3-Attachment B - Scope of Work.docx

ATTACHMENT B - Scope of Work

State Veterans Homes Management Solicitation # KL26-24

A. CONTRACT INFORMATION

1. The State of Utah Department of Veterans and Military Affairs (UDVMA) contracts with a healthcare provider (CONTRACTOR) to operate two Utah State Veterans Homes (HOMES):

a. George E. Wahlen Ogden Veterans Home (GEWOVH) located at 1102 North 1200 West, Ogden, Utah 84404.

b. William E. Christoffersen Veterans Home (WECVH) located at 700 Foothill Dr., Salt Lake City, Utah 84113.

2. CONTRACTOR will operate the HOMES as high quality skilled nursing care facilities with a memory care unit for qualified veterans, veteran spouses and Gold Star parents.

3. UDVMA is the HOMES Governing Authority. The UDVMA’s full-time representative at each HOME is the State Officer (SO).

4. Title and ownership of the physical plant, real property at the HOMES remain with the State of Utah, with CONTRACTOR having the right to use HOMES pursuant to this contract.

5. Services provided at the HOMES will include but not be limited to administration, nursing/resident care, dietary service, recreation, housekeeping, laundry, facility maintenance, plant operations, safety, security, social services, medical records, rehabilitation, behavioral health, and transportation.

6. CONTRACTOR agrees to meet the requirements for state nursing facility license and to maintain uninterrupted certification of the HOMES with the US Department of Veterans Affairs (VA) to remain eligible to receive VA per diem payments for qualified veterans. CONTRACTOR understands it is solely responsible for meeting state license and VA certification requirements.

7. The Request for Proposals (RFP) and the questions/answers submitted in the Utah Public Procurement Place (U3P) shall be considered as attachments to this agreement and shall be used in the interpretation of this agreement.

8. Additional provisions may be added to this contract through formal amendment procedures approved by the State of Utah Division of Purchasing.

B. BACKGROUND

1. GEWOVH is an approximately 85,000 square foot, 120 bed skilled nursing facility located near the Business Depot Ogden campus in Ogden, Utah. It opened in 2009. The design of the facility is organized around the Veterans Administration (VA) concept of culture change which promotes a home-like environment. The home consists of five connected buildings. Four of the buildings are resident communities that accommodate thirty residents each. One of the four communities is a memory care unit. The fifth building is for administration and support services. The administration building includes a large multipurpose room and a therapy room. A basic floor plan is provided as Attachment D to this RFP.

2. The WECVH is an approximately 46,000 sq. ft., 81 bed skilled nursing facility conveniently located on the campus of the Veterans Administration Medical Center (VAMC) in Salt Lake City, Utah. This two-story facility was originally completed in 1997, with a large multipurpose room, restrooms, etc. added in 2008. The upper level has 60 beds (29 semi-private rooms and 2 private rooms). The lower level is a memory care unit with 21 beds (10 semi-private rooms and 1 private room). The building includes space for administrative and support services and a large therapy room. A basic floor plan is provided as Attachment D to this RFP.

The WECVH is scheduled to be replaced with a new 105-bed facility during this contract period. The CONTRACTOR will be directly involved in transitioning the operation to the new facility.

C. FINANCIAL INFORMATION

1. GEWOVH is a 120-bed facility. The average occupancy for 2025 was 113 residents. The WECVH is an 81-bed facility. The average occupancy for 2025 was 74 residents.

2. The Utah Department of Veterans & Military Affairs (UDVMA) receives a per diem for veteran residents from the federal VA based on days of care. The per diem is passed on to the CONTRACTOR for operations less a “holdback” amount of up to $20.00 PPD (See Section H). There are two VA per diem rates, high per diem and basic per diem.

a. High per diem is specific for days of care associated with caring for veterans that have a 70% or higher service-connected disability or are receiving nursing care service because of their service-connected disability (Adjudicated Service-connected Disabled). The high per diem rate is an all-inclusive rate. The current rate for the GEWOVH is $557.19 PPD. The current rate for the WECVH is $576.23 PPD. A high per diem veteran resident cannot be charged additional charges for cost of care. The high per diem rate may increase each year at the beginning of the federal fiscal year. The high per diem increase for FY2026 was 3.2%.

b. The basic per diem rate is specific to days of care associated with caring for veterans that are not service connected or are service connected below 70%. The basic per diem rate is not an all-inclusive rate. The basic per diem rate is established by the VA and is the same in all state veterans’ homes. For FY2026 the basic per diem rate is $148.71 PPD. A basic per diem veteran resident is charged an additional cost for care (veteran share). The CONTRACTOR is responsible for collecting the veteran’s share of cost. When a basic per diem resident is on Medicare or Medicaid, The VA continues to pay the VA per diem rate. The basic per diem rate may increase each year at the beginning of the federal fiscal year. The basic per diem increase for FY 2026 was 3.2%.

3. Spouses of veterans and Gold Star Parents are also eligible for admission up to 25% of total census. Neither veteran spouses nor Gold Star parents are subsidized by the VA.

