COVID-19 Risk Management Analysis Services .doc

Performance Work Statement (PWS)

Risk Management Analysis Services

Version 1.0 4Vision Statement

1 General Information

1.1 Introduction

1.2 Background

1.3 Constraints

1.4 Description of Services

1.5 Non-Personal Services

1.6 Period of Performance

1.7 Place of Performance

1.8 Hours of Operation

1.9 Special Qualifications

1.10 Post Award/Kickoff Conference

1.11 Status Meetings

1.12 Contractor Travel

1.13 Transition In

1.14 Transition Out

2 Definitions and Acronyms

2.1 Definitions

2.2 Acronyms

3 Government-Furnished Property and Services

3.1 Government Services

3.2 Facilities

3.3 Equipment

3.4 Materials

3.5 Quality Assurance (QA)

4 Contractor-Furnished Items and Services

4.1 Facilities

4.2 Equipment

4.3 Material

4.4 Contractor Responsibilities

4.5 Contractor Personnel

4.6 Identification of Contractor Employees

4.7 Quality Control

4.7.1 Quality Control Plan

5 Specific Tasks

5.1 Risk Management Analysis Tool

5.2 Train and Support Account Executives, OHP Management, and Other HUD Users

5.3 Fulfill Data Request and Conduct Special Analysis

6 Deliverables

6.1 Quality Control Plan

6.2 Acceptance Criteria

7 Performance Requirements Summary 8 Related Documents

Performance Work Statement (PWS) Risk Management Analysis Services Vision Statement

To obtain contractor support services to provide 232 and 242 financial risk management analysis solutions to address the rapidly changing financial position of our hospital portfolio directly attributable to the impact of COVID-19 on their operations and finances. By obtaining these services, HUD will be able to manage its $6 billion portfolio of insured hospital loans and accomplish HUD's mission of improving the way HUD does business during its COVID-19 response.

1 General Information

1.1 Introduction

The Department of Housing and Urban Development (HUD), Office of Healthcare Programs (OHP) requires contractor support to analyze the hospital portfolio and provide comprehensive financial risk management services. Since the beginning of the COVID-19 pandemic, the Office of Hospital Facilities (OHF) has and continues to receive more asset management requests than ever before in its program history. The types of the requests vary and include releases of collateral, releases of reserve accounts, emergency debt incurrence, and emergency renovations – all directly related to COVID-19. The types of requests received often have major credit implications and require extremely short turnaround times. In the absence of analytic resources, it is difficult for OHF to assess the overall credit impact these decisions are having on individual borrowers and/or the portfolio as a whole. Amidst the backdrop of a global pandemic and the velocity and significance of the requests OHF is receiving, without adequate risk assessment resources, it is nearly impossible to predict and track in real time the hospitals that are headed for liquidity crises. The Office of Healthcare Programs requires risk management analysis service to meet the needs of our hospitals and identify credit risks attributable the COVID-19 emergency.

1.2 Background

The Office of Hospital Facilities (OHF) insures nearly 100 hospital mortgages with an unpaid principal balance of almost $6.0 billion. For each hospital in the application pipeline and in the portfolio, OHF assigns an Account Executive, a HUD staff member who is the hospitals principal point of contact in the program and who is responsible for knowing the hospital in detail, providing client service to the hospital, and evaluating the financial and operational performance of the hospital. Currently, OHF has no system to assess risk has and there are no effective dashboards to report risk data on a portfolio-wide basis, thus making effective risk mitigation measures difficult to implement and monitor.

1.3 Constraints

The services identified in this PWS will adhere to the rules, regulations, laws, standards, and conventions identified by HUD as well as within the Federal Government. Constraints include the following:

· HUD Handbook 4615.1 REV-1, Hospital Mortgage Insurance Program

· HUD Handbook 1325.01, Privacy Act Handbook

· HUD Handbook 2400.25, Information Technology Security Policy, Revision 4 (and subsequent revisions)

· HUD Handbook 732.3, Personnel Security/Suitability

· Statement on Standards for Attestation Engagements No. 16 (SSAE 16) Reporting on Controls at a Service Organization

· OMB Circular A-123, Managements Responsibility for Internal Control

· OMB Circular A130, Management of Federal Information Resources, Appendix III, Security of Federal Automated Information Resources

