NURSING HOME - Flandreau
Added: Aug 12, 2011 4:25 pm This is a combined synopsis/solicitation for the commercial item identified below, prepared in accordance with the format in FAR Subpart 12.6 as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. Solicitation VA-263-11-RQ-0661 is issued as a Request for Quotation (RFQ), and incorporates provisions and clauses that are in effect tough Federal Acquisition Circular 2005-53. This acquisition shall use Simplified Acquisition Procedures (SAP), and the North American Industry Classification System Code (NAICS) is 623110 with the small business size standard of $13.5 million. The Sioux Falls VA Health Care System Under Statutory Authority 41 USC 253 (c )(5) and 38 U.S.C. 1720 the Government anticipates entering into acquisition negotiations and award of a Basic Ordering Agreement for placement and services of eligible veterans into a nursing home facility located in Flandreau, South Dakota, for a Base Year period 9/1/2011-8/31/2011 with four (4) Option Years. This authority is cited and justification made based on the determination that the Government’s minimum needs can best be satisfied by services available in this location. The nursing facility shall ensure that care meets the health needs and promotes the maximum well being of VA patients. Nursing home care will be furnished to ensure the total medical, nursing, and psychosocial needs of VA beneficiaries. Physician visits, laboratory, x-ray, and other special services for VA patients will be at the same frequency as that provided to other patients at the nursing home receiving the same or comparable level of care. In addition, the care provided will include room, meals, nursing care, and other services or supplies commensurate with the VA authorized level of care, without extra charge. The per diem rate(s) will include the cost of medical care, oral medications, laboratory, x-ray, and other special services authorized by VA, unless otherwise specifically accepted. Facility must have and maintain the South Dakota Department of Health Nursing Facility License. STATEMENT OF WORK: 1.The nursing home shall ensure that care meets the health needs and promotes the maximum well being of VA patients. Nursing home care will be furnished to ensure the total medical, nursing, and psychosocial needs of VA beneficiaries. Physician visits, laboratory, x-ray, and other special services for VA patients will be at the same frequency as that provided to other patients at the nursing home receiving the same or comparable level of care. In addition, the care provided will include room, meals, nursing care, and other services or supplies commensurate with the VA authorized level of care, without extra charge. The per diem rate(s) will include the cost of medical care, oral medications, laboratory, x-ray, and other special services authorized by VA, unless otherwise specifically accepted. 2. Full attention shall be given to motivating and educating patients to achieve and maintain independence in the activities of daily living. Every effort shall be made to keep patients ambulatory and to achieve an optimal level of self-care. 3. Absences of the patient from the nursing home in excess of 48 hours will not be reimbursable. 4. Patients, who begin to require more than the level of care authorized by VA, will be readmitted to an appropriate VA facility, as determined and authorized by VA. When such admission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non-Federal facility may be accomplished provided VA authorization is obtained. VA authorization must be obtained within 72 hours of admission of the patient to a non-Federal facility. If hospitalization of a non-emergency nature is required, it is agreed that readmission to a VA Medical Center will be accomplished as soon as the patient’s condition is sufficiently stabilized to permit admission to VA. 5. In the event a VA beneficiary receiving nursing home care under this contract dies, the nursing home will promptly notify the VA facility authorizing admission and immediately assemble, inventory, and safeguard the patient's personal effects. The funds, deposits, and effects left by the VA patients upon the premises of the nursing home shall be delivered by the nursing home to the person or persons entitled thereto under the laws currently governing the nursing home for making disposition of funds and effects left by patients, unless the beneficiary died without leaving a will, heirs, or next of kin capable of inheriting. When disposition has been made, the itemized inventory with annotation as to the disposition of the funds and effects will be immediately forwarded to the VA facility authorizing admission. Should a deceased patient leave no will, heirs, or next of kin, his/her personal property and funds wherever located vests in and becomes the property of the United States in trust? In these cases the nursing home will forward an inventory of any such property and funds in its possession to the VA facility authorizing admission and will hold them (except articles of clothing necessary for proper burial) under safeguard until instructions are received from VA concerning disposition. 