36C26018Q9746-0001000.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE

OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

BY

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 10-11-2018 663A Department of Veterans Affairs Network Contracting Office 20 1495 Wilmington Drive, Suite 360 DuPont

WA

98327 663A Department of Veterans Affairs Network Contracting Office 20 1495 Wilmington Drive, Suite 360 DuPont

WA

98327 To all Offerors/Bidders

36C26018Q9746 08-24-2018

X X X THE PURPOSE OF THIS AMENDMENT IS TO INSERT PARAGRAPHS IN SECTION B AND REMOVE 2 CLAUSES.

A. B.1.6 GENERAL INFORMATION FOR OFFERORS is inserted in SECTION B.

B. B.2 SPECIAL CONTRACT REQUIREMENTS is inserted in SECTION B before the previous B.2 and the subsequent SECTION B paragraphs are re-numbered.

C. The previous B.4 ITEMIZED PRICE LIST FOR RUG IV SERVICES (now re-numbered as B.5) is replaced in its entirety to now include a line at the bottom “HIV+/AIDS”, “To be negotiated on a case-by-case basis”.

D. FAR clauses 52.232-18 and 52.232-19 are removed.

E. There are no other changes to the solicitation as a result of this amendment, and all other terms and conditions remain unchanged.

POC at Contracting, Darlene Anderson, 253-888-4905 darlene.anderson4@va.gov

DARLENE ANDERSON

Contracting Officer

NCO2015L3-2479

CONTINUATION PAGE

B.1.6. GENERAL INFORMATION FOR OFFERORS:

B.1.6.1. Registration in SAM: Federal Acquisition Regulations require that federal contractors register in the System for Award Management (SAM) located at https://www.sam.gov/portal/public/SAM/. Offerors shall enter all mandatory information into the system. Award cannot be made until the contractor has registered. Offeror’s are encouraged to ensure that they are registered in SAM prior to submitting their Offer.

B.1.6.2. Contractor shall maintain an Active SAM status for the duration of this Blanket Ordering Agreement by renewing their SAM registration annually.

B.1.6.3. Instructions for Proposal Submission: Refer to Addendum, Instructions for Proposal Submission, FAR Provision 52.212-1, Instruction to Offerors -- Commercial Items located within the provision section of this solicitation for specific instructions and documentation to be submitted with the proposal.

B.1.6.4. Procurement Technical Assistance Centers (PTACs) provide government contracting assistance in the form of classes, counseling, access to bid opportunities, contract specification, procurement histories and other information to assist small business successfully compete for government contracts. http://www.aptac-us.org/

B.2 SPECIAL CONTRACT REQUIREMENTS

B.2.1. Under the authority of Public Law 104-262 and 38 USC 1720, the contractor agrees to provide Health Care Resources in accordance with the terms and conditions stated herein, to furnish to and at the Department of Veterans Affairs Medical Center, the services and prices specified in the Section entitled Schedule of Supplies/Services of this contract.

B.2.2. SERVICES: This is a Basic Ordering Agreement (BOA) for the period from date of award for five (5) years, thereafter. No additional option year periods will be a part of any BOA. A contract is formed, in accordance with the terms and conditions of this Agreement, when the Department of Veterans Affairs (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 the VA, all terms and conditions of this agreement shall apply during such time as the VA patient remains in that nursing home at the expense of the VA.

B.2.2.1. This BOA is entered into under the authority in 38 USC 1720.

B.2.2.2. Either party may discontinue the BOA upon 30 days’ written notice. This agreement termination shall be effective on the 31st day following that notification.

B.2.2.3. The Contracting Officer shall review the BOA annually before the anniversary of its effective date and if necessary issue a modification to incorporate any statutory requirements.

B.2.2.4. The services specified in the Sections B.2 through B.12 may only be changed by written modification to this BOA.

B.2.2.5. 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 D of this agreement. VA is obligated only to the extent authorized placements of patients are made under this agreement.

B.2.3. PERSONNEL POLICY:

B.2.3.1. The contractor shall be responsible for protecting the personnel furnishing services under this BOA. To carry out this responsibility, the contractor shall provide the following for these personnel:

1. General liability;

1. Workers compensation;

1. Professional liability insurance;

1. Health examinations;

1. Income tax withholding; and

1. Social security payments.

B.2.3.2. The parties agree that the contractor, its employees, agents and subcontractors shall not be considered VA employees for any purpose.

B.2.4. 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.2.5. 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.2.6. 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.5 ITEMIZED PRICE LIST FOR RUG IV SERVICES

RUG-IV CLASSIFICATION & HIERARCHY

Rehabilitation Plus Extensive Services 2

Rehabilitation Plus Extensive Services 1

RUX, RUL

RVX, RVL

RHX, RHL

RMX, RML

RLX

Residents receiving physical speech or occupational therapy AND receiving IV feeding or medications, suctioning, tracheostomy care, or ventilator/ respirator

RHA, RHB RHC, RMA RMB, RMC RLA, RLB

ES3

Residents receiving complex clinical care or with complex clinical needs such as IV feeding or medications, suctioning, tracheostomy care, ventilator/respirator and co-morbidities that the resident eligible for other RUG categories

HD1, HD2

HC1, HC2

HB1, HB2

LE1, LE2

LD1, LD2

LC1, LC2

LB1, LB2

CD1, CD2

CC1, CC2

CB1, CB2

CA1, CA2

BA1, BA2

PB1, PB2

PC1, PC2

PD1, PD2

PE1, PE2

See attached document: 36C26018Q9746 conformed 10-11-2018.