36C25819Q0002.docx

36C25819Q0002

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

TIME

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.

DUNS:

DUNS+4:

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. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C25819Q0002 01-16-2019 Trevor Hood

(505) 256-2856 01-15-2020 Y Department of Veterans Affairs NCO22-Gilbert Network Contracting New Mexico VA Health Care System 1501 San Pedro Drive SE Albuquerque NM 87108 X 623110 $27.5 Million X N/A X Department of Veterans Affairs New Mexico VA Health Care System 1501 San Pedro Drive SE Albuquerque NM 87108 Department of Veterans Affairs NCO22-Gilbert Network Contracting New Mexico VA Health Care System 1501 San Pedro Drive SE Albuquerque NM 87108

Department of Veterans Affairs ATTN: Non-VA Care (501/136 F) New Mexico VA Health Care System 1501 San Pedro DR SE Albuquerque NM 87108

(505) 265-1711 X2707

(505) 256-2711 CNH fax See CONTINUATION Page Acquisition of Community Nursing Home (CNH) services in support of the New Mexico VA Health Care System (NMVAHCS).

The NMVAHCS is seeking CNH facilities in the NMVAHCS Catchment area. Services to be performed in accordance with the Performance Work Statement and attachments herein.

Contract(s) will be for a base year with four (4) one (1) year options.

This acquisition is being conducted using the procedures at

13.5 and under the authority of 38 U.S.C. 1720.

See CONTINUATION Page N/A. Funding will be provided on order(s) X X X Carlos Acosta Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(continuation from Standard Form 1449, block 18A.)

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

a. CONTRACTOR: (Offerors are requested to designate a point of contact for prompt contract administration).

Name:

Title:

Name of Company:

Street Address:

City, State, Zip Code:

Email:

Phone:

b. GOVERNMENT: Contracting Officer (36C258) (520) 629-4833 Department of Veterans Affairs Contracting Office (501/90C) Attn: Contract Specialist (505) 256-2856 New Mexico VA Health Care System 1501 San Pedro Drive SE Albuquerque NM 87108

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor should be mailed to the following address:

3. INVOICES: Invoices shall be submitted in arrears:

Payments made by VA under any contract pursuant to this contract, constitute the total cost of nursing home care. No additional charges will be billed to Medicare (with the exception of hospice), Medicaid, or private insurance, the beneficiary or his/her family, either by the CNH or any third party furnishing services or supplies required for such care, unless and until specific prior authorization in writing is obtained from the VA facility authorizing placement.

No obligation will be incurred by VA under this contract, until authorizations are issued for nursing home care of specific beneficiaries. VA agrees to make payment on a timely basis for services rendered in accordance with such authorizations upon receipt of proper invoices submitted by the CNH as outlined in this contract. VA will make payment for the day a recipient enters the CNH but not the day the recipient leaves a CNH unless entrance and departure are on the same day, then payment will be made for one (1) day

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with NNPO non-VA Care and Local Fee procedures. Invoices shall be secure faxed to the facility for processing. Invoices must specify “Contracted Nursing Homes.”

Department of Veterans Affairs ATTN: Non-VA Care 501/136F New Mexico VA Health Care System 1501 San Pedro DR SE Albuquerque, NM 87108-5153 Phone: (505) 265-1711 x2707 Secure fax: (505) 256-2711 Contracted Nursing Homes Fax ONLY.

5. ORDERING OFFICER DELEGATION: The CO may delegate an Ordering Officer. Ordering officers will be authorized to place orders against this contract. The Contracting Officer will furnish the Contractor with the names of individuals authorized as ordering officers, by separate memorandum upon issuance of the contract. When ordering officers are added after award, the Contracting Officer will furnish the Contractor with the names of individuals authorized as ordering officers, by memorandum upon ordering officer appointment. Ordering officers are responsible for issuing and administering orders placed under this contract. Ordering officers have no authority to modify any term of this basic contract. Any deviation from the terms of the basic contract must be approved in writing by the Contracting Officer responsible for this contract. The Contractor shall accept orders against this contract only from the Contracting Officer and/or authorized ordering officers. Fulfilling orders from persons other than the Contracting Officer or ordering officer may result in loss or delay in payment for supplies/services provided under such orders.

