36C10G24R0016.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C10G24R0016 4-28-2026

Priscilla Burke 202-236-3526 6-12-2026

15:00 ET

36C10G U.S. Department of Veterans Affairs OPAL | Strategic Acquisition Center

10300 Spotsylvania Ave | STE 400 Fredericksburg VA 22408-2697

X

541611

$24.5 Million

N/A

36C10G

U.S. Department of Veterans Affairs OPAL | Strategic Acquisition Center

10300 Spotsylvania Ave | STE 400 Fredericksburg VA 22408-2697

VAFSC

Financial Services Center

PO BOX 149971

(see Section B.3 invoicing/payment) Austin TX 78714-8917

1 (877) 489-6135

Survey of State Veterans Homes (SVH)

See Performance Work Statement (PWS) in Section B.4 and Schedule of Supplies in Section B.5

X X

X 1

ANNA NORCROSS Warrant #VA-OPAL-SAC-2025-0013 Acquisition Services Division 4A

TABLE OF CONTENTS

SECTION A - SF 1449

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 ACKNOWLEDGEMENT OF AMENDMENTS:

B.3 FEDERAL ACQUISITION REGULATION AND OTHER ASSOCIATED

REGULATIONS, MANUALS, AND DOCUMENTS:

B.4 PERFOMANCE WORK STATEMENT

B.5 PRICE/COST SCHEDULE

ITEM INFORMATION

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 TERMS AND CONDITIONS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (DEVIATION DATE)

C.2 ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

C.3 52.216-18 ORDERING (AUG 2020)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (DEVIATION DATE)

C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.7 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT

(MAR 2000)

C.8 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.9 52.232-18 AVAILABILITY OF FUNDS (APR 1984)

C.10 MANDATORY WRITTEN DISCLOSURES

C.11 VAAR 852.204-72 PERSONNEL VETTING AND CREDENTIALING

(MARCH 2026)

C.12 VAAR 852.211-76 LIQUIDATED DAMAGES – REIMBURSEMENT

FOR DATA BREACH COSTS (FEB 2023) ALTERNATE I (FEB 2023)

C.13 VAAR 852.222-71, COMPLIANCE WITH EXECUTIVE ORDER 13899.

(DEVIATION) (APR 2025)

C.14 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT

REQUESTS (NOV 2018)

C.15 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.16 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER

(OCT 2020)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

ATTACHMENTS

DOCUMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.240-90 SECURITY PROHIBITIONS AND EXCLUSIONS

REPRESENSATIONS AND CERTIFICATIONS (DEVIATION DATE)

E.2 52.209-2 PROHIBITION ON CONTRACTING WITH INVERTED

DOMESTIC CORPORATIONS-REPRESENTATION (DEVIATION DATE)

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY

MATTERS (DEVIATION DATE)

E.4 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES (DEVIATION DATE)

E.5 PROPOSAL SUBMISSION INSTRUCTIONS

E.6 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (DEVIATION DATE)

E.7 BASIS FOR AWARD

E.8 52.216-1 TYPE OF CONTRACT (DEVIATION DATE)

E.9 52.233-2 SERVICE OF PROTEST (DEVIATION DATE)

E.10 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (SEP 2018)

E.11 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY

REFERENCE (FEB 1998)

THIS SECTION INTENTIONALLY LEFT BLANK / SEE NEXT PAGE

CONTINUATION PAGE 36C10G24R0016 Page 4 of 128

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR: Company Name

Address City, State Zip CAGE Code

DUNS

SAM IEU

Tax Identification Number (TIN) Point of Contact (POC) Name/Title POC Email POC Phone Number

b. GOVERNMENT: Contracting Officer 36C10G

OPAL | Strategic Acquisition Center 10300 Spotsylvania Ave | STE 400 Fredericksburg VA 22408-2697

Anna D. Norcross, Primary Contracting Officer Anna.Norcross@va.gov Mauricio Vazquez, Alternate Contracting Officer Mauricio.Vazquez@va.gov Rodney Burgos Cabassa, Alternate Contracting Officer Rodney.Burgoscabassa@va.gov

Priscilla Burke, Primary Contract Specialist Priscilla.Burke@va.gov Nicole Lowther, Alternate Contract Specialist Nicole.Lowther@va.gov Betsy Lawrie, Alternate Contract Specialist Betsy.Lawrie@va.gov

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or [ ] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly [ ]

b. Semi-Annually [ ]

[X] Upon completion of work; quantities identified per Contract Line Item Number (CLIN)

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

5. FSC MANDATORY ELECTRONIC INVOICE SUBMISSION: Contractors are required to submit payment requests in electronic form in accordance with the submission instructions.

mailto:Anna.Norcross@va.gov mailto:Mauricio.Vazquez@va.gov mailto:Rodney.Burgoscabassa@va.gov mailto:Priscilla.Burke@va.gov mailto:Nicole.Lowther@va.gov mailto:Betsy.Lawrie@va.gov

CONTINUATION PAGE 36C10G24R0016 Page 5 of 128

TUNGSTEN ELECTRONIC INVOICE SUBMISSION

FSC e-INVOICE PROGRAM THRU AUSTIN PORTAL

FSC MANDATORY ELECTRONIC INVOICE SUBMISSION FOR AUSTIN PAYMENTS

Contracting POC: Ms. Anna Norcross Contracting Officer Representative (COR): Ms. Kathryn Scott Contract/Task Order Number: TBD Purchase Order Number: TBD

a. Vendor Electronic Invoice Submission Methods: Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below.

1. VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, Tungsten, to transition vendors from paper to electronic invoice submission. Please go to this website: http://www.tungsten-network.com/US/en/veterans-affairs/ to begin submitting electronic invoices, free of charge.

2. A system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) chartered by the American National Standards Institute (ANSI). The X12 EDI Web site is (http://www.x12.org).

b. Vendor e-invoice Set-Up Information:

Please contact Tungsten at the phone number or email address listed below to begin submitting your electronic invoices to the VA Financial Services Center for payment processing, free of charge. If you have question about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below.

1. Tungsten e-Invoice Setup Information: 1-877-489-6135

2. Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

3. FSC e-Invoice Contact Information: 1-877-353-9791

4. FSC e-invoice email: vafsccshd@va.gov

See https://www.fsc.va.gov/einvoice.asp for more information.

6. MINIMUM GUARANTEE: The minimum dollar amount that the Government agrees to order under each contract awarded under this solicitation is $40K. If the Contractor receives total orders for less than the minimum amount, the Government will pay the difference between the amount ordered and the minimum amount guaranteed. The Government's obligation for the minimum amount only applies to the base period of each awarded contract.

7. EXTENT OF OBLIGATION: The Government is obligated only to the extent of authorized purchases actually made under the resultant contract. A minimum guarantee IAW FAR 16.504-5 of $40K will be placed against this contract upon award of the IDIQ contract via a Task Order (TO). The parties agree the Government will fulfill its obligation to order a minimum quantity by paying the Contractor $40K at the end of the ordering period, unless it orders one unit or a combination of units that exceeds $40K before that time, which would otherwise fulfill the obligation.

8. MAXIMUM CEILING AMOUNT: The maximum ceiling amount of $TBD at time of award is the total of all Task Orders combined through the effective period of performance.

http://www.tungsten-network.com/US/en/veterans-affairs/ http://www.tungsten-network.com/US/en/veterans-affairs/ http://www.x12.org/ mailto:VA.Registration@Tungsten-Network.com mailto:vafsccshd@va.gov https://www.fsc.va.gov/einvoice.asp

CONTINUATION PAGE 36C10G24R0016 Page 6 of 128

9. CONTRACTING OFFICER AUTHORITY: The Contracting Officer (CO) for the contract shall be the only individual authorized to direct/redirect the efforts under the contract and task orders issued or in any way modify the items or terms of this contract.

10. SUCCESSOR CONTRACTING OFFICER: The CO who signed this contract and identified is the primary CO for the contract. The Alternate CO is designated. These are the only COs authorized to take formal action on this contract. The alternate will assume authority when a contract action needs to be taken and the primary CO is unavailable. Unless a modification is initiated to change the primary or alternate CO, no other CO has authority to act for or make changes to this contract within his/her authority.

B.2 ACKNOWLEDGEMENT OF AMENDMENTS:

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

B.3 FEDERAL ACQUISITION REGULATION AND OTHER ASSOCIATED

REGULATIONS, MANUALS, AND DOCUMENTS:

The solicitation document and incorporated provisions and clauses are those in effect through Revolutionary FAR Overhaul (RFO) October 2025.

Also, the solicitation document and incorporated provisions and clauses are those in effect through the Department of Veterans Affairs Acquisition Regulation (VAAR) and the VA Acquisition Manual (VAAM) through update January 31, 2025.

CONTINUATION PAGE 36C10G24R0016 Page 7 of 128

B.4 PERFOMANCE WORK STATEMENT

A. GENERAL INFORMATION

A.1. Title of Program:

Surveys of State Veterans Homes

A.2. General Requirements:

The Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Geriatrics and Extended Care (GEC) Program Office has a requirement for conducting surveys at State Veterans Homes (SVHs) to be performed by an independent survey company/contractor. The contractor shall align and follow the Centers for Medicare and Medicaid Services (CMS) survey process. The contractor shall only survey and identify deficient practices in SVHs in accordance with Title 38 Code of Federal Regulations (CFR) Part 51 “Per Diem for Nursing Home, Domiciliary, or Adult Day Health Care of Veterans in State Homes” federal regulations. The survey process shall be performed for each SVH as outlined in the Performance Work Statement (PWS) and carried out via Task Order(s) (TO).

