Attachment_A_SOW_10122016.pdf

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work

Attachment A

STATEMENT OF WORK (SOW)

Title: Long-Term Nursing Home Care Date: October 12, 2016

1. BACKGROUND

The National Hansen's Disease Programs (NHDP), Baton Rouge, Louisiana, is a specialized Federal medical program for the treatment of persons affected by Hansen's disease located east of Baton Rouge and 90 miles north of New Orleans, Louisiana. This program has been owned and operated since 1921 by the Federal Government and has statutory responsibility to provide care for patients affected by Hansen's disease herein referred to as residents. Hansen’s disease is a highly stigmatized disease and facilities experienced with those issues are essential to the holistic care of the resident. Resident under the care of NHDP are currently located in a long-term care nursing facility in Baton Rouge, Louisiana.

2. GENERAL REQUIREMENTS/TASKS

The purpose of this requirement is to procure long-term nursing home care services and facilities in the Baton Rouge, Louisiana metropolitan area. The patient ages range from 79 to 92 years.

The contractor shall have a minimum of three years of experience caring for patients who have stigmatizing illnesses. This is not a real property lease.

The contractor shall provide all facilities, housing, labor, supervision, nursing services, equipment/supplies, resident meals, personal care support, housekeeping, social/recreational services and events as required for the coordination and delivery of long term nursing home care services.

Specific Tasks

• Task 1. Medicaid Case Mix Long Term Nursing Home Care Services

A. Patient Rooms

The contractor shall provide 9 rooms which include the following:

• Each room shall have a minimum of 160 square feet.

• Each room shall have a window to the exterior. Windows shall be weather-tight and equipped with locks.

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work

• Each room shall have a closet.

• Each room shall have handicapped accessible ADA compliant bathroom (sink with toilet) with ample handrails and a full turning ratio for wheelchairs.

• Each room shall be equipped with an emergency call system, emergency lighting in room and bathroom, smoke detectors and sprinkler system.

• Each room shall have individually controlled heating and air conditioning providing outside air in accordance with ASHRAE189-62 Ventilation Standards. Thermostats shall maintain temperatures between 65 and 72 degrees Fahrenheit during heating season and 72 and 78 degrees Fahrenheit during cooling season.

• Each room shall have Lighting fixtures that can maintain a lighting level of 50 foot-candles in living areas. Additionally, lighting fixtures shall maintain a lighting level of 10 foot-candles in other areas to ensure safety.

• Each room shall have telephone and cable television service jack(s).

• All utilities such as electric, gas, water, sewage, solid waste, local telephone, and cable TV services shall be included in the room rate. The cable television service shall include at least one Spanish channel. Long distance telephone services are excluded from the room rate.

• All floor covering shall be resilient flooring. Terrazzo, unglazed ceramic tile and/or quarry tile shall be used in toilet and service areas.

• Each room shall have at least, a bed, a storage piece (dresser or chest of drawers), a seating component (lounge chair, sofa, or loveseat).

Occasional pieces (tables, side chairs, etc. shall be available.

• Residents shall have access to either common showers or a shower shall be included in each room.

B. Meals

The contractor shall provide complete meals and nutritional services, 7 days a week, 365 days a year, for each of the 9 residents under this contract. Meals shall be served in a dining room cafeteria style or by waited table service. If cafeteria style service is provided, assistance shall be provided to residents requiring help in making selections, carrying trays, preparing food for consumption, etc. Special

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work dietary needs shall be provided for patients with medical needs such as diabetes, hypertension, renal failure, etc. Menus shall offer various choices, be rotated, and follow the Louisiana Health and Hospital Nursing Facilities Minimum Licensure Standards

A variety of snacks and beverages shall be available between meals for residents.

