NAC Turnkey Rubric - MAR 2025.pdf

Rubric for HTME Turnkey Review Published: 3 March 2025

Purpose: this document delineates allowable and disallowed work items in turnkey installation projects of high-tech medical equipment (HTME). All HTME turnkey statements of work (SOWs) are assessed against this document to determine segregable and non-segregable work. The SOW evaluation is led by the Equipment

Lifecycle Management office (ELCM) in collaboration with other pertinent subject matter experts. Results of the evaluation are provided to the assigned NAC contracting officer.

The language contained within this document was formulated within the confines of the VA/DLA HTME contracts awarded against Solicitation No. SPE2D1-15-R-0001, section XIV. EXTENDED AND TURNKEY

INSTALLATION REQUIREMENTS.

Definitions:

- Non-segregable: The construction work is so merged with the non-construction work or so fragmented in terms of the locations or time spans in which it is to be performed, that it is not capable of being segregated as a separate contractual requirement. [FAR 22.402(b)(2)(ii)]

- Segregable: Such construction work is physically and functionally separate from and, as a practical matter, is capable of being performed on a segregated basis from the other work required by the contract. [FAR 22.402(b)(1)(iii)]

- Equipment suite1 – existing room(s) wherein the new system will be installed; the entirety of the suite may include the following:

1. Exam room: room where the primary imaging machine is located

2. Control room: room where computer workstations or other control stations are located

3. Equipment room: room where ancillary components and sub-systems are installed

4. MRI Zone 3 ante room

5. Linear Accelerator: treatment vault space and designated area where control equipment is located

**Spaces surrounding the equipment suite are excluded from the suite unless specifically listed above. The following spaces are not part of the suite: patient uptake rooms, restrooms, changing rooms, waiting rooms, offices, corridors, closets, etc.**

- Sub-rooms – smaller partitioned rooms within the equipment suite dedicated to different uses (e.g., exam room, equipment room, control room, anteroom)

- Interior walls – half walls, pony walls, glass partitioned walls, full walls, etc. within the equipment suite that divide the suite into sub-rooms

- Exterior walls – existing walls that constitute the boundary edge of the equipment suite

The following criteria render the SOW as SEGREGABLE:

- Repurposing facility space, such as:

o Moving exterior walls of the equipment suite o Converting nearby spaces to become part of the equipment suite

- Installing a different imaging modality than what is currently in the space.

- The equipment suite is part of a larger renovation project

1 To ensure the SOW evaluation is thorough and accurate, all turnkey modification requests submitted to the NAC must include both of the following: 1. updated as-built drawings of the equipment suite footprint, and 2. proposed future state schematic drawings of the equipment suite footprint

- Building out new space that previously did not exist

- Installing a new mobile/modular suite

If a room does not meet current VA design guide specifications, all work to bring the room up to standard must align with the rubric

SOW Divisions:

ALL DIVISIONS (SPED1-15-R-0001, XIV.a; XIV.c.3.i; XIV.c.4.ii)

NON-SEGREGABLE ITEMS:

• Plans, work plans, work statements, specifications, and/or drawings associated with non-segregable line-items in the SOW2,3

• Project management and on-site supervision services

• Mitigation measures required based on a local infection control risk assessment (ICRA)

• Necessary interim life safety measures (ILSM) to ensure safety/security of patients, staff, visitors, contractors, and the facility during the project

• Pre-assessments/testing of the equipment suite infrastructure to validate specifications of the existing space

• Post-assessments/testing of the equipment suite infrastructure to ensure the new space meets safety standards and design requirements

DIVISION 2: Existing Conditions (SPED1-15-R-0001, XIV.c.3.i; XIV.c.3.iii)

NON-SEGREGABLE ITEMS:

• Temporary removal and reinstallation of building infrastructure to accommodate the de-installation and removal of existing equipment as well as the delivery, rigging, and installation of the new equipment, including but not limited to: walls (interior or exterior walls), shielding, roof, doors, utility systems, etc.

• Removal of existing flooring, adhesive and base material in the equipment suite

• Removal of existing ceiling in the equipment suite and/or in adjacent areas when necessary to access utilities, interstitial spaces, support beams/columns, etc.

• Removal of existing sink in the equipment suite

• Removal of the existing fire sprinkler system in the equipment suite

• Removal of the existing medical gas system in the equipment suite

• Removal of/cover any fire alarm items including smoke detector(s) in the equipment suite

• Removal of any electrical power feeders, circuits, conductors, electrical outlets, etc. as required for the equipment installation

• Removal of existing light fixtures and switches in the equipment suite

• De-installation of existing patient lift system in the equipment suite

• Moving interior walls to increase or decrease the size of sub-rooms

2 Due to the contract type (“Commercial Items”) utilized to purchase and install HTME in a fully operational state, FAR PART 36 (Construction and Architect-Engineer Contracts) clauses are not incorporated. Such professional A/E services may be utilized by the prime vendor; however, the prime’s price proposal shall not include any fees or charges for A/E services.