In accordance with FAR 16.505(b)(2)(i)(A) or FAR 16.505(b)(2)(i)(B), VA has determined it is in the best interest of the Veteran to place the individual order without further competition because the need for these services is sometimes urgent, and providing the opportunity to all IDIQ holders and other vendors would result in unacceptable delays in fulfilling that need. Location primarily will be selected based on the Veterans needs and proximity to the Veteran's home. Authorizations are active for two weeks. CNH will notify the Ordering Officer to accept the referral. Upon acceptance of a VA patient by the CNH, if and when requested by the VA Contracting Officer or authorized representative, the Contractor shall furnish all supplies and services herein described, at the per diem rates for the “Levels of Care” specified in the Performance Work Statement, VA is obligated only to the extent authorized placement of patients is made in accordance with this IDC.

VA acknowledges that, depending on the availability of resources at specific IDIQ holder facilities at specific times, acceptance of a referral may be commercially impracticable for the IDIQ holder. In that event, the IDIQ holder may decline to accept an authorization. If the IDIQ holder has determined that space is not available and will not accept the Veteran, the CNH program personnel will seek another IDIQ contract and an authorization will be issued when a match is found.

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

B.2 PRICE/COST SCHEDULE

The guaranteed minimum award amount for this contract is $ 160.00. The maximum aggregate value of orders that can be placed under this contract is $5,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount.

ITEM INFORMATION

Contract Period: Base POP Begin:

POP End:

DY

Contract Period: Base POP Begin:

DY

Contract Period: Base POP Begin:

DY

Contract Period: Base POP Begin:

DY

Contract Period: Base POP Begin:

DY

Contract Period: Base POP Begin:

DY

Contract Period: Base POP Begin:

DY

Contract Period: Base POP Begin:

DY

B.3 DELIVERY SCHEDULE

New Mexico VA Health Care System 1501 San Pedro DR SE Albuquerque, NM 87108 5153

USA

505 265 1711 X4129 Sarah.Stephens@va.gov

B.4 PERFORMANCE WORK STATEMENT

1. The nursing home shall ensure that care meets the health needs and promotes the maximum well-being of Veterans Affairs (VA) patients. The Nursing home care will be furnished to ensure the total medical, nursing, and psycho-social needs of VA beneficiaries. Physician visits, laboratory, x-ray, and other special services for VA patients will be at the same frequency as that provided to other patients at the nursing home receiving the same or comparable level of care. In addition, the care provided will include a room, meals, nursing care, and other services or supplies commensurate with the VA authorized level of care, without extra charge. All therapy services will be provided by a licensed professional staff and follow the Medicare regulation and procedures of progress toward identified goals. The per diem rate(s) established in this contract will include the cost of medical care, MD visits, Geriatric Psychiatrist, drugs, laboratory, x-ray, and other special services authorized by VA, unless otherwise specifically accepted.

2. Full attention shall be given to motivating and educating patients to achieve and maintain independence in the activities of daily living, to the maximum extent possible.

3. If a VA patient is receiving care at a Community Nursing Home (CNH) pursuant to this contract and that patient requires hospitalization due to an acute condition or an emergency, the CNH will immediately take steps necessary to either admit the patient to an appropriate VA Medical Center (VAMC), or to arrange for emergency transport to the nearest non-Federal emergency room as stated herein. At the onset of such a situation with a VA patient an employee at the CNH facility will immediately contact the appropriate VAMC Emergency Room and obtain instructions as follows:

3.1 If hospitalization of an emergent nature is required and the patient’s condition is critical the VAMC Emergency Room will either:

1. Arrange to transport the Patient to the VAMC Emergency Room; OR

1. The CNH will be instructed by the VAMC Emergency Room to contact 911 for ambulance transport to the closest, non-Federal hospital emergency room.

It is agreed that readmission to a VA facility will be accomplished once the patient's condition is sufficiently stabilized to permit admission to VA.