6. The nursing home shall not maintain nor provide dual or segregated patient facilities, which are segregated on the basis of race, creed, color, or national origin. The nursing home shall neither require such segregated use by written or oral policies nor tolerate such use by local custom. The term facilities shall include but not be limited to rooms, wards, sections, eating areas, drinking fountains, entrances, and other like areas. It is agreed that VA will have the right to inspection of the nursing home and all appurtenances by authorized VA representative(s) to ensure that acceptable standards are maintained and that the necessary care to maintain the well being of the patient is rendered. 7. Veterans receiving care under this agreement, who begin to require acute hospital care, will be readmitted to an appropriate VA facility, as determined and authorized by the VA. When such admission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non-Federal facility may be accomplished provided VA authorization is obtained. VA authorization must be obtained as soon as possible and not to exceed 72 hours of admission to the non-Federal facility. If hospitalization of a non-emergency nature is required, it is agreed that readmission to a VA facility will be accomplished as soon as the patient's condition is sufficiently stabilized to permit admission to VA. 8. If a veteran is re-hospitalized from the nursing home, the nursing home and VA facility will arrange to hold a bed in reserve, when such a decision is in the best interest of the patient and the VA. The number of covered bed hold days will be determined by VA on a case-by-case basis, but will not exceed the number of bed hold days allowed by state Medicaid regulations. Payment will follow state Medicaid regulations. The VA facility will include payment for these "bed hold" days only when the conditions above are met. 9. The VA facility will approve leave days (days away from the nursing home) for long-term placements. The leave must be part of a therapeutic plan and approved by VA. Leave days at VA expense are limited to 6 days per calendar year. Payment will follow state Medicaid regulations. Exceptions may be approved by the VA facility director or designee. 10. Patients receiving care under this contract, who begin to require more than the level of care authorized by VA, will be readmitted to an appropriate VA facility, as determined and authorized by VA. When such admission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non Federal facility may be accomplished provided VA authorization is obtained. VA authorization must be obtained within 72 hours of admission of the patient to a non Federal facility. If hospitalization of a non emergency nature is required, it is agreed that readmission to a VA Medical Center will be accomplished as soon as the patient's condition is sufficiently stabilized to permit admission to VA. 11. It is agreed that VA will have the right to on-site reviews of the nursing home and all appurtenances by authorized VA representative(s) to ensure that acceptable standards are maintained and that the necessary care to maintain the well-being of the patient is rendered. 12. The nursing home shall provide all services specified herein, regardless of the race, color, religion, sex or national origin of the person for whom such services are ordered. In addition, the nursing home warrants that subcontracting will not be resorted to as a means of circumventing this provision. 13. It is agreed that duly authorized representatives of VA will provide follow-up supervision visits to veterans placed to assure the continuity of care and to assist in the veteran's transition back into the community. It is understood that these visits do not substitute nor relieve the nursing home in any way of the responsibility for the daily care and medical treatment of the veteran. 14. All medical records concerning the veteran’s care in the nursing home will be readily accessible to VA. Upon discharge or death of the patient, medical records will be retained by the nursing home for a period of at least tee years following termination of care. Patient records will be maintained in conformance with the Privacy Act of 1974 (§5 U.S.C. 552a). A medical record shall be maintained for each patient, which includes at least the following: Admission identification record; VA Form 10 1204, Referral for Community Nursing Home Care or State-approved referral form; Admitting evaluation (including diagnosis by nursing home physician; Physician orders; Progress notes; the physician orders/notes shall be charted immediately after patient is seen; special reports (laboratory, x ray, activity, etc.; SMA Patient Assessment Form (only if SMA level of care is used); and Minimum Data Set (MDS) information, provided to VA upon admission and every six months thereafter. 15. The beneficiary will be provided nursing home care at the expense of VA for a period not in excess of that stated in the nursing care and treatment plan received from VA unless an extension of the authorization is provided in writing by the placing VA facility. 