Final_RFP_074_2500000266_1_SO_FORM.PDF

Document ID: RFP 074 2500000266 Page: 1

Commonwealth of Kentucky

SOLICITATION

Modification: No Version #:

TITLE: 074/BGVC/PHYSICIAN SERVICES/3.17.25

Date Issued:

03/25/2025 Record Date:

03/18/2025

Solicitation Closes Date:

04/29/2025 Time:

15:00

Solicitation No:

RFP 074 2500000266

Online Bidding Prohibited: Yes For Information Call:

Tonya Houchens

Bid Receiving Location:

Radcliff Veterans Center Bid Receiving 100 Veterans Drive

Radcliff KY 40160

Vendor Customer Number:

Vendor Name:

Phone Number:

Fax Number:

Email Address:

Ordering

Address:

City, State, Zip:

Contact Name:

Contact Email:

Contact Phone Number:

Payment

Address:

City, State, Zip:

Contact Name:

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Ownership Type

__ Sole Proprietorship __ Partnership __ Corporation __ Other_________________________

SIGNATURE OF AUTHORIZED AGENT IS REQUIRED UNLESS RESPONSE

IS SUBMITTED ELECTRONICALLY. FAILURE TO SIGN SHALL RENDER

THE BID INVALID.

Signature X_________________________________________ FEIN#____________________ Date____________

All offers subject to all terms and conditions contained in this solicitation.

Document ID: RFP 074 2500000266 Page: 2

Line Items

Commodity Group: Default

Line CL Description Quantity UOM Unit Cost Line Total or Contract Amnt

1 PHYSICIAN SERVICES/MEDICAL

DIRECTOR

Comm Code Comm Description Manufacturer Model # Manuf Part #

94874PS PSC-Professional Medical Services (Including Physicians, Pha

Extended Description

PHYSICIAN SERVICES/MEDICAL DIRECTOR

Shipping Information Bowling Green Veterans Center

1111 Veterans Way

Bowling Green KY 42101

Billing Information Bowling Green Veterans Center

1111 Veterans Way

Bowling Green KY 42101

Document ID: RFP 074 2500000266 Page: 3

Submission Checklist

The following items will be required to be submitted with bid:

Item

Revised April 2024

PROPOSAL SUBMISSION CHECKLIST

The vendor MUST include the following with the proposal submission.

If the items highlighted below are not submitted with the proposal submission, the Commonwealth MUST deem the proposal non-responsive and SHALL NOT consider for award.

All other items MUST be submitted prior to award.

_____ SIGNED AND COMPLETED SOLICITATION –Section(s) 8.00 and 8.10 of this RFP

(not required if submitting electronically)

_____ *PROPOSED SOLUTION (TECHNICAL) UNDER SEALED COVER AND BY

CLOSING DATE --

Section(s) 8.00 and 8.10 of this RFP

_____ *PROPOSED SOLUTION (COST) UNDER SEALED COVER AND BY CLOSING

DATE --

Section(s) 8.00 and 8.10 of this RFP

_____ TRANSMITTAL LETTER – Section 8.20 of this RFP

_____ PROOF OF REGISTRATION WITH SECRETARY OF STATE BY A FOREIGN

ENTITY -- Section 9.00 of the Personal Service Contract Terms and Conditions of this

RFP

_____ REQUIRED AFFIDAVIT(S) – Section 8.20 of this RFP

*The Commonwealth defines SEALED as “a closure that must be broken to be opened and that thus reveals tampering” (Merriam-Webster Dictionary, https://www.merriam-webster.com/ dictionary/seal

REQUEST FOR PROPOSAL

FOR

PERSONAL SERVICE CONTRACT

Kentucky Department of Veterans Affairs Robert E. Spiller Bowling Green Veterans Center Physician Services/Medical Director Solicitation Number: RFP 074 2500000266

Document Phase Document Description Page 4

2500000266 Final 074/BGVC/PHYSICIAN SERVICES/3.17.25 Total Pages: 32 https://www.merriam-webster.com/dictionary/seal https://www.merriam-webster.com/dictionary/seal

This document constitutes a Request for Proposals for a Personal Service Contract from qualified individuals and organizations to furnish those services as described herein for the Commonwealth of Kentucky, Kentucky Department of Veterans Affairs, Robert E. Spiller Bowling Green Veterans Center.

Offerors are advised that any personal service contract resulting from this RFP must comply with all applicable provisions of KRS 45A and KRS 12.210 prior to becoming effective.

A contract, based on this RFP, may or may not be awarded. Any contract award from this RFP is invalid until properly approved and executed by the Finance and Administration Cabinet and filed with the Legislative Research Commission, Government Contract Review Committee.

1.00 Purpose and Background

Robert E. Spiller Bowling Green Veterans Center (BGVC) is a long-term care facility with a capacity of sixty (60) Veterans. We are looking for general practice Physician to cover BGVC needs. The Physician will also serve as the Medical Director for the facility. BGVC may or may not award this contract as a multi-vendor contract. The purpose of the proposal is to provide an adequate level of Physician coverage when needed.

2.00 Scope of Work

Physicians will provide services to the Veterans of BGVC to include evaluation and management of patient medical care for scheduled and acute encounters. Physician Services shall follow all state and Federal Guidelines/regulations as they pertain to long-term care facilities.