3.2 If hospitalization of an emergent nature is required and the patient’s condition is so critical that there is not sufficient time to contact the VAMC Emergency Room, it is agreed that hospitalization in a non-Federal facility may be accomplished provided the VA is notified in accordance with this contract; and VA notification must be made within 72 hours of the emergency admission of the patient to a non-Federal facility.

NOTE: FAILURE TO COMPLY WITH THE TERMS OF THIS CONTRACT MAY RESULT IN THE NURSING HOME BECOMING RESPONSIBLE FOR ANY ADDITIONAL EXPENSES.

4. If a VA patient is receiving care at a Community Nursing Home (CNH) pursuant to this contract and that patient requires hospitalization for a pre-authorized, non-emergent procedure, it is agreed that readmission to a VA facility will be accomplished as soon as the patient's condition is sufficiently stabilized to permit admission to VA.

5. If a veteran is hospitalized from the nursing home, the nursing home and VA facility will arrange to hold a bed in reserve, only when such a decision is in the best interest of the patient and the VA; or the patient may be responsible for making these arrangements. The number of covered bed hold days will be determined by VA on a case-by-case basis, but will not exceed the number of bed hold days allowed by state Medicaid regulations. The VA facility will include payment for these "bed hold" days only when the conditions above are met. VA payments for “bed hold” will be at 50% of the applicable level of care the respective patient is receiving at the time of leave or transfer.

6. The VA facility will approve leave days (days away from the nursing home) for long-term placements. The leave must be part of a therapeutic plan and pre-approved by the VA. VA approved leave days will be billed at a bed hold rate and will go towards the 6 days (long term Medicaid bed hold amount) of bed hold days per calendar year. Exceptions may be approved by the VA facility director or designee.

7. In the event a VA beneficiary receiving nursing home care under this contract dies, the nursing home will promptly notify the VA office authorizing admission and immediately assemble, inventory, and safeguard the patient's personal effects pending further guidance by VA. With the concurrence of the VA office authorizing admission, the nursing home will:

7.1 all funds, deposits, and effects left by VA patients upon the premises of the nursing home shall be delivered by the nursing home to the person or persons entitled thereto under the laws currently governing the nursing home for making disposition of funds and effects left by patients, unless the beneficiary died without leaving a will, heirs or next of kin capable of inheriting.

7.2 When disposition has been made, the itemized inventory with a notation as to the disposition of the funds and effects will be immediately forwarded to the VA office authorizing admission.

7.3 Should a deceased patient have no will, heirs, or next of kin, his/her personal property and funds wherever located vests in and becomes the property of the United States in trust. In these cases, the nursing home will forward inventory of any such property and funds in its possession to the VA office authorizing admission, and will hold them (except articles of clothing necessary for proper burial) under safeguard until instructions are received from VA concerning disposition.

8. It is agreed that VA will have the right to on-site reviews of the nursing home and all appurtenances by authorized VA representative(s) to ensure that acceptable standards are maintained and that the necessary care to maintain the well-being of the patient is rendered. It is further agreed that the VA will have the right to inspect the contractor’s personnel files.

9. The nursing home shall accept referral of and shall provide all services specified in this contract for any person determined eligible by the VA Under Secretary for Health or his/her designee, regardless of the race, color, religion, sex, or national origin of the person for whom such services are ordered. In addition, the nursing home warrants that subcontracting will not be resorted to as a means of circumventing this provision. Additionally, the nursing home shall not maintain nor provide dual or segregated patient facilities which are segregated on the basis of race, creed, color, or national origin. The nursing home shall neither require such segregated use by written or oral policies, nor tolerate such use by local custom. The term facilities shall include but not be limited to rooms, wards, sections, eating areas, drinking fountains, entrances, and other like areas. It is agreed that VA will have the right to inspection of the nursing home and all appurtenances by authorized VA representative(s) to ensure that acceptable standards are maintained and that the necessary care to maintain the well- being of the patient is rendered.

10. It is agreed that duly authorized representatives of VA will provide follow up supervision visits to veterans placed to assure the continuity of care and to assist in the veteran's transition back to the community. It is understood that these visits do not substitute nor relieve the nursing home in any way of the responsibility for the daily care and medical treatment of the veteran.

