ATTACHMENT 2 OR NURSES PWS Revised.pdf

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Performance Work Statement for Onsite OPERATING ROOM RN Services

1. GENERAL:

1.1. Services Provided: The Contractor shall furnish up to five full-time (5.0 FTE) Registered Nurses (RN) with Operating Room (OR) experience to function as circulating nurses and to assist with Scrub Duties as needed. The contractor shall provide an RN who is fully trained and fully competent to perform the required nursing services for the duration of this one year contract period. Services shall be provided for the Surgery Care Integrated Clinical Communities.

1.2. Place of Performance: Contractor shall furnish services at the MVAHCS, One Veterans Drive, Minneapolis, MN 55417.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority and FAR 12 and 15.

1.4. Policy/Handbooks:

1.4.1. VHA Handbook 1100.17: National Practitioner Data Bank Reports:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.2. VHA Handbook 1100.18 Reporting and Responding To State Licensing Boards:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9174

1.4.3. VHA Handbook 1100.19 Credentialing and Privileging:

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

1.4.4. VHA Directive 1192.01: Seasonal Influenza Prevention Program:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5472

1.4.5. VHA Directive 1220: Facility Procedure Complexity Designation Requirements to Perform Invasive Procedures In Any Clinical Setting:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8365

1.4.6. VA Directive 1663: Health Care Resources Contracting – Buying:

https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

1.4.7. VHA Directive 1907.01: VHA Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235

1.4.8. VHA Directive 1100.20 Credentialing of Health Care Providers:

https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=9444

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

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

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. ABS: American Board of Surgery http://www.absurgery.org/

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

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9174 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5472 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8365 https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fvaww.va.gov%2Fvhapublications%2FViewPublication.asp%3Fpub_ID%3D9444&data=04%7C01%7C%7C5a2fc81d5c9e4c31696308d9ca3b3c47%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637763178024295633%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&sdata=g4iIWP0fMWV1ITn9%2F0vT4lpul7nFJAe%2FDMHlz4MTfT8%3D&reserved=0 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm http://www.absurgery.org/

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1.5.5. ASGS: American Society of General Surgeons https://theasgs.org/

1.5.6. BLS: Basic Life Support

1.5.7. CCNE: Commission on Collegiate Nursing Education:

www.aacn.nche.edu/accreditation

1.5.8. CDC: Centers for Disease Control and Prevention

1.5.9. CR: Contract Discrepancy Report

1.5.10. CEU: Certified Education Unit

1.5.11. CME: Continuing Medical Education

1.5.12. CMS: Centers for Medicare and Medicaid Services

1.5.13. Contracting Officer (CO) – 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.

1.5.14. 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.

1.5.15. COS: Chief of Staff

1.5.16. COVID-19: Coronavirus Disease 2019

1.5.17. CPARS: Contractor Performance Assessment Reporting System

1.5.18. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.5.19. DEA: Drug Enforcement Agency

1.5.20. ED: Emergency Department

1.5.21. EHR: Electronic Health Record - electronic health record system used by the VA

1.5.22. FSMB: Federation of State Medical Boards

1.5.23. Full Time Equivalent (FTE): VA’s definition for full time- working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.

1.5.24. HHS: Department of Health and Human Services

1.5.25. HIPAA: Health Insurance Portability and Accountability Act

1.5.26. HR: Human Resources

1.5.27. ISO: Information Security Officer

1.5.28. Medical Emergency - a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to https://theasgs.org/ http://www.aacn.nche.edu/accreditation

Revision 06/01/2022 Page 3 of 38 body functions, or causing serious or permanent dysfunction of any body-organ or part.

1.5.29. MOD: Medical Officer of the Day

1.5.30. NBSTSA: National Board of Surgical Technology and Surgical Assisting, https://www.nbstsa.org/

1.5.31. NCCT: National Center for Competency Testing, https://www.ncctinc.com/

1.5.32. 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).

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

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

1.5.35. NP: Nurse Practitioner

1.5.36. NPPES: National Plan and Provider Enumeration System

1.5.37. PA: Operating Room RN Assistant

1.5.38. PALS: Pediatric Advanced Life Support

1.5.39. POP: Period of Performance

1.5.40. PPD: Purified Protein Derivative

1.5.41. PWS: Performance Work Statement

1.5.42. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific.