Physicians will follow regulations set forth by Centers for Medicare and Medicaid Services (CMS) and those within his/her scope of practice that includes but is not limited to:

Nursing facility rounds as needed and per regulations.

Resident Charting

Provide 24 hour/day, 365 days per year on-call service.

Coordinate emergency care for BGVC Veterans who may be admitted to a hospital.

Coordinate transport of BGVC Veterans to the closest acute care setting as required.

Coordinate care of BGVC Veterans in an acute care setting.

Supervising the medical care of Veterans means participating in the Veteran’s assessment and care planning, monitoring changes in Veteran’s medical condition, and providing consultation or treatment when contacted by BGVC. It also includes, but is not limited to, prescribing medications and therapy, ordering a Veteran’s transfer to the hospital, conducting required routine visits or delegating to and supervising follow-up visits by Advanced Practice Providers (APP), Nonphysician Practitioners (NPP), or Physician Extenders (PE).

It is the responsibility of BGVC and the Physician to ensure that a Physician is always available for the care of the Veterans. In the event the Physician will be unreachable or unavailable, the Attending Physician may designate another Physician to act on his/her behalf while he/she is unreachable or unavailable. The Physician will be responsible for verifying credentialing of the backup Physician

Document Phase Document Description Page 5 and will have ultimate responsibility for the actions taken by the backup Physician who will be covering during the Attending Physician’s period of unavailability.

Physician should be qualified to provide services in the Commonwealth of Kentucky. Physician must be licensed to practice in the Commonwealth of Kentucky.

Physician should not be an excluded Medicare/Medicaid provider.

Physician will provide service to all Veterans without regard to race, color, creed, national origin, age, sex, religion, or handicap.

Physicians will independently bill facility visits made for BGVC Veteran encounters to BGVC Veteran’s private health insurances to the extent allowable by those carriers, to include Medicare and Medicaid, at the then existing Medicare allowable rates for such encounters and according to federal regulations. Contractor will not bill BGVC Veterans unless as noted in the document

BGVC is responsible for the charges of the Prevailing Rate Veterans and will send a list of current Prevailing Rate Veterans to the Contractor weekly.

BGVC will provide all necessary BGVC Veteran information required for billing resident Medicare, Medicaid and/or private health insurance carriers. However, BGVC shall in no event be held responsible for the collection of any Physician charges billed to BGVC Veterans’ insurances.

BGVC will be billed for:

A. Veterans who do not have insurance: Medicare, Medicaid, or other health insurance to bill for provided Physician visits.

B. Veterans who have a service connection of 70% - 100%, which places them in what BGVC refers to as a Mandatory Status and are seen by a contracted Physician.

The Medicare Fee Schedule will serve as the fee schedule from which the Physician will bill BGVC.

Services excluded from Medicare consolidated billing will not be paid by BGVC.

Contractor will provide two (2) work references on candidate, copy of drug test, copy of background check (National Background check with fingerprinting) - KARES is preferred, and copy of tuberculosis test (must be a two-step completed within the previous twelve (12) months).

Any Medical Directors that come on-site must go through on-site orientation, which will be provided by BGVC. Each Medical Director that works for BGVC must provide required credentialing paperwork per VA guidelines. This will include a copy of their licensure, copy of relevant school transcript, other relevant certifications, medical self-attestations filled out (provided by BGVC), signed Scope of Work (form provided by BGVC), resume, and completed work information form (provided by BGVC).

The Medical Director will take part in all mandatory trainings provided by BGVC.

Cost of travel and lodging will be paid by the Contractor and is not the responsibility of BGVC.

BGVC RESPONSIBILTY

BGVC will provide personnel services, space, and equipment as are reasonably necessary for the proper and efficient operation of Physicians. This includes, but is not limited to, support

Document Phase Document Description Page 6 services such as Nursing Administration, Accounting, Purchasing, Medical Records, Patient Transportation, etc.

The following Guidelines and Regulations are provided to inform the Physician of the requirements of this position and the responsibilities of the Physician under CMS guidelines and regulations.

Guidelines/Regulations as they pertain to long-term care Facilities include, but not limited to:

F710 §483.30 Physician Services

A physician must personally approve in writing a recommendation that an individual be admitted to a facility. Each resident must remain under the care of a physician. A physician, physician assistant, nurse practitioner, or clinical nurse specialist must provide orders for the resident’s immediate care and needs.

§483.30(a) Physician Supervision. The facility must ensure that §483.30(a) (1) The medical care of each resident is supervised by a physician.

§483.30(a)(2) Another physician supervises the medical care of residents when their attending physician is unavailable.

INTENT §483.30(a)

The intent of this regulation is to ensure the medical supervision of the care of each resident by a physician and that orders for the resident’s immediate care and needs are provided throughout the resident’s stay.

DEFINITIONS §483.30(a) “Attending physician” refers to the primary physician who is responsible for managing the resident’s medical care. This does not include other physicians whom the resident may see periodically, such as specialists.

“Nonphysician practitioner (NPP)” is a nurse practitioner (NP), clinical nurse specialist (CNS), or physician assistant (PA).

“Nurse practitioner” is a registered professional nurse currently licensed to practice in the State and who meets the State’s requirements governing the qualification of nurse practitioners.

“Clinical nurse specialist” is a registered professional nurse currently licensed to practice in the State and who meets the State’s requirements governing the qualifications of clinical nurse specialists.