11. All medical records concerning the veteran's care in the nursing home will be readily accessible to VA. Upon discharge or death of the patient, medical records will be retained by the nursing home for a period of at least three years following termination of care. Patient records will be maintained in conformance with the Privacy Act of 1974 (5 U.S.C. 552a). A medical record shall be maintained for each patient that includes at least the following:

11.1 Admission identification record.

11.2 Admitting evaluation (including diagnosis by nursing home physician).

11.3 Physician orders.

11.4 Progress notes. The physician orders/notes shall be charted immediately after patient is seen.

11.5 Special reports (laboratory, x ray, activity, etc.).

11.6 Minimum Data Set (MDS) information, provided to VA upon admission and every six months thereafter.

12. The beneficiary will be provided nursing home care at the expense of VA for a period not in excess of that stated in the referral form, unless an extension of the authorization is provided in writing by the placing VA facility.

13. The authorization agreement, VA Form 10-7078, for the affected patient will terminate whenever a VA patient is re-hospitalized for 15 calendar days or more, whether in a VA or in a non-Federal facility. A new authorization agreement will be required at the time the patient returns.

14. Level of Care Classification Effective Records: The level of care classification and associated per diem rate will remain in effect for each placement until and unless one of the following events takes place:

14.1 The recipient is discharged and subsequently qualifies for a new admission assessment.

14.2 The minimum data set (MDS) triggers a significant change.

14.3 The nursing home submits an assessment requesting a change in the level of care classification and VA approves it. Classification changes may also occur based on a determination by VA. VA will make the determination whether classification changes require readmission to VA.

15. The VA, at its sole option, will monitor the professional care and administrative management of services provided to VA beneficiaries under this agreement, through one or any combination of the following methods; reviews of state agencies reports, on-site review of the Nursing Home by VA staff, and/or on-site monitoring of VA patients. It is agreed that the Nursing Home shall provide VA with copies of all state agency reports when requested, and cooperate fully with VA's quality improvement-quality assurance program functions relating to this agreement, including VA's on-site review and monitoring. It is further agreed that the VA will have the right to inspect contractor’s employee personnel files. The VA contracting Officer shall make all final determinations as to the contractor's reasonable cooperation with VA and compliance with these requirements. It is understood that certain internal quality indicator/quality assurance information is not available for VA review. Current quality measure and current individual MDS information will be made available.

16. In the event a VA beneficiary receiving nursing home care under this contract decides to leave the facility, as soon as possible the nursing home will, but not to exceed 48 hours, notify the VA that the VA beneficiary has voluntarily left the facility.

17. In the event a VA beneficiary receiving nursing home care under this contract desires to leave the facility for 24 hours or more [excludes scheduled appointment and off-site medical treatment] on a pass, the nursing home must obtain approval from the VA office authorizing admission BEFORE the VA beneficiary is granted a pass and allowed to leave the facility.

18. The nursing home is RESPONSIBLE FOR SUPERVISING VA BENEFICIARIES HOUSED AT THEIR FACILITY WHETHER THE BENEFICIARY IS AT THE FACILITY, OR HAS BEEN TRANSPORTED TO A CLINIC OR OTHER TREATMENT FACILITY, TO THE DOCTOR, OR TO THE VAMC.

18.1 The nursing home is responsible for complying with all the rules, policies and regulations expressed by the state in which they operate as they relate to nursing facilities providing 24 hours per day protective oversight to their residents.

18.2 If a veteran is sent to an outpatient appointment at the VA (or admission exam where admission is not a certainty) the nursing home must make a judgment as to whether the veteran needs physical assistance due to disability or oversight due to confusion. The nursing home must assure that adequate oversight is provided during the trip to the VA or while in the outpatient clinic.

18.3 Oversight can be provided by a family member, clergy person, volunteer or any other person who, in the judgment of the nursing home can responsibly and capably provide the necessary oversight. However, someone from the facility or a family member or volunteer must be with a resident who evidences any mental confusion or who would have a problem negotiating his/her way through the outpatient clinic process.