· Homeland Security Presidential Directive 12 (HSPD12)

· OMB Memorandum M-05-24, Implementation of Homeland Security Presidential Directive (HSPD) 12

· OMB Memorandum M-03-22, OMB Guidance for Implementing the Privacy Provisions of the E-Government Act of 2002

· OMB Memorandum M-99-20, Security of Federal Automated Information Resources

· OMB Memorandum M-06-15, Safeguarding Personally Identifiable Information

· OMB Memorandum M-06-16, Protection of Sensitive Agency Information

· OMB Memorandum M-06-19, Reporting Incidents Involving PII

· OMB Memorandum M-06-20, Reporting Instructions for the Federal Information Security Act and Agency Privacy Management

· OMB Memorandum for Chief Information Officers: https://www.fismacenter.com/fedrampmemo.pdf

· Federal Information Processing Standards (FIPS) Publications http://csrc.nist.gov/publications/PubsFIPS.html

· Federal Information Processing Standards 201 (FIPS 201), Sections 2.1 and 2.2

· NIST Special Publications (800 Series) http://csrc.nist.gov/publications/PubsSPs.html

· Federal Information Security Management Act (FISMA)

· Federal Information Systems Controls Audit Manual (FISCAM, Government Accountability Office)

· Statements of Federal Financial Accounting Concepts and Standards, Federal Accounting Standards Advisory Board (FASAB)

· Authoritative Documents from Accounting and Auditing Policy Committee Processes

· Generally Accepted Government Auditing Standards (GAGAS)

1.4 Description of Services

OHP requires additional risk management services and business risk tools to enhance the underwriting and asset management decision making process for Account Executives.

These services and tools will also be useful for the Office of Risk Management to ensure that all facilities are of acceptable risk, and to monitor the entire portfolio of OHP exposures at HUD using a single platform.

The Contractor shall be required to furnish all the necessary services, qualified personnel, materials, equipment, not otherwise provided by the Government. Services and capabilities include:

· Financial Statement Spreading

· Financial Modeling

· Portfolio Risk Analysis and Monitoring

· Database Maintenance

· Training and Support

· Custom Ad Hoc Analysis and Reports

Detailed descriptions of specific tasks are provided in Section 5 Specific Tasks and Deliverables.

1.5 Non-Personal Services

The Government will neither supervise Contractor employees nor control the method by which the Contractor performs the required tasks. Under no circumstances shall the Government assign tasks to, or prepare work schedules for, individual Contractor employees. It shall be the responsibility of the Contractor to manage its employees and to guard against any actions that are of the nature of personal services, or give the perception of personal services.

If the Contractor believes that any actions constitute, or are perceived to constitute personal services, it shall be the Contractor's responsibility to notify the Contracting Officer (CO) immediately. These services shall not be used to perform work of a policy, decision making, or management nature, i.e. inherently Government functions. All decisions relative to programs supported by the Contactor shall be the sole responsibility of the Government.

1.6 Period of Performance

The period of performance shall be for one base period of 12 months and one 12-month option period.

1.7 Place of Performance

The services to be performed under this contract shall be performed at the contractor facility.

1.8 Hours of Operation

The Contractor is responsible for providing services between the hours of 9:00am-5:00pm Monday thru Friday except for Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closing, or similar Government directed facility closings. Weekly hours shall not exceed a forty (40) hour work week and a typical workday will be 8 hours each day Monday through Friday. The Government reserves the right to change hours of operation or restrict contractor access. Work outside of these daily hours is prohibited without Contracting Officer approval. Government agencies will not be available during scheduled holidays, inclement weather, weekends, and after duty hours.

The Contractor shall at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within the contract when the Government facility is not closed for the above reasons. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce is essential.

1.9 Special Qualifications

N/A

1.10 Post Award/Kickoff Conference

The Contractor shall attend any post award conference convened by the contracting activity or contract administration office in accordance with FAR Subpart 42.5. The Government intends to convene a Post Award Conference with the Contractor within ten business days after contract award. The Contracting Officer will notify the Contractor of the specific date, location, and agenda within five business days after contract award.