“Physician assistant” is a person who meets the applicable State requirements governing the qualifications for assistants to primary care physicians.

Document Phase Document Description Page 7

F711 §483.30(b) Physician Visits

The physician must—

§483.30(b)(1) Review the resident’s total program of care, including medications and treatments, at each visit required by paragraph (c) of this section.

§483.30(b)(2) Write, sign, and date progress notes at each visit; and

§483.30(b)(3) Sign and date all orders except for influenza and pneumococcal vaccines, which may be administered per physician-approved facility policy after an assessment for contraindications.

INTENT §483.30(b)

The intent of this regulation is to have the physician take an active role in supervising the care of the residents. Physician visits should not be superficial visits but must include an evaluation of the resident’s condition and total program of care, including medications and treatments, and a decision about the continued appropriateness of the resident’s current medical regimen.

GUIDANCE §483.30(b)

Except where the regulation specifies the task must be completed personally by the physician, the term “attending physician” or “physician” also includes a non-physician practitioner (NPP) involved in the management of the resident’s care, to the extent permitted by State law.

Total program of care includes all care the facility provides residents to maintain or improve their highest practicable physical, mental, and psychosocial well-being, as defined by the comprehensive assessment and plan of care. Care includes medical services and medication management, physical, occupational, and speech/language therapy, nursing care, nutritional interventions, social work, and activity services that maintain or improve psychological functioning.

During required visits, the physician must document a review of the resident’s total program of care, including the resident’s current condition, progress, and problems in maintaining or improving their physical, mental, and psychosocial well-being and decisions about the continued appropriateness of the resident’s current medical regimen. The physician need not review the total plan of care at each visit but must review the total plan of care at visits required by §483.30(c), F712.

Progress notes must be written, signed, and dated at each physician visit, which may be done in a physical chart or electronic record, in keeping with facility practices.

During visits, the physician must also sign and date all orders, except for influenza and pneumococcal vaccinations, which may be administered per physician-approved facility policy after an assessment for contraindications. This includes co-signing orders written by NPPs, qualified dietitians, other clinically qualified nutrition professionals and qualified therapists, as required by state law.

Document Phase Document Description Page 8

In cases where facilities have created the option for a resident’s record to be maintained by computer, rather than hard copy, electronic signatures are acceptable. See Guidelines for §483.70(i)(1), F842, for information on facility safeguards concerning electronic signatures.

Physician orders may be transmitted by facsimile machine if the following conditions are met.

The physician should have signed and retained the original order from which the facsimile was transmitted and be able to provide it upon request. Alternatively, the original may be sent to the facility at a later time and substituted for the facsimile.

The facility should photocopy the faxed order if the faxed order is subject to fading over time.

The facsimile copy can be discarded after facility photocopies it.

It is not necessary for a physician to re-sign the facsimile order when he/she visits the facility.

When rubber stamp signatures are authorized by the facility’s management, the individual whose signature the stamp represents shall place in the administrative offices of the facility a signed statement to the effect that he/she is the only one who has the stamp and uses it. A list of computer codes, identification numbers and/or written signatures must be readily available and maintained under adequate safeguards. Adequate safeguards may include, but are not limited to, locked in a drawer, locked in a location that is accessible only by appropriate staff as defined by the facility; or available on a protected electronic site accessible by appropriate staff as defined by the facility.

F712 §483.30(c) Frequency of physician visits

§483.30(c)(1) The residents must be seen by a physician at least once every 30 days for the first 90 days after admission, and at least once every 60 days thereafter.

§483.30(c)(2) A physician visit is considered timely if it occurs not later than 10 days after the date the visit was required.

§483.30(c)(3) Except as provided in paragraphs (c)(4) and (f) of this section, all required physician visits must be made by the physician personally.

In a NF the physician visit requirement may be satisfied in accordance with State law by a NPP who is not an employee of the facility but who is working in collaboration with a physician and who is licensed by the State and performing within the state’s scope of practice. (See §483.30(f)).

In a NF, medically necessary visits performed by NPPs employed by the facility, may not take the place of physician required visits, nor may the visit count towards meeting the physician visit schedule prescribed at §483.20(c)(1).

§483.30(c)(4) At the option of the physician, required visits in SNFs, after the initial visit, may alternate between personal visits by the physician and visits by a physician assistant, nurse practitioner or clinical nurse specialist in accordance with paragraph (e) of this section.

DEFINITIONS §483.30(c)

Document Phase Document Description Page 9

Must be seen, for purposes of the visits required by §483.30(c)(1), means that the physician or NPP must make actual face-to-face contact with the resident, and at the same physical location, not via a telehealth arrangement. There is no requirement for this type of contact at the time of admission, since the decision to admit an individual to a nursing facility (whether from a hospital or from the individual’s own residence) generally involves physician contact during the period immediately preceding the admission.

“Nonphysician practitioner (NPP)” means a nurse practitioner (NP), clinical nurse specialist (CNS) or physician assistant (PA).

GUIDANCE §483.30(c)

The timing of physician visits is based on the admission date of the resident.

In a SNF, the first physician visit (this includes the initial comprehensive visit) must be conducted within the first 30 days after admission, and then at 30-day intervals up until 90 days after the admission date. After the first 90 days, visits must be conducted at least once every 60 days thereafter.