3 Work plans/drawings bearing the stamp of licensed professional engineers are non-segregable; VA facilities should ensure all vendors adhere to established VA policies regarding project planning and execution

• Crane and rigging rental for de-installation and delivery of equipment, to include supplies and accessories to move equipment to and from the final location

• Repair of damaged/removed infrastructure (extreme scenarios will be evaluated on a case-by-case basis)

• Testing/scanning of existing concrete to locate rebar and assess structural integrity

• Linear accelerator treatment vault door replacement/modification

• Minor reconfiguration of interior walls (see segregable section regarding complete relocation of sub-rooms)

• Asbestos sampling/testing

SEGREGABLE ITEMS:

• Changing the existing modality to a different modality

• Moving exterior walls that changes the overall footprint of the equipment suite (e.g. Cath Lab suite was 15’ x 20’ and is being expanded to 18’x 20’)

• Removal of flooring outside of the equipment suite

• Complete relocation of sub-rooms within the equipment suite

• Asbestos abatement

DIVISION 3: Concrete (SPED1-15-R-0001, XIV.b.2)

• For floor mounted equipment: core drilling and filling voids around new duct, conduit, etc. to match existing concrete material

• Furnish and install concrete to patch floor depressions and opening where the prior equipment was removed

• Furnish and install a self-leveling underlayment in the equipment room below the equipment to meet preinstallation specifications

• Installation of special foundations, pads on slab-on-grade, or pits directly required for the equipment installation

• Installation of false floors and platforms required for proper installation and operation of the equipment

• Floor leveling work if required for equipment installation

SEGREGABLE ITEMS:

• If existing room requires additional concrete poured or patched outside of the direct equipment installation needs

DIVISION 4: Masonry (SPED1-15-R-0001, XIV.b.2; XIV.c.3.iii)

• Reinstall any masonry that had to be removed due to equipment deinstallation or the delivery of the new equipment

• Furnish and install masonry patches for any new vents or other items associated directly to the equipment that would affect the exterior brick veneer

SEGREGABLE ITEMS:

• Any masonry work not tied directly to equipment deinstallation or installation

DIVISION 5: Metals (SPED1-15-R-0001, XIV.b.2)

• Furnish and install structural members to attach to existing steel beams/columns below the equipment to support the new equipment load

• Furnish and install a roof top structural steel support (specifically for an MRI chiller install)

• Furnish and install structural steel support in the ceiling and/or walls to support the new HTME

• Furnish and install structural steel support in the ceiling and/or walls to support components or ancillary devices/systems that are integral to the full functionality of the pending NAC HTME award

• Furnish and install structural steel support in the ceiling and/or walls necessary to relocate existing devices/systems due to room configuration changes

• Seismic anchoring/bracing

SEGREGABLE ITEMS:

• Structural modifications to accommodate a different modality than what was previously in the space

• Structural modifications to accommodate components or ancillary devices/systems purchased separate from the pending NAC HTME award and are not integral to the full functionality of the

HTME

DIVISION 6: Wood, Plastics, and Composites (SPED1-15-R-0001, XIV.b.2)

• Furnish and install casework/cabinetry necessary to house ancillary/peripheral equipment and supplies to optimize clinical functionality of the room

• Furnish and install replacement casework/cabinetry to ensure the room promotes an optimal patient experience

• Furnish and install countertops

• Addition of “smart”/RTLS/RFID/Pharmacy/POU cabinets, etc.

DIVISION 7: Thermal and Moisture Protection (SPED1-15-R-0001, XIV.c.6)

• Furnish and install caulking and fire rated sealant compound at penetrations

• Furnish and install caulking at countertops, back splashes, cabinets, and new and reinstalled door frames

• Furnish and install waterproofing of all penetrations

• Patch any roof penetrations created during deinstallation of old equipment or installation of new equipment

• Additional thermal and moisture protection not tied directly to equipment deinstallation or installation

DIVISION 8: Openings (SPED1-15-R-0001, XIV.b.2; XIV.c.3.iii)

• Reinstall door(s), door frame(s) and hardware that were removed as part of the project

• Furnish and install replacement doors

SEGREGABLE ITEMS:

• Furnish and install new door(s) where there previously was not a door AND is not related to any equipment or patient/employee ingress/egress requirements

DIVISION 9: Finishes (SPED1-15-R-0001, XIV.b.2; XIV.c.3.iii)

• Furnish and install interior walls within the equipment suite

• Furnish and install metal studs on each side of new door frames

• Furnish and Install flooring for the equipment suite

• Furnish and install new ceiling within the equipment suite due to ceiling work and in instances where the ceiling height has changed.

• Furnish and install new cove base where new walls are installed or where flooring replacement occurs

• Repair, furnish, and/or install ceiling grid and panels in areas outside the equipment suite that were removed during the project

• Repair, patch, prime and/or paint areas to restore the aesthetics of the room impacted by the installation work, with the intent to maintain an optimal patient care experience.

