor Profile
Record
Completed Vendor Profile
Record
Completed Vendor Profile
Record
Provide documentation of
criminal background check
Provide documentation of
criminal background check
Provide documentation of
criminal background check
Provide documentation of nonexclusion from participating in
federal programs
(OIG,GSA,SDN sanction list)
Provide documentation of nonexclusion from participating in
federal programs (OIG,GSA,
SDN sanction list)
Provide documentation of nonexclusion from participating in
federal programs
(OIG,GSA,SDN sanction list)
Provide documentation of TB
test results – To be completed
annually
Provide documentation of TB
test results – To be completed
annually
Provide documentation of
measles/rubella immunization
Provide documentation of
measles/rubella immunization
Provide documentation of
chicken pox immunization
Provide documentation of
chicken pox immunization
Provide documentation of
aseptic technique education
Provide documentation of
education/certification on service
or equipment being provided
Provide documentation of
education/certification on service
or equipment being provided
Provide documentation of
education/certification on service
or equipment being provided
Confidentiality Statement
Confidentiality Statement
Confidentiality Statement
Gift Disclosure Statement
Gift Disclosure Statement
Gift Disclosure Statement
Provide Documentation of Flu
confirmation – To be completed
annually
Provide Documentation of Flu
confirmation – To be completed
annually
Provide Documentation of Flu
confirmation – To be completed
annually
Effective Date of this Version: 9/1/14
Page 13 of 22
Vendor Procedure for Restricted Patient Care Areas
Purpose
To state MedStar Health’s specific rules for access and activities of all vendor representatives at MedStar
Health patient care facilities related to restricted clinical areas defined as:




Perioperative areas
GI Endoscopy areas
Labor and Delivery, Nursery
All Imaging areas to include Cath and EP labs and Nuclear Medicine
Policy
All vendor representatives doing business at a MedStar Health patient care facility will comply with the
established credentialing requirements and policies associated with product trials and procurement.
Procedure
Upon arrival, all vendor representatives must meet requirements set forth in the Vendor Access Policy.
Vendor Representatives in Restricted Patient Care Area
The presence of vendor representatives as technical advisors in any clinical area must be requested by
the physician, specialty coordinator or manager, and approved by the designated clinical representative.
Patient authorization may be required for a vendor representative to be present.
A Vendor Identification Badge does not grant permission to provide direct patient care or indicate that
MedStar Health or its facilities have approved the representative to provide such care. Only individuals
who have met all applicable MedStar Health/facility requirements regarding credentialing, clinical
privileges and/or other qualifications are permitted to provide direct patient care. Vendor representatives
who are present while patient care is being rendered must always follow the direction, when given, of the
attending physician or other MedStar Health/facility clinician involved in the procedure.
Vendor representatives are limited to the specific case(s) they have been requested to attend and are not
to enter into any other procedure rooms where cases are being preformed. All other MedStar Health
policies concerning the presence of vendors must be followed. If standing approval is needed, a written
request from the surgeon, or chief of the clinical service, stating the reason for “standing approval” must
be submitted to the facility of that clinical area. Once approved by the director, an annual re-approval will
occur.
Vendor representatives are not permitted to approach other clinicians to sell or, in any other way, detail
their products unless specifically requested to do so by the clinician. Vendors will not encourage clinicians
or hospital staff to bring in any product outside of the established MedStar Health process.
Vendor representatives must use the appropriate billing form to document product or implant use and
charges. The form should include patient name and number, item description, item number, quantity
used, and cost per item and total cost. This form must be completed at the time of the procedure and
given to the appropriate materials representative or charge nurse. If this does not occur, the product will
not be invoiced and will be considered a donation to MedStar Health. The patient will not be charged for
the product.
Loaner Instrument and/or Instrument Sets
For electively scheduled surgical cases, loaner instruments and or non-stocked implants must be
received into the hospital BY 13:30 ON THE DAY PRIOR TO THE SCHEDULED OPERATIVE
PROCEDURE WITH A COUNT/INVENTORY SHEET AND PRICING. If instruments are not received by
this time, the case may be changed or cancelled by unit management.
Effective Date of this Version: 9/1/14
Page 14 of 22
Instruments must be brought to the hospital clean and free of debris.
Representative should pick up loaner instrument sets within 24 hours after the surgical procedure unless
special arrangements have been made. The hospital is not responsible for instrumentation left more than
24 hours from the completion of the case.
New Products
Any product, service or equipment brought into a MedStar Health facility not in compliance with the
MedStar Health Product Review Process will be considered a donation to MedStar Health for which there
will be no remuneration.
The only exception is in an emergent situation with the authorization of a MedStar Health manager.
Effective Date of this Version: 9/1/14
Page 15 of 22
Obtaining a Vendor Badge
Vendor Identification Badge
Email all information to medstar@cardquest.com
Card Quest may be reached by phone at 813-288-0004.
When all requirements are complete, the representative will be notified of where and when to pick up their
badge via email. A photo ID will be required for badge pick-up.