The skill set required of the contractor personnel surveying SVHs includes long-term care surveyor experience or expertise to include state or CMS survey experience in conducting surveys of nursing homes; the ability to analyze and interpret Quality Measures (QM) generated by the Resident Assessment Instrument (RAI)/Minimum Data Set (MDS); and the ability to utilize the CMS survey process in the assessment of 38 CFR Part 51 regulations. All surveyors shall have a minimum of three years experience in external review, with knowledge, skills, and abilities to include the application of a wide range of qualitative and/or quantitative methods for the accurate assessment of compliance or noncompliance with applicable programmatic laws, policies, and regulations. The contractor shall have personnel with the educational backgrounds necessary to fully assess all applicable 38 CFR Part 51 regulations, including but not limited to Registered Nurses, Social Workers, Dietitians, and Nursing Home Administrators. Surveyors performing the life safety and fire protection portion of the survey shall have the training and educational background (e.g., Fire Protection Engineer, Fire Marshall, General Contractor, Industrial Hygienist) necessary to adequately interpret and apply the applicable National Fire Protection Association (NFPA) code to the correct SVH occupancy. The contractor is responsible to perform and maintain primary source verification of personnel training credentials, licenses, certifications, registrations, resumes, and years of experience in clinical, life safety, and NFPA surveyor positions with emphasis on CMS long term care expertise.

The contractor shall conduct SVH Annual, For Cause, and Recognition surveys and will possess the qualifications necessary to perform an assessment of compliance with 38 CFR Part 51 regulations at nursing homes, domiciliaries, and Adult Day Health Care (ADHC) programs; assess SVHs’ provision of high-quality care to residents; and identify areas of noncompliance with Title 38 CFR Part 51 regulations. At least one surveyor on each survey team shall be a licensed Registered Nurse. For one SVH facility only (Juana Diaz, Puerto Rico), contractor shall have a professional Spanish linguist (interpreting both the written and spoken language into English). No government personnel shall be utilized.

The contractor shall be responsible for reviewing and scoring all applicable standards in Title 38 CFR Part 51 to include Subparts B - F. As specified in 38 CFR §51.31(a), a survey, as necessary, may cover all parts of the home or only certain parts, and may include review, audit, and production of any records that have a bearing on compliance with the requirements of this part (including any reports from state or local entities), as well as the completion and submission to VA of all required forms.

CONTINUATION PAGE 36C10G24R0016 Page 8 of 128

The contractor shall also be responsible to provide SVH management all five required VA forms for each survey as required by the Office of Management and Budget (OMB) under 38 CFR §51.31(a) upon survey entrance and request from SVH management that all five VA forms be completed, signed, and returned by the second day of the survey; the names and descriptions of all five forms are detailed in Section C.4.3, below. The contractor shall be responsible for evaluating all required VA forms for accuracy and completeness before the time of survey exit. The contractor shall also be responsible to complete all applicable life safety checklists per level of care according to NFPA standards in Title 38 CFR Part 51. The ratings per federal regulation are “Met” or “Not Met”. No recommendations are to be written into any survey report.

A.3. Overall Desired Outcomes/Objectives VA has a commitment to ensure the SVHs maintain high quality standards. VA has implemented the survey program modeled upon the CMS survey process to perform an independent assessment of SVH compliance with Title 38 CFR Part 51 regulations.

On a national level, this type of survey process assures standards are indeed being met. The CMS survey process is considered a standard best practice for nursing homes in the United States; however, not all SVHs are CMS certified. The community standard of assessing level of performance against CMS standards includes an annual survey by a state agency under the auspices of CMS. Of note, SVHs do not receive F-tags or K-tags.

The CMS survey process, in addition to assessment of compliance to the federal regulations, is specific to nursing homes, but it will be used for the Domiciliary and ADHC programs as well. The majority of SVH surveys are unannounced for annual and for cause surveys, but VA Recognition surveys are announced to SVHs. VA requires services of conducting surveys at SVHs to assess compliance with 38 CFR Part 51 regulations applicable to the level of care. The survey report cites specific deviations from professional or community standards of care and 38 CFR Part 51.

VA requires an independent contractor to conduct SVH surveys with the appropriate CMS survey expertise. The purpose of these surveys is to:

(1) Identify areas of concern with quality of care through direct observations and medical record reviews in person.

(2) Assess areas of concern to determine if the SVH is in compliance with applicable

38 CFR Part 51 regulations.

(3) Assure quality of care and safety needs and services are met and provided.

(4) Provide information on best practices and the standards of care as appropriate.

(5) Recognize and certify SVHs annually for compliance to the applicable 38 CFR

Part 51 regulations to continue to receive federal per diem payments.

B. SCOPE OF WORK

The contractor shall perform all services. The contractor shall provide all qualified personnel, equipment, supplies, facilities, transportation, travel, tools, materials, supervision, and other items and non-personal services necessary to successfully perform the services as defined in this Performance Work Statement (PWS) except for those items specified as Government Furnished Property (GFP) and Government Furnished Services (GFS).

Contractor shall ensure any GFP and GFS are safeguarded In Accordance With (IAW) the PWS. Contractor shall ensure requirements in the PWS are accomplished and IAW the applicable documents listed in Section D - Contract Documents, Exhibits, Or Attachments.