1.5.43. QA/QI: Quality Assurance/Quality Improvement

1.5.44. QM/PI: Quality Management/Performance Improvement

1.5.45. QASP: Quality Assurance Surveillance Plan

1.5.46. Veterans Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

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

1.5.48. 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.

1.5.49. VETPro: a federal web-based credentialing program for healthcare providers.

https://www.nbstsa.org/ https://www.ncctinc.com/ http://www.nlnac.org/

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1.5.50. Veterans Affairs Medical Center (MINNEAPOLIS VAHCS): Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the Minneapolis VA Health Care System (VAHCS).

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License: The Contractor’s RN(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice nursing 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’s RN(s) 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: N/A

2.1.3. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 and VHA Directive

1100.20 referenced above. The Contractor is responsible to ensure that proposed Operating Room RN(s) possesses the requisite credentials. No services shall be provided by any Contractor’s RN(s) prior to obtaining approval by the Minneapolis VAHCS Professional Standards Board, Medical Executive Board and Medical Center Director.

2.1.3.1. Clinical Practice: Authorization by the MVAHCS Director to provide specific patient care and treatment services in the organization, within well-defined limits, based on the individual's license, education, training, experience, competence, judgment, and physical and mental health.

2.1.3.2. If a Contractor’s RN(s) is not credentialed or has credentials suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.4. Technical Proficiency: Contractor’s RN(s) 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’s RN(s) and Contractor’s RN(s) shall be responsible for abiding by the Facility's rules, and regulations (referenced herein) that govern staff behavior.

2.1.5. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor’s RN(s) registered or certified by national/medical associations shall continue to meet the minimum standards to remain current.

Contractor shall report CEUs hours to the credentials office for tracking. Failure to provide shall result in loss of privileges for Contractor’s RN(s).

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2.1.6. Training (ACLS, BLS, EHR and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the Contractor’s RN(s) as required by the VA. Other training may become required. VA will communicate any changes to the training requirement to the contractor.

Training Frequency Annual Hours

VA Privacy and Information Security Awareness and Rules of Behavior (TMS# 10176)

Once a Year 1 hour

Mandatory Training for Transitory, Part-time and Intermittent Clinical Staff

(TMS# 20152)

Once a Year 1 hour

ACLS/BLS (TMS# 324129) Every 24 months 4 hours

Additional training may be required per VHA or Medical Center directives

Unknown Unknown

2.1.7. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for Operating Room RNs 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 Contractor’s RN(s) upon hire in accordance with CDC guidance. (This is applicable to all health care workers). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results.

2.1.7.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor Operating Room RNs {This is applicable to all health care workers}.

2.1.7.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor Operating Room RNs {This is applicable to all health care workers}.

2.1.7.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor Operating Room RNs {This is applicable to all health care workers}.

2.1.7.5. INFLUENZA: Contractors shall provide proof that all Contractor Operating Room RNs have received the annual Influenza vaccine unless it is contraindicated. If the Contractor Operating Room RN has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

2.1.7.6. COVID-19: Contractors shall comply with VHA Supplemental Contract Requirements for Combatting COVID-19 {This is applicable to all health care workers}. – See Section D attachment.

2.1.7.7. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO

BLOODBORNE PATHOGENS: Contractor shall provide evidence of

Revision 06/01/2022 Page 6 of 38 completing and passing generic self-study blood-borne pathogen training for all Contractor’s RN(s) {This is applicable to all health care workers}; 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.

2.1.7.8. The MINNEAPOLIS 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.

2.1.9. Conflict of Interest: The Contractor and all Contractor’s RN(s) 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 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 any and 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 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 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

Revision 06/01/2022 Page 7 of 38 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’s RN(s) 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 into 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.

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 and VHA Directive 110.20. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the http://oig.hhs.gov/exclusions/index.asp

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MINNEAPOLIS 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’s RN(s) 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’s RNs are prohibited from referring VA patients to contractor’s or their own practice(s).