1.11 Status Meetings

The Contracting Officer, Contracting Officers Representative (COR) and other Government personnel, as appropriate may meet periodically with the Contractor to also review Contractor performance, requirement status, etc. At these meetings, the Contracting Officer will apprise the Contractor of how the Government views the Contractor's performance or progress of the requirement. The Contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the Government. Post Award Conference and subsequent meetings may be held via teleconference.

1.12 Contractor Travel

Prior to travel, the Contractor shall coordinate with and receive Government authorization from the COR for all travel. Reimbursement of travel costs will be in accordance with the Federal Travel Regulation and in accordance with FAR 31.205-46. The Contractor shall travel using the lower cost mode transportation commensurate with the mission requirements. When necessary to use air travel, the Contractor shall use the tourist class, economy class or similar lodging accommodations to the extent they are available and commensurate with the mission requirements. HUD will not reimburse Contractor's local travel. Local travel is defined as travel within fifty (50) miles of Washington, DC. All other travel will be reimbursed on a cost reimbursable basis; no profit or fee will be paid.

1.13 Transition In

N/A

1.14 Transition Out

To minimize any decrease in productivity and to prevent possible negative impacts on additional services, the Contractor shall have sufficient personnel on board during the 180-day Transition-Out period. The incumbent Contractor shall ensure a smooth transition with the successor Contractor during the Transition-Out period, prior to completion of contractual performance. The incumbent Contractor shall aid the successor in the development of plans, procedures, and methods for the assumption of all on going work. The Contractor shall provide an orderly transition of work acceptance and accomplishment, such that full control by the successor Contractor is achieved by the end of the new contract Transition-In period.

2 Definitions and Acronyms

2.1 Definitions

Business/Work Days - Every official work day of the week which are days between and including Monday to Friday. This does not include public holidays and weekends.

Calendar Day - Any day of the week.

Contractor - A supplier or vendor awarded a contract to provide specific supplies or service to the Government. The term used in this contract refers to the prime.

Contracting Officer (CO) - A person with authority to enter into, administer, and/or terminate contracts and make related determinations and findings on behalf of the Government. Note: the only individual who can legally bind the Government.

Contracting Officer's Representative (COR) - An employee of the U.S. Government appointed by the Contracting Officer to perform contract administration activities in regard to technical issues. This individual has authority to provide technical direction to the Contractor as long as direction is within the scope of the contract, does not constitute a change and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

Defective Service - A service output that does not meet the standard of performance associated with the Performance Work Statement.

Deliverable - Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

Government Furnished Property (GFP) - Government-furnished property means property in the possession of, or directly acquired by, the Government and subsequently furnished to the Contractor for performance of a contract. Government-furnished property includes, but is not limited to, spares and property furnished for repair, maintenance, overhaul, or modification. Government-furnished property also includes contractor-acquired property if the contractor-acquired property is a deliverable under a cost contract when accepted by the Government for continued use under the contract.

Performance Requirements Summary (PRS) - A listing of the performance requirements under the contract that are to be evaluated by the Government on a regular basis, performance indicators for these requirements, performance standards for these requirement and surveillance methods to be used to determine if performance standards are met.

Performance Standard - The Contractor's performance level required by the Government.

Performance Work Statement (PWS) - A statement of work for performance-based acquisitions that describe the required results in clear, specific and objective terms with measurable outcomes.

Physical Security - Actions that prevent the loss or damage of Government property.

Quality Assurance (QA) - Policies and procedures adopted by the Government to ensure that supplies and services acquired under Government contracts conform to the contracts quality requirements.

Quality Assurance Surveillance Plan (QASP) - A plan describing how the agency will survey, observe, test, sample, evaluate and document the Contractor's performance in meeting critical performance standards identified in the contract.

Quality Control (QC) - All necessary measures taken by the Contractor to assure that the quality of an end product of service shall meet contract requirements.

Service Contract - A contract that directly engages the time and effort of a Contractor whose primary purpose is to perform an identifiable task rather than to furnish an end item of supply.

Subcontractor - Any person , other than the prime Contractor, who offers to furnish or furnishes any supplies, material, equipment, or services of any kind under a prime contract or a subcontract entered into in connection with such prime contract, and any person who offers to furnish or furnishes general supplies to the prime contractor or a higher tier subcontractor. The Government does not have privity of contract with a subcontractor.