16. The authorization agreement, VA Form 10-7078, and the contract for the affected patient will terminate whenever a VA patient is rehospitalized for 15 calendar days or more, whether in a VA or in a non-Federal facility. A new authorization agreement and contract will be considered at the time the patient returns. 17. Level of Care Classification Effective Records: VA will contract for 53 categories of care under Resource Utilization Groups (RUG-III). A description of the RUG-III systems can be found in §42 CFR Parts 409, et.al. The level of care classification and associated per diem rate will remain in effect for each placement until and unless one of the following events takes place: (a) The recipient is discharged and subsequently qualifies for a new admission assessment, (b)The nursing home’s Minimum Data Set (MDS) assessment will be completed at customary times during a patient’s stay, dependent on projection for short term or long term residence, and adhering to the most current MDS frequency guidelines from Medicare MDS or BRA or MPAF. The applicable per diem rate will continue until the next assessment. In addition, assessment will be made eight (8) days after the completion of an episode of authorized rehabilitation therapy, after a rehospitalization, after a significant change in status and at VA’s request. Classification changes will be approved by VA. VA staff will audit approximately 20% of the MDS assessments. Based on these findings, VA retains the right to remove the automatic applicability of the nursing home generated MDS assessment for payment purposes, and (c) Therapy Requirements – All therapy provided under this contract will be individual therapy, rather than group therapy, unless otherwise ordered by the authorizing VA facility. NOTE: Prior to starting a therapy program, facility must obtain VA pre-authorization. 18. The VA, at its sole option, will monitor the professional care and administrative management of services provided to VA beneficiaries under this agreement, tough one or any combination of the following methods; reviews of state agencies reports, on-site inspection of the Nursing Home by VA staff, and/or on-site monitoring of VA patients. It is agreed that the Nursing Home shall provide VA with copies of all state agency reports when requested, and cooperate fully with VA’s quality improvement-quality assurance program functions relating to this agreement, including VA’s on-site inspection and monitoring. The VA Contracting Officer shall make all final determinations as to the contractor’s reasonable cooperation with VA and compliance with these requirements. SPECIAL CONTRACT REQUIREMENTS: (1) TERMINATION OF SERVICES: VA reserves the right to remove any or all VA patients from the nursing home at any time, when it is determined to be in the best interest of the VA or the patients, without additional costs to the Government (2) EXTENSION OF AGREEMENT: This agreement may be extended for four (4) one year periods at the option of the Government in accordance with 52.217-9, Option to Extend the Term of the Contract. Notice of an extension must be served in writing by the Government sixty days prior to the scheduled expiration date. The extension is granted subject to the availability of funds, (3) MINIMUM QUANTITIES: It is impossible to determine the exact or estimated amount, which will be expended under this agreement. No obligation will be incurred by VA under this agreement, until authorizations are issued for nursing home care of specific beneficiaries. VA agrees to make payment on a timely basis for services rendered in accordance with such authorizations upon receipt of proper invoices submitted by the nursing home as outlined in this agreement. VA will make payment for the day a recipient enters the facility but not the day the recipient leaves a facility unless entrance and departure are on the same day, then payment will be made for one day, (4) LIFE SAFETY CODE CLAUSE: The administrator of your facility is required to notify the VA Contracting Officer at least 3 days prior to any planned facility changes that could impact the Life Safety Code and other safety features of the facility, which were in existence at the time this contract was issued. The VA Contracting Officer will notify the VA Fire Safety Officer responsible for the Life Safety Code inspection of your facility and he/she will review (inspect the facility if required) the proposed changes and provide necessary approval/disapproval of your facility to house veterans during and/or after the proposed changes. Examples of facility change (but not limited to) that require VA Contracting Officer notification are as follows; interior finish, corridor partitions/walls, patient room doors, linen/trash chutes, exits, emergency lighting, fire alarm systems, automatic sprinklers, smoke barrier walls/doors, oxygen systems, compressed gas storage, HVAC, electrical and fuel gas systems, (5) If the veteran had a former VA primary care physician, VA policy precludes this provider being available to the veteran during the period of nursing home care. The assigned nursing home physician is the primary doctor during the nursing home stay and is responsible for writing or approving admission and