36C26018Q9746-0003001.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

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 54

36C26018Q9746 08-24-2018

Darlene Anderson 253-888-4905 08-23-2019

12:00am Pacific

Department of Veterans Affairs

Network Contracting Office 20

1495 Wilmington Drive

Suite 360

Dupont WA 98327

X

623110

$27.5 Million

Net 30 days

X

N/A

X

Department of Veterans Affairs

Veterans Integrated Services Network 20

Washington, Oregon, Idaho & Alaska

Network Contracting Office 20

1495 Wilmington Drive

Suite 360

Dupont WA 98327

FMS-VA-2(101)

Financial Services Center

PO Box 149971

Austin TX 78714-9971

866-372-5540

See CONTINUATION Page

This is an open and continuous solicitation for Community

Nursing Home Services within Veterans Integrated Service

Network 20 (VISN 20), incorporating the states of

Washington, Oregon, Idaho, and Alaska. Multiple Basic

Ordering Agreements (BOA) are anticipated to be awarded against this Request for Quotes, as required in response to

Veteran Healthcare Administration social workers acting on behalf of qualified Veterans seeking this care.

Specific locations of services and the applicable periods of performance will be stated in the individual BOAs for these services. BOA periods of performance will be for a total of five (5) years with no incorporated option periods.

Interested parties should note the instructions for submitting a quote in the Basis of Award section of this solicitation, page 48.

$0.00

See CONTINUATION Page

X X

X one(1)

Darlene Anderson

NCO2015L3-2479

36C26018Q9746

Table of Contents

SECTION A

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

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SPECIAL CONTRACT REQUIREMENTS

B.3 RATE DETERMINATION

B.4 ORAL MEDICATIONS

B.5 ITEMIZED PRICE LIST FOR RUG IV SERVICES

B.6 PERFORMANCE WORK STATEMENT (PWS)

B.7 ACCEPTABLE SAFETY AND SANITATION PRACTICES

B.8 MEDICARE/MEDICAID STANDARDS

B.9 ECONOMIC PRICE ADJUSTMENT

B.10 TERMINATION OF SERVICES

B.11 PAYMENTS

B.12 MINIMUM QUANTITIES

B.13 VHA HANDBOOK 1143.2 ELIGIBILITY REQUIREMENTS

SECTION C - CONTRACT CLAUSES

C.1 52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS AND

REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS (APR 2014)

C.2 52.204-4 PRINTED OR COPIED DOUBLE-SIDED ON RECYCLED PAPER (MAY

2011)

C.3 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (JAN

2017)

C.4 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2018)

C.5 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.6 52.224-1 PRIVACY ACT NOTIFICATION (APR 1984)

C.7 52.224-2 PRIVACY ACT (APR 1984)

C.8 52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS

SUBCONTRACTORS (DEC 2013)

C.9 52.237-3 CONTINUITY OF SERVICES (JAN 1991)

C.10 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.11 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.12 VAAR 852.216-73 ECONOMIC PRICE ADJUSTMENT—STATE NURSING HOME

CARE FOR VETERANS (MAR 2018)

C.13 VAAR 852.222-70 CONTRACT WORK HOURS AND SAFETY STANDARDS ACT—

NURSING HOME CARE FOR VETERANS (MAY 2018)

C.14 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2012)

C.15 VAAR 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(JAN 2008)

C.16 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984)

C.17 VAAR 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED TO

BENEFICIARIES (JAN 2008)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 QUALITY ASSURANCE SURVEILLANCE PLAN

D.2 WAGE DETERMINATION DOL LINK

D.3 AUTHORIZATION & INVOICE FOR MEDICAL & HOSPITAL SERVICES

D.4 REFERRAL FOR NURSING HOME CARE

SECTION E - SOLICITATION PROVISIONS

E.1 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.2 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.5 ADDENDUM TO 52.212-2, BASIS OF AWARD