2.6. Inherent Government Functions: Contractor and Contractor’s RN(s) 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’s RN(s) 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

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’s RN(s). When a Contractor or Contractor’s RN(s) has 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 (or Contractor’s RN(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. The VA Full Time Equivalency (FTE): FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

2.9.2. The minimum number of Operating Room (OR) RNs required to be on site on a daily basis is (5.0) FTE as defined in paragraph Hours of Operation in this section.

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2.9.3. Nursing Personnel. Personnel provided by this task order shall be subject to the same quality assurance/quality management standards as those required for comparable MVAHCS or government personnel. Nursing personnel shall be responsible for compliance with all policies and procedures in accordance with MVAHCS written policies, procedures, and regulations and VHA regulations. All personnel must maintain a neat personal appearance and professional decorum.

All Joint Commission (JC) standards shall be met during the performance of this task order.

2.9.4. 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.

2.9.5. Personnel 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 (15) calendar day(s) 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 (15) calendar days prior to making any permanent substitutions.

2.9.5.1. 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 (15) 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.

2.9.5.2. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive workdays 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 (2) weeks will require the procedure as stated above.

2.9.5.3. 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’s RN(s), s/he may request, without cause, immediate replacement of said Contractor’s RN(s). The CO and COR shall deal with issues raised concerning Contractor’s RN(s) conduct. The final arbiter on questions of acceptability is the CO.

2.9.5.4. Contingency Plan: Because continuity of care is an essential part of MINNEAPOLIS VAHCS’s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractor’s RN(s) leaves

VHASTCPenkhT Highlight

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Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA HOURS OF OPERATION/SCHEDULING:

3.1. VA Business Hours: The Minneapolis VAHCS is open 24 hours per day 7 days a week, 365 days per year. Administrative offices, clinics and the O.R. general hours of operation are Monday through Friday 6:30am – 7:30pm, excluding Federal Holidays. The services covered by this contract shall be furnished by the contractor as defined in the work schedule below.

3.1.1. Supervision. Work assignments will be made by the Nurse Manager or his/her representative in each respective work area.

3.1.2. Hours of Performance. Contractor’s personnel must be on-site at the Minneapolis VAHCS in a timely manner in accordance with VA Rules and Regulations. The Contractor shall provide nursing personnel to support a 7 day a week, 24 hours per day operation to include holidays. The shift times listed below are the most common but are not exhaustive. All shifts will provide 15-minute breaks every 4 hours. Shift posted at a minimum of 3 weeks in advance. Contract key personnel will be scheduled (Monday – Friday) for the following shifts:

Shift 1 7:00 am – 3:30 pm

Shift 2 9:30 am – 6:00 pm

Shift 3 11:00 am – 7:30 pm

*Note: The daily tour of duty is eight and a half hours including a 30-minute unpaid lunch break.

3.1.2.1 The Government reserves the right to specify the beginning and ending time of work shifts. Duty hours can be changed at the discretion of the Nurse Manager or his/her representative. Hours scheduled do not include travel time involved in reaching the place of duty.

3.1.2.2 Any employee provided by the Contractor shall not be scheduled by the Contractor to work more than 12 hours in a given 24-hour period in performance of this task order.

3.1.2.3 The Government reserves the right to verify the hours worked by the Contractor to include implementing sign-in/sign-out procedures or using a time clock if appropriate.

3.1.3. Time Schedule. Requirements will be projected as far in advance as possible;

however, for situations such as when the patient workload increases, the MVAHCS reserves the right to request additional coverage (if specified in the schedule of services).

3.1.3.1. In the event that the patient workload increases/decreases in any unit the Nurse Executive or his/her representative reserves the right to assign the nursing personnel to any appropriate or understaffed care units or to cancel any scheduled shift or shifts. The COR or the Nurse Executive or his/her representative will contact the Contractor’s point

Revision 06/01/2022 Page 11 of 38 of contact at least 24-hour notice prior to the start of the shift to be cancelled.

3.1.3.2. A request for shift coverage is considered a late request if the request is made after the start of the shift. Any requests made prior to the start of a shift will not be considered a late request.

3.1.4. Infection Control. Health care providers provided by the Contractor shall exercise the universal precautions set forth by the Centers for Disease Control (CDC) when providing direct patient care at MVAHCS.

