36C26318R0484-001.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 96

36C26318R0484 08-29-2018

Charles Morin, Contract Specialist 651-293-3035 09-26-2018

5:00PM CST

Department of Veterans Affairs

NCO 23 - Minneapolis

Attention: Charles Morin

316 Robert Street N.

St. Paul MN 55101

X

6214929

$38.5 Million

N/A

X

N/A

Department of Veteran Affairs

Sioux Falls VA Health Care System

2501 West 22nd Street

Sioux Falls, SD 57105

NCO 23 - St. Paul

Attention: Charles Morin

316 Robert Street N.

St. Paul MN 55101

Y

Financial Services Center

PO Box 149971

Austin TX 78714-9971

See CONTINUATION Page

Acute Dialysis Services for the

Sioux Falls VA Health Care System

Period of Performance: 1/1/2019 - 12/31/2019

See Subsection B.2 Schedule of Services page 5.

See Subsection B.3 Performance Work Statement page 15.

See CONTINUATION Page

X X x ONE

36C26318R0484

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 SCHEDULE OF SERVICES

B.3 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (MAY

2015)

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

C.3 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL

(JAN 2011)

C.4 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION

SYSTEMS (JUN 2016)

C.5 52.216-18 ORDERING (OCT 1995)

C.6 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.7 52.216-22 INDEFINITE QUANTITY (OCT 1995)

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

C.9 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.10 52.228-5 INSURANCE—WORK ON A GOVERNMENT INSTALLATION (JAN 1997) 46

C.11 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.12 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984)

C.13 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.14 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND

COMPLIANCE (JUL 2018)

C.15 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2012)

C.16 VAAR 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(JAN 2008)

C.17 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984)

C.18 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2018)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (JAN 2017)

E.2 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL 2013)

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

E.4 52.217-5 EVALUATION OF OPTIONS (JUL 1990)

E.5 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.6 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (JAN 2008)

E.7 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-

OWNED SMALL BUSINESS EVALUATION FACTORS (JUL 2016)(DEVIATION)

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

E.9 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(JAN 2008)

E.10 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (JAN 1998)

E.11 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) 81

E.12 VAAR 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED TO

BENEFICIARIES (JAN 2008)

E.13 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (JAN 2003)

E.14 VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (JAN 2003)

E.15 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

ITEMS (NOV 2017)

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:

b. GOVERNMENT: Contracting Officer

NCO 23 – St. Paul 316 Robert Street N., Suite 503 St. Paul, MN 55101

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

[X] 52.232-34, 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 (Monthly) [X]

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Department of Veterans Affairs

Financial Services Center PO Box 149971

Austin TX 78714-9971

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the

Solicitation numbered and dated as follows:

AMENDMENT NO DATE

B.2 SCHEDULE OF SERVICES

SCHEDULE OF SERVICES

The Contractor shall furnish all personnel to provide services necessary to perform on-site Acute Dialysis

Nursing Services to eligible beneficiaries of the Department of Veterans Affairs (VA), Sioux Falls, SD

VA Health Care System (VAHCS. The Contractor’s care shall cover the range of services as would be provided in a state-of-the-art health care medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards.

Place of Performance: Services shall be provided on-site, Sioux Falls VAHCS, 2501 W 22nd Street, Sioux Falls SD 57105.

Period of Performance: Twelve (12) Month Base Period and four (4) 12-Month Option Years (to be exercised at the discretion of the Government)

Contract Type: The Government intends to award a Fixed Priced Indefinite Quantity Contract on a per procedure basis. An Indefinite Quantity Contract is being used because it is impossible to determine with any certainty the exact amount of service that will be required under this contract.

• The guaranteed minimum contract quantity is $5,000.00. The Government is not required to place an order in excess of the guaranteed minimum.

• The maximum quantity/contract quantity/amount, including the base year and any option years exercised, shall not exceed $1,250,000.00.

