36C10G24R0017.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

36C10G24R0017 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 Community Living Centers (CLCs)

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 .......................................................... Error! Bookmark not defined.

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 PERFORMANCE 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 52.232-18 AVAILABILITY OF FUNDS (APR 1984)

C.9 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.10 VAAR 852.204-72 PERSONNEL VETTING AND CREDENTIALING

(MARCH 2026)

C.11 VAAR 852.211-76 LIQUIDATED DAMAGES – REIMBURSEMENT

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

C.12 852.222-71, COMPLIANCE WITH EXECUTIVE ORDER 13899.

(DEVIATION) (APR 2025)

C.13 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT

REQUESTS (NOV 2018)

C.14 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.15 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER

(OCT 2020)

C.16 MANDATORY WRITTEN DISCLOSURES

C.17 SUPPLEMENTAL INSURANCE REQUIREMENTS

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 36C10G24R0017 Page 4 of 114

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 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.

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 36C10G24R0017 Page 5 of 114

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

TUNGSTEN ELECTRONIC INVOICE SUBMISSION

FSC e-INVOICE PROGRAM THRU AUSTIN PORTAL

FSC MANDATORY ELECTRONIC INVOICE SUBMISSION FOR AUSTIN PAYMENTS

Contracting POC: Mr. Mauricio Vazquez COR (Contracting Officers Representative): Ms. Rhonda Toms 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 (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 the contract awarded under this solicitation is $40K. If the Contractor receives total orders for less than the minimum amounts, 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 the 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 16.504-1(b) of $40K will be placed against this contract per awardee 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.

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 36C10G24R0017 Page 6 of 114

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.

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 Contracting Officer who signed this contract and identified is the primary Contracting Officer for the contract. The Alternate Contracting Officer is designated. These are the only two Contracting Officers authorized to take formal action on this contract. The alternate will assume authority when a contract action needs to be taken and the primary Contracting Officer 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 36C10G24R0017 Page 7 of 114

B.4 PERFORMANCE WORK STATEMENT

A. GENERAL INFORMATION

A.1. Title of Project:

Long Term Care Surveys of VA Community Living Centers (CLC) and Spinal Cord

Injury/Disorders (SCI/D) Long Term Care Centers.

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 VA owned and operated Community Living Centers (CLCs) and Spinal Cord Injury/Disorders (SCI/D) Long Term Care Centers to be performed from an independent survey contractor. The contractor shall utilize the Centers for Medicare and Medicaid (CMS) process for CLCs and SCI/D Long Term Care Centers by utilizing the applicable federal regulations found in Title 42 Public Health Code Federal Regulations Part 483, Requirements for States and Long Term Care Facilities (LTCF) and the Long-Term Care (LTC) State Operations Manual (SOM) Appendix PP. The survey process shall be performed for each CLC and five SCI/D Long Term Care Centers according to the Performance Work Statement (PWS) and carried out via Task Order(s) (TO).

The skill set required of the contractor personnel surveying the CLCs and SCI/D Long Term Care Centers includes: long-term care trained surveyors with experience or expertise, to include conducting state or CMS surveying 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, correlate, and differentiate the CMS survey process to the operations of VA owned and operated CLCs and SCI/D Long Term Care Centers. The contractor shall conduct surveys and assess CLCs and SCI/D Long Term Care Centers to ensure CLCs and LTCs are operating within federal guidelines to provide high quality care to residents and to identify areas to improve, as necessary. 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 Title 42 Public Health Code Federal Regulations Part 483, including, but not limited to, Registered Nurses, Social Workers, and Dietitians. 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 CLC occupancy.

The contractor is responsible for performing and maintaining 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. At least one surveyor on each survey team shall be a licensed Registered Nurse.

VA owned and operated CLCs use the Holistic Approach to Transformational Change (HATCh) as the framework for resident centered care. The HATCh model is an approach to nursing home care that supports quality of life and it uses the whole person, whole team, and whole health approach. CLCs put special emphasis on the

CONTINUATION PAGE 36C10G24R0017 Page 8 of 114 work practices, care practices, leadership practices, and environment of care. These four categories of the HATCh model have tremendous impact on resident care (see Attachment A - HATCh Introduction to VA CLCs).