C. Resident Care

The contractor shall provide care in accordance with the Patient’s Bill of Rights, Standards for Long Term Health Care Facilities and Practice Guidelines, The Nurse Practice Act of Louisiana (RN and LPN), Louisiana Registry of Certified Nurse Aide Registry, and Louisiana Health and Hospital Nursing Facilities Minimum Licensing Standards.

a. Daily Living Assistance

The contractor shall provide assistance to the residents for activities involving daily living, to maintain the highest practicable well-being for the resident. This assistance shall be provided for the following activities:

• Bathing

• Dressing

• Grooming

• Transferring

• Ambulating

• Good Nutrition

• Personal Hygiene

• Oral Hygiene

• Toileting

b. Pressure Ulcer Treatment

The contractor shall assess residents for pressure ulcers. Within 24 hours of an ulcer being observed, the Contractor shall report findings to the physician and initiate treatment according with an approved plan of care.

This treatment shall promote healing and prevention of new pressure ulcers. Care of pressure ulcers shall be based on evidenced based practices.

c. Urinary Incontinence

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work

The contractor shall assess and treat residents for urinary incontinence. Residents with urinary incontinence shall be assessed for the need of bladder retraining program. An indwelling catheter or diapers shall not be used unless the clinical condition indicates a need. Residents shall receive treatment and services to prevent urinary tract infections.

d. Range of Motion

The contractor shall assess and treat residents for limited range of motion.

Residents with limited range of motion shall receive treatment and services to increase range of motion and to prevent decline in range of motion.

e. Mental and Psycho-Social

The contractor shall assess and treat residents for social and related problems. The contractor shall assist residents in dealing with social and related problems.

Residents who display adjustment difficulty shall receive appropriate treatment and services to address their specific needs.

f. Nutrition

The contractor shall assess and treat residents for acceptable parameters of nutritional status. The contractor shall endure that residents maintain acceptable parameters of nutritional status, such as body weight and protein levels, unless a resident has a clinical condition that indicates that this is unavoidable. The contractor shall ensure that all residents receive diets as ordered by a physician;

residents identified with significant nutritional problems shall receive appropriate medical nutrition therapy based on current professional standards.

g. Gastric Feeding

The contractor shall assess and treat residents for challenges in eating. The contractor shall assist residents who are fed by a gastric tube in a manner to prevent complications and to restore normal eating if possible.

h. Hazards and Accidents

The contractor shall ensure that the facilities and environment remain free of accident hazards and that adequate supervision is present to prevent accidents.

Any accident or injury shall be investigated and then reported to the COR, Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work residents physician, and to appropriate state agencies. The notification shall take place once the incident/accident is no longer an immediate threat or crisis has ended. A copy of the accident/incident report shall be provided to the COR within 72 hours of the event.

i. Hydration

The contractor shall assess and treat residents for proper fluid intake. The contractor shall provide residents with sufficient fluid intake to maintain proper hydration and health.

j. Special Needs

The contractor shall assess and treat residents for special needs. Residents with special needs shall receive proper treatment and care. Special needs shall include;

injections, parenteral and enteral fluids, colostomy, ureterostomy, ileostomy care, tracheostomy care, tracheal suction, respiratory care, foot care, and prostheses.

k. Recreational and Entertainment Activities

The contractor shall provide suitable recreational and entertainment activities for each resident, according to their specific needs and interests. The contractor shall have a variety of activities and shall include outdoor activities a minimum of twice per week for a minimum of 30 minutes in suitable weather. An attendant shall be provided for residents who require closer observations or assistance due to cognitive or mobility impairments when engaging in outside activities. Outside recreational activities shall be reported on the daily report as they occur. NHDP outside activities shall be counted as one of the twice per week activities.

l. Resident Emergency Notifications

The contractor shall notify resident physicians and the COR when a medical or non-medical emergency exists.

m. Resident Care Planning

The contractor shall assess and determine the appropriate level of care as required for each of the residents. The contractor shall create resident care plans that are individualized, age specific, culturally sensitive and reflect best practices for disease management and rehabilitation. Resident care planning shall be

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work developed, implemented, monitored, and evaluated in collaboration with residents physicians and COR. The contractor shall provide and ensure that personnel providing services under this contract have appropriate skills.

