CSP018118_DVS011_-_Contract.pdf

Index No.: DVS011

Eff. Date: 11/01/23

STATE OF OHIO

DEPARTMENT OF ADMINISTRATIVE SERVICES

GENERAL SERVICES DIVISION

OFFICE OF PROCUREMENT SERVICES

4200 SURFACE ROAD, COLUMBUS, OH 43228-1395

MANDATORY USE CONTRACT FOR: COMPREHENSIVE PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY

SERVICES AT OHIO VETERANS HOME GEORGETOWN

CONTRACT NUMBER: CSP018118 EFFECTIVE DATES: 11/01/23 TO 09/30/26

The Department of Administrative Services has accepted Proposals submitted in response to Request for Proposal (RFP) No.

SRC11199 that opened on 09/13/23. The evaluation of the Proposal responses has been completed. The Offeror listed herein has been determined to be the highest ranking Offeror and has been awarded a Contract for the services listed. The respective Proposal response including, Contract Terms & Conditions, any Proposal amendment, special Contract Terms & Conditions, specifications, pricing schedules and any attachments incorporated by reference and accepted by DAS become a part of this Services Contract.

This Requirements Contract is effective beginning and ending on the dates noted above unless, prior to the expiration date, the Contract is renewed, terminated, or cancelled in accordance with the Contract Terms and Conditions.

This Requirements Contract is available to the Ohio Department of Veterans' Service as applicable.

The agency is eligible to make purchases of the contracted services in any amount and at any time as determined by the agency. The State makes no representation or guarantee that department will purchase the volume of services as advertised in the Request for Proposal.

This Requirements Contract and any Amendments thereto are available from the DAS Web site at the following address:

https://procure.ohio.gov/

COST SUMMARY FORM

Comprehensive Physical, Occupational and Speech Therapy Services at Ohio Veterans Home Georgetown

DESCRIPTION

Daily per diem rate

(Based on CMS PDPM Urban Rates)

Occupational Therapy PDPM

$28.50 per diem rate

Speech/Language Pathology PDPM

Physical Therapy PDMP

Medicare B (Unskilled) 69% of HCPCS Code

Managed Care/Private Pay/Private Insurance/ Hospice/Service Connected

$0.97 per minute

For managed care and private insurance providers that follow the PDPM model, rates shall be reimbursed at the Daily per diem rate.

DESCRIPTION RATE

Trainings Hourly Rate $0.00

All costs must be in U.S. Dollars.

The State will not be responsible for any costs not identified.

There will be no additional reimbursement for travel or other related expenses.

The bid per diem rates shall be adjusted based on length of stay as outlined below in Table 1 and Table 2, as applicable.

TABLE 1:

Medicare Payment Days Adjustment Factor

1-20 1.00

21-27 .98

28-34 .96

35-41 .94

42-48 .92

49-55 .90

56-62 .88

63-69 .86

70-76 .84

77-83 .82

84-90 .80

91-97 .78

98-100 .76

TABLE 2:

Medicare Payment Days Non-Therapy Activity Adjustment Factor

1-3 3.00

4-100 1.00

CONTRACTOR INDEX

CONTRACTOR AND TERMS: CONTRACT NO.: CSP018118

249410 Premier Therapy, LLC TERMS: Per Contract 110 Central Square Drive Beaver Falls, PA 15010

CONTRACTOR’S CONTACT: Mr. Erik Kennerk Telephone: (800) 875-7041 Cell: (330) 510-0447 Fax: (724) 775-8669 Email: ekennerk@embracepremier.com