No Government employee shall be used for or perform any portion of the requirements of this acquisition. Task Orders shall be placed during the current period of performance to indicate services required to be rendered.

CONTINUATION PAGE 36C10G24R0016 Page 9 of 128

The Government shall neither supervise contractor employees nor control the method by which the contractor performs the required tasks. Under no circumstances shall the Government assign tasks to, or prepare work schedules for, individual contractor employees. It is the responsibility of the contractor to manage its employees to prevent any actions that are in the category of personal services or give the perception of personal services. If the contractor believes that any contractor employee actions constitute, or are perceived to constitute personal services, it shall be the contractor’s responsibility to notify the CO immediately.

There are currently 173 State-Owned and Operated SVHs across the United States; this includes all 50 states, territories, tribal lands and possessions of the United States and the Commonwealth of Puerto Rico (See Attachment A – SVH Master Survey Schedule Listing).

It is anticipated that a range of approximately three to twelve additional SVHs may be added each year during the lifetime of this contract and shall be required to be surveyed for recognition and then annually for certification. The recognition survey process falls under 38 U.S.C. §§ 1741-1745. The State-Owned and Operated SVHs provide three levels of care to include nursing home care, domiciliary care, and ADHC.

B.1. Quality Assurance

B.1.1. Quality Assurance:

The contractor shall have an established Quality Assurance Program (QAP) which details procedures to verify services being performed to those Government standards according to the Acceptable Performance Objectives (APOs) and Acceptable Quality Levels (AQLs).

B.1.2 Quality Assurance Plan (QAP):

The QAP shall demonstrate effective measures of the accuracy, quality, and reliability of adherence to the requirements of this contract throughout the contract’s duration. The QAP is a formal document that outlines the processes, standards, and responsibilities necessary to ensure that a product or service meets predetermined quality levels throughout its lifecycle. The QAP serves as a strategic blueprint for achieving quality in projects or processes. It details the specific activities, standards, tools, methodologies, and responsibilities required to consistently meet quality objectives. The primary purpose of the QAP is to provide guidance and direction to all stakeholders involved, ensuring quality is built into the process from the beginning rather than relying solely on inspection of the final output.

The QAP shall provide a detailed description of the management and operational strategy that sequences the events that this organization shall employ to ensure prompt and efficient delivery of the products and services required.

The QAP is developed by the contractor and approved by the Government in compliance with the contract requirements. The Contractor, and not the Government, is responsible for management and quality control actions necessary to meet the quality standards set forth by the contract and task order performance. The QAP shall be used to guide and to comprehensively document the implementation of the required management and quality control actions to achieve the specified results/outcomes.

The QAP shall be submitted per the Solicitation requirements. The final QAP shall be submitted via the first Task Order at the Kickoff meeting. It shall be provided with only minor updates from the QAP submitted in accordance with the Solicitation.

CONTINUATION PAGE 36C10G24R0016 Page 10 of 128

B.1.3. Quality Assurance Surveillance Plan (QASP):

The QASP is the key surveillance process document. The QASP is used for managing contractor performance by ensuring that systematic quality assurance methods validate contractor quality control efforts to be timely, effective, and delivering the results required in the contract. The QASP directly corresponds to the performance objectives and standards (i.e. quality, quantity, timeliness) specified in the PWS. It provides specific details on how the contractor will survey, observe, test, sample, evaluate, and document contractor performance results to determine if they have met the required standards for each objective in the PWS.

The Government shall utilize the contractor submitted and VA approved

QASP, which is part of the QAP, throughout the life of the contract to ensure the contractor is performing the services required by this PWS via the APOs and AQLs established. Performance shall be evaluated by VA based on contractor performance meeting the QASP standards.

The QASP provides Government surveillance oversight of the Contractor’s quality control efforts to assure timely and effective delivery of the results specified in the contract and/or task order. The QASP shall reflect the Contractor’s responsibility to perform effective Quality Control. The QASP shall be developed by the contractor concurrent with and traceable to PWS Acceptable Performance Objectives, Performance Standards, and Acceptable Quality Levels for Satisfactory or Higher performance of this contract throughout the contract’s duration.

The QASP shall be submitted to the CO per the Solicitation. The final QASP shall be submitted via the first Task Order at the Kickoff meeting. It shall be provided with only minor updates from the QASP submitted in accordance with the Solicitation. It shall be implemented as written to ensure objectivity and consistency.

B.1.4. Corrective Action Request (CAR):

When a concern with contractual compliance and/or performance is identified, the contractor will be notified via an email by the CO in the form of an official cover letter and by Corrective Action Request (CAR) procedure and form or a cure notice. (See Attachment B Corrective Action Request Procedure and Form).

B.1.5. Survey Observations The Program Office will conduct observations of the survey process. Survey observations are mandated by Public Law 117-328 and recommended by the Government Accounting Office (GAO) #19-428 (Final Report July 2019, Recommendation #1). Survey observations are focused on the contractor surveyors’ compliance to following the CMS survey process, PWS requirements, professional accountability, adherence to required infection control protocols, and accuracy of surveyors’ assessment and interpretation of 38 CFR Part 51 regulations.