A.3. Overall Desired Outcomes / Objectives VA has a commitment to ensure the VA CLCs and SCI/D Long Term Care Centers maintain high quality standards. On a national level, this type of survey process assures standards are indeed being met. Furthermore, the CMS survey process is considered a standard best practice for nursing homes in the United States. Federally owned and operated CLC or SCI/D Long Term Care Centers are not CMS certified, however are aligned with the industry standard of annual oversight surveys by utilizing applicable federal regulations of Title 42 Public Health Code Federal Regulations, Part 483 Requirements for States and Long-Term Care Facilities, and the Long-Term Care State Operations Manual (SOM) Appendix PP from CMS.

VA’s requirement is for an independent contractor to conduct surveys of VA CLCs and SCI/D Long Term Care Centers, with appropriate CMS survey expertise, to:

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

(2) Assess areas of concern to determine standards of care and compliance with applicable regulations of Title 42 Public Health Code Federal Regulations, Part 483, Requirements for States and Long Term Care Facilities, and the Long-Term Care State Operations Manual Appendix PP;

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

(4) Educate and reinforce VA CLC, SCI/D Long Term Care Centers staff on Veteran-centered care.

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. The requirements in the PWS must be completed and IAW the applicable documents list in Section D - Contract Documents, Exhibits, Or Attachments. No Government employee shall perform any portion of the requirements of this acquisition. Task Orders (TO) shall be placed during the current period of performance to indicate services required to be rendered.

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. The contractor must manage its employees to prevent against any actions in the PWS that fall into the category of personal services or give the perception of personal services. If the contractor believes that any actions constitute, or are perceived to constitute personal services, it shall be the contractor's responsibility to notify the Contracting Officer immediately.

There are currently 134 VA CLCs and 5 SCI/D Long Term Care Centers across the United States and Puerto Rico (Attachment B - List of VA CLCs and SCI/Ds). Additional CLCs and/or SCI/D Long Term Care Centers may be added during the lifetime of this contract to be surveyed. It is anticipated that a range of approximately one to five additional CLCs may

CONTINUATION PAGE 36C10G24R0017 Page 9 of 114 be added during the lifetime of this contract and shall be required to be surveyed annually.

The SCI/D Long Term Care Center surveys will be independent of CLC surveys within the same VA Medical Center (VAMC). The SCI/D Long Term Care Center surveys will be completed consecutive to the CLC surveys being conducted in VAMCs that provide both services.

B.1. Quality Assurance

B.1.1. Quality Assurance The contractor shall have an established Quality Assurance Program which details procedures to verify services being performed to those Government standards according to the Acceptable Performance Objectives (APO) 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 submitted to the Government in compliance with their contract deliverables. 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 TOs.

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. 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.

B.1.3. Quality Assurance Surveillance Plan (QASP) The QASP is the key surveillance process document. The QASP is used for managing contractor performance assessment by ensuring that systematic quality assurance methods validate that contractor quality control efforts are timely, effective, and are delivering the results specified in the contract. The QASP directly corresponds to the performance objectives and standards (i.e., quality, quantity, timeliness) specified in the Performance Work Statement (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.

CONTINUATION PAGE 36C10G24R0017 Page 10 of 114

The Government shall utilize the contractor’s Quality Assurance Surveillance Plan (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 rated based on the performance meeting the standards.

The QASP is put in place to provide 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 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 assure 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 Contracting Officer (CO) in the form of an official cover letter and by Corrective Action Request (CAR) procedure and form or a cure notice (see Attachment C Corrective Action Request Procedure and Form).

B.1.5. Survey Observations

The Program Office will conduct observations of the survey process. CLC survey observations are requirements adapted from the Government Accounting Office (GAO) #19-428 (Final Report July 2019; Recommendation #1). Survey observations are inclusive of the contractor’s surveyors’ compliance to the CMS survey process, PWS deliverables, professional accountability, adherence to required infection control protocols, and accuracy of surveyors’ assessment and interpretation of applicable federal regulations of 42 Public Health Code Federal Regulations Part 483, Requirements for States and Long Term Care Facilities, and the Long-Term Care State Operations Manual Appendix PP.