Pricing Instructions:

Offerors must fill out the cells in the following columns in the Price Schedule for each Contract Line Item

Number (CLIN).

Period of Performance:

Base Year: 1/1/2019 to 12/31/2019

Option Year 1 1/1/2020 to 12/31/2020

Option Year 2 1/1/2021 to 12/31/2021

Option Year 3 1/1/2022 to 12/31/2022

Option Year 4 1/1/2023 to 12/31/2023

Pricing

Total for base period:

Total for Option Year 1 period:

Total for Option Year 2 period:

Total for Option Year 3 period:

Total for Option Year 4 period:

Total for base performance period and all option years: $_________________________

BASE YEAR: 1/1/2019 to 12/31/2019

CLIN Description Estimated

Quantity

Unit Unit

Price

Amount

0001 Acute Hemodialysis Nursing Procedure, On-Site, Monday through Friday, 7:30 AM to 4:30 PM.

250 EA

0002 Acute Hemodialysis Nursing Procedure, On-Site, After Hour, (evening/weekend).

50 EA

0003 Emergency Response to the Sioux Falls VAHCS

(within 60 minutes). To be billed in addition to the normal business hour or after hour procedure.

12 EA

0004 Maintain Water Treatment and Dialysate Systems in accordance with the manufacturer’s guidelines and standards of practice. Two (2) times per week, 104 times per year for a total of three (3) dialysis systems.

104 EA

0005 Attend Sioux Falls VAHCS Dialysis Quality

Meeting. One (1) hour per month, twelve (12) times per year.

12 EA

Training Hours. Five (5) hours per employee, maximum of two (2) employees for a total of ten

(10) hours per year.

10 EA

0007 Culture Draw 10 EA

0008 Acute Hemodialysis Nursing Procedure at the

Contractor’s facility, as needed (when services cannot be performed at the Sioux Falls VAHCS due to natural disaster, construction, loss or damage to equipment, contamination of equipment, etc.)

10 EA

0009 Laboratory Test (when procedure is performed at the contractor’s facility). Various Tests for BUN, URR, Kt/V, Anemia, Hemoglobin, Iron Saturation and Ferritin, Nutrition, Albumin, Potassium, and

Bone and Mineral Metabolism.

10 EA

0010 Pharmaceutical Cost (when procedure is performed at the contractor’s facility). Various

Drugs: Calcitriol, Etelcalcetide, Iron Sucrose, Lanthanum Carbonate, Sevelamer, and other pain medications.

10 EA

Total Cost for Base Period:__________________

OPTION YEAR ONE: 1/1/2020 to 12/31/2020

Unit Unit

Price

Amount

1001 Acute Hemodialysis Nursing Procedure, On-Site, Monday through Friday, 7:30 AM to 4:30 PM.

250 EA

1002 Acute Hemodialysis Nursing Procedure, On-Site, After Hour, (evening/weekend).

50 EA

1003 Emergency Response to the Sioux Falls VAHCS

(within 60 minutes). To be billed in addition to the normal business hour or after hour procedure.

12 EA

1004 Maintain Water Treatment and Dialysate Systems in accordance with the manufacturer’s guidelines and standards of practice. Two (2) times per week, 104 times per year for a total of three (3) dialysis systems.

104 EA

1005 Attend Sioux Falls VAHCS Dialysis Quality

Meeting. One (1) hour per month, twelve (12) times per year.

(10) hours per year.

10 EA

1007 Culture Draw 10 EA

1008 Acute Hemodialysis Nursing Procedure at the

Contractor’s facility, as needed (when services cannot be performed at the Sioux Falls VAHCS due to natural disaster, construction, loss or damage to equipment, contamination of equipment, etc.)

10 EA

1009 Laboratory Test (when procedure is performed at the contractor’s facility). Various Tests for BUN, URR, Kt/V, Anemia, Hemoglobin, Iron Saturation and Ferritin, Nutrition, Albumin, Potassium, and

Bone and Mineral Metabolism.