Subordinate Contracting Officer Representative (SCOR) - (Secondary COR) The person appointed on a contract who has the same level of experience and certification level as the Primary COR on a contract action.

Work Week - Monday through Friday, unless specified otherwise.

2.2 Acronyms

AQL - Acceptable Quality Level

ARAMS - Automated Renewal and Amendment System

BAA - Business Area Analysis Study

CBT - Computer-Based Training

CCB - Change Control Board

CCMB - Configuration Change Management Board

CMMI - Capability Maturity Model Integration

CFO or OCFO - Office of the Chief Financial Officer of HUD

CFR - Code of Federal Regulations

CIO or OCIO - Office of the Chief Information Officer of HUD

CO - Contracting Officer

COR - Contracting Officer's Representative

COTS - Commercial Off-the-Shelf

CPO - Office of the Chief Procurement Officer of HUD

EST - Eastern Standard Time (U.S.)

ETC - Estimate to Completion

GAO - U.S. General Accounting Office

HUD - U.S. Department of Housing and Urban Development

HUDAR - HUD Acquisition Regulation

HUD/ISG - Internet Services Group within the Telecom Processing Division

HUD Web - HUDs Intranet Web Site and related WEB pages.

IG or OIG - Inspector General (Office of)

IT - Information Technology

IV&V - Independent Validation and Verification

LOOCS - Line of Credit Control System

OCPO - Office of the Chief Procurement Officer

OIG - Office of Inspector General

OMB - Office of Management and Budget

PL - Public Law

PM - Project Manager

POC - Point of Contact

PPM - Project Planning and Management

QA - Quality Assurance

QASP - Quality Assurance Surveillance Plan

QCP - Quality Control Plan SCOR - Subordinate Contracting Officer Representative

SF - Standard Form

TBD - To be determined

U.S.C - United States Code

3 Government-Furnished Property and Services

The Contractor shall ensure accurate control and accountability of all Government-Furnished Property in accordance with the terms and conditions of this contract. The Government will furnish, at no cost to the Contractor, the GFP shown below.

3.1 Government Services

No Government services will be provided.

3.2 Facilities

No facilities will be provided by the Government.

3.3 Equipment

No equipment will be provided by the Government.

3.4 Materials

Copies of required materials may be provided to the Contractor in hard copy or soft copy. All materials will remain the property of the Government and will be returned to the COR upon request or at the end of the contract period.

3.5 Quality Assurance (QA)

The Government shall evaluate the Contractor's performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the Government must do to ensure that the Contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable quality level.

4 Contractor-Furnished Items and Services

The Contractor shall furnish, all facilities, equipment, and supplies required to perform the work under this contract that are not listed under Government-Furnished Property and Services.

4.1 Facilities

The contractor shall furnish all facilities required to perform the work under this contract that are not listed under Government Furnished Property and Services.

4.2 Equipment

The contractor shall furnish all equipment required to perform the work under this contract that are not listed under Government Furnished Property and Services.

4.3 Material

The contractor shall furnish equipment and supplies required to perform the work under this contract that are not listed under Government Furnished Property and Services.

4.4 Contractor Responsibilities

The Contractor shall only conduct business with designated Government personnel listed as points of contact (POCs). Names of authorized personnel shall be provided to the Contractor by the Government, in writing, and updated as necessary throughout the contract period.

U.S. Government records, copies of original results and reports, verified original data, corrected data and corrected supporting final reports which are maintained by the Contractor remain the property of the U.S. Government. These files/results must be surrendered to the COR.

4.5 Contractor Personnel

The Contractor shall provide a Contract/Project Manager who shall be responsible for the performance of work. An alternate shall also be designated to act in the absence of the Contract/Project Manager. These Contractor personnel (main point of contact and alternate point of contact) are considered Key Personnel by the Government and shall be listed as such in accordance with HUDAR 2452.237-70, "Key Personnel. The Contract/Project Manager and alternate shall have full authority to act on all contact matters relating to daily operations of this contract. Accordingly, at a minimum, the points of contact shall have the technical knowledge of the requirement and be in the position to actually receive assignment, guidance, and direction from the COR, PM, and CO per HUDAR 2452.237-73, "Conduct of Work and Technical Guidance" and shall be allocated enough hours to the requirement to ensure successful performance. These points of points of contact shall each be an employee of the Contractor. An employee of a subcontractor is not acceptable for either of these positions.