E.3 52.216-1 TYPE OF CONTRACT (APR 1984)

E.4 52.216-27 SINGLE OR MULTIPLE AWARDS (OCT 1995)

E.5 52.225-25 PROHIBITION ON CONTRACTING WITH ENTITIES ENGAGING IN

CERTAIN ACTIVITIES OR TRANSACTIONS RELATING TO IRAN—REPRESENTATION

AND CERTIFICATIONS (OCT 2015)

E.6 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.7 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(JAN 2008)

E.8 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (JAN 1998)

E.9 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) .. 54

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: (to be determined at time of award)

b. GOVERNMENT: Contracting Officer 36C260

Network Contracting Office 20

1495 Wilmington Drive

Suite 360

Dupont WA 98327

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

[] 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 []

c. Other [X] Monthly in arrears

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be mailed to the following address: (To be specified at time of award)

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

AMENDMENT NO DATE

0001 10/11/2018

6. GENERAL INFORMATION FOR OFFERORS:

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.

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

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.

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:

General liability;

Workers compensation;

Professional liability insurance;

Health examinations;

Income tax withholding; and

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.3 RATE DETERMINATION

B.3.1. The per diem rate is established by the current Medicaid rate for Medicaid approved nursing homes plus a fair market amount (percentage) to cover the cost of supplies, services, and equipment above that provided under Medicaid established by the local state Medicaid agency (SMA). Rates established after the effective date of this contract will constitute a modification to the contract.

B.3.2. VA will use Medicaid rates for room, board, and routine nursing care.

B.3.3. 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, mental health services, complex wound care, and rental equipment.

B.3.4. Special equipment, e.g. clinitron bed, isare not considered routine ancillary services (and may be provided by the VA).

B.3.5. 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).

B.3.6. 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.4 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.5 ITEMIZED PRICE LIST FOR RUG IV SERVICES

RUG-IV CLASSIFICATION & HIERARCHY

Major RUG-IV

Category

RUG-IV

Group Codes

Characteristics Associated with Major

RUG-IV Category Per Diem Rate

Rehabilitation Plus Extensive Services

RUX, RUL,

RVX, RVL,

RHX, RHL,

RMX, RML,

RLX

Residents satisfying all of the following three conditions:

• Having a minimum activity of daily living (ADL) dependency score of 2 or more.

• Receiving physical therapy, occupational therapy, and/or speech-language pathology services while a resident.

Ultra (U)-720+ minutes Very High (V)-500-719 minutes High (H)-325-499 minutes Medium (M)-150-324 minutes Low (L)-45-149 minutes

• While a resident, receiving complex clinical care and have needs involving tracheostomy care, ventilator/respirator, and/or infection isolation.

Rehabilitation RUA, RUB, RUC, RVA, RVB, RVC, RHA, RHB, RHC, RMA, RMB, RMC, RLA, RLB

Residents receiving physical therapy, occupational therapy, and/or speech-language pathology services while a resident.

Ultra (U)-720+ minutes Very High (V)-500-719 minutes

High (H)-325-499 minutes

Medium (M)-150-324 minutes Low (L)-45-149 minutes

ADL Score

11-16 = C 6-10 = B

0-5 = A

Extensive Services ES3, ES2, ES1

Residents satisfying the following two conditions:

• Having a minimum ADL dependency score of 2 or more.

• While a resident, receiving complex clinical care and have needs involving:

tracheostomy care, ventilator/respirator, and/or infection isolation.

RUG-IV CLASSIFICATION & HIERARCHY

Major RUG-IV

Category

RUG-IV

Group

Codes

Characteristics Associated with Major

RUG-IV Category Per Diem Rate

Special Care High HE2, HE1, HD2, HD1, HC2, HC1, HB2, HB1

Residents satisfying the following two conditions:

•Having a minimum ADL dependency score of 2 or more.