10 EA

1010 Pharmaceutical Cost (when procedure is performed at the contractor’s facility). Various

Drugs: Calcitriol, Etelcalcetide, Iron Sucrose, Lanthanum Carbonate, Sevelamer, and other pain

Total Cost for Option Year One:__________________

OPTION YEAR TWO: 1/1/2021 to 12/31/2021

Unit Unit

Price

Amount

2001 Acute Hemodialysis Nursing Procedure, On-Site, Monday through Friday, 7:30 AM to 4:30 PM.

250 EA

2002 Acute Hemodialysis Nursing Procedure, On-Site, After Hour, (evening/weekend).

50 EA

2003 Emergency Response to the Sioux Falls VAHCS

(within 60 minutes). To be billed in addition to the normal business hour or after hour procedure.

12 EA

2004 Maintain Water Treatment and Dialysate Systems in accordance with the manufacturer’s guidelines and standards of practice. Two (2) times per week, 104 times per year for a total of three (3) dialysis systems.

104 EA

2005 Attend Sioux Falls VAHCS Dialysis Quality

Meeting. One (1) hour per month, twelve (12) times per year.

(10) hours per year.

10 EA

2007 Culture Draw 10 EA

2008 Acute Hemodialysis Nursing Procedure at the

Contractor’s facility, as needed (when services cannot be performed at the Sioux Falls VAHCS due to natural disaster, construction, loss or damage to equipment, contamination of equipment, etc.)

10 EA

2009 Laboratory Test (when procedure is performed at the contractor’s facility). Various Tests for BUN, URR, Kt/V, Anemia, Hemoglobin, Iron Saturation and Ferritin, Nutrition, Albumin, Potassium, and

Bone and Mineral Metabolism.

10 EA

2010 Pharmaceutical Cost (when procedure is performed at the contractor’s facility). Various

Drugs: Calcitriol, Etelcalcetide, Iron Sucrose, Lanthanum Carbonate, Sevelamer, and other pain

Total Cost for Option Year Two:__________________

OPTION YEAR THREE: 1/1/2022 to 12/31/2022

Unit Unit

Price

Amount

3001 Acute Hemodialysis Nursing Procedure, On-Site, Monday through Friday, 7:30 AM to 4:30 PM.

250 EA

3002 Acute Hemodialysis Nursing Procedure, On-Site, After Hour, (evening/weekend).

50 EA

3003 Emergency Response to the Sioux Falls VAHCS

(within 60 minutes). To be billed in addition to the normal business hour or after hour procedure.

12 EA

3004 Maintain Water Treatment and Dialysate Systems in accordance with the manufacturer’s guidelines and standards of practice. Two (2) times per week, 104 times per year for a total of three (3) dialysis systems.

104 EA

3005 Attend Sioux Falls VAHCS Dialysis Quality

Meeting. One (1) hour per month, twelve (12) times per year.

12 EA

3006 Training Hours. Five (5) hours per employee, maximum of two (2) employees for a total of ten

(10) hours per year.

10 EA

3007 Culture Draw 10 EA

3008 Acute Hemodialysis Nursing Procedure at the

Contractor’s facility, as needed (when services cannot be performed at the Sioux Falls VAHCS due to natural disaster, construction, loss or damage to equipment, contamination of equipment, etc.)

10 EA

3009 Laboratory Test (when procedure is performed at the contractor’s facility). Various Tests for BUN, URR, Kt/V, Anemia, Hemoglobin, Iron Saturation and Ferritin, Nutrition, Albumin, Potassium, and

Bone and Mineral Metabolism.

10 EA

3010 Pharmaceutical Cost (when procedure is performed at the contractor’s facility). Various

Drugs: Calcitriol, Etelcalcetide, Iron Sucrose, Lanthanum Carbonate, Sevelamer, and other pain

Total Cost for Option Year Three:__________________

OPTION YEAR FOUR: 1/1/2023 to 12/31/2023

Unit Unit

Price

Amount

4001 Acute Hemodialysis Nursing Procedure, On-Site, Monday through Friday, 7:30 AM to 4:30 PM.

250 EA

4002 Acute Hemodialysis Nursing Procedure, On-Site, After

Hour, (evening/weekend).