Permitting up to 10 days’ slippage of a due date will not affect the next due date. However, do not specifically look at the timetables for physician visits unless there is indication of inadequate medical care. The regulation states that the physician (or his/her delegate) must visit the resident at least every 30 or 60 days. There is no provision for physicians to use discretion in visiting at intervals longer than those specified at §483.30(c), F712. Although the physician may not delegate the responsibility for conducting the initial visit in a SNF, NPPs may perform other medically necessary visits prior to and after the physician’s initial visit, as allowed by State law.

After the initial physician visit in SNFs, where States allow their use, a NPP may make every other required visit. (See §483.30(e), F714 Physician delegation of tasks in SNFs.) These alternate visits, as well as medically necessary visits, may be performed and signed by the NPP.

(Physician co-signature is not required, unless required by State law).

In SNFs and NFs, facility policy that allows NPPs to conduct required visits, and/or allows a 10-day slippage in the time of the required visit, does not relieve the physician of the obligation to visit a resident personally when the resident’s medical condition makes that visit necessary.

Table 1: Authority for Non-physician Practitioners to Perform Visits, Sign Orders and Sign Medicare Part A Certifications/Re-certifications when Permitted by the State

Initial Comprehensive

Visit /Orders

Other Required Visits^

Other Medically Necessary Visits

& Orders+

Certification/ Recertification

SNFs

PA, NP & CNS

employed by the facility

May not perform/ May not sign

May perform alternate visits

May perform and sign

May not sign

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PA, NP & CNS

not a facility employee

May not perform/ May not sign

May perform alternate visits

May perform and sign

May sign subject to State

Requirements NFs

PA, NP, & CNS

employed by the facility

May not perform/ May not sign

May not perform

May perform and

Not applicable

PA, NP, & CNS

not a facility employee

May perform/ May sign*

May perform May perform and

Not applicable

*A NPP may provide admission orders if a physician personally approved in writing a recommendation for admission to the facility prior to admission. For additional requirements on physician recommendation for admission and admission orders, see §483.30(a), F710.

^Other required visits are the physician visits required by 483.30(c)(1) other than the initial comprehensive visit.

+Medically necessary visits are independent of required visits and may be performed prior to the initial comprehensive visit.

±Though not part of a compliance determination for this section, this requirement is provided for clarification and relates specifically to coverage of a Part A Medicare stay, which can take place only in a Medicare-certified SNF.

In a facility where beds are dually certified under Medicare and Medicaid, the facility must determine how the resident stay is being paid in order to identify whether physician delegation of tasks is permissible and if a NPP may perform the tasks. For example:

For residents in a Part A Medicare stay, the NPP must follow the requirements for physician services in a SNF. This includes, at the option of a physician, required physician visits alternated between personal visits by the physician and visits by a NPP after the physician makes the initial comprehensive visit; and

For residents in a Medicaid stay, the NPP must follow the requirements for physician services in a NF. A NPP who is not employed by the facility and is working in collaboration with a physician may perform any required physician task for a resident in a Medicaid-stay, at the option of the State. (NPPs employed by the facility may not perform required physician visits but may perform other medically necessary visits.

It is expected that visits will occur at the facility rather than the doctor’s office unless office equipment is needed or a resident specifically requests an office visit. If the facility has established policy that residents leave the grounds for medical care, the resident does not object, and this policy does not infringe on his/her rights including the right to privacy, there is no prohibition to this practice. The facility should inform the resident of this practice, in accordance with §483.10(g)(16), F581, Notice of rights and services.

Certifications/Re-certifications in SNFs: Under 42 C.F.R. §424.20, certifications and re-certifications are required to verify that a resident requires daily skilled nursing care or rehabilitation services. NPs, CNSs, and PAs who are not employed by the facility and who are

Document Phase Document Description Page 11 working in collaboration with a physician may sign the required initial certification and re-certifications when permitted under the scope of practice for the State. 42 C.F.R. §424.20(e)(2).

§483.30(d) Availability of physicians for emergency care

The facility must provide or arrange for the provision of physician services 24 hours a day, in case of emergency.

F714 §483.30(e) Physician delegation of tasks in SNFs.

§483.30(e)(1) Except as specified in paragraph (e)(4) of this section, a physician may delegate tasks to a physician assistant, nurse practitioner, or clinical nurse specialist who—

(i) Meets the applicable definition in §491.2 of this chapter or, in the case of a clinical nurse specialist, is licensed as such by the State.

(ii) Is acting within the scope of practice as defined by State law; and

(iii) Is under the supervision of the physician.

§483.30(e)(4) A physician may not delegate a task when the regulations specify that the physician must perform it personally, or when the delegation is prohibited under State law or by the facility’s own policies.

§483.30(f) Performance of physician tasks in NFs.

At the option of State, any required physician task in a NF (including tasks which the regulations specify must be performed personally by the physician) may also be satisfied when performed by a nurse practitioner, clinical nurse specialist, or physician assistant who is not an employee of the facility but who is working in collaboration with a physician.

INTENT §483.30(e)(1)&(4) To allow the physician, under certain conditions, to delegate tasks to a nurse practitioner, clinical nurse specialist or physician assistant, working under the physician’s supervision.

DEFINITIONS §483.30(e)(1)&(4)

“Clinical nurse specialist” is a registered professional nurse currently licensed to practice in the State and who meets the State’s requirements governing the qualifications of clinical nurse specialists.