•Receiving complex clinical care or have serious medical conditions involving any one of the following: comatose, septicemia, diabetes with insulin injections and insulin order changes, quadriplegia with a higher minimum ADL dependence criterion (ADL score of 5 or more), chronic obstructive pulmonary disease (COPD) with shortness of breath when lying flat, fever with pneumonia, vomiting, weight loss, or tube feeding meeting intake requirement, parenteral/IV feeding, or respiratory therapy.

Special Care Low LE2, LE1, LD2, LD1, LC2, LC1, LB2, LB1

Residents satisfying the following two conditions:

•Having a minimum ADL dependency score of 2 or more.

•Receiving complex clinical care or have serious medical conditions involving any of the following: cerebral palsy with ADL dependency score of 5 or more, multiple sclerosis with ADL dependency score of 5 or more,— Parkinson’s disease with ADL dependency score of 5 or more, respiratory failure and oxygen therapy while a resident, tube feeding meeting intake requirement, ulcer treatment with two or more ulcers including venous ulcers, arterial ulcers or Stage II pressure ulcers, ulcer treatment with any Stage III or IV pressure ulcer, foot infections or wounds with application of dressing, radiation therapy while a resident, or dialysis while a resident.

Clinically Complex CE2, CE1, CD2, CD1, CC2, CC1, CB2, CB1, CA2, CA1

Residents receiving complex clinical care or have conditions requiring skilled nursing management, interventions or treatments involving any of the following: pneumonia, hemiplegia with ADL dependency score of 5 or more, surgical wounds or open lesions with treatment, burns, chemotherapy while a resident, oxygen therapy while a resident, IV medications while a resident, or transfusions while a resident.

RUG-IV CLASSIFICATION & HIERARCHY

Major RUG-IV

Category

RUG-IV

Group

Codes

Characteristics Associated with Major

RUG-IV Category Per Diem Rate

Behavioral Symptoms and Cognitive Performance

BB2, BB1,

BA2, BA1

Residents satisfying the following two conditions:

•Having a maximum ADL dependency score of 5 or less.

•Having behavioral or cognitive performance symptoms, involving any of the following:

difficulty in repeating words, temporal orientation, or recall (score on the Brief Interview for Mental Status <=9), difficulty in making self understood, short term memory, or decision making (score on the Cognitive Performance Scale >=3), hallucinations, delusions, physical behavioral symptoms toward others, verbal behavioral symptoms toward others, other behavioral symptoms, rejection of care, or wandering.

Reduced Physical Function

PE2, PE1,

PD2, PD1,

PC2, PC1,

PB2, PB1,

PA2, PA1

Residents whose needs are primarily for support with activities of daily living and general supervision.

HIV+/AIDS To be negotiated on a case-by-case basis

B.6 PERFORMANCE WORK STATEMENT (PWS)

B.6.1. The nursing home shall ensure that care meets the health needs and promotes the maximum well-being of VA patients. Nursing home care will be furnished to ensure the total medical, nursing, and psycho-social needs of VA beneficiaries. Physician visits, mental health services, complex wound care, 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 room, meals, nursing care, and other services or supplies commensurate with the VA authorized level of care, without extra charge. The per diem rate(s) established in this Basic Ordering Agreement (BOA) will include the cost of medical care, mental health services, complex wound care, drugs, laboratory, x ray, and other special services authorized by VA, unless otherwise specifically excepted.

B.6.2. 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. Every effort shall be made to keep patients ambulatory and to achieve an optimal level of self-care.

B.6.3. Veterans receiving care under this BOA, who begin to require acute hospital care, will be readmitted to an appropriate VA facility, as determined and authorized by the VA. When such admission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non-Federal facility may be accomplished provided VA authorization is obtained. VA authorization must be obtained as soon as possible and not to exceed 72 hours of admission to the non-Federal facility. If hospitalization of a non-emergency nature is required, 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. If a veteran is re-hospitalized from the nursing home, the nursing home and VA facility will arrange to hold a bed in reserve, when such a decision is in the best interest of the patient and the VA. 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. Payment will follow state Medicaid regulations. The VA facility will include payment for these "bed hold" days only when the conditions above are met.