18.4 In the absence of any other person, the nursing facility should send a staff member to assure protective oversight. This judgment is made by the nursing home and does not preclude “dropping off” a mentally alert and physically capable resident for a medical appointment or some other activity, to be picked up at a later time.

18.5 When the veteran is in the outpatient clinic at the VA, s/he still is considered a resident of the nursing facility that is thereby responsible to provide physical assistance and protective oversight. The VA’s responsibility in the outpatient clinic is for treatment only. If the contracted nursing home is unable to staff protective oversight the contract nursing home is responsible for rescheduling outpatient clinic appointment to accommodate staffing.

19. Annual reviews will be completed by the VA facility. Reviews will include life safety as well as clinical review. The contract nursing home shall provide the VA facility with copies of all State/Federal licensures, certifications, and State reports such as the 2567 (plan of correction), 671 staffing report, Casper Reports, MDS-QI profile, copies of complaint investigations reports conducted by the State over the past year, and any other monitoring/performance reports as needed. Each standard monitored will need to be acceptable and/or contracted facility will need to establish a plan to improve/meet a standard within a specific timeframe.

20. If at any time the contract nursing home receives a Notice of Non-Compliance or a Notice of Sub-Standard Care resulting from the federal survey, the contract nursing home will notify the Community Nursing Home Care Coordinator by telephone within 24 hours of the receipt of such assignment. In the absence of the Community Care Coordinator, The Chief, Associate Chief of Staff for Geriatrics and Extended Care and the Associate Chief Nurse Geriatrics and Extended Care at the VA will be notified by telephone. The contract nursing home will provide a written explanation to the Community Care Coordinator explaining the circumstances surrounding the assignment of the notice of Non-Compliance or Notice of Sub-Standard care, within 72 hours.

21. Transportation to and from the VA hospital for outpatient and admission appointments is to be provided by the contract nursing home. The VA, can provide transportation on a as needed basis, notification needs to be timely by the contract nursing home. Those patients who have family or others capable of transporting and providing supervision to the veteran in the outpatient area at the VA are encouraged to do so if indicated appropriate by contract nursing home provider.

22. Oral medications, which comprise more than 8.5% of the per diem rate on a monthly basis, are excluded from that rate. High drug costs will be determined or priced using the Federal Supply Schedule (FSS) plus a transaction fee of 3% per month. All calculations will be made on a monthly basis. When a high cost drug patient is identified, VA staff must be advised promptly to establish an appropriate course of action, which may include the provision of the medications by VA.

23. The C & A requirements do not apply and a Security Accreditation Package is not required.

24. Contingency Plan: The contractor shall provide Nursing Home contingency plan for emergency situations. The plan shall include effective emergency planning for properly executing the emergency plan. The plan shall also include circumstance of unforeseen events such as hurricane, fire, or emergency situation which requires evaluation of patients to be relocated to another facility. Contingency plan should include guidance regarding the decision to evacuate or shelter in place, and require local emergency managers to review nursing home emergency plans. Evacuation may include assistance primarily from parent corporations and/or “sister” facilities.

Planning: Keep a supply of food and water on hand to feed residents and staff for a period of 7 to 10 days, allowing for a gallon of water per person per day. In the event of fire, flood, or damaged facilities, plan for evacuation and relocation of patients to an alternative facility such as a school or hospital. Make prior arrangements with emergency transportation companies to move residents to the alternative facility. Decide how to handle the transport of important records, medications, and other necessities. Create detailed evacuation maps with primary and secondary routes highlighted. Provide a section in your plan for communicating with families of residents and staff who are off-duty so all stakeholders aware of the status of your nursing home.

Procedures: Develop specific procedures for notifying staff to implement the disaster plan and describe the hierarchy of who makes decisions for the facility. For a weather-related disaster, train staff to monitor conditions and start prepping to perform their designated duties if disaster strikes. For instance, assign one staff member to stay in touch with key agencies to alert them to the situation and to explain the actions your facility is contemplating. Another employee needs to confirm the availability of staff and call in additional employees to help evacuate and take care of residents.