4. Annual Increases in the VA per diem rate at the beginning of the federal fiscal year will be recognized by the UDVMA as additional funds to be used by the CONTRACTOR for the operation of the HOMES.

D. RATE INFORMATION

1. FY2026 Rates Per Patient Day (PPD) for GEWOVH

a. Basic per diem veteran with private bathroom $148.71 VA per diem + $110.19 resident share = $258.90 PPD

b. Basic per diem veteran with semi-private bathroom $148.71 VA per diem + $92.78 resident share = $241.49 PPD

c. High per diem veteran $557.19 VA per diem + $0 resident share = $557.19 PPD

d. Spouse/Gold Star Parents with private bathroom $0 VA per diem + $241.94 resident share = $241.94 PPD

e. Spouse/Gold Star Parents with semi-private bathroom $0 VA per diem + $222.87 resident share = $222.87 PPD

2. FY2026 Rates PPD for WECVH

a. Basic per diem veterans with private rooms $148.71 VA per diem + $118.78 resident share = $267.49 PPD

b. Basic per diem veterans with semi-private rooms $148.71 per diem + $91.61 resident share = $240.32

c. High per diem veteran with private room $576.23 VA per diem + $0 resident share = $576.23 PPD

d. Spouse/Gold Star Parents $0 VA per diem + $207.92 resident share = $207.92 PPD

3. All beds in both HOMES are certified for Medicare. Twenty-seven beds are certified for Medicaid at the GEWOVH, and 10 beds are certified for Medicaid at the WECVH. The CONTRACTOR is responsible for managing the Medicare and Medicaid program and to bill for appropriate days of care and services. As noted above, for basic per diem residents, the VA continues to pay the established per diem rate ($148.71 for FY2026) when a basic per diem veteran is on Medicare or Medicaid.

4. UDVMA is not under any obligation to adjust the daily resident share of cost for basic per diem veteran or the daily rate for spouses and Gold Star parents. CONTRACTOR is not precluded from seeking a rate adjustment if unexpected circumstances related to overall patient acuity, cost of supplies, staffing needs or other factors warrant such an adjustment.

5. Requests for adjustments to the resident share of the daily rate must be submitted to SO a minimum of 60 days before the proposed effective date, unless waived in writing by the UDVMA. The amount of any increase as well as the effective date of any adjustment shall be at the discretion of the UDVMA Executive Director.

6. Any resident not entitled to receive the VA per diem, such as veteran spouses and Gold Star parents, may be charged a daily rate not to exceed 110% of the total rate (per diem plus resident share) for the basic per diem veteran.

E. CENSUS INFORMATION

1. Census Mix for GEWOVH

a. Calendar Year 2024

b. Calendar Year 2025

2. Census Mix for WECVH

a. Calendar Year 2024

b. Calendar year 2025

3. The cost line on the State of Utah contract resulting from this solicitation will represent the anticipated dollar amount of VA per diem passed on to the CONTRACTOR for operational purposes. Parties agree that changes in patient days, patient mix, and Federal per diem may make the final contract amount higher or lower.

F. PHARMACY INFORMATION

1. The VA provides medications for veterans that have a 50% or 60% service-connected disability. The VA also provides medication for those that qualify for the VA benefit called Pension/Aid & Attendance (A&A), and those deemed catastrophic disabled. Approximately 19% of GEWOVH residents qualify to get their medications from the VA. Approximately 5% of the WECVH residents qualify.

2. The CONTRACTOR is responsible for pharmacy costs associated with residents that are on high per diem, Medicare and Medicaid.

G. PENSION/AIDE & ATTENDENCE

1. Basic per diem veteran residents that cannot afford their monthly share of cost can apply for the VA benefit called Pension/Aid & Attendance (A&A). This is an income-based benefit that if applied for and approved, will provide the veteran up to approximately $2,424 per month to help the veteran pay for his or her share of cost.

H. HOLDBACK FUND

1. The State of Utah will hold back (retain) up to $20.00 PPD from the monthly VA per diem payment. The funds are used to cover HOMES renovation, repair, and new equipment, etc. with a cost of more than $3,000.00 per individual item. Covering bundled items where each item is less than $3,000.00 per individual item will be at the discretion of the UDVMA Executive Director. The funds also cover the state officer’s salary and benefits and a preventative maintenance agreement with the State of Utah Division of Facilities Construction and Management (DFCM). At the discretion of the UDVMA Executive Director, the holdback amount may be adjusted to allow additional funds for operation. The current holdback is set at $15.00 PPD.

2. Money held in the administrative fee/holdback fund controlled by the UDVMA, may be used to support operations needs at the HOMES in an emergency at the discretion of the UDVMA Executive Director. Such emergency situations include natural disasters and other unforeseen circumstances that may interrupt normal operations.

I. STATE FLEET VEHICLES

1. The GEWOVH has 4 vehicles that are part of the state fleet. The WECVH has 3 vehicles that are part of the state fleet. The CONTRACTOR is responsible for lease costs, gas, maintenance and repairs. The 2025 costs for GEWOVH were approximately $81,000. The 2025 costs for WECVH were approximately $41,000.