3.1.4.1. Contractor staff shall not wear artificial nails, whether self or professionally applied, while providing direct patient care at the

MVAHCS.

3.1.4.2. Contractor staff shall not wear perfumes, colognes or other fragrances while providing direct patient care at the MVAHCS.

3.1.5. Uniforms. The Contractor’s employees shall be appropriately attired in accordance with MVAHCS uniform policy. The Contractor personnel must also wear Contractor furnished badges identifying the employee and the employing company and a MVAHCS issued ID badge. The Contractor must wear these badges in accordance with regulations and at all times while performing services under this task order.

3.1.5.1. All nursing personnel will wear special protective clothing and/or equipment provided by the MVAHCS when directed or as necessary for infection control purposes.

3.1.5.2. The wearing of jewelry will comply with standards in accordance with MVAHCS policy.

3.1.6. Contractor key personnel must be on-site at the MVAHCS for their assigned shift, in their scrubs and ready to work at the start of their assigned shift. The Contractor must notify the COR prior to the start of any tour when assigned key personnel are unavailable for their assigned shift.

3.1.7. Off-hours Coverage: Contractor must make the contractor’s personnel available on-call during all hours when the Minneapolis VAHCS operating rooms are closed, including evenings, weekends, and holidays.

3.1.7.1. Contract personnel will rotate with VA staff to provide off hours call coverage. Off hours call coverage hours are:

• Weekday: Monday – Thursday, 7:00 pm – 6:30 am

• Weekend: Friday at 7:00 pm – Monday at 6:30 am

• Holidays: varies depending on the holiday

3.1.7.2. Call Coverage averages. Key personnel will provide Call Coverage as follows:

• M-Th: One work day every two weeks.

• F-Su: One weekend every two months.

3.1.7.3. Call coverage may result in call back to staff the OR at the medical center. On-call personnel must be available with 15 minutes by phone and on-site within 60 minutes.

VHASTCPenkhT Highlight

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3.2. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

• New Year’s Day

• President’s Day

• Martin Luther King’s Birthday

• Memorial Day

• Juneteenth

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

• Any day specifically declared to be a national holiday.

3.3. Cancellations: N/A

4. CONTRACTOR RESPONSIBILITIES

4.1. Clinical Personnel Required: The Contractor shall provide Contractor’s RN(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.1.1. Contractor’s RN(s) 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.

4.2. Standards of Care: The Contractor’s RN(s)’ care shall cover the range of OPERATING ROOM RN 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 TJC, VA and national standards as established by:

4.2.1. The professional standards of the Joint Commission (TJC):

http://www.jointcommission.org/standards_information/standards.aspx

4.2.2. The standards of the American Hospital Association (AHA):

http://www.hpoe.org/resources?show=100&type=8

4.2.3. The requirements contained in this PWS

4.2.4. Shall provide to the COR or designee for each Contractor personnel prior to the performance of work:

• Copy of valid and unencumbered licenses and certifications for licensed or certified employees

• Social Security Number http://www.jointcommission.org/standards_information/standards.aspx http://www.hpoe.org/resources?show=100&type=8

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• Copies of current CPR certification. If ACLS is required for an assignment, the Contractor shall provide a copy of current ACLS certification

• A current resume, curriculum vitae or profile containing work history, education, competencies, and references.

4.3. Teaching: N/A

4.4. MEDICAL RECORDS

4.4.1. Authorities: Contractor’s RN(s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.552a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

4.4.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Health records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA10A7). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services provided to VA patients are captured in the VA electronic health record system as required by VA policy as discussed in 4.4.4.

4.4.3. Disclosure: Contractor’s RN(s) may have access to patient medical records for the purpose of providing medical care and services to VA patients and performing services under the contract; however, Contractor shall obtain permission from the VA before disclosing any patient information outside VA.

VA authorizes the Contractor to discuss patient health information for coordination of care within community health care providers in compliance with VA regulations, HIPAA and VHA Handbook 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.4.4. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235 and all guidelines provided by the MINNEAPOLIS VAHCS.