50 EA

0003 Emergency Response to the Sioux Falls VAHCS

(within 60 minutes). To be billed in addition to the normal business hour or after hour procedure.

12 EA

0004 Maintain Water Treatment and Dialysate Systems in accordance with the manufacturer’s guidelines and standards of practice. Two (2) times per week, 104 times per year for a total of three (3) dialysis systems.

104 EA

0005 Attend Sioux Falls VAHCS Dialysis Quality Meeting.

One (1) hour per month, twelve (12) times per year.

maximum of two (2) employees for a total of ten (10) hours per year.

10 EA

0007 Culture Draw 10 EA

0008 Acute Hemodialysis Nursing Procedure at the

Contractor’s facility, as needed (when services cannot be performed at the Sioux Falls VAHCS due to natural disaster, construction, loss or damage to equipment, contamination of equipment, etc.)

10 EA

0009 Laboratory Test (when procedure is performed at the contractor’s facility). Various Tests for BUN, URR, Kt/V, Anemia, Hemoglobin, Iron Saturation and

Ferritin, Nutrition, Albumin, Potassium, and Bone and

Mineral Metabolism.

10 EA

0010 Pharmaceutical Cost (when procedure is performed at the contractor’s facility). Various Drugs: Calcitriol, Etelcalcetide, Iron Sucrose, Lanthanum Carbonate, Sevelamer, and other pain medications.

Total Cost for Option Year Four:__________________

Total Cost for Base Performance and All Option Years:_________________

In accordance with FAR 16.504(a)(1), The guaranteed minimum and maximum dollar amounts are listed in the table below. These amounts cover the base and option of the contract.

The maximum dollar amounts listed shall not be exceeded.

Minimum $5,000.00

Maximum $1,250,000.00

Ordering Procedures:

A task order will be placed by the Administrative NCO 23 Contracting Officer.

Each ordering vehicle will document the quantity, and other pertinent data to ensure the services provide the appropriate level of patient care to the maximum order allowable under the resultant contract. No additional services are authorized without prior approval through the

Administrative Contracting Officer and/or Contracting Officer.

It is anticipated that a single contract will be awarded.

B.3 PERFORMANCE WORK STATEMENT

Performance Work Statement (PWS) for

On-Site Acute Dialysis Nursing Service

1. GENERAL:

1.1. Services Provided: The Contractor shall provide On-Site Acute Dialysis Nursing Service in accordance with the terms, conditions, and specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA), Sioux Falls VA Health Care System (VAHCS).

Services will be provided on a 24-hour per day, seven days per week basis, including holidays and weekends. The Sioux Falls VAHCS will provide physician oversight and retain ultimate authority over and responsibility for each patient’s care and treatment.

1.2. Place of Performance: Contractor shall furnish services at the Sioux Falls VA Health Care

System (VAHCS), 2501 W. 22nd Street, Sioux Falls, SD 57105.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority.

1.4. Policy/Handbooks: the contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1.4.1. VA Directive 1663: Health Care Resources Contracting - Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347

1.4.2. VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

1.4.3. VHA Handbook 1100.17: National Practitioner Data Bank Reports -http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.4. VHA Handbook 1100.18 Reporting and Responding to State Licensing Boards -http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.4.5. VHA Handbook 1100.19 Credentialing and Privileging -

http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.4.6. VHA Handbook 1907.01 Health Information Management and Health Records:

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

1.4.7. Privacy Act of 1974 (5 U.S.C. 552a) as amended

http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.4.8. Joint Commission – http://www.jointcommission.org/standards/