Practice and Test: Practice implementing the disaster plan with your staff. For instance, schedule fire drills every quarter for each staffing shift. Test your emergency telephone contact list to confirm the numbers on the roster are correct. Put your generators and critical equipment that require power to the test to make sure they all work as intended. Document all of your practice and testing as a way to prove your facility is staying on top of disaster planning in the event of liability issues.

B.5 VANH130 INVOICES

Invoices shall be submitted promptly to the authorizing facility by the 15th calendar day following the end of the month in which services were rendered. All invoices must include the full name and address of the nursing home and shall reflect the patient's name, social security number, number of days billed, level of care category, and per diem rate. Failure to include this information may result in delayed payments.

B.6 VANH140 AUTHORIZATIONS

Authorizations for nursing home care will be accomplished on VA Form 10-7078, Authorization and Invoice for Medical and Hospital Services. Each authorization validity period will be from the initial effective date to disposition. Any extension to the original authorization validity period, regardless of the number of days, requires a new VA Form 10-7078.

B.7 VANH150 ANCILLARY COSTS

Ancillary costs are pre-approved costs for supplies or services not identified as included in the all-inclusive rate or any other pre- authorized rate or schedule or payment for items or services provided under this agreement. Ancillary costs such as medications, and special equipment, may not be added to any invoice without written permission of the VA medical center placing the veteran. If permission is received, the nursing home must also submit the physician's order for the medication/supply, the dispensing log, the supplier and the cost charged by the supplier to the nursing home, and what the nursing home is charging the VA.

B.8 VANHA100 VA NURSING HOME LANGAUGE

This is an Indefinite Delivery Indefinite Quantity (IDIQ) contract for a five (5) year period. An order is formed, in accordance with the terms and conditions of this agreement, when VA agrees to place a patient in the nursing home and the nursing home agrees to accept the patient. Upon acceptance by the contractor of beneficiaries of Department of Veterans Affairs (VA), all terms and conditions of this agreement shall apply during such time as a VA patient remains in that nursing home at the expense of VA.

Upon acceptance of a VA patient by the nursing home, if and when requested by the Contracting Officer or authorized representative, the contractor shall furnish all supplies and services herein described, at the per diem rates for the levels of care specified below. VA levels of care are defined in Section E of this agreement. VA is obligated only to the extent authorized placements of patients are made under this agreement.

B.9 VANHA110 RATE DETERMINATION

The per diem rate is established by the current Medicare rate for Medicare approved nursing homes to cover the cost of supplies, services, and equipment above that provided under Medicare established by the local state Medicare agency (CMS). Rates established after the effective date of this contract will constitute a modification to the contract.

VA will use Medicare rates for room, board, and routine nursing care.

For all levels of nursing care, a percentage is added for routine ancillary services/supplies, such as drugs, nursing supplies, oxygen (occasional use), x-ray, laboratory, physician visits, and rental equipment.

Special equipment, e.g. clinitron bed, is/are not considered routine ancillary services (and may be provided by the VA).

Drug costs which comprise more than eight and one-half percent (8.5%) of the per diem rate are generally not considered routine ancillary supplies (and may be provided by the VA).

Rehabilitation therapies will be provided as a distinct level of care. Hospice Care and Dialysis are not included in the rate. VA or other payers may be used for Hospice and Dialysis, as determined by the veteran with VA approval.

B.10 VANHA120 ECONOMIC PRICE ADJUSTMENT

This provision does not apply to ancillary services that may be added or deleted from the agreement.

The per diem rate(s) will apply throughout the term of this contract, including extension period(s). The rate(s) may be adjusted only to reflect a change in a Medicare rate as authorized by the CMS. Normally, this will be on an annual basis. The negotiated percentage at or around the Medicare rate, to cover the all-inclusive nature of the contract, will not be renegotiated; but will be applied and added to the new Medicare rate for the adjusted per diem rate for each level of care item. This clause does not apply to rates for non-Medicare nursing homes. In this regard, new rates will be negotiated requiring a modification to the contract. Each per diem price adjustment under this clause is subject to the following limitations:

Any adjustment shall be limited to the effect of increases or decreases in the approved CMS's patient care components within the affected Medicare groups.