B.6.4. 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 approved by VA. Leave days at VA expense are limited to 6 days per calendar year. Payment will follow state Medicaid regulations.

Exceptions may be approved by the VA facility director or designee.

B.6.5. Patients receiving care under this BOA, who begin to require more than the level of care authorized by VA, will be readmitted to an appropriate VA facility, as determined and authorized by VA.

When such admission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non-Federal facility may be accomplished provided VA authorization is obtained. VA authorization must be obtained within 72 hours of admission of the patient to a non-Federal facility. If hospitalization of a non-emergency nature is required, it is agreed that readmission to a VA Medical Center will be accomplished as soon as the patient's condition is sufficiently stabilized to permit admission to VA. Notice of all reportable events on VA BOA veterans and all facility sentinel events shall be given within 24 hours or immediately on the first business day after a weekend or holiday.

B.6.6. In the event a VA beneficiary receiving nursing home care under this BOA dies, the nursing home will notify the VA office authorizing admission within 24 hours, or immediately on the first business day after a weekend or a holiday. The nursing home shall immediately assemble, inventory, and safeguard the patient's personal effects pending further guidance by VA.

B.6.7. 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. The contractor shall adhere to the Acceptable Quality Levels as described in the Quality Assurance Surveillance Plan (QASP) in Section D.1 of this BOA.

B.6.8. The nursing home shall accept referral of and shall provide all services specified in this BOA 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.

B.6.9. 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 for nor relieve the nursing home in any way of the responsibility for the daily care and medical treatment of the veteran.

B.6.10. All medical records concerning the veteran's care in the nursing home will be readily accessible to the VA. If the nursing facility has an electronic charting system, remote access to VA patient records shall be granted to VA clinical staff. 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:

Admission identification record;

VA Form 10-7078, Referral for Community Nursing Home Care, or State-approved referral form;

Admitting evaluation (including diagnosis by nursing home physician);

Physician orders;

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

Special reports (laboratory, x ray, activity, etc.); and SMA Patient Assessment Form (only if SMA level of care is used).

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

B.6.11. 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.

B.6.12. 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.

B.6.13. 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:

B.6.14. The recipient is discharged and subsequently qualifies for a new admission assessment.

B.6.15. 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. The VA will make the determination whether classification changes require readmission to VA.

B.6.16. The VA, at its sole option, will monitor the professional care and administrative management of services provided to VA beneficiaries under this BOA, 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 BOA, including VA's on-site review and monitoring. 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 as follows:

Reviews of state agencies reports;

On-site review of the Nursing Home by VA staff; and On-site monitoring of VA patients.

B.6.17. The nursing home shall alert the VA within 24 hours in the event of any of the following situations:

The Veteran is discharged from the nursing home facility;

The Veteran goes to an emergency room or is otherwise hospitalized;

The Veteran dies in the nursing home facility; or The Veteran is involved in a mandated referral situation.

B.7 ACCEPTABLE SAFETY AND SANITATION PRACTICES

B.7.1. 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 the signed BOA.

B.7.2. The State Fire Marshal Report will be reviewed annually prior to the anniversary of the effective date of the BOA and if necessary a modification may be issued.

B.8 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.

B.9 ECONOMIC PRICE ADJUSTMENT

B.9.1. The contractor shall comply with the language at VA Acquisition Clause 852.216- 73, Economic Price Adjustment – State Nursing Home Care for Veterans (MAR 2018), when requesting an adjustment of rates under this Basic Ordering Agreement.

B.9.2. Any Economic Price Adjustment requested by the contractor must be made effective by issuance of a bilateral modification signed by both the contractor and the contracting officer.