1.4.9. HHS OIG Website – http://oig.hhs.gov/exclusions/index.asp

1.4.10. American Journal for Infection Control – AJIC 1998; 26:289-354 – http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

1.5. Definitions/Acronyms: Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.5.1. ABIM: American Board of Internal Medicine – Nephrology http://www.abim.org/certification/policies/internal-medicine-subspecialty-policies/nephrology.aspx

1.5.2. ACGME: Accreditation Council for Graduate Medical Education

1.5.3. ACLS: Advanced Cardiac Life Support

1.5.4. AOD: Admitting Officer of the Day

1.5.5. BLS: Basic Life Support

http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347 https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm http://www.jointcommission.org/standards/ http://oig.hhs.gov/exclusions/index.asp http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf http://www.abim.org/certification/policies/internal-medicine-subspecialty-policies/nephrology.aspx http://www.abim.org/certification/policies/internal-medicine-subspecialty-policies/nephrology.aspx

1.5.6. CCNE: Commission on Collegiate Nursing Education:

www.aacn.nche.edu/accreditation

1.5.7. CDC: Centers for Disease Control and Prevention

1.5.8. CDR: Contract Discrepancy Report

1.5.9. CEU: Certified Education Unit

1.5.10. CME: Continuing Medical Education

1.5.11. CMS: Centers for Medicare and Medicaid Services

1.5.12. CO: Contracting Officer - The person executing this contract on behalf of the

Government with the authority to enter into and administer contracts and make related determinations and findings.

1.5.13. COR: Contracting Officer’s Representative (COR) – A person appointed by the

CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.5.14. COS: Chief of Staff

1.5.15. CPARS: Contractor Performance Assessment Reporting System

1.5.16. CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.5.17. DEA: Drug Enforcement Agency

1.5.18. ED: Emergency Department

1.5.19. EMR: Electronic Medical Record

1.5.20. FSMB: Federation of State Medical Boards

1.5.21. HHS: Department of Health and Human Services

1.5.22. HIPAA: Health Insurance Portability and Accountability Act

1.5.23. HR: Human Resources

1.5.24. ISO: Information Security Officer

1.5.25. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.5.26. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org

1.5.27. Non-Contract Provider - any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

1.5.28. NP: Nurse Practitioner

1.5.29. NPPES: National Plan and Provider Enumeration System

1.5.30. OSHA: Occupational Safety and Health Administration

1.5.31. OIT: Office of Information and Technology

1.5.32. OPM: Office of Personnel Management

1.5.33. OPPE: Ongoing Provider Practice Evaluation

1.5.34. PA: Physician Assistant

1.5.35. PIV: Personal Identity Verification

1.5.36. POP: Period of Performance

1.5.37. PPD: Purified Protein Derivative

1.5.38. PWS: Performance Work Statement

1.5.39. QA/QI: Quality Assurance/Quality Improvement

1.5.40. QM/PI: Quality Management/Performance Improvement

1.5.41. QASP: Quality Assurance Surveillance Plan

1.5.42. Veterans Health Administration (VHA): The central office for administration of the

VA medical centers through throughout the United States. The VHA is in

Washington, D.C.

1.5.43. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers.

http://www.aacn.nche.edu/accreditation http://www.nlnac.org/

1.5.44. VISTA (Veterans Integrated Systems Technology Architecture): A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

1.5.45. VetPro: a federal web-based credentialing program for healthcare providers.

1.5.46. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the

Sioux Falls VA Health Care System (VAHCS).

2. QUALIFICATIONS:

2.1. Staff/Facility. The contractor shall identify a minimum of two (2) Acute Dialysis Nurses

(Registered Nurses) to provide contract coverage for On-Site Acute Dialysis Nursing

Services at the Sioux Falls VAHCS.