Adjustments will occur no more frequently than those issued by the CMS.

No adjustments will be made until the Contracting Officer receives an CMS authenticated copy of the new rate, signed and dated in a conspicuous area at the top right of the document by the authorized nursing home official. Within ten days after this occurs, the Contracting Officer will execute an approval signature and date at the approximate location of the nursing home official's signature, the action of which will serve as the effective date of the adjusted rate. A copy of the fully executed document will be sent to the nursing home official for record keeping purposes.

B.11 VANHA130 ORAL MEDICATIONS

Oral medications, which comprise more than 8.5% of the per diem rate on a monthly basis, are excluded from that rate. High drug costs will be determined or priced using the Average Wholesale Price (AWP) of the drugs plus a transaction fee of 3% per month. All calculations will be made on a monthly basis. When a high cost drug patient is identified, VA staff must be advised promptly to establish an appropriate course of action, which may include the provision of the medications by VA.

B.12 VANHC100 TERMINATION OF SERVICES

VA reserves the right to remove any or all VA patients from the nursing home at any time, when it is determined to be in the best interest of VA or the patients.

B.13 VANHC120 PAYMENTS

Payments made by VA under this contract constitute the total cost of nursing home care. No additional charges will be billed to Medicare Part B, the beneficiary or his/her family, either by the nursing home or any third part furnishing services or supplies required for such care, unless and until specific prior authorization in writing is obtained from the VA facility authorizing placement. The contractor will not solicit contributions, donations, or gifts from patients or family members.

B.14 VANHC130 ACCEPTABLE SAFETY AND SANITATION PRACTICES

Acceptable safety and sanitation practices shall be observed throughout the facility. The building shall conform to the standards of the Life Safety Code (National Fire Protection Association Standard #101) in effect on the date of contract award.

B.15 VANHC140 MINIMUM QUANTITIES

It is impossible to determine the exact or estimated amount which will be expended under this contract. No obligation will be incurred by VA under this contract until authorizations are issued for nursing home care of specific beneficiaries. VA agrees to make payment on a timely basis for services rendered in accordance with such authorizations upon receipt of proper invoices submitted by the nursing home as outlined in Section E of this contract. VA will make payment for the day a recipient enters the facility but not the day the recipient leaves a facility unless entrance and departure are on the same day then payment will be made for one day.

B.16 VANHE110 DEPARTMENT OF VETERANS AFFAIRS (VA) COMMUNITY NURSING HOME PROGRAM LEVEL OF CARE - DESCRIPTIONS Included as attachment D09 in Section D.

B.17 VANHE150 MEDICARE/MEDICAID STANDARDS

The contractor is required to follow Medicare/Medicaid standards for all VA placements, except Life Safety. Medicare and Medicaid clinical and program standards are found in 42 CFR 483.

SECTION C - CONTRACT CLAUSES

C.1 ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS Clauses that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

The following clauses are incorporated into 52.212-4 as an addendum to this contract:

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

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

http://www.acquisition.gov/far/index.html http://www.va.gov/oal/library/vaar/ (End of Clause)

C.3 52.216-18 ORDERING (OCT 1995)

(a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the Schedule. Such orders may be issued from date of award through end date of last option plus 6 months, if extended.

(b) All delivery orders or task orders are subject to the terms and conditions of this contract. In the event of conflict between a delivery order or task order and this contract, the contract shall control.

(c) If mailed, a delivery order or task order is considered "issued" when the Government deposits the order in the mail. Orders may be issued orally, by facsimile, or by electronic commerce methods only if authorized in the Schedule.

(End of Clause)

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

(a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than $160.00, the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract.

(b) Maximum order. The Contractor is not obligated to honor—

(1) Any order for a single item in excess of $1,000,000.00;

(2) Any order for a combination of items in excess of $5,000,000.00; or

(3) A series of orders from the same ordering office within 90 days that together call for quantities exceeding the limitation in paragraph (b)(1) or (2) of this section.

(c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section.

(d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within 1 days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.

