Xandar Kardian - Facility Deployment Checklist

We are thrilled to help support your continued commitment to innovation in long term care and that you have chosen Xandar Kardian's radar based patient monitoring solution for your facility. To simplify the process for your team to organize the installation, you can use this link to enter and update key facility information. You can find a presentation with background on the technology and installation here. You can save responses at any time by hitting the save responses button at the bottom of the page. Please don't hesitate to contact Linda Mayhue (linda@xkcorp.com) if you have any questions!

Question Title

* 1. Facility Details (where sensors will be installed)

Key Contact (Facility Administrator)

Facility Name

Email Address

Phone Number

Question Title

* 2. Operator/ Group Name

Question Title

* 3. Total Number of Beds to be monitored

Question Title

* 4. Please provide a breakdown of the facility layout for rooms where the sensors will be installed

Number of single occupancy (Private) rooms

Number of double occupancy (2 bedded) rooms

Number of three bedded rooms

Number of four bedded rooms

Question Title

* 5. Please upload a floorplan for your facility that is as detailed as possible.

Question Title

* 6. If you can, please upload photos of typical single, double, triple, and 4 bed rooms.

Question Title

* 7. Current Electronic Medical Record Provider

Question Title

* 8. Integration with PCC is preferred prior to go-live. Please confirm if this has already been completed or requested

Integration will be completed prior to go live (Link to PCC Authorization Instructions)

Integration has already been completed or requested

Standalone Installation (no integration)

Name of contact person for EMR access (for RPM Provider & XK Clinical Support).

Question Title

* 9. Will the facility staff require access to the Xandar Kardian Resident Health dashboard?

Yes

Name and contact information for Director of Nursing or Clinical Champion

Question Title

* 10. Preferred Sensor Color

White

Black

Question Title

* 11. Please select preferred installation type

Secure with no construction required. Stand secured to floor using double sided tape to prevent accidental movement

#1 Floor Stand (no construction)

Sensor on wall near bed. Data cable is dropped vertically to reach gateway near floor.

#2 Wall Mount (Cord Behind Wall)

Sensor on wall near bed. Cords are mounted on surface of wall and secured by clips or channel cover.

#3 Wall Mount (Cord on Surface)

Discrete or invisible installation. Virtual Site visit required; additional cost may apply

#4 Custom: Ceiling (added cost)

Question Title

* 12. Would you Like to Have a Shelf Installed

Sensor is mounted directly to wall (with 2 screws)

No Shelf

Small Shelf

Floating shelf system on wall above bed. Additional costs may apply.

Decorative Shelf

Question Title

* 13. Preferred installation start date (average installs are two or three days per facility)

First Choice of Start Date

Date

Second Option for Start Date

Date

Third Option for Start Date

Date

Question Title

* 14. The Xandar Kardian gateway receives power from a standard electrical outlet. Please confirm that there will be a sufficient number of outlets available in each resident room as follows: 1 outlet available in each private and semi-private room, or 2 outlets available for each 3 and 4 bed rooms.

Yes, there are a sufficient number of outlets available

No, there may not be sufficient number of outlets available (further discussion required)

Additional Comments and contact Information for Facility/Maintenance Lead

Question Title

* 15. Xandar Kardian sensors require WiFi connectivity. Please select your preferred Wifi connectivity option

Facility creates a dedicated SSID and password that is provided by Xandar Kardian

Xandar Kardian will use an existing SSID that has been dedicated to medical devices (please provide exact SSID and password in next question)

I have concerns about the WiFi network in my facility. Please provide me with options regarding cellular connectivity instead

Name and Contact Information for Indvidual Responsible for Wifi at the facility.

Question Title

* 16. Please upload a screenshot of the network name from your computer or phone. See example

Question Title

* 17. What is the existing password for the wifi network listed above?

Exact Password

Question Title

* 18. Facility Details (where sensors will be installed)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Question Title

* 19. Please provide any additional pertinent information required to support or facilitate installation in your facility

Page1 / 1

100% of survey complete.