The Indian Health Service awarded a purchase order to Cirrus Concept Consulting, LLC (operating as Alto Healthcare Staffing) on April 13, 2021, for registered nursing services at the Tohatchi Health Center with a ceiling value of $48,972.00. Work is performed in Gallup, New Mexico. The order covers labor-hour staffing to support the emergency department, intensive care unit, perioperative areas, and other clinical departments. The ultimate completion date is December 31, 2021. The procurement used no set-aside and was issued under NAICS code 561320 (temporary help services), with evaluation criteria including nurse qualifications, active licenses and certifications, contractor experience of at least three years, and three references.