If a resident does not comply with all or part of their resident care plan or prescribed treatment, their physicians and COR shall be notified promptly so an alternative plan or changes can be considered.

D. Rehabilitative and Restorative Therapy

The contractor shall provide rehabilitative and restorative services per written physician orders to each resident. Therapies shall be provided by licensed therapist or trained personnel with appropriate equipment and supplies as determined by best practice guidelines.

E. Basic Respiratory Therapy

The contractor shall provide basic respiratory therapy, supplies and services (oxygen, nebulizer, oral suctioning, etc.), per written physician orders, to each resident under this contract.

F. Over the Counter Medications (Non-Prescription)

The contractor shall provide all over the counter medications (non-prescription), per written physician orders, to each resident.

G. Housekeeping Services

The contractor shall provide housekeeping services for the facility which shall be clean and odor free. Resident rooms and public areas of the facility shall be maintained and kept clean and shall be free of dirt, debris, and dust to maintain a lustrous appearance. Spills shall be cleaned immediately. Worn items shall be repaired or replaced to maintain facility appearance. Buildings and grounds shall be well cared for and maintained. Housekeeping services shall be provided to each resident's room and living quarters no later than 12:00 p.m. daily.

Housekeeping services in each room shall also include the following; change linens weekly, dusting, sweeping, and mopping. Bathrooms shall be cleaned daily. Carpeted floors shall be vacuumed weekly. Non-carpeted resident rooms shall be buffed and waxed quarterly.

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work

H. Laundry Services

The contractor shall provide laundry services onsite for residents under this contract. All laundry items shall be labeled with the residents name upon purchase and prior to providing for laundry service. The contractor shall be responsible for ensuring laundered items are returned to the resident without additional defects.

The contractor shall be responsible for lost or misplaced items.

I. Transportation to Medical Appointments

The contractor shall provide transportation services to residents for medical appointments, procedures, test, and etc. within a 50 mile radius of the long term care facility. An attendant who is capable of assisting the resident with self-care needs and can serve as an effective liaison between the resident and provider regarding the encounter shall accompany the residents. The nine residents incur approximately 35 medical appointments per calendar year with an average of 20 miles per round trip.

Transportation for NHDP sponsored activities shall be provided by NHDP.

J. Durable Medical Equipment/Medical Supplies

The contractor shall provide all medical supplies and equipment such as catheters, ostomy bags, oxygen, nebulizers, wound care products, etc. for each resident under this contract. All medical supplies and equipment shall be approved for use by the COR and resident's physicians. The contractor shall be responsible for cost of medical supplies and equipment if prior approval was not obtained from the COR and resident's physician.

K. Premium Certified Nursing Assistant (CNA) Service

See key personnel section of SOW

L. Credentialing and Physician Care

Credentialing

NHDP physician shall be credentialed and granted staffing privileges by the contractor.

Physician Care

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work

NHDP physicians will be the primary care provider for residents under this contract and will visit the facility to make rounds on a scheduled basis as determined by NHDP. Physician rounds are typically conducted weekly on Wednesdays and Fridays. NHDP physicians will determine the need for admission, discharge, and transfer to other healthcare facilities for residents under this contract. The physician will write orders for healthcare services and collaborate with the contractor in developing the plan of care, restorative therapies, rehabilitative procedures, motorized wheelchairs, special diets, etc

M. Unique Transportation

Upon approval by a NHDP physician and COR, unique transportation services shall be coordinated by the contractor, up to 78 times per year within a 50 miles radius of place of performance. The contractor shall promptly arrange transportation of a resident for special circumstances such as to receive dialysis treatment. The contractor shall be reimbursed for costs associated with approved frequent transportation services on a mileage basis per federal travel regulation mileage rates and for labor for having an accompanying nursing home staff go with the resident.