The CO will assign the COR and the Program Office will identify designated

National Program Managers for Quality and Oversight to conduct such survey observations and record observations in accordance with the Observation Record (Attachment C). Only the scores from observations completed by either the COR or alternate COR will be used in the evaluation of the

CONTINUATION PAGE 36C10G24R0016 Page 11 of 128 contractor’s performance. Scores are given on the Observation Record for each individual surveyor on a scale of one to four assessing conformance to established criteria. (See Performance Metrics Table, page 41 for rating info)

B.2. Period of Performance The period of performance shall be a 12 month base period and four (4) 12 month option periods. A continuation of performance of any services may be exercised more than once, but the total extension of performance hereunder shall not exceed six months beyond any option period.

B.3. Type of Contract

The Government will award a single Indefinite Delivery/Indefinite Quantity (IDIQ) Fixed Price (FP) contract per the Federal Acquisition Regulation (FAR)

16.504 Indefinite-Quantity Contracts. Firm Fixed Price (FFP) Task Order(s) (TO) will be placed during the period of performance for required services.

B.4. Type of Orders Task Orders shall be issued only in writing by the Strategic Acquisition Center (SAC) CO(s) identified in paragraph B.1.1b. Requirements for additional number of services are required within any current period of performance. No oral orders are authorized, and no other field units can place orders.

Not all Contract Line Items Number(s) (CLIN) are required to be ordered on any given Task Order. CLINs will be identified on every order and the quantity being ordered. For the minimum and maximum order limitations, reference Section C: Contract Clauses:

52.216-18 ORDERING

52.216-19 ORDER LIMITATIONS

B.5. Place of Performance

All work completed under this PWS shall take place at the contractor’s facility and at the SVHs.

B.6. Recognized Holidays The contractor shall not perform services on the following Federal holidays.

New Year’s Day Juneteenth Veterans Day MLK Jr.’s Birthday Independence Day Thanksgiving Day President’s Day Labor Day Christmas Day Memorial Day Columbus Day

B.7. Hours of Operation

The contractor is responsible for conducting surveys Monday through Friday, except Federal Holidays or when the SVH is closed due to local or national emergencies, administrative closings, or similar State Government-directed facility closings.

However, surveys for SVHs may be required to be conducted prior, during, and after routine local business hours to accomplish all required assessments of compliance.

This may include surveyors arriving early or staying later at the facility for off-hour observations of care delivery (e.g., early AM medication pass, early care observation, evening dinner meal observation). Surveys shall not occur the week of the National Association for State Veterans Homes (NASVH) Winter or Summer Conference.

CONTINUATION PAGE 36C10G24R0016 Page 12 of 128

B.8. Business Day For purposes of communication with and submission of deliverables to the Program Office, an administrative business day is 7:30AM Eastern Time (ET) to 5:00PM ET.

These are Mondays through Fridays, excluding federal holidays and weekends.

The contractor is responsible for conducting normal business between the hours of 7:00AM and 5:00PM Eastern Time Monday through Friday, except federal holidays.

If performance is required at a Government facility when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings, the contractor shall seek clarification from the COR and CO to perform or cancel.

B.9. Definitions

The following definitions are used throughout the PWS and are to be construed as the statement of the meaning of a word, word group, sign, or symbol; a statement expressing the essential nature of something; a product of defining; and the action or the power of describing, explaining, or making definite.

For additional contractual definitions, see the Federal Acquisition Regulation (FAR) Subpart 2.101 – Definitions. This FAR part defines words and terms that are frequently used in the FAR; provides cross-references to other definitions in the FAR of the same word or term; and provides for the incorporation of these definitions in solicitations and contracts by reference.

These definitions have been derived by several sources, including but not limited to the FAR, The Department of Veteran’s Affairs Acquisition Regulations (VAAR), Law Insider Dictionary, Investopedia, Dictionary.com, Encyclopedia Britannica, and Black’s Law Dictionary.

Accurate: Means free from error or defect; consistent with a standard, rule, or model.

Complete: Full; entire; including every item or element of the thing spoken of, without omissions or deficiencies; as, a “complete” copy, record, schedule, or transcript.

Comprehensive: Means complete; including all or nearly all elements or aspects of something.

Current: Whatever is at present in course of passage, present in its progress, the service rendered, and the compensation therefore measured by the time of the occurrence of the event. Passing in time or belonging to the time actually passing, now passing, present in its course, as the current month.

Deliverable: Used to describe the quantifiable goods or services that must be provided upon the completion of a project. Deliverables can be tangible or intangible in nature. A deliverable is a product or service created or performed in the completion of a project. When you consider a project, there are elements of input (what goes into the project such as time, resources, information, etc.) and elements of output - the deliverables. Key deliverables are the main outputs set and produced in the completion of a project.

Final: Last; conclusive.

Final Submission: Exists when nothing remains to be done to render submission complete.