The Contract/Project Manager or alternate shall be available between the hours of 9:00am to 5:00pm Monday through Friday EST, except Federal Holidays or when the Government facility is closed for administrative reasons.

4.6 Identification of Contractor Employees

All Contractor/subcontractor personnel shall wear company picture identification badges as to distinguish themselves from Government employees. When conversing with Government personnel during business meetings, over the telephone, or via electronic mail, Contractor/subcontractor personnel shall identify themselves as such to avoid situations arising where sensitive topics might be better discussed solely between Government employees. Contractors/subcontractors shall identify themselves on any attendance sheet or any coordination documents they may review. Electronic mail signature blocks shall identify their company affiliation. Where practicable, Contractor/subcontractors occupying collocated space with their Government program customer shall identify their workspace area with their name and company affiliation, or at a minimum, "Contractor" after name.

4.7 Quality Control

The Contractor shall establish and maintain a complete quality control program that shall ensure services are performed in accordance with this contract. The Contractor shall develop and implement procedures to identify, prevent, and ensure non reoccurrence of defective services. The Contractor's quality control program is the means by which he assures himself that his work complies with the requirements of the contract. The Contractor shall provide the associated Quality Control Plan to the Government as directed.

4.7.1 Quality Control Plan

The Contractor shall develop, maintain, enforce, and document a Quality Control Plan (QCP). The QCP shall ensure the Government receives the level of quality that is consistent with the requirements specified in this contract. The QCP shall be sufficiently detailed to provide the Contractor's methodology for identifying and recruiting qualified personnel. The QCP shall also provide the Contractor's methodology for resolving problems identified by the Government during reviews conducted in accordance with its Quality Assurance Surveillance Plan (QASP). The QCP shall also provide the Contractor's methodology for establishing an internal feedback system for support personnel, and for resolving problems identified by that feedback system. The QCP shall demonstrate and validate that the services or deliverables to be provided under the contract are completed with a level of quality that meets the minimum performance threshold established in the Government's QASP. The QCP shall address Quality Management Approach, Quality Assurance, Quality Control and Quality Standards.

5 Specific Tasks

5.1 Risk Management Analysis Tool

The Contractor shall provide a risk management analysis tool. The Contractors tool should be able to do the following:

Performance Standards

a) Standard: The Contractor shall provide a reliable risk management tool AQL: Zero deviation from the standard Deliverables A002 Financial Reports

5.1.1 Collect Administrative, Financial and Utilization Data

· Provide the capability to create, edit, and delete hospital administrative, financial, and utilization information.

· Import existing historical data.

· Facilitate and support ongoing data entry from Account Executives.

· Minimize data entry errors.

· Update database data in real-time.

5.1.2 Analyze and Report Quarterly and Annual Financial and Utilization Data

· Provide database search capabilities.

· Spread hospital financial and non-financial data (balance sheet, profit/loss statements, ratios, cash flows, and utilization statistics).

· Build and model financial projections.

· Model financial statement data for underwriting new deals and managing existing credits.

· Model and analyze UCA Cash Flow for both historical data and future projections.

· Benchmark performance to comparable hospitals and regions.

· Develop hospital industry-specific probability of default analysis and hospital industry-specific shadow ratings.

· Develop risk rating analysis on individual obligors and portfolio.

· Run multiple projection scenarios (i.e. feasibility, budget, Affordable Care Act impact, etc.) and perform sensitivity analysis based on changing economic and legislative issues.

· Allow the creation and analysis of "family entities” based on parent, subsidiary, holding companies, etc.

5.1.3 Provide System Administration and Data Maintenance

· Maintain analytic tools and databases

· Provide flexible data storage capabilities.

· Ensure system scalability to accommodate any potential future program or user growth.

· Export financial data to HUDs Online Property Integrated Information Suite (OPIIS) to manage individual financial information on borrowers, counterparty risk and the portfolio consistent with Multi-Family and Assisted Living programs.