4.4.5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. Contractor will not release or disclose copies of records and will refer all such requests to the Release of Information Department at the VA facility were assigned.

http://www.rms.oit.va.gov/SOR_Records/24VA19.asp http://www.rms.oit.va.gov/SOR_Records/24VA19.asp http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235

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4.4.6. Management for Medical Records: National Archives and Records Administration record disposition requirements are found in RCS 10-1 Chapter 6. 6000 series.

4.4.7. Document Security. All evaluations, records, reports, documents, and other records of patients, whether in paper, verbal, or electronic form, will remain the property of and subject to the exclusive control of the MVAHCS and the U.S. Government. All reports and documents prepared by the Contractor’s employees in the fulfillment of this task order are the property of the MVAHCS and the U.S. Government.

4.5. Direct Patient Care: estimated 99% of the time involved in direct patient care.

4.5.1. Per the qualification section of this PWS, the Contractor shall provide the following staff: Operating Room (OR) RN

4.5.2. Scope of Care: Contractor’s RN(s) (as appropriate and within scope of practice/privileging) shall be responsible for providing OPERATING ROOM RN Operating Room RN care, including, but not limited to:

4.5.2.1. Clinic and Surgical Care: The operating room nurse shall be a patient care advocate providing safe and effective patient care. Prior to a surgical procedure the circulating nurse draws up the patient’s plan of care and spends time with the patient to ensure that any allergies or other health-related issues are fully documented and that patient’s concerns are addressed through instruction and education of patient and the patient’s family.

4.5.2.1.1. Contractor provider(s) shall be present on time for any scheduled shifts as documented by physical presence in the operating room at the scheduled start time. Contractor provider(s) shall provide on call coverage as assigned including nights, weekends, and holidays. Contractor provider(s) shall cover all shifts rotating evenly amongst staff.

4.5.2.1.2. Operative Services: Contractor Operating Room RN(s) shall provide comprehensive clinical Operating Room RN services, including but not limited to the following:

Provides patient care including the administration of medications and blood products

Before a surgical procedure gets underway, the circulating nurse is responsible for ensuring that the O.R. is set up correctly. This includes checking its inventory of disposables, such as pads and sponges, and freshly-sterilized instruments.

The circulating nurse and scrub nurse help set up the surgical area laying out instruments and supplies according to the surgeon’s preferences.

The nurse checks all equipment needed during the procedure to verify that it’s clean, safe, and functioning normally.

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When the patient arrives in the O.R. suite, the circulating nurse verifies the patient’s identity and necessary consent forms and then reviews the surgical site and nature of the procedure with the surgeon.

The circulating nurse along with other members of the surgical team position the patient correctly on the operating table.

Hooks up any necessary suction and cauterization equipment and assists the anesthetist or anesthesiologist with intubation.

During the operation, the circulating nurse provides the surgical team with sterile fluids and medications as needed and ensures proper labeling. The nurse also replenishes the surgical team’s supplies if they need additional disposables or instruments.

After the surgery is completed, the circulating nurse helps the anesthetist with tube removal, oversees the patient’s removal to a post-anesthesia recovery area, and updates the post-anesthesia nurse on the patient’s condition.

Helps the scrub nurse and other staff members to clean the room and prepare it for the next procedure.

Communicates patient information to the charge nurse/nurse manager.

Efficiently and appropriately uses the computerized patient record system (CPRS) and VISTA to accurately document intraoperative nursing care delivery. Nurse accurately documents implants.

The circulating nurse communicates effectively; maintains adaptability/flexibility; supports coworkers; and is able to resolves problems independently.

Must maintain the highest standard of integrity during interactions with patients, patients’ families; nurses, doctors; and other healthcare professionals. Contract personnel will consistently communicate and treat others in a courteous, tactful and respectful manner.

Contract personnel providing services at the Minneapolis VAHCS shall provide services in accordance with the Minneapolis VA policies listed below. The Minneapolis VA policies are only available on the Minneapolis VA Intranet site. This site is not available to the general public.

• EC-14D – PIV Card Policy (Personnel Identification Verification-ID Badge)

• EC-28A – O.R. Security

• IC-01F – Infection Precautions

• IM-01K – Medical Records (Management of Information)

• IM-06D – Information Security Policy/Procedures

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• PE-01G – Assessment of Patients

Must be able to effectively communicate with other disciplines to facilitate treatment planning and implementation. RN will collaborate with divergent multidisciplinary team members in a manner that enhances coordination of comprehensive patient care. The Circulating Nurse participates effectively in team meetings, treatment planning, and participates in continuous improvement initiatives.