The Contracting Officer will assign the Contracting Officer’s Representative (COR) and the Program Office will identify designated National Program Managers for CLC Unannounced Survey Program, Quality and Oversight to conduct such survey observations, record, and score observations according to Program Office Standard Operating. Only the scores from observations completed by either the COR or alternate COR will be used in the evaluation of the contractor’s performance. Scores are given for each individual surveyor on a scale of one to four assessing conformance to established criteria. (see Attachment D – Survey Observation Record)

B.2. Period of Performance The period of performance shall be a 12 month base period and four, 12 month option periods. A continuation of performance of any services may be exercised more than

CONTINUATION PAGE 36C10G24R0017 Page 11 of 114 once, but the total extension of performance hereunder shall not exceed 6 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 by the Strategic Acquisition Center (SAC) Contracting Officer(s) as 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 CLC and SCI/D Long Term Care Center.

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 CLC is closed due to local or national emergencies, administrative closings, or similar VA directed facility closings. However, all surveys for CLCs and SCI/D Long Term Care Centers are not limited to any time frame or time zone to accomplish all the required assessments of compliance. This may include surveyors arriving early or staying later at the facility for off-tour observations of care delivery (e.g., early a.m. medication pass, early care observation, evening dinner meal observation).

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 the days between and including Monday to Friday and do not include Federal holidays and weekends. The contractor is responsible for conducting normal business, between the hours of 7:00am and 5:00pm ET 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; contractor shall seek clarification from the COR and CO to perform via another method or cancel all together.

CONTINUATION PAGE 36C10G24R0017 Page 12 of 114

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, a sign, or symbol; a statement expressing the essential nature of something; a product of defining; the action or the power of describing, explaining, or making definite.

For additional contractual definitions, see the FAR 2.101 – Definitions. This FAR Section 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 connection in which it is used, as it is a word susceptible of various meanings. It may import absolute physical necessity or 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 it's force and meaning must be determined with relation to the particular object sought.

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

also a method of action, procedure, or arrangement.

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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.

CLC Management: CLC Management refers to the persons who have responsibility for managerial, supervisory, and/or operational oversight of the CLC or VA Medical Center (VAMC). These persons may have the title of Medical Center Director, CLC Medical Director, CLC Chief Nurse, Nurse Manager.

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. (i.e. within 3 to 5 business days of the last day of an onsite survey.)

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

APO Acceptable Performance Objectives

AQL Acceptable Quality Level(s)

ATO Authority to Operate

BAA Business Associate Agreement(s)

CAP Corrective Action Plan(s)

CAR Corrective Action Request(s)

CLC Community Living Center

CIO Chief Information Officer

CLIN Contract Line Items Number(s)

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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

LTC Long Term Care

MDS Minimum Data Set

MS Microsoft

MOU Memorandum of Understanding

NARA National Archives and Records Administration

NISP National Industrial Security Program

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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

SCI/D Spinal Cord Injury/Disorder

SOM State Operations Manual

SOR Systems of Record(s)

SSP System Security Plan

SLTCF State Long Term Care Facilities

TO Task Order(s)

USC United States Code

VA Department of Veterans Affairs

VAID VA Implementation Diagram

VHA Veterans Health Administration

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

CONTINUATION PAGE 36C10G24R0017 Page 16 of 114 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 delivery date for a deliverable cannot be met, the contractor shall submit a written explanation 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 intended to be required as part of any deliverable requirement. The COR will acknowledge receipt, review the facts, and communicate any additional concerns within two business days in accordance with applicable regulations.

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 of 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.

C.2.1. Task 1: Kickoff Meeting

The Kickoff 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, location (in person or virtual) of the meeting. The contractor shall attend meeting with appropriate staff, prepare an agenda, presentation materials, and attendee list (with email addresses), which shall be provided to Contracting in PDF format and

CONTINUATION PAGE 36C10G24R0017 Page 17 of 114 approved for distribution to all attendees at least five business days prior to the meeting. This meeting duration is estimated at one half to full day per occurrence.

At the start of the base kickoff meeting, the contractor shall provide a final QAP and QASP (as described in B.1.2 and B.1.3) to 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 TASK DELIVERABLE DESCRIPTION

Activity 3 Task 7 Deliverable 7 Survey Script Activity 4 Task 11 Deliverable 14 Electronic Feedback Mechanism Activity 5 Task 12 Deliverable 16 Program Work Plan Activity 5 Task 13 Deliverable 17 Communication Plan Activity 5 Task 14 Deliverable 18 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 submissions.

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.