“Nurse practitioner” is a registered professional nurse who is currently licensed to practice in the State, who meets the State’s requirements governing the qualification of nurse practitioners and who meets one of the following conditions:

(1) is currently certified as a primary care nurse practitioner by the American Nurses’ Association or by the National Board of Pediatric Nurse Practitioners and Associates;

or

(2) has satisfactorily completed a formal 1 academic year educational program that (i) prepares registered nurses to perform an expanded role in the delivery of primary care;

Document Phase Document Description Page 12

(ii) includes at least 4 months (in the aggregate) of classroom instruction and a component of supervised clinical practice; and (iii) awards a degree, diploma or certificate to persons who successfully complete the program; or

(3) has successfully completed a formal educational program (for preparing registered nurses to perform an expanded role in the delivery of primary care) that does not meet the requirements above and has been performing an expanded role in the delivery of primary care for a total of 12 months during the 18-month period immediately preceding September 22, 2006.

“Physician assistant” is a person who meets the applicable State requirements governing the qualifications for assistants to primary care physicians, and who meets at least one of the following conditions:

(1) is currently certified by the National Commission on Certification of Physician Assistants to assist primary care physicians; or

(2) has satisfactorily completed a program for preparing physician’s assistants that (i) was at least 1 academic year in length; (ii) consisted of supervised clinical practice and at least 4 months (in the aggregate) of classroom instruction directed toward preparing students to deliver health care; and (iii) was accredited by the American Medical Association’s Committee on Allied Health Education and Accreditation; or

(3) Has satisfactorily completed a formal educational program (for preparing physician assistants) that does not meet the requirements above and has been assisting physicians for a total of 12 months during the 18-month period that ended on December 31, 1986.

“Non-physician practitioner (NPP)” is a nurse practitioner (NP), clinical nurse specialist (CNS), or physician assistant (PA) as defined above.

GUIDANCE §483.30(e)(1)&(4) The extent to which physician services may be delegated to NPPs in SNFs is governed by the provisions of §483.30(e), while the extent to which these services may be performed by NPPs in NFs is governed by the provisions of §483.30(f). (Refer to table in F712).

In SNFs, when personal performance of a particular task by a physician is specified in the regulations, performance of that task cannot be delegated to anyone else. The tasks of examining the resident, reviewing the resident’s total program of care, writing progress notes, and signing orders may be delegated unless prohibited by State law or facility policies.

DEFINITIONS §483.30(f)

“Collaboration” is a process often governed by the laws of a given State in which a non-physician practitioner (NPP) works with one or more physicians to deliver health care services within the scope of the NPP’s expertise, with medical direction and appropriate supervision as provided for in jointly developed guidelines or other mechanisms.

In the absence of State law governing collaboration, such collaboration is to be evidenced by NPPs documenting the NPP’s scope of practice and indicating the relationships that they have with physicians to deal with issues outside their scope of practice.

The collaborating physician does not need to be present with the NPP when the services are furnished or to make an independent evaluation of each resident who is seen by the NPP.

§ 51.340 Physician and other licensed medical practitioner services.

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The State home must provide its residents the primary care necessary to enable them to attain or maintain the highest practicable physical, mental, and psychosocial well-being. When a resident needs care other than the State home is required to provide under this subpart, the State home is responsible to assist the resident to obtain that care. The State home must ensure that a physician personally approves in writing a recommendation that an individual be admitted to a domiciliary.

Each resident must remain at all times under the care of a licensed medical practitioner assigned by the State home. The name of the practitioner will be listed in the resident's medical record.

The State home must ensure that all of the following conditions in paragraphs (a) through (e) of this section are met:

(a) Supervision of medical practitioners. Any licensed medical practitioner who is not a physician may provide medical care to a resident within the practitioner's scope of practice without physician supervision when permitted by State law.

(b) Availability of medical practitioners. If the resident's assigned licensed medical practitioner is unavailable, another licensed medical practitioner must be available to provide care for that resident.

(c) Visits. The primary care physician or other licensed medical practitioner, for each visit required by paragraph (d) of this section, must

(1) Review the resident's total program of care, including medications and treatments;

(2) Write, sign, and date progress notes; and

(3) Sign and date all orders.

(d) Frequency of visits. The primary care physician or other licensed medical practitioner must conduct an in-person medical assessment of the resident at least once a calendar year, or more frequently based on the resident's condition.

(e) Availability of emergency care. The State home must assist residents in obtaining emergency care.

§ 51.150 Physician services.

A physician must personally approve in writing a recommendation that an individual be admitted to a facility. Each resident must remain under the care of a physician.

(a) Physician supervision. The facility management must ensure that—

(1) The medical care of each resident is supervised by a primary care physician;

(2) Each resident's medical record lists the name of the resident's primary physician, and

(3) Another physician supervises the medical care of residents when their primary physician is unavailable.

(b) Physician visits. The physician must—

(1) Review the resident's total program of care, including medications and treatments, at each visit required by paragraph (c) of this section;

(2) Write, sign, and date progress notes at each visit; and

(3) Sign and date all orders.

(c) Frequency of physician visits.

(1) The resident must be seen by the primary physician at least once every 30 days for the first 90 days after admission, and at least once every 60 days thereafter, or more frequently based on the condition of the resident.