J. UTILITY COST

1. The following are basic utility costs for the HOMES for the 2025 calendar year.

a. GEWOVH

b. WECVH

K. MANAGEMENT FEE

1. The management fee under the current contract is 6% of “gross revenue less contractual adjustments”. The management fee is a line-item expense on the monthly financial statement. The management fee includes corporate overhead costs associated with corporate personnel, corporate offices and corporate programs and a reasonable operating profit. Specifically, these costs include corporate building costs, corporate oversight time, computer support, risk management, program development, and corporate legal and accounting services. These costs must be factored in as a part of the management fee and not appear in any other line item on the financial statements. This contract provision may be audited annually by the Office of the State Auditor.

a. The following costs may be allocated specifically from the central office to the HOMES based upon an appropriate and negotiated HOMES allocation as consistent with all affiliated facilities and are not included in the Management Fee:

1. General/Professional Liability Insurance for the HOMES along with the portion of allocated self-funded portions of the GL/PL Corridor Program (based on the rate per state per bed).

2. Other insurance directly apportioned to the HOMES property (direct incremental or apportioned cost), Crime and Auto (direct incremental or apportioned cost).

3. Software licensure purchases for the HOMES (clinical, financial, timekeeping, ADP payroll, health records, other allocated by license fee and depreciated over the life of the program).

4. Kronos (or similar) time clock purchases for the HOMES (direct purchased depreciated over the life of the equipment), payroll processing fee.

5. Software maintenance fees and fees from the central computer/server vendor (direct billed cost to the HOMES).

6. Medical insurance/direct benefits costs of the HOMES (by employees on the plans).

7. Workers compensation insurance costs (based on percentage of payroll dollars for Utah).

8. Any potential tax liability or reserve accrual accounts.

9. Cost reporting fees to HOMES.

10. Interest and fees related to any borrowed funds from CONTRACTOR which will be based on either comparable rate from the CONTRACTOR available working line of credit, or if not active, for CONTRACTOR comparable interest (and fees, if applicable) rates on working lines of credit related to skilled nursing facilities.

11. Banking fees.

12. Other items as agreed upon and approved by UDVMA.

2. CONTRACTOR is encouraged to use available revenue to promote the very best program possible for the residents of the HOMES. Excess net income is transferred to the state hold back fund controlled by the UDVMA to support the SO, renovation, repairs, new equipment, and other expenses authorized by the UDVMA Executive Director.

3. Calendar year 2025 total revenue, net of ancillary expenses, for the GEWOVH was $18,863,593.

4. Calendar year 2025 total revenue, net ancillary expenses, for the WECVH was $13,903,949.

L. COMPENSATION

1. CONTRACTOR understands that the UDVMA is not providing direct compensation to CONTRACTOR. The CONTRACTOR receives an agreed upon percentage of gross revenue less contractual adjustment for services provided under this contract.

2. CONTRACTOR is responsible for bearing the risk of paying for all services associated with performing the terms of this contract.

3. The CONTRACTOR is responsible for the billing and collection for services rendered to all residents. For third party payers such as Medicare, Medicaid and Private Insurance, the CONTRACTOR is responsible for the billing and collection of services rendered. The CONTRACTOR is responsible for obtaining provider numbers, all cost reporting and third-party billing contracts. At the GEWOVH all 120 beds are certified for Medicare and 27 beds are certified for Medicaid. At the WECVH all 81 beds are certified for Medicare and 10 beds are certified for Medicaid.

4. CONTRACTOR shall have sole responsibility for ensuring residents are eligible for State Veteran Home benefits (VA per diem) before admission. CONTRACTOR shall prepare, and submit to the SO, for forwarding to the VA, all documents and information necessary for VA per diem reimbursement.

5. Non-routine services may result in charges by CONTRACTOR more than the daily rate as agreed upon by UDVMA.

M. CONTRACTOR SHALL (GENERAL):

1. Coordinate and work through the on-site SO who is employed by the UDVMA and with the Veterans Nursing Home Advisory Board as established by statute.

2. Manage and operate the HOMES in compliance with all applicable laws, rules, regulations, standards, and policies of the federal, state, and local government and any other entity that has relevant jurisdiction. If any requirements differ, the higher or stricter requirement shall prevail.

3. Manage and operate the HOMES in a manner to ensure that each resident receives the necessary medical, nursing, dental, and rehabilitative services needed to achieve their maximum level of independent functioning and the best possible quality of life. The minimum services to be available for each resident must be those required by the VA, Centers for Medicare and Medicaid Services (CMS) and the Utah Department of Health (DOH).

4. Manage and operate the HOMES in a manner that respects the rights and dignity of the residents.

5. Secure and retain all licenses and certification required to legally operate the HOMES as skilled nursing care facilities with Alzheimer’s care units and other licenses and certifications as may be required by the VA, CMS, DOH, or any other licensing authority. Failure to maintain the proper licenses or certification by an accrediting agency is a material breach of this contract. If CONTRACTOR fails to maintain VA approval of HOMES, pending appeal rights, and per diem payments are stopped by the VA, CONTRACTOR shall forfeit that portion of the daily rate for such period, unless the per diem payments are restored through an appeal. CONTRACTOR will have standing to independently pursue such an appeal with the VA and shall fully cooperate with any appeal filed by the UDVMA. CONTRACTOR may not seek reimbursement of the forfeited per diem payments from the UDVMA or residents. UDVMA may also terminate the contract or impose other reasonable remedies at the UDVMA's discretion if CONTRACTOR loses VA approval of HOMES, regardless of the status of any appeal rights with the VA.