· Ensure system compatibility with business intelligence software used at HUD such as Oracle and SAS.

· Provide security and technical controls outside of HUDs firewall. It is expected that 75 HUD employees in multiple geographic locations will access the tools.

· Possess the flexibility to possibly manage the future data requirements of the Office of Residential Care Facilities (Section 232).

5.2 Train and Support Account Executives, OHP Management, and Other HUD Users

The Contractor shall prepare training materials and will provide initial staff-led training for Account Executives, OHF management and other HUD users via a variety of classroom, electronic, and self-study techniques.

The Contractor shall develop and maintain efficient and effective methods for providing ongoing guidance, training, and support to Account Executives, OHP management, and other HUD users.

Performance Standards

a) Standard: The contractor shall train and support HUD staff.

AQL: Zero deviation Deliverables A003 Initial User Training and Ongoing User Support

5.3 Fulfill Data Request and Conduct Special Analysis

The Contractor shall conduct ad hoc special analyses upon request of the project manager, using annual financial statement data, program data, and other available data sources to (a) improve OHF underwriting, asset management, resource management, or portfolio analysis, and/or to (b) improve methods for analyzing these activities.

Performance Standards

a) Standard: The Contractor shall prepare ad hoc written reports involving data analysis on topics approved by the Project Manager.

AQL: Zero deviation from the standard.

Deliverables A004 Ad hoc Written Reports

6 Deliverables

The Contractor shall complete all work and submit all deliverables as specified herein. The Government reserves the right to make changes to delivery dates.

Relates to Section 6.2 Quality Control Plan

6.1 Quality Control Plan

The Contractor's QCP shall be delivered to the COR within 30 days after contract award (or with the Contractor's proposal if it is an evaluation factor). The QCP shall be submitted to the COR within ten (10) business days when changes are made thereafter. After acceptance of the QCP, the Contractor shall receive the Contracting Officer's acceptance in writing of any proposed change to its quality control system.

6.2 Acceptance Criteria

All deliverables shall be submitted in a draft format agreed upon by the Contractor and the Government. Upon review and acceptance by the Government, the Contractor shall address all Government comments and submit a final draft within five (5) business days of Government notification.

7 Performance Requirements Summary

The summary chart below lists the contract's primary requirements, the associated performance standards, the expected target performance, and the methods of surveillance. While some contract requirements may not be listed in the chart below, requirements not appearing on the PRS chart do not negate the Contractor's obligation to perform all requirements as specified in the contract. Additionally, HUD reserves all rights and remedies under the provisions and clauses of the contract when performance of any contract requirement, whether or not listed below, is unacceptable.

HUD will develop a Quality Assurance Surveillance Plan to be used to provide contract oversight. In conjunction with the Contractor's Quality Control Plan and various other methods of assessing performance, the COR and PM may perform on-site reviews and/or other types of verification to determine that the specified target performance requirements have been met.

Regular review of Contractor performance is critical to the overall success of the contract. On a monthly basis, the COR will evaluate the quality of the product or services.

8 Related Documents

The Contractor shall abide by all applicable regulations, publications, manuals, policies, and procedures in the performance of this contract.

Performance Requirement Summary (PRS)

AQL: Zero deviation

100% deduction of invoice CLIN

AQL: Zero deviation from the standard

100% deduction of invoice CLIN.

AQL: Zero deviation from the standard

100% deduction of invoice CLIN.

AQL: Zero deviation from the standard.

100% deduction of invoice CLIN.

�What is the current limitation and how will the new contract resolve the issue?

�Hopefully this revision address your comments.

�The PWS states there is no transition, will some type of transition be necessary when replacing the multiple platforms in use?

�Addressed

�Is this aditional service goingto be set up as an optional CLIN?

�No additional CLINS are necessary. Removed.

�Did you confirm this is acceptable? Some contractors have fought thisin the past.

�This is standard ARRT tool language. I am comfortable with it, but I am willing to change it if OCPO feels that it is necessary.

�Open quotation.

�Addressed

�What capability are you looking for from the contractor?

�The capability to meet the needs of residential care facilities, if necessary.