Document Phase Document Description Page 14

2500000266 Final 074/BGVC/PHYSICIAN SERVICES/3.17.25 Total Pages: 32 https://www.ecfr.gov/current/title-38/section-51.340#p-51.340(a) https://www.ecfr.gov/current/title-38/section-51.340#p-51.340(e) https://www.ecfr.gov/current/title-38/section-51.340#p-51.340(d) https://www.ecfr.gov/current/title-38/section-51.150#p-51.150(c)

(2) A physician visit is considered timely if it occurs not later than 10 days after the date the visit was required.

(3) Except as provided in paragraphs (c)(4) of this section, all required physician visits must be made by the physician personally.

(4) At the option of the physician, required visits in the facility after the initial visit may alternate between personal visits by the physician and visits by a physician assistant, nurse practitioner, or clinical nurse specialist in accordance with paragraph (e) of this section.

(d) Availability of physicians for emergency care. The facility management must provide or arrange for the provision of physician services 24 hours a day, 7 days per week, in case of an emergency.

(e) Physician delegation of tasks.

(1) Except as specified in paragraph (e)(2) of this section, a primary physician may delegate tasks to:

(i) a certified physician assistant or a certified nurse practitioner, or

(ii) a clinical nurse specialist who—

(A) Is acting within the scope of practice as defined by State law; and

(B) Is under the supervision of the physician.

Note to paragraph (e):

An individual with experience in long term care is preferred.

(2) The primary physician may not delegate a task when the regulations specify that the primary physician must perform it personally, or when the delegation is prohibited under State law or by the facility's own policies.

F841 (Rev. 225; Issued: 08-08-24; Effective: 08-08-24; Implementation: 08-08-24) §483.70(g)

Medical Director

§483.70(g)(1) The facility must designate a physician to serve as medical director. §483.70(g)(2) The medical director is responsible for— (i) Implementation of resident care policies; and (ii)The coordination of medical care in the facility.

DEFINITIONS §483.70(g) “Medical director” means a physician who oversees the medical care and other designated care and services in a health care organization or facility. Under these regulations, the medical director is responsible for coordinating medical care and helping to implement and evaluate resident care policies that reflect current professional standards of practice.

“Physician/practitioner” (physician assistant, nurse practitioner, clinical nurse specialist) means the individual who has responsibility for the medical care of a resident. “Current professional standards of practice” refers to approaches to care, procedures, techniques, treatments, etc., that are based on research and/or expert consensus and that are contained in current manuals, textbooks, or publications, or that are accepted, adopted or promulgated by recognized professional organizations or national accrediting bodies. “Resident care policies” refers to the facility’s overall goals, directives, and governing statements that direct the delivery of care and services to residents consistent with current professional standards of practice.

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2500000266 Final 074/BGVC/PHYSICIAN SERVICES/3.17.25 Total Pages: 32 https://www.ecfr.gov/current/title-38/section-51.150#p-51.150s(c)(4) https://www.ecfr.gov/current/title-38/section-51.150#p-51.150(e) https://www.ecfr.gov/current/title-38/section-51.150#p-51.150(e)(2)

3.00 Evaluation Criteria

BGVC shall conduct a comprehensive, fair, and impartial evaluation of all proposals. BGVC may reject any proposal that is incomplete or in which there are significant inconsistencies or inaccuracies. BGVC reserves the right to reject all proposals.

BGVC has established a Proposal Evaluation Committee to review, evaluate and verify information submitted by the offeror.

Each vendor is responsible for submitting all relevant, factual and correct information with their offer to enable the evaluator(s) to afford each vendor the maximum score based on the available data submitted by the vendor.

BGVC shall evaluate the proposals by assigning scores as indicated.

Technical Proposal Evaluation

Criteria Maximum Points Possible Mandatory Requirement

__ Must provide copy of License to Practice Medicine in the Commonwealth of Kentucky __ Must provide copy of DEA License __ Must submit a copy of current/active liability insurance, __ Must provide verification that you have not been excluded as a Medicare/Medicaid Provider.

Requirements that include the words “Shall”, “Will”, “Must” indicate a mandatory requirement

Mandatory Requirement means a condition set out in the specifications or statement of work that must be met without exception.

PROPOSALS THAT DO NOT MEET

MANDATORY REQUIREMENTS WILL BE

DEEMED NON-RESPONSIVE AND WILL

NOT BE CONSIDERED.

Pass/Fail

Provide response time to BGVC when services are requested.

Submit a resume of professional education and experience of staff who will be providing services to BGVC Veterans.

Provide a report that documents any disciplinary or corrective action taken against you at any time during the last three (3) years by licensing or regulatory authorities. If you have none, please supply a document that states that fact.

Provide one (1) copy of your professional background report from the National Practitioner Data Bank

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Provide documentation as to the number of years with direct service experience in long- term care setting with geriatrics.

Provide a sample copy of a detailed billing invoice that will be used if contract is awarded.

Maximum Points Possible 900

Cost Proposal Evaluation

Criteria Maximum Points Possible Submit the monthly fee for Medical Director Services, which excludes any charges or fees related to billing of visits.

Maximum Points Possible 600

Oral Demonstration/Presentation Evaluation, if required

Oral Demonstration/Presentation

The Commonwealth reserves the right to require Oral Presentations/Demonstrations to verify or expand on the Technical or Cost Proposals. Oral Presentations/Demonstrations may be conducted through videoconferencing or by conference call, if it is in the best interest of the Commonwealth to do so.