Necessary: This word must be considered in the context in which it is used, as it is a word susceptible of various meanings. It may import absolute physical necessity or

CONTINUATION PAGE 36C10G24R0016 Page 13 of 128 inevitability, or it may import that which is only convenient, useful, appropriate, suitable, proper, or conducive to the end sought. It is an adjective expressing degrees, and may express mere convenience or that which is indispensable or an absolute physical necessity. It may mean something which in the accomplishment of a given object cannot be dispensed with, or it may mean something reasonably useful and proper, and of greater or lesser benefit or convenience and its force and meaning must be determined with relation to the particular object sought.

Plan: A delineation: a design, draft, form, or representation; the representation of anything drawn on a plane, as a map or chart; a scheme; a sketch; a method of action, procedure, or arrangement.

Quantitative: The purpose is to explain, predict, and/or control phenomena through focused collection of numerical data. Test hypotheses, deductive. Administration of tests and questionnaires (close ended). Conclusions and generalizations formulated at end of study, stated with predetermined degree of certainty. Inferences and /or generalizations are the researcher’s responsibility. Never 100% certain of findings.

Qualitative: The purpose is to explain and gain insight and understanding of phenomena through intensive collection of narrative data, generate hypothesis to be test inductive. Raw data are in words. Essentially ongoing, involves using the observations/comments to come to a conclusion. Conclusions are tentative (conclusions can change), reviewed on an ongoing basis, conclusions are generalizations. The validity of the inferences/generalizations are the reader’s responsibility.

Sufficient: Adequate, enough, as much as may be necessary, equal, or fit for end proposed, and that which may be necessary to accomplish an object.

SVH Management: SVH Management refers to the person who has responsibility for running the SVH. Depending on the SVH, this person may have the title of Administrator, Commandant, Chief Executive Officer, or Superintendent.

Timely or Reasonable Time: Such length of time as may fairly, properly, and reasonably be allowed or required, having regard to the nature of the act or duty, the subject matter, and to the attending circumstances.

Update: To change (something) by including the most recent information; to make (something) more modern; to give (someone) the most recent information about something.

B.10. Acronyms The following acronyms are used throughout the PWS and are to be construed as the statement of the meaning of a word(s) abbreviated, but holding the same meaning.

This list is not all inclusive, but represents the main acronyms used throughout.

ADC Average Daily Census

ADHC Adult Day Health Care

APO Acceptable Performance Objective(s)

AQL Acceptable Quality Level(s)

ATO Authority to Operate

CONTINUATION PAGE 36C10G24R0016 Page 14 of 128

BAA Business Associate Agreement(s)

CAP Corrective Action Plan(s)

CAR Corrective Action Request(s)

CFR Code of Federal Regulations

CIO Chief Information Officer

CLIN Contract Line Items Number(s)

CO Contracting Officer

COR Contracting Officer’s Representative

CMS Centers for Medicare and Medicaid Services

CPARS Contractor Performance Assessment Reporting System

IDR Informal Dispute Resolution

CSP Cloud Service Provider(s)

CSCA Contractor Security Control Assessment

DSS Defense Security Service

FDCC Federal Desktop Core Configuration

FedRAMP Federal Risk and Authorization Management Program

FISMA Federal Information Security Management Act

FFP Firm Fixed Price

FP Fixed Price

GEC Geriatrics and Extended Care

GFE Government Furnished Equipment

GFS Government Furnished Service(s)

IAW In Accordance With

IDIQ Indefinite Delivery/Indefinite Quantity

IJ Immediate Jeopardy

ISA Interconnection Agreements

ISO Information Security Officer

JAB Joint Authorization Board

CONTINUATION PAGE 36C10G24R0016 Page 15 of 128

MDS Minimum Data Set

MS Microsoft

MOU Memorandum of Understanding

NARA National Archives and Records Administration

NASVH National Association for State Veterans Homes

NISP National Industrial Security Program

NFPA National Fire Protection Association

PDF Portable Document Format

PIA Privacy Impact Assessment

PII Personally Identifiable Information

POA&M Plan of Action and Milestones

PWP Program Work Plan

PWS Performance Work Statement

QAP Quality Assurance Plan

QASP Quality Assurance Surveillance Plan

QM Quality Measures

RAI Resident Assessment Instrument

SAC Strategic Acquisition Center

SAP Security Assessment Plan

SAR Security Assessment Report

SOR Systems of Record(s)

SSP System Security Plan

SVH State Veterans Homes

TO Task Order(s)

USC United States Code

VA Department of Veterans Affairs

VAID VA Implementation Diagram

VHA Veterans Health Administration

CONTINUATION PAGE 36C10G24R0016 Page 16 of 128

C. SPECIFIC MANDATORY

ACTIVITIES, TASKS, and ASSOCIATED DELIVERABLES

C.1. General Requirements

All tasks, activities, and deliverables specified in this section shall be ordered by the Government via a TO. The Contract Line Item Number(s) (CLIN) shall identify the task number and quantity required. All aspects of any task shall be performed as ordered on a TO. Any TO not indicating such required CLIN and quantity shall not be required to be provided by the contractor. CLINs will be designated with either activity, task, and/or associated deliverables. The activities are the overarching requirements which correlate to tasks and deliverables.