B.10 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.11 PAYMENTS

Payments made by VA under this BOA, 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 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. The contractor will not solicit contributions, donations, or gifts from patients or family members. The contractor agrees to invoice in a timely and accurate manner in accordance with the instructions in Section B.1., paragraph 4 of this

BOA.

B.12 MINIMUM QUANTITIES

It is impossible to determine the exact or estimated amount which will be expended under this BOA. No obligation will be incurred by VA under this BOA 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 B.1 of this BOA. 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.13 VHA HANDBOOK 1143.2 ELIGIBILITY REQUIREMENTS

VHA Handbook 1143.2 lists the basic requirements that a nursing home facility/organization must comply with in order to be considered for award of a BOA to provide community nursing home services for Veterans. It is emphasized that such BOAs will only be awarded if the facility/ organization demonstrates that they comply with all the requirements below, and it is determined by the Department of Veterans Affairs that a nursing home BOA is desired to be awarded to a particular facility/organization based upon actual or probable need.

B.13.1 INITIAL REVIEW OF CONTRACT NURSING HOMES:

B.13.1.1. CNHs are considered for VA CNH’s Program, when the VA Health Care Facility (VAHCF) has determined that a need exists for additional CNH options. In cases where this need has been confirmed, a nursing home requesting to participate in the CNH Program is mailed, a VA Form 10-1170, Contract Award for Furnishing Nursing Home Services to Beneficiaries of the Veterans Administration, and a descriptive cover letter by the Contracting Officer.

B.13.1.2. The Contracting Officer notifies the CNH Review Team of the nursing home’s intent. An evaluation must be planned by the CNH Review Team.

B.13.1.3. A contract can only be established between a CNH and one (1) VAHCF. Generally, the contract exists between the CNH and the VAHCF which has cognizance for that geographic location.

B.13.1.4. Nursing homes are reviewed prior to consummation of an initial contract with VA. The CNH provides evidence of State licensure and limited additional information listed in B.14.1.7., below.

B.13.1.5. All NHs under VA contract must be certified under Title XVIII (Medicare) or Title XIX (Medicaid) or have received special approval from the GEC SHG. For CNH document review purposes, the NH Compare system and the MDS-based Quality Indicator (QI) Profile provide nursing home-specific information on quality and management.

B.13.1.6. Community nursing homes are required to meet all state licensing requirements including the state requirements pertaining to level of medical liability insurance (MLI). When CNH’s with existing contracts have documented efforts to purchase MLI, but have been denied by reason of a moratorium on new policies, or by price prohibitions, VA contracts may be renewed if the CNH meets all other contract care provisions. However, VA will not establish new contracts with non-participating CNH’s that do not have the level of MLI required by the state.

B.13.1.7. The CNH Review Team must obtain and must analyze the Compare and MDS QI Profile data, and all other necessary state survey reports and information. This may include a copy of the most recent State Survey Agency (SSA) Form 2567, Statement of Deficiencies and Plan of Correction, and any complaints against a CNH that are reported to the State. NH Compare information is available on-line:

http://www.medicare.gov/nhcompare/home.asp. A copy of SSA Form 2567 may be requested from the State or the nursing home being reviewed. A copy of the most recent MDS QI Profile will be requested from the nursing home being reviewed. This profile includes all quality indicators reported through MDS to CMS with facility, State, and national percentages.

B.13.1.8. When the CNH Review Team’s document examination indicates that the nursing home is in either substantial compliance or that deficiencies have been corrected, an informational visit is made to the home by a VA representative designated by the CNH Review Team. This visit is designed to meet the leadership of the nursing home, to learn about the nursing home’s special programs, and to determine how the nursing home can best meet veterans’ needs.

B.13.1.9. When the CNH Review Team’s document examination indicates deficiencies of scope, severity, or number that prevent the CNH from meeting the standards for initial and annual CNH reviews as detailed in VHA Handbook 1143.2, paragraph 11c, and the plan of correction does not adequately answer these deficiencies, the CNH Review Team either conducts an on-site survey, or recommends that the contract not be initiated. This action is taken after consultation with the SSA in order to ensure that a VA site visit is necessary. The team members must include a registered nurse, social worker, plus other disciplines, as appropriate, to evaluate the specific areas of non-compliance.