(End of Clause)

C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)

(a) This is an indefinite-quantity contract for the supplies or services specified, and effective for the period stated, in the Schedule. The quantities of supplies and services specified in the Schedule are estimates only and are not purchased by this contract.

(b) Delivery or performance shall be made only as authorized by orders issued in accordance with the Ordering clause. The Contractor shall furnish to the Government, when and if ordered, the supplies or services specified in the Schedule up to and including the quantity designated in the Schedule as the "maximum." The Government shall order at least the quantity of supplies or services designated in the Schedule as the "minimum."

(c) Except for any limitations on quantities in the Order Limitations clause or in the Schedule, there is no limit on the number of orders that may be issued. The Government may issue orders requiring delivery to multiple destinations or performance at multiple locations.

(d) Any order issued during the effective period of this contract and not completed within that period shall be completed by the Contractor within the time specified in the order. The contract shall govern the Contractor's and Government's rights and obligations with respect to that order to the same extent as if the order were completed during the contract's effective period; provided, that the Contractor shall not be required to make any deliveries under this contract after 6 months after completion of final option period.

(End of Clause)

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

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within 30 days. The specified rates under this clause will be the rates in effect under the contract each time an option is exercised under this clause.

(End of Clause)

C.7 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

The Contractor shall not make reference in its commercial advertising to Department of Veterans Affairs contracts in a manner that states or implies the Department of Veterans Affairs approves or endorses the Contractor’s products or services or considers the Contractor’s products or services superior to other products or services.

(End of Clause)

C.8 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (DEC 2009)

The offeror agrees, if awarded a contract, to use the service-disabled veteran-owned small businesses or veteran-owned small businesses proposed as subcontractors in accordance with 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, or to substitute one or more service-disabled veteran-owned small businesses or veteran-owned small businesses for subcontract work of the same or similar value.

(End of Clause) C.9 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND COMPLIANCE (JUL 2018)

(a) This solicitation includes the clause: 852.215-70 Service-disabled veteran-owned and veteran-owned small business evaluation factors. Accordingly, any contract resulting from this solicitation will include the clause 852.215-71 Evaluation factor commitments.

(b) The Contractor is advised that in performing contract administration functions, the Contracting Officer may use the services of a support contractor(s) to assist in assessing Contractor compliance with the subcontracting commitments incorporated into the contract. To that end, the support contractor(s) may require access to the Contractor's business records or other proprietary data to review such business records regarding contract compliance with this requirement.

(c) All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the Contractor's business records or other proprietary data reviewed or obtained in the course of assisting the Contracting Officer in assessing the Contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs.

(d) Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the Contractor to protect proprietary information as required by FAR 9.505-4, Obtaining access to proprietary information, paragraph (b). The Contractor is required to cooperate fully and make available any records as may be required to enable the Contracting Officer to assess the Contractor compliance with the subcontracting commitments.

(End of Clause)

C.10 VAAR 852.219-76 SUBCONTRACTING PLANS MONITORING AND COMPLIANCE (JUL 2018)

(a) This solicitation includes FAR 52.219-9, Small Business Subcontracting Plan, and VAAR 852.219-9, VA Small Business Subcontracting Plan Minimum Requirement.

(b) Accordingly, any contract resulting from this solicitation will include these clauses, unless the contract is awarded to a small business concern. The Contractor is advised in performing contract administration functions, the Contracting Officer may use the services of a support contractor(s) to assist in assessing the Contractor's compliance with the plan, including reviewing the Contractor's accomplishments in achieving the subcontracting goals in the plan. To that end, the support contractor(s) may require access to the Contractor's business records or other proprietary data to review such business records regarding the Contractor's compliance with this requirement.

(c) All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the Contractor's business records or other proprietary data reviewed or obtained in the course of assisting the Contracting Officer in assessing the Contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs.

(d) Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the Contractor to protect proprietary information as required by FAR 9.505-4, Obtaining access to proprietary information, paragraph (b). The Contractor is required to cooperate fully and make available any records as may be required to enable the Contracting Officer to assess the Contractor compliance with the subcontracting plan.

(End of Clause)

C.11 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2012)

(a)…