36C26323Q0681 RFQ Document.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. UEI: EFT:

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. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

618-23-4-4002-0460

36C26323Q0681

Todd Penkhus (320) 252-1670 x6561 06-26-2023

1600 CDT

36C263

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

Joshua Imdacha

Something Street, STE 300

Coralville IA 56303

X 100

X

621399

$9 Million

N/A

X

Department of Veterans Affairs

VA Medical Center (RM-90C)

4801 Veterans Drive

Saint Cloud MN 56303-2099

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE 506

Saint Paul MN 55415

Department of Veterans Affairs

Financial Service Center

PO Box 149971

Austin TX 78714

512-460-5540

See CONTINUATION Page

Up to five (5) FTE (2080 Hours) Operating Room Registered

Nurses to support the Minneapolis VA Health Care System

Period Of Performance: 7/1/2023 - 6/30/2023

Service Contract Act WD # 2015-4945 applies to all services performed under the contract.

This is a Total Service Disabled Veteran Owned Small

Business Set-aside (SDVOSB).

FOR CONSIDERATION ALL QUESTIONS MUST BE RECEIVED 72 HOURS

BEFORE DATE STIPULATED IN BLOCK 8 OF THE SF1449 FORM.

EMAIL ALL QUESTIONS AND RESPONSES TO Todd.Penkhus@va.gov

& Joshua.Imdacha@va.gov SIGN SF1449 AND RETURN ALL PAGES

WITH OFFER SUBMISSION

Review FAR 52.212--1 Instructions to Offerors

Review FAR 52.212--2 Evaluation Factors

Evaluation of Offers: Comparative Evaluation

See CONTINUATION Page

618-3630160-4002-820200-2581-618C3XXX-010041152

X X

X ONE

Joshua Imdacha

Contracting Officer

06-13-2023

36C26323Q0681

Table of Contents

SECTION A

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

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PERFORMANCE WORK STATEMENT REGISTERED NURSES FOR OPERATING

ROOM SUPPORT

B.3 PRICE/COST SCHEDULE

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (DEC 2022)

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

C.3 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.4 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.5 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.6 VAAR 852.204-70 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR

PERSONNEL (MAY 2020)

C.7 VAAR 852.219-73 VA NOTICE OF TOTAL SET-ASIDE FOR VERIFIED SERVICE-

DISABLED VETERAN-OWNED SMALL BUSINESSES (NOV 2022)

C.8 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018)

C.9 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING--

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (NOV 2022)

C.10 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.11 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.12 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) . 60

C.13 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019)

C.14 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (NOV 2021)

C.15 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAR 2023)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 QUALITY SURVEILANCE PLAN (QASP)

D.2 IT SECURITY OPERATING ROOM NURSES

D.3 RULES OF BEHAVIOR

D.4 CONTRACTOR CERTIFICATION IMMIGRATION AND NATIONALITY ACT OF

D.5 ATTACHMENT SERVICE CONTRACT ACT WD 15-4975

D.6 ORGANIZATIONAL CONFLICTS OF INTEREST

D.7 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING-CERTIFICATE OF

COMPLIANCE

D.8 KEY PERSONNEL TRACKER

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAR 2023)

E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

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

E.6 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020) . 80

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

(OCT 2018)

E.8 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.9 VAAR 852.237-72 CRIME CONTROL ACT—REPORTING OF CHILD ABUSE

(OCT 2019)

E.10 VAAR 852.239-75 INFORMATION AND COMMUNICATION TECHNOLOGY

ACCESSIBILITY NOTICE (FEB 2023)

E.11 VAAR 852.273-70 LATE OFFERS (NOV 2021)

E.12 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.13 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (DEC 2022)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C263

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

Joshua Imdacha

Something Street, STE 300

Coralville IA 56303

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

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly

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 https://www.tungsten-network.com

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

AMENDMENT NO DATE

B.2 PERFORMANCE WORK STATEMENT REGISTERED NURSES FOR

OPERATING ROOM SUPPORT

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

Revision 06/01/2022 Page 5 of 101 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

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 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/ https://theasgs.org/ http://www.aacn.nche.edu/accreditation

Revision 06/01/2022 Page 6 of 101

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

Revision 06/01/2022 Page 7 of 101 jeopardy, causing other serious medical consequences, causing impairments to 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.

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

Revision 06/01/2022 Page 8 of 101

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.

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

Revision 06/01/2022 Page 9 of 101

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).

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}.

Revision 06/01/2022 Page 10 of 101

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 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 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

Revision 06/01/2022 Page 11 of 101 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 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

Revision 06/01/2022 Page 12 of 101 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 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

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

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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.

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. In the event a scheduled

Operating Room RN is unable to complete an assigned shift, the contractor shall provide replacement OR RN coverage and notify the Contracting

Office Representative (COR) at the Minneapolis VAHCS immediately of the schedule change.

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.

Revision 06/01/2022 Page 14 of 101

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

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

Revision 06/01/2022 Page 15 of 101 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 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.

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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 to 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 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.

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

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• 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

• 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

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

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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.

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.

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

Revision 06/01/2022 Page 19 of 101

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.

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

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…