B.13.1.10. For all contracts, a Safety Officer must always conduct an initial site survey. The nursing home is required to be in compliance with the most recent edition of the Life Safety Code (LSC). All new homes entering the CNH Program must be fully sprinkled. This affects homes new to the CNH Program;

not contract renewals.

B.13.1.11. Based on the preceding evaluation process, the CNH Review Team through the CNH Coordinator, makes recommendations to the Contracting Officer on the disposition of the application.

B.13.2. ANNUAL REVIEW OF CNHs:

B.13.2.1. Once a CNH has a VA BOA, the review process is completed and documented every 12 months, and no more than 90 days prior to expiration of the BOA. If a BOA is canceled and renegotiated during the year for the purpose of establishing a new per diem rate or for an ownership change, it is not necessary to conduct another review as long as the review has been conducted within the required 12-month time limit.

B.13.2.2. The CNH team repeats the process described in B.14.1 above for annual reviews. In addition, the team must review the findings of the ongoing monitoring visits to the nursing home. NOTE: Triennial site surveys for LSC compliance will be conducted, unless otherwise indicated by the review process.

B.13.2.3. The CNH Review Team must document the findings and recommendations on each review and follow-up review conducted.

http://www.medicare.gov/nhcompare/home.asp

B.13.2.4. Based on the preceding review processes, the CNH Review Team through the CNH Coordinator, makes recommendations to the Contracting Officer on the disposition of the contract renewal.

B.13.2.5. The CNH Review Team, through the CNH Oversight Committees, provides documentation on its findings and the CNH disposition or the Certification Report. Reports will be made on the CNH Website, when it becomes available and updated quarterly. This certification includes the dates each CNH was reviewed, how the reviews were conducted, if on-site surveys by the CNH Review Team were necessary, if consultation with the SSA was obtained, and other pertinent information and recommendations. A program monitor, examining the overall quality of CNHs under contract, will be drawn from the website data set.

Interested parties may view the entire text of VHA Handbook 1143.2, VHA Community Nursing Home Oversight Procedures, at the following link:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5440 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5440

SECTION C - CONTRACT CLAUSES

C.1 52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS AND

REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS

(APR 2014)

(a) This contract and employees working on this contract will be subject to the whistleblower rights and remedies in the pilot program on Contractor employee whistleblower protections established at 41 U.S.C.

4712 by section 828 of the National Defense Authorization Act for Fiscal Year 2013 (Pub. L. 112–239) and FAR 3.908.

(b) The Contractor shall inform its employees in writing, in the predominant language of the workforce, of employee whistleblower rights and protections under 41 U.S.C. 4712, as described in section 3.908 of the Federal Acquisition Regulation.

(c) The Contractor shall insert the substance of this clause, including this paragraph (c), in all subcontracts over the simplified acquisition threshold.

(End of Clause)

C.2 52.204-4 PRINTED OR COPIED DOUBLE-SIDED ON RECYCLED PAPER

(MAY 2011)

(a) Definitions. As used in this clause—

"Postconsumer fiber" means— (1) Paper, paperboard, and fibrous materials from retail stores, office buildings, homes, and so forth, after they have passed through their end-usage as a consumer item, including: used corrugated boxes; old newspapers; old magazines; mixed waste paper; tabulating cards;

and used cordage; or

(2) All paper, paperboard, and fibrous materials that enter and are collected from municipal solid waste; but not

(3) Fiber derived from printers' over-runs, converters' scrap, and over-issue publications.

(b) The Contractor is required to submit paper documents, such as offers, letters, or reports that are printed or copied double-sided on paper containing at least 30 percent postconsumer fiber, whenever practicable, when not using electronic commerce methods to submit information or data to the

Government.

