36C26120Q0527-001.docx

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Q402--Intent to Sole Source Palm Village CNH
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36C26120Q0527
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36C26120Q0527 Schedule of Services and Price- Palm Village.docx

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B.3 SCHEDULE OF SERVICES

Contractor shall provide Nursing Home Care services for eligible Veterans at contractor’s place of business within the Fresno, CA area. All services shall be provided in accordance with the specifications, terms and conditions contained herein.

The guaranteed minimum, for the contract is one room for one veteran for one day. The maximum of the contract, inclusive of ordering periods, shall not exceed $2,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount.

(NOTE: The reference to the published rate means the date the rates are published and distributed, not the effective dates. In other words, if the rates are effective August 1, but they are not published until the subsequent March, then the rates for this contract would change in March.)

PERIOD OF PERFORMANCE: July 01, 2020 through June 30, 2025

ITEM NUMBER
DESCRIPTION OF SUPPLIES/SERVICES
UNIT
PER DIEM RATE
1001
BED HOLD

(State Medicaid Daily Rate = VA BASE)

DY
Reimbursed at Current State Medicaid without Supplement
1002
RESPITE

(State Medicaid Daily Rate = VA BASE)

DY
Reimbursed at Current State Medicaid without Supplement
1003
HOSPICE CARE
DY
Reimbursed at Current State Medicaid daily rate plus ___%
1004
REDUCED PHYSICAL FUNCTION, BEHAVIOR & COGNITIVE PERFORMANCE
DY
Reimbursed at Current State Medicaid daily rate plus ___%
1005
CLINICALLY COMPLEX
DY
Reimbursed at Current State Medicaid daily rate Plus ___%
1006
SPECIAL CARE HIGH
DY
Reimbursed at Current State Medicaid daily rate Plus ___%
1007
SPECIAL CARE LOW
DY
Reimbursed at Current State Medicaid daily rate Plus ___%
1008
EXTENSIVE SERVICES
DY
Reimbursed at Current State Medicaid daily rate Plus ___%
1009
REHABILITATION
DY
Reimbursed at Current State Medicaid Plus ___%
1010
REHABILITATION + EXTENSIVE SERVICES
DY
Reimbursed at Current State Medicaid daily rate Plus ___%

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