The contractor shall also 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; duration is estimated at two days for the base period and four hours per each subsequent option throughout the Period of Performance.

C.2.2. Task 2: Monthly Meeting

The contractor shall attend the monthly meeting, with the appropriate staff, 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 their agenda topics so that the contractor can consolidate Government and contractor topics, in order to have a complete agenda. The contractor shall provide agenda 5 business days prior to the meeting and shall establish an MS Teams invitation for the monthly meeting calls.

The monthly meeting dates and times shall be coordinated and established at the kickoff meeting. The contractor shall prepare and submit their agenda in PDF format and other meeting materials 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 hour per occurrence.

C.2.3. Task 3: Quarterly Meeting

The quarterly meeting shall be attended by the contractor with the appropriate 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, CONTINUATION PAGE 36C10G24R0017 Page 18 of 114 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 contractor shall establish a MS Teams invitation for the Quarterly Meeting calls.

The quarterly meeting date and time shall be coordinated and established at the kickoff meeting. The contractor shall prepare and submit agenda to the COR in PDF format and all required materials 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 two hours per occurrence.

Deliverable #1: Kickoff 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.

Scheduling of surveys, by the contractor, shall be established, updated, and finalized throughout the performance period to ensure current schedules can be completed on TOs to ensure facilities are surveyed per the CLC Master Survey Schedule Listing provided to the contractor, travel arrangements booked, schedules meet required annual or for cause survey timeframes, and available survey capacity for all surveys required. The survey schedule shall include the name of CLC and SCI/D Long Term Care Centers, survey team members and email addresses, and survey dates.

Desired Outcome / Objective:

The CLC 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 CLC surveys occur when required and are inclusive of appropriate personnel to allow for a complete assessment of all applicable federal regulations of 42 Public Health Code Federal Regulations, Part 483 Requirements for States, and Long Term Care Facilities from the Long-Term Care State Operations Manual Appendix PP.

C.3.1. Task 4: Quarterly Survey Schedule

The contractor shall provide a survey schedule on a quarterly basis to the Government in PDF format within 10 business days from issued TO.

Each quarterly survey schedule update shall include the following:

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

(2) Dates for entire survey; surveyor names; identification of the surveyor team lead and their company contact phone number;

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(3) Dates for life safety survey; and

(4) Surveyor email addresses.

C.3.2. Task 5: 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 10 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: Quarterly Survey Schedule Deliverable #5: TO Survey Schedule Change

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. 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. Surveyors shall be required to wear visible, contractor-provided identification at all times during all surveys. Surveyors shall have business attire and shall conduct themselves in a professional manner at all times. The surveys shall be performed onsite at CLC, SCI/D Long Term Care facilities, in person.

At VAMCs that have both SCI/D Long Term Care and a CLC, SCI/D Long Term Care surveys shall be scheduled to be completed immediately following the associated CLC survey on the same survey.

The number and type of surveyors (clinical and life safety) and duration of survey will be determined by the contractor and can be based on the number of operating beds in the CLC and average daily census. The Table of Surveyor Component Guide is provided as a guide that the Government expects the contractor to follow (see Attachment E). The Program Office will provide the contractor the number of operating beds and the average daily census by means of TO(s).

This contract requires the contractor to conduct Annual Surveys for CLCs and SCI/D Long Term Care Centers. The contractor must utilize the CMS process and protocols and the applicable regulations of 42 Public Health Code Federal Regulations Part 483 Requirements for States and Long Term Care Facilities from the Long-Term Care State Operations Manual Appendix PP to conduct the surveys.

Deficiencies identified at the conclusion of a survey are defined and written IAW the applicable regulations of 42 Public Health Code Federal Regulations Part 483 Requirements for States and Long Term Care Facilities and Long-Term Care State Operations Manual Appendix PP.

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For all surveys, the contractor shall establish a pre-exit call that includes the contractor survey team and a representative from the Program Office. The purpose of this call is for the survey team to provide the Program Office with a verbal summary of all potential deficiencies that will be on the final survey report. This verbal summary shall include applicable regulations of 42 Public Health Code Federal Regulations Part 483 Requirements for States and Long Term Care Facilities from the Long-Term Care State Operations Manual Appendix PP that is anticipated to have an identified deficiency, the information from the survey that led to the identified deficiency, and the likely scope/severity…