(End of Clause)

C.3 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL

ITEMS (JAN 2017)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any

Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the

Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at FAR

52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the

Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds

Transfer—System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other

Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by

EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

(i) Payment.—

(1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt payment. The Government will make payment in accordance with the Prompt Payment Act

(31 U.S.C. 3903) and prompt payment regulations at 5 CFR part 1315.

(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212-5(b) for the appropriate EFT clause.

(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or the specified payment date if an electronic funds transfer payment is made.

(5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment, the

Contractor shall—

(i) Remit the overpayment amount to the payment office cited in the contract along with a description of the overpayment including the—

(A) Circumstances of the overpayment (e.g., duplicate payment, erroneous payment, liquidation errors, date(s) of overpayment);

(B) Affected contract number and delivery order number, if applicable;

(C) Affected line item or subline item, if applicable; and

(D) Contractor point of contact.

(ii) Provide a copy of the remittance and supporting documentation to the Contracting Officer.

(6) Interest.

(i) All amounts that become payable by the Contractor to the Government under this contract shall bear simple interest from the date due until paid unless paid within 30 days of becoming due. The interest rate shall be the interest rate established by the Secretary of the Treasury as provided in 41 U.S.C. 7109, which is applicable to the period in which the amount becomes due, as provided in (i)(6)(v) of this clause, and then at the rate applicable for each six-month period as fixed by the Secretary until the amount is paid.

(ii) The Government may issue a demand for payment to the Contractor upon finding a debt is due under the contract.

(iii) Final decisions. The Contracting Officer will issue a final decision as required by 33.211 if—

(A) The Contracting Officer and the Contractor are unable to reach agreement on the existence or amount of a debt within 30 days;

(B) The Contractor fails to liquidate a debt previously demanded by the Contracting Officer within the timeline specified in the demand for payment unless the amounts were not repaid because the

Contractor has requested an installment payment agreement; or

(C) The Contractor requests a deferment of collection on a debt previously demanded by the

Contracting Officer (see 32.607-2).

(iv) If a demand for payment was previously issued for the debt, the demand for payment included in the final decision shall identify the same due date as the original demand for payment.

(v) Amounts shall be due at the earliest of the following dates:

(A) The date fixed under this contract.

(B) The date of the first written demand for payment, including any demand for payment resulting from a default termination.

(vi) The interest charge shall be computed for the actual number of calendar days involved beginning on the due date and ending on—

(A) The date on which the designated office receives payment from the Contractor;

(B) The date of issuance of a Government check to the Contractor from which an amount otherwise payable has been withheld as a credit against the contract debt; or

(C) The date on which an amount withheld and applied to the contract debt would otherwise have become payable to the Contractor.

(vii) The interest charge made under this clause may be reduced under the procedures prescribed in

32.608-2 of the Federal Acquisition Regulation in effect on the date of this contract.

(j) Risk of loss. Unless the contract specifically provides otherwise, risk of loss or damage to the supplies provided under this contract shall remain with the Contractor until, and shall pass to the Government upon:

(1) Delivery of the supplies to a carrier, if transportation is f.o.b. origin; or

(2) Delivery of the supplies to the Government at the destination specified in the contract, if transportation is f.o.b. destination.

(k) Taxes. The contract price includes all applicable Federal, State, and local taxes and duties.

(l) Termination for the Government's convenience. The Government reserves the right to terminate this contract, or any part hereof, for its sole convenience. In the event of such termination, the Contractor shall immediately stop all work hereunder and shall immediately cause any and all of its suppliers and subcontractors to cease work. Subject to the terms of this contract, the Contractor shall be paid a percentage of the contract price reflecting the percentage of the work performed prior to the notice of termination, plus reasonable charges the Contractor can demonstrate to the satisfaction of the Government using its standard record keeping system, have resulted from the termination.