2.1.1. License – Contractor personnel assigned to perform the services covered by this contract shall be licensed in any State, Territory, or Commonwealth of the United

States or the District of Columbia) when services are performed onsite on VA property. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contractor personnel who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2. Board Certification/Eligibility – Contractor personnel assigned to perform services covered by this contract shall be certified Registered Nurses and meet the requirements for appointment to the Medical Staff, Sioux Falls VAHCS, as outlined in the Medical Staff Bylaws. The services to be performed by contractor personnel will be performed within the VA policies and procedures and the regulations of the Medical Staff Bylaws of the VAHCS. Documentation verifying current certification shall be provided to the COR on an annual basis for each year of contract performance.

2.1.3. Credentialing and Privileging –Credentialing and/or Privileging is to be done in accordance with the provisions of VHA Handbook 1100.19

(http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910). The Contractor is responsible to ensure that proposed personnel possesses the requisite credentials enabling the granting of privileges. No services shall be provided by the Contractor’s personnel prior to obtaining approval by the Sioux Falls VAHCS Professional Standards

Board, Medical Executive Board and Medical Center Director.

2.1.3.1. At the time of award the contractor shall provide all information necessary to comply with VA requirements for credentialing and/or privileging of contracted personnel.

2.1.3.2. If contract personnel are not credentialed and/or privileged or has credentials and/or privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.4. Technical Proficiency – Contractor personnel shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor personnel and contractor personnel shall be responsible http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 for abiding by the Facility's Medical Staff By-Laws, rules, and regulations

(referenced herein) that govern medical staff behavior.

2.1.5. Continuing Medical Education (CME)/ Certified Education Unit (CEU)

Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the Sioux Falls VAHCS. Contractor personnel registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credentials office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contractor personnel.

2.1.6. Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor personnel shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by contractor personnel as required by the

VA.

NOTE: Acute Dialysis Nurses are required to provide evidence of current BLS

Training (or equivalent to include CPR/AED Training or VA Heart Saver Class).

Training classes are offered at the Sioux Falls VAHCS at no cost to the contractor.

Contact the COR for registration instructions.

Training Frequency Duration

Blood Product Administration TMS 8563 Annual 1 hour

Blood Administration Complications TMS 8562 Annual 1 hour

VA Privacy and Information Security Awareness and Rules of Behavior TMS 10176

Annual 1 hour

Privacy and HIPAA TMS 10203 Annual 1 hour

Age Specific and Cultural Competencies TMS

3945965

Annual 0.5 hour

Life Sustaining Treatment Decisions Initiative: New

Processes to Support Patient-Centered Care

TMS 31722

Annual 1 hour

Prevention and Management of Disruptive Behavior

Reporting Requirement Level 1 TMS 7831

Annual 1.5 hours

Computerized Patient Record System (CPRS) Tab by Tab Update TMS 8512

One-Time 1.5 hours

VISTA Imaging Training TMS 3940847 One-Time 0.5 hour

Service Line Specific Training (to be identified) Varies Varies

2.1.7. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for personnel within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year.

2.1.7.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all contract personnel. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. The TST or IGRA testing shall be repeated annually.

2.1.7.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractor shall

provide proof of immunity for all contract personnel.

2.1.7.3. VARICELLA: Contractor shall provide proof of immunity for all contract personnel.

2.1.7.4. ACELLULAR PERTUSSIS: Contractor shall provide proof of 1 Tdap vaccination for all contractor personnel.

2.1.7.5. INFLUENZA: Contractor shall provide proof that all contractor personnel have received the annual Infulenza vaccine unless it is contraindicated. If the contractor employee has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season.

2.1.7.6. OSHA REGULATION CONCERNING OCCUPATIONAL

EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all contract personnel; provide their own

Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records;

and ensure that proper follow-up evaluation is provided following an exposure incident. The Sioux Falls VAHCS shall notify the Contractor of any significant communicable disease exposures as appropriate.