Follows safety and infection control practices to include:

• Appropriate use of equipment and supplies

• Maintains safe and orderly work areas

• Reports safety hazards, accidents, and injuries

• Demonstrates infection control practices and disease prevention

4.5.2.1.3. Intraoperative Follow-up: The Contractor Operating Room RN(s) shall be present in the operating suite for all OPERATING ROOM RN procedures.

4.5.2.1.4. Postoperative Follow-Up. Contractor’s RN(s) rounds shall be conducted on postoperative patients in the Surgical Intensive Care Unit (SICU) and on the wards. All cases will be discussed in morbidity and mortality conferences, and the Contractor’s RN(s) will provide appropriate information to the COR for inclusion in departmental reports.

4.5.2.1.5. Contractor Operating Room RN(s) shall provide consultative services at the patient’s bedside if the patient is not ambulatory and in the clinic setting if the patient is able to report to the outpatient clinic.

4.5.2.2. Medications: Contractor Operating Room RN(s) shall follow all established medication policies and procedures. No sample medications shall be provided to patients.

4.5.2.3. Discharge education: Contractor Operating Room RN(s) shall provide discharge education and follow up instructions that are coordinated with the next care setting for all OPERATING ROOM RN clinical or surgical patients.

4.5.2.4. COMMUNICATING TEST RESULTS TO PROVIDERS AND

PATIENTS: In accordance with VHA Directive 1088, Communicating Test Results to Providers and Patients, all test results requiring action must be communicated by the ordering provider, or designee, to patients no later than 7 calendar days from the date on which the results are available. For test results that require no action, results must be communicated by the ordering provider, or designee, to patients no later than 14 calendar days from the date on which the results are available. The Contractor shall provide the VA with the

Revision 06/01/2022 Page 17 of 38 name, pager and telephone numbers of a LIP (Operating Room RN, nurse practitioner, or Operating Room RN assistant) at the Outpatient Site of Care to accept critical test results discovered on tests done by the VA. For critical results, the LIP must respond back to the VA within forty-five (45) minutes of the initial page or telephone call. The receiving LIP will document the results in the record and conduct a “read back” procedure to ensure accuracy of transmission and translation of all verbal results. The contractor shall determine a plan to fulfill critical test result procedures, per VA policy. VA will not be responsible for the failure of the Contractor to receive critically abnormal test results. Critical results must be reported to the clinician by the radiologist by telephone. Documentation of this notification, “who, when” must appear in the radiology report. For critical results that represent an imminent danger to the patient, the Contractor shall notify the patient immediately. Mechanisms must be in-place to provide notification of test results for patients receiving care in accordance with VHA Directive 1088, Communicating Test Results to Providers and Patients.

4.5.3. ADMINISTRATIVE: estimated 1% of time not involved in direct patient care

4.5.3.1. Quality Improvement Meetings: The Contractor’s RN(s) shall participate in continuous quality improvement activities and meetings with committee participation as required by the MINNEAPOLIS VAHCS Chief of Service, Nurse Executive, or designee.

4.5.3.2. Staff Meetings: The Contractor’s RN(s) shall attend staff meetings as required by the MINNEAPOLIS VAHCS Chief of Service, Nurse Executive, or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement.

4.5.3.3. QA/QI documentation: The Contractor’s RN(s) shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations.

4.5.3.4. Patient Safety Compliance and Reporting: Contractor’s RN(s) shall follow all established patient safety and infection control standards of care. Contractor’s RN(s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be documented in the medical record of those impacted and disclosed to the patient or surrogate. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit an entry in the Patient Safety Reporting System, following up with COR as required or requested.

4.6. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY

IMPROVEMENT(QI)

4.6.1. Quality Management/Quality Assurance Surveillance: Contractor personnel shall be subject to Quality Management measures, such as patient satisfaction

Revision 06/01/2022 Page 18 of 38 surveys, OR efficiency matrix, including on time starts, turnover times.

Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP).

The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

4.6.2. Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. In the event that The Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

4.6.3. 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…