This is the opportunity for the vendor to present and demonstrate the solution and to answer questions or to clarify the understanding of the evaluation committee in accordance with the requirements of this RFP. The Commonwealth reserves the right to reject any or all proposals in whole or in part based on the oral presentations/demonstrations.

If required, the top 03 highest ranking vendors may be invited. Scheduling will be at the discretion of the Commonwealth. The Commonwealth reserves the right not to require oral presentations/demonstrations.

Maximum Points Possible 200

Total Proposal Evaluation

Technical Proposal 900

Cost Proposal 600

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Oral Demonstrations/Presentations, if required 200

MAXIMUM POINTS POSSIBLE 1700

4.00 Schedule of RFP Activities

The following schedule presents the major activities associated with the RFP distribution, written questions and proposal submission. The Commonwealth reserves the right at its sole discretion to change the Schedule of Activities, including the associated dates and times.

Release of RFP 3/25/25

Written Questions due by: 3:00PM EST TIME 4/8/25

Anticipated Commonwealth Response to Written Questions 4/15/25

Proposals Due by: 3:00PM EST TIME 4/29/25

All bidders are cautioned to be aware of the security in the Carl M. Brashear Radcliff Veterans Center located at 100 Veterans Drive, Radcliff, Kentucky. All bids shall be time stamped at the Radcliff Veterans Center front desk no later than the due date and time defined in this Solicitation.

In person or courier delivered bids in response to this Solicitation shall be delivered to Jason Gumm, BGVC Administrator. Delays due to building security checks shall not be justification for acceptance of a late bid.

*NOTE: ALL TIME REFERENCES ARE TO THE EASTERN TIME ZONE.

5.00 Offeror’s Conference

Not Applicable

6.00 Point of Contact

The Agency Contact named below shall be the sole point of contact throughout the procurement process. All communications, oral and written (regular mail, express mail or electronic mail), concerning this procurement shall be addressed to:

Tonya Houchens 270-535-5471 Tonya.Houchens@ky.gov

From the issue date of this RFP until a Contractor(s) is selected and the selection is announced, Offerors shall not communicate with any other Commonwealth staff concerning this RFP.

7.00 Questions Regarding this RFP

Questions must be submitted in writing to the Agency Contact. The Commonwealth will respond to salient questions in writing by issuing an Addendum to the Solicitation. The Addendum shall be posted to the Commonwealth’s eProcurement page.

8.00 Proposal Submission

Hard Copy Proposals

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Each qualified offeror shall submit only one (1) proposal. Alternate proposals shall not be allowed. Failure to submit as specified shall result in a non-responsive proposal.

The vendor should complete the "Vendor" box on the face of the solicitation. An authorized representative of the vendor shall sign where indicated on the face of the solicitation.

Acknowledgment of Addenda

It is the vendor's responsibility to check the web site for any modifications to this solicitation.

Vendors are encouraged to acknowledge each addendum by signing and submitting the latest addendum with their response. However, signing the face of the solicitation as indicated above constitutes the vendor’s acknowledgement of and agreement to be bound by the terms of all addenda issued.

Failure to specifically acknowledge addenda will not excuse the vendor from adhering to all changes to the requirements of the solicitation set forth therein nor provide justification for any pricing changes.

All submitted technical and cost proposals shall remain valid for a minimum of six (6) months after the proposal due date.

8.10 Format of Response

Hard Copy Proposals

A. Proposals shall be submitted in three (3) parts: The Technical Proposal, the Cost Proposal, and if applicable the Proprietary Information.

1. The Technical Proposal should include one (1) marked original hard/paper copy technical and number marked technical thumb/flash drives (in Microsoft Word, Microsoft Excel, or PDF format ONLY). Do not include embedded documents, hyperlinks, or hyperlinks to videos.

2. The Cost Proposal should include one (1) marked original hard/paper copy cost and number marked cost thumb/flash drives (in Microsoft Word, Microsoft Excel, or PDF format ONLY). Do not include embedded documents, hyperlinks, or hyperlinks to videos.

3. Any Proprietary Information should include one (1) marked original hard/paper copy proprietary and number marked proprietary data thumb/flash drives (in Microsoft Word, Microsoft Excel, or PDF format ONLY). Do not include embedded documents, hyperlinks, or hyperlinks to videos.

Proposal shall be submitted by mail or hand-delivered in-person or courier-delivered to the following address:

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Attn: Jason Gumm, BGVC Administrator, Carl M. Brashear Radcliff Veterans Center, 100 Veterans Drive, Radcliff, Kentucky 40160.

Physician Services

RFP 074 2500000266

TECHNICAL PROPOSAL

Name of Offeror

The outside cover of the package containing the cost proposal shall be marked:

RFP 074 2500000266

COST PROPOSAL

If applicable, the outside cover of the package containing the proprietary shall be marked:

RFP 074 2500000266

PROPRIETARY PROPOSAL

All proposals must be received no later than 3:00PM EST on 4/29/2025.

Pricing shall only be provided in the Cost Proposal. DO NOT SUBMIT ANY PRICING

INFORMATION IN THE TECHNICAL PROPOSAL.

All submitted Technical and Cost Proposals shall remain valid for a minimum of six (6) months after the proposal due date.