Contractor shall adhere to current CDC/HICPAC Guideline for

Infection Control in health care personnel (as published in American

Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.8. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National

Plan and Provider Enumeration System (NPPES) be provided to the Contracting

Officer with the proposal. https://npidb.org

2.1.9. Conflict of Interest: The Contractor and all contractor personnel are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The

Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.10. Citizenship related Requirements:

2.1.10.1. The Contractor certifies that the Contractor shall comply with all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by

Homeland Security, Immigration and Customs Enforcement and the

U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf https://npidb.org/ while providing services to Department of Veterans Affairs patient referrals;

2.1.10.2. While performing services for the Department of Veterans Affairs, the

Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent

Amendments, as well as applicable Federal Acquisition Regulations.

2.1.10.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of

Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs

Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services

Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.1.10.4. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18

U.S.C. 1001.

2.1.10.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document.

2.1.11. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and

Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.11.1. Therefore, Contractor shall review the HHS OIG List of Excluded

Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contractor personnel are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.11.2. By submitting their proposal, the Contractor certifies that the HHS

OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

http://oig.hhs.gov/exclusions/index.asp

2.2. Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical

Center Director as provided in VHA Handbook 1100.19. Clinical/Professional performance monitoring and review of all contract personnel covered by this contract for quality purposes will be provided by the Sioux Falls VAHCS COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. Non-Personal Healthcare Services: The parties agree that the Contractor and all contractor personnel shall not be considered VA employees for any purpose.

2.4. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees.

2.5. Prohibition against Self-Referral: Contractor personnel are prohibited from referring VA patients to contractor’s or their own practice(s).

2.6. Inherent Government Functions: Contractor and contractor personnel shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.7. No Employee status: The Contractor shall be responsible for protecting contractor personnel furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations to include:

2.7.3.1. Annual TB Skin Test and recent chest X-ray if there is a history of positive TB skin test.

2.7.3.2. Evidence of Hepatitis B immunity (hepatitis immune titer, if the individual has had the series of shots; if no immunity, evidence that the individual has started the Hepatitis B vaccination series

2.7.3.3. Evidence of Hepatitis C titer

2.7.3.4. Varicella titer if contracted employee has not had chicken pox

2.7.4. Income tax withholding, and

2.7.5. Social security payments.

2.8. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contractor personnel. When a Contractor or contract personnel has/have been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (contractor personnel) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. The contractor shall identify/provide a minimum of two (2) Registered Nurses, licensed, trained, and certified, to provide On-Site Acute Dialysis Nursing

Services.

2.9.2. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled contract employee is unable to complete an assigned procedure, the contractor shall provide replacement coverage within 2 hours and notify the Contracting Officer’s

Representative (COR) immediately of the schedule change.

2.9.3. Contractor shall provide the names of contract personnel assigned to the performance of this contract:

Key Personnel/Substitute Name(s) Official/Professional Title

2.9.4. Emergency Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The

Contractor shall notify the CO, in writing, within 30 calendar days after the occurrence of any of these events and provide the information required below.

After 90 days, the Contractor shall submit the information required below to the

CO at least 30 calendar days prior to making any permanent substitutions.

2.9.4.1. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within 30 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.9.4.2. For temporary substitutions where the key person shall not be reporting to work for three consecutive work days or more, the

Contractor shall provide a qualified replacement for the key person.

The substitute shall have comparable qualifications to the key person.

Any period exceeding two weeks will require the procedure as stated above.

2.9.5. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA

COS or designee show documented clinical problems or continual unprofessional behavior/actions with any contractor personnel, s/he may request, without cause, immediate replacement of said contractor personnel. The CO and COR shall deal with issues raised concerning contractor personnel conduct. The final arbiter on questions of acceptability is the CO.

2.9.6. Contingency Plan: Because continuity of care is an essential part of the Sioux Falls

VAHCS’s medical services, The Contractor shall have a contingency plan in place to be utilized if contractor personnel leave the Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

2.9.7. Note: Evidence of completion of required licensure, credentials, required training, current competencies, and background investigations must be validated for all contractor personnel referred to perform services under this contract prior to providing direct patient care. Contractor shall not have any personnel report to duty until written notification is received from the Contracting Officer advising that the candidate(s) presented has met all requirements for contract performance.