24-Hour Vendor Badges
24-Hour Vendor Badges may be obtained from the Security Department or desk at the individual patient
care facilities.
Vendor Identification Badge
Vendor representatives may obtain Vendor Access Program information by visiting:
MedStarHealth.org/VendorAccess
Effective Date of this Version: 9/1/14
Page 16 of 22
Vendor Representative Sign-In/Sign-Out Procedure
All vendors entering MedStar Health facilities will be required to sign in and sign out when entering and
exiting the facility. The grid below outlines the appropriate sign-in and sign-out location at the respective
facilities.
VENDOR PHOTO IDENTIFICATION BADGE – ALL LEVELS
24-HOUR VENDOR IDENTIFICATION BADGE
Hospital/Entity
9 a.m. – 5 p.m.
Other Hours
MedStar Franklin Square
Medical Center
Employee/HR Entrance
Employee/HR Entrance
MedStar Good Samaritan
Hospital
Hospital Main Entrance
ER Entrance after 9:00 p.m.
MedStar Georgetown University
Hospital
Gorman Bldg – Lower Level
Gorman Bldg – Lower Level
MedStar Harbor Hospital
Main Entrance,ER and Gruehn
Bldg
ER Entrance after 9:00 p.m.
MedStar Montgomery Medical
Center
Main Entrance – Security Desk
ER Entrance after 8:00 p.m.
MedStar National Rehabilitation
Network
Main Entrance – Security Desk
Main Entrance – Security Desk
MedStar St. Mary’s Hospital
Main Entrance – Security Desk
ER Entrance after 8:00 p.m.
MedStar Southern Maryland
Hospital Center
Main Entrance – Security Desk
ER Entrance after 8:00 p.m.
MedStar Surgery Center
Main Entrance Desk
Main Entrance Desk
MedStar Union Memorial
Hospital
Any Entrance
ER Entrance after 8:00 p.m.
MedStar Washington Hospital
Center
Security Operations Center
RM G-9
Security Operations Center
RM G-9
Additional Sign-In/Sign-Out Procedures
Some MedStar Health restricted areas, i.e., Pharmacy; Perioperative areas may require additional signin/sign-out procedures. Please check with the department you are visiting to confirm any additional
requirements.
Effective Date of this Version: 9/1/14
Page 17 of 22
Vendor Profile Record
General Information
Full Name of Company
Company Phone
Company Address
City, State, Zip
Supervisor’s Name
Supervisor’s Phone
Local Representative Information
Full Name
Address
City, State, Zip
Email Address
Badge Level Requested
Phone
___ Level I
___Level II
___Level III
___Teach
___Demonstrate
___Equipment
___Instrumentation
___Prosthesis/Implants
___Services and Repairs
Product Line or Service
Indicate specific product by name
My qualifications and specific
training enable me to (select all
that apply)
My product(s) can be used in a
patient procedure:
___Products
___Drugs
___Clinical Staff
___Department Management
___Physicians
___Technicians
___With my assistance ___Without my assistance
I am qualified to teach and demonstrate this product(s) because I have had special training in its use
(to include hazards). My training includes (credentials, specific training/education and dates completed.
Please attach all certification documentation for review.
I HAVE READ, UNDERSTAND AND AGREE TO ALL THE INFORMATION IN THE VENDOR ACCESS
INFORMATION PACKET.
Signature
Date
Print Name
Effective Date of this Version: 9/1/14
Page 18 of 22
General Confidentiality Statement
I understand and agree that as part of one or more work projects (the “Project”) performed on the
premises of, or on behalf of, any MedStar Health entity, I may, both prior to, during, and after the Project,
have access to, or come in contact with, Confidential Information.
I understand that Confidential Information includes, but is not limited to, any of the following information or
materials owned by or in the possession of any MedStar Health entity or created or received in
connection with the Project: All business, financial, strategic and operational information, personnel
information, quality improvement information, utilization management information, risk management
information, operational policies or procedures, patient data or information, medical records, promotional
and marketing programs, business plans, product specifications, manufacturing processes and
operations, information about techniques, analytical methodology, safety, testing data and results, future
market and product plans, billing and financial data, computer passwords/access rights, trade secrets,
ideas and any other information of a technical, scientific, or economic nature.
I understand that all Confidential Information obtained, received, reviewed or which I may have contact
with relating to the Project, is confidential in nature. I further understand and agree that I shall, at all
times, ensure the confidentiality of all Confidential Information I have contact with, and comply with all
applicable laws, as well as maintain patient privacy. I further agree that I shall only review or access the
materials and information necessary to fulfill my obligations in connection with the Project. I agree that my
agents, subcontractors, or other third parties may receive Confidential Information in connection with the
Project only if they agree to the same conditions and restrictions that apply to me and that I am
responsible for obtaining such assurances. I agree that in the event I receive any legal process
requesting that I reveal any Confidential Information, I shall inform an appropriate any MedStar Health
entity representative and afford any MedStar Health entity with a reasonable opportunity to review the
request and for any MedStar Health entity to seek to protect the Confidential Information.