6. Develop, implement, and maintain policies and procedures for all aspects of the management and operations of HOMES that will ensure high standards of resident care which are in accordance with all federal, state, and local regulatory requirements. The UDVMA shall have the right to review and approve all policies and procedures proposed and in use at HOMES. In the event of contract cancellation or termination for any reason, the UDVMA will have the option to continue to use such policies and procedures until it is no longer necessary.

7. Develop, or have in effect, a comprehensive facility wide Quality Assurance (QA) program which shall include, but not be limited to, audit and medical chart review. The program should incorporate continuous quality monitoring techniques and must meet federal and state standards and regulations. In addition to direct patient care services, the plan should provide for the continuous monitoring of all services provided by the CONTRACTOR to include food service, housekeeping, laundry, maintenance, safety, security, and other ancillary support services.

a. The QA Committee will meet monthly. The Medical Director will participate as a member of this committee. CONTRACTOR will have overall responsibility for the QA Program at the HOMES and designate a nurse who will be responsible for implementation and oversight of the QA program. The SO will be invited to attend.

b. The QA director or designee will establish and implement in-service training for nursing, professional and support personnel. In-service training will be conducted at least quarterly.

c. CONTRACTOR shall integrate infection control into its QA program. The infection control nurse will oversee and coordinate a facility wide audit monthly to ascertain if the environment is free from infectious hazards. Findings will be forwarded to the QA Committee.

8. Have in place transfer agreements signed by CONTRACTOR and local acute care facilities for emergencies.

9. Provide or arrange transportation for residents for non-emergency medical and surgical procedures. Provide transportation for residents to VA Medical Centers, hospitals, or other health care facilities. Any costs for services outside the scope of this contract must be borne by a third-party payer, if available to CONTRACTOR, or by the resident/payer.

10. Notify the SO immediately following notification required by law, of any abuse or suspected abuse of a resident, any unexpected or unexplained injury or death of a resident, or any immediate threat to the health and safety of a resident.

11. Follow the VA protocol on reporting Sentinel Events and include SO in all correspondence with the VA specific to a sentinel event.

12. Meet with the Veterans Nursing Home Advisory Board on at least a quarterly basis. The Board may also choose to meet more often, if necessary.

13. Provide appropriate insurance coverage including property, personal liability, injury, and general liability. UDVMA and its officials shall be named as an insured for purposes of providing indemnity when required by this contract. CONTRACTOR will also provide workers’ compensation coverage for its employees.

a. Upon termination of this Agreement for any reason CONTRACTOR will furnish "tail coverage" under a "claims made policy" for a period of seven (7) years since Utah has a medical malpractice statute of limitations for two years from the known date of an incident but not longer than four (4) years from the date of the incident.

N. THE CONTRACTOR SHALL (OPERATIONAL):

1. Assume full responsibility for management and supervision of the daily operation of the HOMES.

2. Assume full responsibility for development, implementation, and operation of all necessary administrative systems including, but not limited to, accounting, personnel, reporting, administrative records, medical records, purchasing, etc., which will ensure the proper preparation of all financial statements and maintenance of financial records including, but not limited to payroll, accounts receivable, accounts payable, resident trust funds and operating statement. CONTRACTOR shall maintain all records for periods of time as required by federal and state law and shall make sure records are available for review and audit by the UDVMA or its representatives.

3. Be responsible for the purchase, repair, or replacement of individual equipment items with a cost of $3,000.00 or less (excluding taxes) per item or unit. Such equipment shall become the property of the State. CONTRACTOR will receive full benefit from all warranties in effect, if any, for equipment purchased. Under certain circumstances, such as excessive net income, the CONTRACTOR may agree to cover the cost of items that exceed the $3,000.00 threshold.

4. Provide the UDVMA with an annual budget to include estimated income and expenses by category before the beginning of each fiscal year and monthly operating statements for HOMES. Monthly statements should show monthly, year to date and budgeted income and expense amounts by category.

5. Provide clinical, financial, and operational reports and data to the UDVMA as requested by the SO or by UDVMA leadership.

6. Provide the UDVMA, and their respective authorized representatives unlimited access to the physical plant, administrative and financial data, and any other information deemed necessary to audit records, verify services, verify the quality of care delivered, resolve complaints, respond to inquiries, and otherwise perform required duties.

7. Assume responsibility for review of medical eligibility, in accordance with existing federal and state law, of applicants for admission to HOMES.

8. Assume responsibility for collecting and accounting for income from residents from all sources and third-party payments.