If for any reason the contractor cannot meet a deliverable date, the contractor shall submit a written notice explaining to the CO and COR within three business days before the deliverable date. This notice to the CO and COR shall include the original deliverable due date, cite the reasons for the delay, describe the impact on the overall program, and include a firm commitment of when the work shall be completed. This is required as part of any deliverable requirement. The COR will then review the facts and discuss with the CO. The COR or CO shall respond to the contractor acknowledging receipt and communicate any additional concerns within two business days.

C.2. Activity 1: Meetings

Meetings are the coming together of people to discuss one or more topics, often in a formal or business setting, but meetings also occur in a variety of other environments (virtual or in person). Meetings can be used as form of group decision-making.

Meetings are designed for:

(1) Information sharing;

(2) Problem solving;

(3) Brainstorming;

(4) Decision making; and

(5) Building relationships.

Meetings shall be conducted throughout the performance period to allow for updates and dialogue on aspects, issues, and concerns related to the performance of the contractor. These meetings shall be coordinated and scheduled monthly to quarterly depending on necessity.

Desired Outcome / Objective:

Meetings may pertain and include these aspects, but not limited and designed to:

introduce Government and contractor team members including roles and responsibilities, update contact information to all parties, complete a full review of the PWS along with associated timeframes and deadlines, discuss responsibilities / authorities, discuss plans for clear lines of communication between the Government and the contractor, identify any potential successes, conflicts or issues in performance, and provide clear understanding of quality assurance measures of all requirements of the contractor. Meetings may also serve to facilitate dialogue and discussion of matters pertinent to disputes, process improvement, resolution management, and review of any matters related to specific task completion, deliverable submission, interpretation variances of requirement, and Contractor Performance Assessment Reporting System (CPARS). By having these meetings throughout the process, the goal is to establish a mutual understanding of how to achieve the highest program standards.

CONTINUATION PAGE 36C10G24R0016 Page 17 of 128

C.2.1. Task 1: Kick-Off Meeting The Kick-Off Meeting between the Program Office, Contracting, and the contractor shall be scheduled within 10 business days from the start of the first TO performance period start date. This shall be part of the first TO requirement. Contracting shall coordinate the date, time, and location (in person or virtual) of the meeting. The contractor shall attend the meeting, prepare an agenda, presentation materials, and attendee list (with email addresses), which shall all be provided to and approved by Contracting, in PDF format, for distribution to all attendees at least five business days prior to the meeting.

At the start of the base Kick-Off Meeting, the contractor shall provide a final QAP and QASP (as described in B.1.2 and B.1.3) to the COR in PDF format.

Also, the contractor shall provide the following deliverables, as required, in the associated activity, task, deliverable, and deliverables schedule table:

Activity 2: Task 4, Deliverable 4: Annual Survey Schedule Activity 3: Task 7, Deliverable 7: Survey Script Activity 4: Task 17, Deliverable 18: Electronic Feedback Mechanism Activity 5: Task 18, Deliverable 20: Program Work Plan Activity 5: Task 19, Deliverable 21: Communication Plan Activity 5: Task 20, Deliverable 22: Contractor Personnel Training Plan

Note: Some of these deliverables were required as part of the proposal submission and this is the final / complete deliverable to be provided to the government. It shall not deviate in any substantial form from the original contractor’s solicitation proposal, unless agreed by the CO.

At the start of the option period Kick-off meetings, the contractor shall provide the following deliverable, as required, in the associated activity, task, deliverable, and deliverables schedule table:

Activity 2: Task 4, Deliverable 4: Annual Survey Schedule

Note: These deliverables may be provided prior to the kickoff meetings in order for the government to review and have dialogue with the contractor as to the content and finalization and acceptance of the deliverables.

Following the Kick-Off Meeting, the contractor shall provide meeting minutes in PDF format to all attendees within 15 business days following the meeting.

This meeting shall occur at the beginning of every performance period. The duration is estimated at two days in the base period and four hours in each subsequent option period.

C.2.2. Task 2: Monthly Meeting The contractor shall attend the monthly meeting, prepare an agenda, presentation materials, and attendee list (with email addresses) provided by the contractor to facilitate discussion on status updates, schedule deviations or barriers, any areas of concern or of interest, introduction of new personnel and positions, as well as staff losses and feedback evaluations. The Government will provide additional agenda topics so that the contractor can consolidate Government and contractor topics in order to have a complete agenda. The contractor shall establish a MS Teams invitation for the monthly meeting calls.

CONTINUATION PAGE 36C10G24R0016 Page 18 of 128

The monthly meeting dates and times shall be approved by the VA CO and may initially be established at the Kick-Off Meeting. The contractor shall prepare and submit their agenda in PDF format to the COR at least five business days prior to the meeting. The contractor shall also provide meeting minutes in PDF format to all attendees within five business days following the meeting. This meeting duration is estimated at one and a half hours per occurrence.