I agree to inform appropriate representatives of any MedStar Health entity of any breach of confidentiality
for which I become aware and to reduce the effect of such breach by retrieving any inappropriately
disclosed Confidential Information and taking any other actions necessary to minimize the effect or
damages of such disclosure or use of such Confidential Information. I understand and agree that these
obligations shall remain effective before, during and after the conclusion of the Project.
Signature of Contractor
Date
Print Name
Effective Date of this Version: 9/1/14
Page 19 of 22
Vendor Gift Disclosure Form
I, _________________________________________________, an authorized representative of
______________________________________________ (company name), attest that during the time
period January 1, 20___ through December 31, 20___, Vendor provided only the gifts or other items of
value described in this form to MedStar Health, Inc. or any of its affiliates or any employees or
representatives of such entities. Please note that any item or service provided under the express terms of
a written contract between Vendor and MedStar Health or its affiliates need not be reported on this form.
None (check here): _____
The following gifts or other items of value (describe in reasonable detail, including date, to whom the
gift/item of value was provided and approximate value):
____________________________________________________________________________________
____________________________________________________________________________________
The signature below represents our attestation that no gifts or other items of value other than those
described above were provided during this reporting period.
Signature and Title
Effective Date of this Version: 9/1/14
Date
Page 20 of 22
Vendor Access Programs FAQs
SEND NO ORGINAL DOCUMENTS—NO DOCUMENTS WILL BE RETURNED
1. How do I provide documentation of substance abuse testing?
If you have had testing done in the past, as part of your company’s hiring practice, have your HR
department or a senior employee in your company, document this on company letterhead. If you have
never been tested, you can request your physician to write an order for it to be done. We request that the
standard 1 0-panel test be performed by a NIDA/SAMSI certified lab. Once your physician receives
theresults, he/she can document the testing on either MD letterhead or a prescription slip.
DO NOT SEND ACTUAL TEST RESULTS
2. How do I provide documentation of Measles/Rubella and Chicken Pox
immunizations?
You can have your physician document, on letterhead or a prescription slip, that you had the
immunizations and/or the diseases as a child, OR your physician may require you to have blood tests
(titers) done to validate immunity. In either case, your physician can document this for you.
3. How do I document having had a criminal background check?
Check with your HR dept. or with a senior employee in your company. If it was done as part of the
company hiring practice, they can document it on company letterhead. There is no time limit/restriction
associated with this requirement. If you need to have a background check done, we request that the
standard 7-year federal/state/county criminal check, OFAC, GSA/OIG/SND and Social Security Number
checked done.
DO NOT SEND THE ACTUAL CRIMINAL BACKGROUND INFORMATION
4. How do I provide documentation of non-exclusion from participating in
federal programs (OIG, GSA, SND sanction list)?
See above #3
5. How do I document education/certification on service or equipment being
provided?
Based on the service you will be providing or the equipment/product(s) you represent, you need to
validate that you have received appropriate training. On company letterhead, a senior employee or HR
can validate training and/or you can submit proof (copies) of educational classes/seminars, etc.
6. How do I document aseptic technique training?
Your company on company letterhead can document that you have had this training, or you can submit
proof (copies) of educational classes/seminars, etc.
BADGES WILL NOT BE ISSUED UNTIL ALL DOCUMENTATION IS RECEIVED.
Effective Date of this Version: 9/1/14
Page 21 of 22
MedStar Health Hospitals
Central Maryland Region
MedStar Franklin Square Medical Center
9000 Franklin Square Drive
Baltimore, MD 21237
443-777-7000
MedStarFranklin.org
MedStar Good Samaritan Hospital
5601 Loch Raven Boulevard
Baltimore, MD 21239
443-444-8000
MedStarGoodSam.org
MedStar Harbor Hospital
3001 South Hanover Street
Baltimore, MD 21225
410-350-3200
MedStarHarbor.org
MedStar Union Memorial Hospital
201 East University Parkway
Baltimore, MD 21218
410-554-2000
MedStarUnionMemorial.org
Washington, DC, Region
MedStar Georgetown University Hospital
3800 Reservoir Road, NW
Washington, DC 20007
MedStar Montgomery Medical Center
18101 Prince Philip Drive
Olney, MD 20832
202-444-2000
MedStarGeorgetown.org
301-774-8655
MedStarMontgomery.org
MedStar National Rehabilitation Network
102 Irving Street, NW
Washington, DC 20010
2020-877-1000
MedStarNRH.org
MedStar Southern Maryland Hospital Center
7503 Surratts Road (on rt 5)
Clinton, MD 20735
301-868-8000
MedStarSouthernMaryland.org
MedStar St. Mary’s Hospital
25500 Point Lookout Road
Leonardtown, MD 20650
310-475-8981
MedStarStMarys.org
MedStar Washington Hospital Center
110 Irving Street, NW
Washington, DC 20010
202-877-7000
MedStarWashington.org
To obtain your vendor access badge please click here.
https://cardquest.com/medstar-health-vendor-access-program-1.html
Effective Date of this Version: 9/1/14
Page 22 of 22