9. Assume full responsibility for providing all supplies, provisions, consumables, and equipment required for operation of HOMES.

a. At any time that the CONTRACTOR ceases to operate the HOMES, the HOMES must be returned fully stocked and equipped for continued operation, just as it was initially provided to the CONTRACTOR.

10. Pay for and assume full responsibility for providing all utilities and fuels, including but not limited to water, natural gas, electricity, sewer, diesel oil, gasoline, telephone, garbage and hazardous waste disposal.

11. Assume liability for all federal, state, and local taxes and pay for any necessary permits and licenses. The contract includes all applicable federal, state, and local taxes and duties. These obligations may be paid through operational funds of HOMES. In no event shall the UDVMA assume or be held responsible for any of the above-mentioned costs.

12. Provide, at no charge, office space for the SO and Veteran Service Officer (VSO) stationed at the HOMES and other such space as may be required by the UDVMA.

13. Allow UDVMA staff to schedule meetings in the Conference Room or the Multipurpose Room if it does not interfere with CONTRACTOR’s operation and or resident centered activities.

14. Assume responsibility for the recruitment and coordination of volunteers to enhance the quality of life for the residents.

15. Provide or make available to all residents, complete medical care, and rehabilitation services as required by law, regulation, or standards and as prescribed or directed by medical professionals.

16. Provide all residents with complete transportation services to fulfill their medical, therapeutic, and recreational needs. The vehicles will be provided by the State. CONTRACTOR will be responsible for covering related expenses from the Utah Division of Fleet Services for each state vehicle. The expenses include a lease fee, fuel fee, maintenance fee.

17. Provide nursing services 24 hours per day, 7 days per week. The mix and number of direct care staff will meet resident needs as set forth by VA, CMS, and DOH. Nursing services will be under the supervision of the director of nursing, a registered nurse licensed to practice in Utah. A nurse supervisor (RN) will be on each shift and should be experienced in gerontological nursing. Each community will have immediate access to a nurse on each shift who will be either an RN or an LPN who is a graduate of an approved school of nursing and currently licensed in Utah. CONTRACTOR will employ sufficient backup nursing personnel or make contractual or other arrangements to always ensure nursing availability.

a. Nursing services provided will focus on rehabilitative nursing care directed at assisting each resident to achieve and work towards the highest possible level of self-care and independence.

b. All nursing personnel will receive first aid and CPR training. CPR training shall be offered to all employees on an annual basis.

18. Conduct resident care conferences as required by federal and state law. The resident care conference will be attended by an established interdisciplinary team, chaired by the director of nursing or designee. The purpose is to ensure each resident's total program is adequate and appropriately meets his/her health and social needs.

19. Be willing to enter into agreement with an accredited institute of higher learning to provide a setting for geriatric training in concert with their respective College of Nursing---to provide for on-site visits and interface for the purpose of providing an additional training opportunity for nursing students as well as additional care and social interface for veteran residents with nursing and other health care students and faculty.

20. Implement a Social Services program at the HOMES directed by a qualified social worker. If the social worker does not possess an MSW degree, a state licensed social work consultant must be provided. The Social Services program will be staffed to meet the needs of the residents.

21. Implement a high-quality activities program directed by a certified director. The director will be a certified activity director, a master therapeutic recreation specialist (MTRS) or a licensed therapeutic recreation technician, with consultation from an MTRS. In addition, he/she will have experience in directing and managing both therapeutic group and individual activity programs. The activity director, or designee will also serve as the volunteer services coordinator to ensure integration with volunteer service programs.

a. The activities program shall be staffed to meet the needs of the residents.

b. Provide individualized services to the HOMES residents. The Activities Director or Volunteer Services Coordinator will work closely with the Director of Social Services to assist in obtaining community resources to help meet the specific needs of the individual resident.

c. Arrange religious services with community churches based upon resident requests. The HOMES will not exert preferences regarding religious activities.

d. Provide Barber and Beauty Services for residents.

e. Provide a monthly activities calendar to SO.

f. Participate as a member of the HOMES Resident Care Conferences.

22. Provide complete laundry services for the operation of HOMES.

23. Provide complete housekeeping services for the operation of HOMES which ensure cleanliness and comply with infection control policies and other sanitary standards under federal, state, and local law.

24. Maintain complete and accurate medical records of residents' care that comply with VA, CMS, DOH requirements including all other applicable legal requirements pertaining thereto.

a. Ensure confidentiality of all residents’ medical records.

b. In the event of a change in CONTRACTOR (Provider), UDVMA shall require both the current and new operator (Provider) to negotiate and enter into an Operational Transfer Agreement (OTA.) Such OTA shall include provision for necessary access to medical records and will adhere to, and be in accordance with, all Federal and State laws, rules, and regulations including HIPAA. Medical Records Forms will be provided by CONTRACTOR and approved by the UDVMA. A data system will be designed and implemented for the purpose of providing patient and healthcare services.