N. Authorization for Care

The NHDP physician shall provide a written authorization (which may be a physicians order) for medical appointments, labs, x-rays (c-scans, MRI's), therapy services (physical, occupational, and speech, etc) equipment, or supplies not defined in the Statement of Work (SOW). The contractor shall schedule the appointment, arrange transportation, fax the physician order to the COR, and send an attendant with the resident to appointments. The NHDP Appointment Authorization Form (See Appendix B) shall accompany each resident to their appointment and shall serve as approval for services authorized by NHDP. The percentage to be covered by NHDP is set by Medicare Part A and B. NHDP shall be responsible for outstanding balances and co-pays of residents. The contractor shall present an Explanation of Benefits (EOB) along with an invoice for the remainder of balance due for NHDP payment.

The contractor shall submit a list of authorizations for appointments to the COR each month and shall include the residents name, date of service, and name of provider (Appendix C). The list is due by the 5th day of each month (for example, appointments which occurred between January 1 to January 30 will be due by February 5th).

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work

• Task 2. Prescription Medications

The contractor shall provide all prescription medications, per written NHDP physician orders, for each resident. All residents under this contract have Medicare Part D Insurance. Medicare Part D Insurance shall be the first payor for resident prescription medications. The percentage to be covered by NHDP is set by Medicare D. NHDP shall be responsible for outstanding balances and co-pays of residents. The contractor shall present an Explanation of Benefits (EOB) along with an invoice for the remainder of the balance due for NHDP payment.

• Task 3. Resident Change in Health Status Report

The contractor shall submit a daily report on the status of residents to note changes in the health status of residents. This report shall be sent to the COR and the residents physicians. The report shall include falls, skin tears, wounds, changes in eating patterns, weights, hemodynamic instability or an overall decline in health status (See Appendix A).

INTERPRETER SERVICES

The contractor shall provide interpreter services for residents to assist providers in communicating and understanding resident's needs. Many residents under this contract speak Spanish. The residents, contractor and the contracts staff shall have immediate access to an on-site interpreter or a language line service. The contractor staff shall be knowledgeable regarding how to access and utilize the interpreter services. Interpreter services shall be available 24 hours per day, 365 days per year.

EMERGENCY PREPAREDNESS

The contractor shall provide a 24-hour emergency response call systems. The contract shall have an emergency preparedness and evacuation plan. The contractor shall communicate with the COR, physicians, and families of residents prior to implementation of evacuation plans. The contractor shall provide the COR with updates throughout the process. In the event of an evacuation from the facility, the contractor shall keep the COR abreast of the resident’s location and status daily.

RESIDENTS ABSENCES FROM FACILITY

A NHDP resident physician shall provide an order prior to a resident leaving the facility for any reason (family requests, community visits, home visits, etc. If visits away from the facility are

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work determined not to be therapeutic or the resident cannot be safely managed, the physician shall recommend discontinuation of pass privileges.

PERIOD OF PERFORMANCE

The period of performance shall be for a 12 month base period with four 12 month option periods (actual dates will be entered at time of contract award).

PLACE OF PERFORMANCE

The facility shall be located within 15 miles of the NHDP, 1770 Physicians Park Drive, Baton Rouge, Louisiana (address to be specified at time of contract award) and shall include nine private, contiguous rooms, and a public space shall be provided within a single facility for nine residents who are under the care of NHDP.

KEY PERSONNEL

The contractor shall provide a supervisor/manager (program manager) who shall be responsible for resolving problems and provide direction regarding resident care and complaints. The contractor shall provide Licensed Practical Nurse (LPN) services 24 hours per day, 365 days per year, to provide care to residents. The contractor shall provide a dedicated Certified Nursing Assistant (CNA) to provide direct patient care for 12 consecutive hours per day (hours to be determined upon award of the contract but preference is between the hours of 7:00 AM to 7:00 PM local time, to care solely for the residents. The dedicated certified nursing shall not be reassigned to any other duties unless 100% of the residents under this contract are participating.