C.2.3. Task 3: Quarterly Meeting The quarterly meeting shall be attended by the contractor with the staff prepared to discuss Performance Metrics as they relate to the quarterly evaluated performance of the contractor by the Government. These areas for discussion primarily include Performance Objectives, Performance Standards, and Acceptable Quality Levels. The contractor shall prepare, provide/submit, present their independent analysis, and participate in the conversation of all facets of performance. A briefing template based on the Performance Metrics will be provided to the contractor at the first kickoff meeting to be used throughout the contract.

The quarterly meeting date and time shall be coordinated and established at the kickoff meeting. The contractor shall prepare and submit all required materials and agenda to the COR in PDF format at least five business days prior to the meeting. The contractor shall establish a MS Teams invitation for the Quarterly Meeting calls. The contractor shall also provide meeting minutes in PDF format to all attendees within five business days following the meeting. This meeting duration is estimated at two hours per occurrence.

Deliverable #1: Kick-Off Meeting Deliverable #2: Monthly Meeting Deliverable #3: Quarterly Meeting

C.3. Activity 2: Survey Schedules A schedule or a timetable, as a basic time-management tool, consists of a list of times at which possible tasks, events, or actions are intended to take place, or of a sequence of events in the chronological order in which such things are intended to take place. This is the process of creating a schedule, deciding how to order these tasks and how to commit resources between the variety of possible tasks. Schedules are necessary, in situations where individuals need to know what time they must be at a specific location to receive a specific service, and where people need to accomplish a set of goals within a set time. Schedules can usefully span both short periods, such as a daily or weekly schedule, and long-term planning for periods of several months or years.

The contractor shall establish, update, and finalize survey schedules throughout the performance period to ensure current schedules can be completed on TOs to ensure facilities are surveyed per the SVH Master Survey Schedule Listing. The survey schedule shall include the SVH, appropriate level of care to include nursing home, domiciliary, and ADHC for those facilities who offer multiple levels of care on the same survey visit.

The contractor shall make and book travel, ensure schedules meet required annual or for cause survey timeframes, recognition surveys effectively planned, and ensure available survey capacity available for all surveys required.

CONTINUATION PAGE 36C10G24R0016 Page 19 of 128

Desired Outcome / Objective:

The SVH survey schedules are essential documents that must be provided as required to avoid missed surveys, excessive/overage capacity of the contractor, and overlap which could result in survey delays. The goal is to ensure SVH surveys occur when required and are inclusive of appropriate personnel to allow for a complete assessment of all applicable 38 CFR Part 51 regulations for each SVH by level(s) of care.

C.3.1. Task 4: Annual Survey Schedule

The contractor shall develop the annual survey schedule, with the above referenced information on para C.3. for all facilities identified in the performance period. (See Attachment A) The schedule shall be provided to the Government in PDF format within ten business days from the first TO of the base period (due at kickoff meeting) and by five business days after the first TO of every option period. The annual survey schedule shall include the following three elements:

(1) Number of SVHs to be surveyed per month;

(2) Month of survey (within two months of Recognition month; and

(3) Week of surveys by level of care (where applicable).

C.3.2. Task 5: Quarterly Survey Schedule The contractor shall revise/update the annual survey schedule on a quarterly basis with the above referenced information in section C.3.1. However, the revisions and updates shall align with the Annual Survey Schedule with any deviations being agreed to by the government. The schedule shall be provided to the Government in PDF format within ten business days from issued TO. Each quarterly survey schedule update shall include the following:

(1) Number and name of SVHs to be surveyed;

(2) Dates for entire survey;

(3) Surveyor names; identification of the surveyor team lead and their company contact phone number;

(4) Dates for life safety survey;

(5) Dates of surveys by level of care (where applicable);

(6) Identification of which surveyor will review clinical, life safety, administrative, fiscal standards; and

(7) Surveyor email addresses.

C.3.3. Task 6: Task Order Survey Schedule Change

Changes shall be limited as much as possible by the Government. Any survey schedule change on a TO, requested by the Government, must be issued via a modification mutually agreed upon by both parties. The contractor shall make the change and submit a revised survey schedule in PDF format that incorporates the change within ten business days from the effective date of any modification of a TO or the award date of a TO.

The contractor’s revised survey schedule must match what is provided to the contractor in the TO. The only revisions to a survey schedule are acts of God, mutually agreed changes by both parties, health or precautionary situations where the health of any party may cause injury.

Deliverable #4: Annual Survey Schedule Deliverable #5: Quarterly Survey Schedule Deliverable #6: TO Survey Schedule Change

CONTINUATION PAGE 36C10G24R0016 Page 20 of 128

C.4. Activity 3: Surveys Surveys are a method of gathering information using relevant questions from a sample of people with the aim of understanding or appraising conditions (positive or negative) as a situation arises, areas of study in whole or part. Surveys provide a critical source of data and insights for evaluation to determine acceptable standards are being met and if not for corrective action to be implemented to attain the standard required level of care.

Surveys shall be conducted by the contractor, as required by TO, in direct correlation to the Annual and Quarterly survey schedules.