25. Provide a high-quality dietary service program to meet the needs of the residents that follows all applicable federal and state laws, regulations, or standards and as prescribed or directed by medical professionals. Meals provided will be in accordance with the dietary allowances of the Food and Nutrition Board of the National Council adjusted for age, sex, and activity. All applicable food preparation and handling standards shall be strictly followed. Therapeutic diets will be prepared and served according to the diet order prescribed by the physician under the supervision of a qualified dietician. The dietary department will be organized and staffed to meet the dietary needs of the residents. A qualified dietician will supervise services. Dietary policies and procedures will comply with the highest federal and state guidelines.

26. Provide complete pharmacy goods and services for the residents in accordance with all requirements of the VA, CMS, DOH, the Federal Drug Enforcement Agency, and any other regulatory body and as prescribed or directed by medical professionals, including medication, medical supplies and dietary supplements, both prescriptions, and over the counter.

a. Provide a qualified pharmacist to oversee the HOMES pharmaceutical services, to monitor drug related services, ensure accuracy, and coordinate pharmaceutical services that residents are entitled to receive through the VA and to make recommendations for improvement.

b. Comply with all federal and state laws related to procurement, storage, administration and disposal of prescription, non-prescription and controlled drugs.

c. Be responsible for tube feeding and decubitus care products and may seek third party reimbursement such as Medicare or private insurance for these services and products.

27. Provide or make available to all residents, all personal, specialized medical equipment as required by federal or state law, regulation, or standards and as prescribed or directed by medical professionals, including, but not limited to, prosthetics, orthotics, hearing aids, corrective eye wear, and specialized beds.

28. Provide or make available to all residents complete dental goods and services for the residents as required by federal and state law, regulation, or standards and as prescribed or directed by medical or dental professionals.

29. Provide an on-site physical, occupational and speech therapy program with personnel licensed by the state which meets or exceeds all state and federal law, regulation, and standards. The therapy program shall include enough qualified restorative nursing assistants to ensure all interested residents receive restorative nursing care.

30. Develop an admission committee to review resident admissions in accordance with the HOMES admissions policy and denial/safety protocols. The UDVMA has the right to review admissions and admission procedures at its discretion.

a. Develop and provide informational sheets/brochures on services provided for veterans and family members that are inquiring.

31. Implement an ongoing, concerted, marketing effort. Establish and maintain contact with organizations and individuals likely to encounter veterans in need of services and/or to refer them to the HOMES. These will include, but are not limited to:

a. The Utah Department of Veterans and Military Affairs.

b. The Veterans Benefit Administration – Salt Lake City Regional Office.

c. VA, private, and public hospitals throughout Utah.

d. Social service agencies and social workers within hospitals and other long-term care institutions.

e. Veterans service organizations.

f. Associations for the elderly, church groups and fraternal organizations.

32. Provide necessary accounting systems and security to safeguard and account for the personal funds of residents.

33. Develop and implement a complaint resolution program, including a resident council, which allows the residents to express grievances and recommend changes.

34. Provide complete mortuary policies that ensure the sensitivity and expediency of death notification, documentation, and disposition of remains.

35. Provide or contract to provide other services as necessary, including but not limited to, laboratory, medical records, and mobile x-ray.

36. Provide medical supplies and daily care items.

37. Provide the UDVMA copies of all subcontracting agreements.

38. Ensure appropriate inventory control and security procedures to maintain and protect property of the State of Utah.

39. Be responsible for supporting Information Technology needs of the residents including network connection, device, and system upgrades, etc.

40. Institute and maintain adequate controls over state property vested under their control and be liable for losses resulting from damage, theft, and acts of negligence. All property within the HOMES that belongs to the State of Utah, other than those items declared expendable by the UDVMA, will be maintained in inventory.

O. CONTRACTOR SHALL (PERSONNEL):

1. Recognize the UDVMA right to participate in and mutually agree with the CONTRACTOR on the selection and continued employment of the administrator, director of nursing and the medical director.

2. Not, as part of its agreement with employees or subcontractors, prevent any employee or subcontractor from working in HOMES in the event of cancellation or termination of the contract for any reason.

3. Employ a full-time, licensed, nursing home administrator, in accordance with the Utah Health Facility Administrator’s Licensure Act.

a. The administrator will be the CONTRACTOR’s representative at HOMES.

b. The HOMES administrator will meet with the SO as requested.

4. Allow the SO and UDVMA leadership to attend all meetings at its discretion, relating to the management and operation of the HOMES, including meetings to discuss patient care issues.

5. Employ a licensed medical director who shall be responsible for the overall medical care in HOMES. The medical director shall ensure that adequate and appropriate medical services are provided to residents of the HOMES and that such services are consistent with the standards set by the VA, CMS and the DOH.

6. Ensure that all physicians practicing at the HOMES are properly credentialed according to the policies and procedures of the VA, CMS and the DOH.

7. Ensure continued operation and appropriate staff coverage in the event of any work stoppage.

8. Ensure that each resident has a designated primary physician who will be responsible for the overall medical care of that resident. Residents may be seen or treated by a physician or other licensed health care practitioner of their own choosing at their own expense.

9. Ensure that all personnel employed at the HOMES have required background checks completed and where required, are properly licensed, credentialed or certified for the work they perform.