all other orders as soon as the veteran arrives at the community nursing home. The community nursing home physician is responsible for general medical care, urgent evaluation and intervention. Physician visits will be according to medical assistance guidelines. The assigned nursing home physician will provide timely care following the most current CMS guidelines; arranging 24/7 access for patient care, easy access to staff for consultation, provide timely response to calls and arrange for timely physician back-up according to OBRA guidelines (Ref. 42 CFR 483.40 OBRA Guidelines), (6) In emergencies, nursing home staff will utilize the 911 local emergency systems as for any resident; advance directives/living wills shall be considered according to nursing home doctor’s orders. When private hospitalization or emergency services are required, the patient, spouse, financial guardian, or insurer is financially responsible. Service connected veterans may qualify for VA coverage of emergency care provided the VAMC is contacted by the private hospital physician within 72 hours of admission. This includes the cost of necessary transportation for such care, (7) VA MEDICAL CENTER CONSULTATION/RESOURCES: (a) Telephone Care Communications System (TCCS): For urgent-same day outpatient specialty care or for non-urgent scheduled clinic appointments/consultations, phone 605-336-3230 x6181 between 9AM and 3PM Monday tough Friday, excluding holidays. If a same day appointment is anticipated, please call as early as possible, (b) Admissions System phone number 605-336-3230. For non-emergency consultation/evaluation for admission to the VA Medical Center (after initial evaluation/intervention by the nursing home physician), (8) Ancillary Services/Supplies: Any additional cost to the all-inclusive contract must be preapproved according to the following terms: (a) Medications/supplies will be billed/paid according to generic average wholesale pricing guidelines; monthly invoices verifying cost must be submitted for payment of any additional approved rates. Discharge Medications – on the day of discharge, the facility will dispense medications for a 14 day supply to the veteran and facility can bill to the VA at the AWP, and (b) Billing: The patient, family and any other entitlement programs (e.g., Medicare, Medicaid) will not be billed for uncovered services/costs during the VA contract period. This constitutes double billing and Federal fraud, (9) The VAMC will pay two-day bed hold for therapeutic passes or re-hospitalization; for longer periods the family must make arrangements with the contract facility to hold a bed. Reimbursement for all bed holds will be 70% of the prevailing per diem rate. After a patient absence of fifteen (15) consecutive days the patient authorization for VA contract care ends, and (10) The contract nursing home will assume responsibility for arranging dental care at the veteran’s/families’ expense. This solicitation incorporates the following FAR clauses, provisions and addendums: 52.212-1, Instructions to Offerors- Commercial Items (June 2008); 52.212-3, Offeror Representations and Certifications-Commercial Items (May 2011); 52.212-4, Contract Terms and Conditions-Commercial Items (June 2010); 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive Orders-Commercial Items (May 2011) (including the following numbers in paragraph (b): 7, 21, 24, 26, 27, 28, 29, 30, 36, 38, 40, 46 and 52.222-41, 52.222-42, and 52.226-6); 52.217-8 Option to Extend Services (Nov 1999); 52.217-9 Option to Extend the Term of the contract (Mar 2000); 52.219-6 Notice of Total Small Business Set-Aside (June 2003); 52.232-18 Availability of Funds (Apr 1984); 52.232-19 Availability of Funds for the Next fiscal Year (Apr 1984); 52.237-3 Continuity of Services (Jan 1991) and the following VAAR Clauses: 852.203-70 Commercial Advertising; 852.215-70 SDVOSB AND VOSB Evaluation Factors; 852.237-7 Indemnification and Medical Liability Insurance; 852.270-1 Representative of Contracting Officers; 852.271-70 Nondiscrimination in Services Provided to Beneficiaries; and 852.273-75 Security Requirements for Unclassified Information. The Government shall award a contract resulting from this solicitation to the responsive/responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government per FAR 13.106-2. Responses shall include technical specifications, descriptive material, and other such information corresponding to each minimum required item, which demonstrates the Offeror’s capabilities, and shall identify where the offered service meets or does not meet each of the Governments functional and performance minimum specifications listed herein. Information concerning clauses and provision incorporated by reference may be obtained at http://www.acquisition.gov. Quotation is due by 4:00 pm CT on Monday, August 22, 2011, with anticipated award date of 9/1/2011. Quote may be mailed, faxed or emailed to Denise Hill at the Department of Veterans Affairs, VA Health Care System (90C), 2501 W 22nd Street, Sioux Falls, SD 57105. Fax: (605) 333-6829, or e-mail: denise.hill@va.gov. VA26311RQ0661 Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 23
8/12/11, 4:25 PM