8.20 Format of Technical Proposal

The Technical Proposal must be arranged and labeled in the manner set forth below.

Transmittal Letter – a Transmittal letter shall be submitted on Offeror’s letterhead and signed by an agent authorized to bind the Offeror. The Transmittal letter shall include the following:

a. A statement that deviations are included, if applicable.

b. A statement that proprietary information is included, if applicable.

c. A statement that, if awarded a contract as a result of this Solicitation, the Offeror shall comply in full with all the requirements of the Kentucky Civil Rights Act, and shall submit all data required by KRS 45.560 to 45.640.

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d. A sworn statement that, pursuant to KRS 11A.040, that Offeror has not knowingly violated any provisions of the Executive Branch Code of Ethics.

e. A statement certifying that the price in this proposal was arrived at independently without collusion, consultation, communication, or agreement as to any matter relating to such prices with any other Offeror or with any competitor.

f. A statement affirming that the Offeror is properly authorized under the laws of the Commonwealth of Kentucky to conduct business in this state and will remain in good standing with the Office of the Kentucky Secretary of State for the duration of any awarded contract resulting from this Solicitation.

g. The name, address, telephone number and email address and website address, if available, of the contract person to serve as a point of contact for day-to-day operations.

h. Subcontractor information to include the name of the company, address, telephone number and contact name, if applicable.

i. Foreign entity’s organization number issued by the Secretary of State in a certificate of authority or a statement of foreign qualification, if applicable.

Completed and Signed Solicitation and Addenda – An authorized representative MUST complete and sign the Solicitation form and include the following:

a. “Vendor” box and “Payment” box should be completed.

b. Vendor shall indicate ownership type.

c. Vendor shall provide “FEIN” if applicable.

d. Vendor shall provide date the form is completed and signed.

e. Signed face of the most recent Addenda, if applicable.

Signed and Notarized Required Affidavit for Bidders or Offerors - available at the following link:

https://finance.ky.gov/office-of-the-secretary/Pages/finance-forms.aspx.

Signed and Notarized Required Affidavit for Bidders, Offerors and Contractors Claiming Resident Bidder Status – if applicable. Available at the following link:

https://finance.ky.gov/office-of-the-secretary/Pages/finance-forms.aspx.

*Offerors not claiming Resident Bidder Status need not submit this affidavit.

Signed and Notarized Required Affidavit for Bidders, Offerors and Contractors Claiming Qualified Bidder Status – if applicable. Available at the following link:

https://finance.ky.gov/office-of-the-secretary/Pages/finance-forms.aspx.

*Offerors not claiming Qualified Bidder Status need not submit this affidavit.

Response to the Technical Portion of the RFP – Please provide a detailed response to the technical requirements outlined in the Evaluation Criteria. No cost information shall be provided in the technical portion.

8.30 Format of Cost Proposal

The Cost Proposal must be submitted under separate cover from the Technical Proposal and must be arranged and labeled in the manner specified. The proposal with the lowest price receives the maximum score. The remaining proposals with the next lowest price receives points by dividing the lowest price by the next lowest price and multiplying that percentage by the available points.

8.40 Certification Regarding Debarment and Suspension

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2500000266 Final 074/BGVC/PHYSICIAN SERVICES/3.17.25 Total Pages: 32 https://finance.ky.gov/office-of-the-secretary/Pages/finance-forms.aspx https://finance.ky.gov/office-of-the-secretary/Pages/finance-forms.aspx https://finance.ky.gov/office-of-the-secretary/Pages/finance-forms.aspx

In accordance with Federal Acquisition Regulation 52.209-5, the Offeror shall certify, by signing the Solicitation, that to the best of its knowledge and belief, the Offeror and/or its Principals is (are) not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any state or federal agency.

For the purposes of this certification, “Principals”, means officers, directors, owners, partners, and persons having primary management or supervisory responsibilities within a business entity (e.g., general manager, plant manager, head of subsidiary, division, or business segment, and similar positions.

9.00 Rules of Procurement

To facilitate this procurement, various rules have been established. These are described in the following paragraphs.

Offerors should review and comply with the General Conditions and Instructions for Solicitation/ Contract listed under “Response to Solicitation” located on the eProcurement web page at https://finance.ky.gov/eProcurement/Pages/doing-business-with-the-commonwealth.aspx The procurement process will provide for the evaluation of proposals and selection of the winning proposal in accordance with state law and regulations. KRS Chapter 45A of the Kentucky Model Procurement Code provides the regulatory framework for the procurement of services by state agencies.

9.10 Technical Proposal Evaluation

BGVC will evaluate the proposal based on the technical portion of the Evaluation Criteria. Each Offeror is responsible for submitting all relevant, factual and correct information with their offer to enable the evaluator(s) to afford each vendor the maximum score based on the available data submitted by the Offeror. Past Offeror Performance may be considered in the award of this Contract. Offerors with a record of poor performance in the last twelve (12) months may be found non-responsible and ineligible for award.

9.20 Cost Proposal Evaluation

BGVC will evaluate the proposal based on the cost portion of the Evaluation Criteria.

9.30 Right to Reject/Waiver of Minor Irregularities

The Commonwealth reserves the right at its discretion to reject any and all offers. The Commonwealth also reserves the right at its discretion to waive informalities and minor irregularities in…