10. Prior to assuming duties, ensure that all personnel are provided with a new employee orientation that addresses policies, procedures, regulations, safety, and medical practices.

11. Ensure all HOMES employees participate in a continuing education program and meet the minimum educational and training requirements set forth in the latest federal and state regulations and laws for their position.

12. Establish policies designed to recruit, develop, and retain exceptional personnel to ensure quality health care delivery. CONTRACTOR shall offer competitive salaries and benefits necessary to attract qualified applicants and employees.

13. Provide hiring preference to veterans and their families (spouse or child of veteran) applying for work at the HOMES if the individual meets the job qualifications and is a qualified candidate as determined by CONTRACTOR (Utah Code Section 34-50-103).

14. Ensure employees meet or exceed minimum requirements established by state and federal regulations.

15. Allow personnel files to be inspected by the SO or UDVMA leadership during normal business hours.

16. Ensure operation and coverage in the event of a labor dispute or strike.

P. THE CONTRACTOR SHALL (MAINTENANCE):

1. Assume responsibility for general and routine preventative and corrective maintenance of the HOMES physical plant and equipment.

2. Coordinate with the State of Utah Division of Facilities and Construction Management (DFCM) on preventative maintenance of major mechanical systems. UDVMA covers the cost of DFCM support through the holdback funds at the GEWOVH and the WECVH.

3. Monitor and take full advantage of any warranties in effect on all equipment and furnishings.

4. Maintain detailed records of preventative and corrective maintenance performed on equipment, building, or grounds of the HOMES. Make the maintenance log available to the SO as requested.

5. Maintain furniture, equipment, and machinery in good repair in accordance with State of Utah personal property policies and rules. Disposal or retirement of same must be in accordance with State of Utah personal property disposal policies and rules and must be approved by the UDVMA prior to such disposal or retirement.

6. Return the HOMES and equipment to the UDVMA at the end of any contract period in the same condition as it was at the beginning of the contract period, excluding reasonable wear and tear.

7. Provide the following services including, but not limited to:

a. Grounds maintenance on a year-round basis to include landscaping, automatic irrigation system, weed control, snow removal and cleanliness.

b. Extermination and pest control.

c. Trash disposal and removal.

d. Complete facility-wide housekeeping.

e. Provide security to ensure that the building, grounds, residents, staff, volunteers, and visitors are safe.

1. Designate an on-call security officer, which may be any properly designated and trained employee, for the HOMES, 24 hours, 7 days per week, to ensure the safety of residents, staff, and visitors and to monitor all fire, safety, and patient care systems. A report of incidents, occurrences, and events in the HOMES will be made available to the SO within a reasonable time, not to exceed 24 hours.

f. Dispose of medical and infectious waste in compliance with all applicable regulations and standards.

g. Establish and operate the HOMES at minimum as a nonsmoking facility.

8. Comply with all federal, state, and local life safety standards and regulations. Meet or exceed requirements specified in regulations concerning fire prevention, protection, and disaster preparedness. Conduct fire drills on each shift in accordance with federal and state requirements. Test emergency equipment as required by state and federal law. Provide regular training in safety and preparedness for all employees.

Q. THE STATE SHALL (GENERAL):

1. Appoint a SO to represent the UDVMA and to work with CONTRACTOR in the operation of the HOMES. SO will ensure contract compliance for the management, operation, and administration of the HOMES.

a. The SO, upon request, will support the administrator and staff in resolving patient care complaints.

b. Annually, SO will audit the resident trust fund (accounts).

2. Be responsible for the purchase, repair, or replacement of individual equipment items with the cost of $3,000.00 or more (excluding taxes) per item or unit, not the direct result of abuse or negligence on the part of CONTRACTOR. The purchase of bundled items that exceed the $3,000.00 threshold will be at the discretion of the Executive Director, UDVMA. Items replaced because of negligence shall not be recognized as an allowable cost.

3. Be responsible for payment of items that exceed the $3,000.00 threshold. SO will follow Utah Division of Purchasing procurement rules when making such purchases.

4. Station additional UDVMA employees at the HOMES as needed to fulfill the obligations of the department.

5. Manage all cash donations through the SO. Cash donations for the HOMES will be deposited as a restricted fund into a state-controlled account. Resident Council may recommend to the SO how the donation funds are used. Generally, the funds are used to supplement the recreation budget and provide quality entertainment and recreation for the residents.

6. Pay for miscellaneous expenses associated with daily UDVMA staff office operations.

7. Assume responsibility for telecommunication, office equipment maintenance and replacement for UDVMA employees.

8. Assist the CONTRACTOR in public relations and soliciting applicants with the goal of achieving and maintaining full occupancy.

9. Assist, if requested to do so, in the review process to determine the eligibility of applicants for admission to HOMES.

10. Submit pharmacy reimbursement requests to the VA for eligible residents if applicable.

11. Prepare, from information provided by CONTRACTOR, all invoices, and documents necessary for reimbursement of the VA per diem and will submit claims to the VA. Payment for monthly per diem less the established holdback will be paid to CONTRACTOR by the end of the following month.