The contractor shall provide a list of designated care givers and relief staff within 10 days of the effective date of the award and shall provide updates within 10 days of changes in staff.

Designated care direct givers who are assigned to perform work under this contract.

The contractor shall post a work schedule delineating staff assignments for residents. The schedule must include the name of the staff providing care, resident's name, duties assigned (such as bathing, shaving, grooming etc), and work hours or shift. This information shall be available to the COR at all times and/or upon request.

The contractor shall provide appropriate continuing education, in service training, and meetings for staff. The contractor shall require staff to attend training on Hansen's Disease provided by NHDP as deemed appropriate.

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work

The contractor shall adequately screen employees for satisfactory work references, health examinations, and criminal background checks to ensure they are suitable for the work to be performed.

The contractors staff assigned to perform services under this contract shall meet or exceed all current City, County, State and Federal licensures, certifications and training relative to the function they are to perform under this contract. Minimally, included, would be re-certification(s), continuing education and/or refresher courses. These requirements shall be maintained current throughout the life of the contract. Personnel certifications and documentation shall be presented to the Contracting Officer upon request.

Contractor staff shall wear a company uniform with their name visible on the outside of the uniform. This can be a legend on a uniform or uniform jacket or by means of a name badge or a combination of both. Uniforms shall be clean and maintained to present a professional image.

The Contracting Officer may request that the contactor exclude form work such personnel as the Contracting Officer deems incompetent, careless, unqualified, unfit, or unsuitable or whose continued employment is inconsistent with the best interest of the Federal Government. The Contracting Officer reserves the right to exclude from work any personnel previously barred from NHDP.

The following are examples of incidents that could result in the removal of a staff member:

• Violation of rules and regulations.

• Disorderly conduct, use of abusive or offensive language, quarreling, intimidation by words or actions of fighting. Participating in disruptive activities, which interfere with the normal and efficient operations of the Federal Government, is also considered disorderly conduct.

• Theft, vandalism, immoral conduct, or any criminal action.

• Possessing, selling, consuming or being under the influence of intoxicants, illegal drugs or substance that produces similar affects.

• Unauthorized use of Federal Government property.

• Possession of weapons while on duty.

In the event of a dispute of misconduct, the Contracting Officer will make the final determination if a staff member should be removed from performing under this contract.

The following key personnel shall be identified by the contractor.

• Program Manager (PM)

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work

Duties /Responsibilities:

The project director shall assist with planning, coordinating and implementing activities associated with administrative management, operations, equipment, space management, logistics, budget, travel and other areas for the performance accountability and management.

Work collaboratively with NHDP to ensure task described under the contract are executed.

• Licensed Practical Nurse (LPN)

Duties/Responsibilities:

• Participate in the delivery and evaluation of resident care.

• Ensure health, comfort, and safety of residents according to facility guidelines and best practices of disease management.

• Coordinate care and services with other health care professionals.

• Attend to the holistic needs of the residents.

• Serve as a direct care giver and provide oversight to the total care of the residents.

• Administer medications and perform other procedures as directed.

• Certified Nursing Assistant (CNA)

Duties/Responsibilities:

• Assist residents in dressing, bathing, eating, elimination, dressing, and etc...

• Take vital signs and reports abnormalities to supervisor.

• Collects non-invasive body fluid specimens.

• Assist residents with mobility, transfer, and activities to improve endurance.

• Interacts with and stimulates residents.

• Carries out thorough conversations and activities with residents.

• Accompanies residents to outdoor public areas as requested.

• Works under the supervision of a registered nurse.

CONTRACTOR FURNISHED

The contractor shall furnish all personnel, material, adequate and accessible facilities, and equipment needed for performance of this contract.

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work

A. General Facility Requirements

• The facility shall be accredited by the Joint Commission on the Accreditation of Healthcare Organizations and shall meet all federal, state and local licensing requirements for this type of housing.