3. HOURS OF OPERATION

3.1. Work Schedule: Coverage hours are continuous, 24 hours a day, seven (7) days a week, including weekends and Federal Holidays.

3.2. It is required that one (1) Dialysis Nurse be on-call for 24 hours a day, seven (7) days a week including all Federal Holidays, who can report to the Sioux Falls VAHCS within 60 minutes of notification to support emergent cases.

3.2.1. On-call service is considered part of the contract service and will not be paid separately. Any procedure performed during an on-call status for an emergency procedure shall be paid the same rate as the regular procedure.

3.3. Dialysis procedures shall be performed in the designated Dialysis Room or in Intensive

Care Unit (ICU) at the Sioux Falls VAHCS.

3.4. The Sioux Falls VAHCS will notify the contractor one (1) business day in advance of the procedure date for recurring and routine requirements.

3.5. Disaster/Emergency Coverage. Unless a state of emergency has been declared or services are otherwise cancelled by the Sioux Falls VAHCS, the Contractor shall be available and present during scheduled procedure day/time.

3.6. Standards of Care. The Standards of Care should be equal to that provided by the VA if the

VA were capable of providing the services required at their location. The contractor shall provide competent, quality Dialysis Service Nurses to required patients of the Sioux Falls

VAHCS, in the performance of contract requirements. Contractor shall provide all services specified in this contract for any VA beneficiary.

3.7. Absences. Appropriate coverage shall be provided in accordance with the contract terms and conditions and must be supplied by the contractor. The contractor’s employee must be present at the Sioux Falls VAHCS and must be able to perform the required service(s) for the period specified in the contract. Back-up coverage is required at all times.

3.8. Cancellation.

3.8.1.1. The VA must be informed at least 72 hours in advance if there will be a significant change in contractor’s ability to perform to allow for planning of service coverage and workload distribution.

3.8.1.2. The VA will notify the contractor when patient substitutions are used to prevent a cancellation. In the event a patient substitution cannot be utilized, the

VA will inform the contractor at least 72 hours in advance.

4. CONTRACTOR RESPONSIBILITIES

4.1. Clinical Personnel Required: The Contractor shall provide contractor personnel who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.2. Contractor personnel shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices.

4.3. Standards of Care: Contractor personnel care shall cover the range of Acute Dialysis

Nursing services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

4.3.1. American Board of Nephrology:

http://www.abim.org/certification/policies/internal-medicine-subspecialty-policies/nephrology.aspx

4.3.2. VA Standards: VHA Directive 2006-041 “Veterans’ Health Care Service

Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

4.3.3. The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx

4.3.4. The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

4.3.5. The requirements contained in this PWS

4.4. Specific Duties:

4.4.1. The contractor shall be responsible for providing:

4.4.1.1. Acute Hemodialysis

4.4.1.2. Patient Education. Provide education to the patient on end stage renal disease as ordered by the VA Staff Nephrologist.

4.4.1.3. Maintain Dialysis Access Site. Utilize appropriate techniques to maintain hemodialysis catheters, hemodialysis fistulas, and peritoneal catheters.

4.4.2. Contractor personnel shall be responsible for the composition of the dialysate, administering IV solutions, blood and blood products and medications (as ordered by the attending VAHCS physician) placed into the dialyzer blood line system necessary for treatments. Contractor personnel shall be responsible for the provision of the following ordered services:

4.4.2.1. Set up and safety check of machine and water treatment system

4.4.2.2. Initiating treatment, monitoring of treatment, and termination of treatment

4.4.2.3. Documentation of treatment in patient medical records

4.4.2.4. Clean up of dialysis equipment and proper storage of machine and supplies

4.4.3. Contractor will respond to the VA facility within six hours of calls for emergent

ICU dialysis from the ordering VAHCS physician, ready to begin dialysis treatment.