12. Provide initial telecommunications and data processing systems. In the event of cancellation or termination of the contract for any reason, all such systems (including hardware, software, data, and documentation) shall remain the property of UDVMA.

13. Have the right to inventory all State property within the HOMES at any time. No state property shall be removed from the HOMES without the permission of the UDVMA. CONTRACTOR will institute and maintain adequate controls over state property vested under their control. CONTRACTOR will be liable for losses resulting from damage, theft, and acts of negligence. All property within the HOMES that belongs to the State of Utah, other than those items declared expendable by the UDVMA, will be maintained in inventory.

14. Give CONTRACTOR notice if the services rendered do not correspond to the description, quality, quantity, etc., as detailed in the contract, or are unsatisfactory in any manner. Under such conditions, the UDVMA will notify CONTRACTOR in writing as to those specific performance areas not in compliance. CONTRACTOR will then provide a written plan of action to the UDVMA within 5 working days of notification outlining the remedies to be taken. If the written plan of action is unsatisfactory or the contract deficiencies are not remedied to the satisfaction of the UDVMA as per a satisfactory plan of action, then the UDVMA may terminate the contract, withhold VA per diem or other payments, or take other appropriate action.

15. Have the authority to require termination of any CONTRACTOR employee in the HOMES for good cause.

16. Ensure inventory control. Final per diem payment under this contract will not be made by the UDVMA until all inventories are restored to the original levels which existed at the beginning of the contract and until an audit of equipment and other state property is completed by the UDVMA. All other CONTRACTOR responsibilities required under the contract must also be fulfilled.

R. MISCELLANEOUS PROVISIONS

1. The contract established for HOMES shall be for five (5) years. There will be a single renewal option for 3 Years, if exercised by UDVMA.

2. CONTRACTOR will provide certification that they possess legal authority to enter into agreements and that a resolution, motion or similar action has been duly adopted or passed as an official act of the governing body, providing authority to enter into this agreement, including all understandings and assurances contained herein, and directing and authorizing the person identified as the official representative of the governing body to act in connection with the agreement and to provide such additional information as may be required.

3. Should the contract result in a book or other copyrighted materials, CONTRACTOR may copyright the work only with UDVMA permission. The UDVMA shall have a royalty- free nonexclusive and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use the work for government use.

4. Any publications resulting from or primarily related to State financial assistance shall contain acknowledgment of State support, in whole or in part.

5. Upon termination or expiration of this contract, the data, reports, and other documents developed by CONTRACTOR for HOMES under this contract will be required to be delivered to UDVMA at no additional cost.

6. CONTRACTOR shall hold harmless the State of Utah, its employees, and officers from liability of any nature or kind arising out of claim or suit for the use of any copyrighted or un copyrighted composition used in the performance of the services it shall provide as a part of the contract. CONTRACTOR agrees to assume the defense of all such suits and pay the costs, attorney fees, damages, and expenses incidental thereto, subject to the right of the State to provide additional legal counsel at the State's own expense.

7. Except as stated in this contract, CONTRACTOR is prohibited from subcontracting, assigning, transferring, conveying, subletting, or otherwise disposing of this agreement or its right, title, or interest or its power to execute such agreement to any other person, company, or corporation without the previous written consent and express approval of UDVMA.

8. No modification or change of any provision in the contract shall be made, or construed to have been made, unless such modification is mutually agreed to, in writing, by CONTRACTOR and UDVMA, and incorporated as a written amendment(s) to this contract. Memoranda of understanding or correspondence shall not be construed as an amendment to the contract.

9. If the HOMES becomes uninhabitable due to acts of God, environmental hazard or acts beyond the reasonable control of CONTRACTOR, the obligation to make any payments otherwise due under this contract shall be suspended so long as such conditions shall exist. If the condition continues for six (6) months, CONTRACTOR may terminate the contract without any liability to the UDVMA upon ninety (90) days’ written notice. The UDVMA shall pay CONTRACTOR in accordance with the provisions of the contract until the effective date of termination.

10. Prior to commencing work on this contract, CONTRACTOR shall provide HOMES with a Certificate of Insurance, with an insurer and coverage acceptable to the UDVMA.

11. CONTRACTOR policies and procedures, quality assurance programs and special documentation and software programs are unique and proprietary to CONTRACTOR. Upon termination of this contract the UDVMA agrees to return to CONTRACTOR those proprietary documents and software, except for those which are part of patient records and for inventory purposes for the UDVMA, and that such items are not used by any future Operators of the HOMES without CONTRACTOR's express permission and then only for a limited period as is necessary to maintain uninterrupted access to patient records.

12. Software programs for electronic medical records are proprietary to the licensing agreement held by CONTRACTOR's parent company. The licensing agreements are owned by CONTRACTOR and the software company unless the HOMES choose to purchase them separately as capital expenditure. Unless purchased by UDVMA for HOMES, licenses will remain the property of CONTRACTOR.

13. CONTRACTOR may terminate this contract on thirty (30) days’ written notice if Congress terminates or significantly reduces the payment of VA per diem payments to UDVMA which are not appropriately offset by rate adjustments approved by UDVMA.