• The facility shall be located in a prime district with attractive surroundings with a prevalence of modem design and/or tasteful rehabilitation in modem use. All building and grounds maintenance shall be provided. Grounds shall be professionally landscaped. Streets and public sidewalks shall be well maintained.

• The facility shall be in compliance with all requirements of the Americans with

Disabilities Act (ADA).

• The facility shall meet all federal, state and local requirements for facilities of this type, including remote exits, smoke detectors, sprinkler systems, interior finishes with low lame spread ratings, and incorporating other means to control the effects of fire.

• Public areas shall include attractive community living rooms, activity rooms, and dining rooms all with comfortable seating and tables, which are available for use by the residents under this contract and their families.

• A full service beauty salon shall be on site with services scheduled and adequately available for use by residents under this contract.

• Parking spaces shall be available and sufficient to support residents under this contract, NHDP staff, and related visitors.

• Usable outdoor activity areas shall be available to provide places to walk, ride wheelchairs and sit. Outdoor areas shall be well maintained.

• The entire facility and surrounding outdoor activity areas shall have a level of security which deters unauthorized entry, deters loitering and disruptive acts.

• Exits shall be clearly marked and shall be unlocked from the inside.

• Mail services shall be available for in-coming and out-going mail. All mail relating to medical care for the resident under this contract shall be forwarded to the COR.

• Hot water temperature shall be maintained below 120 degrees in patient areas.

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work

FEDERAL GOVERNMENT FURNISHED

The Federal Government shall furnish:

• Reporting Forms

• SecureZip

• Secure Email File Transfer (SEFT), National Institutes of Health (NIH) Secure Email and

File Transfer Service

The contractor shall be held liable for loss and damage due to neglect or abuse of Federal Government property by their personnel.

The contractor and their personnel shall take all reasonable precautions, as directed by the Federal Government or in the absence of the Federal Governments direction, in accordance with sound commercial industry standards, to safeguard and protect personnel and Federal Government property.

PAYMENT SCHEDULE

The Contractor shall submit monthly invoices after services are rendered and accepted by the

COR.

Request for Proposal (RFP) # 17-258-SOL-00002; Title: Long-Term Nursing Home Care; Attachment A – Statement of Work

SCHEDULE OF DELIVERABLES

The contractor shall submit reports and deliverables to the COR in accordance with “Schedule of Deliverables” listed below.

All reports and deliverables shall list the following at the top of the first page:

• Contract number.

• Deliverable item number.

• Deliverable item delivery due date.

• Date of submission.

• All deliverable items are to be separate physical submissions.

• All deliverable items are subject to the review and concurrence of the COR.

Schedule of Deliverables

Item Quantity Due Date Place to Report

Resident change in health status report, Task 3

Daily by written or verbal report.

No later than 2:00 P.M. (Central Time) daily, or earlier depending on the severity of the health status event.

Send to:

National Hansen’s Disease Programs ATTN: COR, HD Long Term Care 1770 Physicians Park Drive Baton Rouge, LA. 70806

Number of authorizations for medical appointments report, Task 4

Once per month, 12 per 12 month period of performance.

Submit by the 5th of each month.

Send to:

National Hansen’s Disease Programs ATTN: COR, HD Long Term Care 1770 Physicians Park Drive Baton Rouge, LA. 70806

List of designated care givers and relief staff, Key Personnel.

Varies

Within 10 days of contract award and immediately when there are changes in caregivers

Send to:

National Hansen’s Disease Programs ATTN: COR, HD Long Term Care 1770 Physicians Park Drive Baton Rouge, LA. 70806

Medical records, confidentiality and maintenance of patient records.

Varies

Within 30 days 1) expiration of this contract, or 2) discharge or death of a resident.

Send to:

National Hansen’s Disease Programs ATTN: COR, HD Long Term Care 1770 Physicians Park Drive Baton Rouge, LA. 70806