• Stain/varnish new door(s)

• Furnish and install viewing windows

• Furnish and install walls outside the equipment suite

DIVISION 10: Specialties (SPED1-15-R-0001, XIV.b.2; XIV.c.3.iii, XIV.c.4.iii)

• Patch and repair any damage done during work even if outside the immediate equipment suite

(including but not limited to floors, ceilings, and walls)

• Installation and relocation of prefabricated interior screens, partitions, modular furniture, and dividers that are moveable/detachable

• Reinstallation and certification of the patient lift(s) when equipment layout changes require relocation of the lift system

• Installation of components or ancillary devices/systems that are included on the pending NAC HTME award

SEGREGABLE ITEMS:

• Any work needed for equipment purchased in a NEW space or hospital build

• Additional rooms not required for the operation of the equipment – i.e., bathroom, dressing room, etc.

• Installation of components or ancillary devices/systems purchased through any method other than the pending NAC HTME award

DIVISION 11: Equipment

DIVISION 12: Furnishings

DIVISION 13: Special Construction (SPED1-15-R-0001, XIV.c.5)

• Furnish and install the required radiation/RF shielding for the safe operation of the equipment to meet physicist requirements and preinstallation specifications (within existing floor layout); this may come in the form of all new panels or just some patching around new wall penetrations.

• Testing of the radiation/RF shielding in the room after completion of the shielding installation and equipment delivery/installation.

• Furnish and install radiation/RF shielding for NEW walls/partitions (new build out).

DIVISION 21: Fire Suppression (SPED1-15-R-0001, XIV.c.4.iii; XIV.c.6)

• Reinstall sprinkler heads that were removed as part of the project

• Relocate sprinkler heads when required for equipment layout changes

• Replacement of specialty fire extinguishing systems specific to protecting the equipment (i.e. MRI)

• Sprinkler system recertification if the system was modified

• Fire alarm recertification if the system was modified

• Addition of sprinkler heads in areas outside the equipment suite

DIVISION 22: Plumbing (SPED1-15-R-0001, XIV.b.2; XIV.c.3.v; and XIV.c.4.iii)

• Reinstall plumbing fixtures (sinks, faucets, med gas outlets, etc.) that were removed as part of the project

• Furnish replacement plumbing fixtures to modernize the space for an optimal patient care experience

• Install replacement plumbing fixtures either in the same location or in a different location within the equipment suite when required for equipment layout changes

• Install new plumbing lines (water supply lines, drains, med gas lines, etc.) when relocation of fixtures is required for equipment layout changes

• Recertification of the medical gas system

• Furnish and install a condensate drain for new air conditioning units included in the equipment contract

• Addition of new plumbing lines and fixtures that do not exist in the current space

DIVISION 23: Heating, Ventilating, and Air Conditioning (SPED1-15-R-0001, XIV.b.2; XIV.c.3.v; XIV.c.4.iii)

• Reinstall supply and return diffusers and grills that were removed as part of the project

• Furnish replacement diffusers and grills to modernize the space for an optimal patient care experience

• Install replacement diffusers and grills either in the same location or in a different location within the equipment suite when required for equipment layout changes

• Reroute HVAC ducts when relocation of diffusers and/or grills is required for equipment layout changes

• Furnish and install additional diffusers and grills when required for equipment layout changes or to provide an optimal patient care experience

• Furnish and install replacement HVAC components directly tied to the equipment (i.e., MRI chiller, fan coil unit, additional AC capacity to account for additional heat load of the new equipment, etc.)

• Furnish and install an enclosure for an air handler unit installed exterior to the building

• Install mechanical ventilation and separate exhaust systems

• Furnish and install associated piping, insulations, filters, cryogen vent and all other accessories for a replacement MRI water chiller

• Final air balancing and testing

SEGREGABLE ITEMS:

• Furnish and install a new or replacement HVAC system servicing an area other than the equipment suite

• Construct a new enclosure space for an air handler installed exterior to the building

DIVISION 26: Electrical (SPED1-15-R-0001, XIV.b.2; XIV.c.3.v; and XIV.c.4.iii)

• Furnish and install a normal feeder and/or emergency feeder to connect equipment to the facility electrical infrastructure

• Furnish and install replacement subpanels dedicated specifically for the equipment suite

• Furnish and install new breaker(s) and/or circuit(s) to support new equipment

• Reconnect any disconnected electrical conductors and circuits

• Furnish and install new electrical feeder(s), breaker(s), and/or circuit(s) necessary for new HVAC requirements/components of the new equipment

• Reinstall electrical fixtures (lights, outlets, switches, etc.) that were removed as part of the project

• Furnish and install replacement electrical fixtures to modernize the space for an optimal patient care experience

• Install replacement electrical fixtures either in the same location or in a different location within the equipment suite when required for equipment layout changes

• Install new electrical runs (including necessary raceways, conduits, trays, etc.) when relocation of fixtures is required for equipment layout changes

• Electrical rough-in4 work for components or ancillary devices/systems that are integral to the full functionality of the pending NAC HTME award

SEGREGABLE ITEMS:

• Furnish and install new electrical feeder to increase facility electrical power

• Furnish and install new electrical feeder for equipment purchased external to the HTME contract

• Electrical distribution equipment including distribution panels, panelboards, switchboards, switch gears, transformers, motor control centers, etc.

DIVISION 27: Communications (SPED1-15-R-0001, XIV.b.2; XIV.c.3.v; and XIV.c.4.iii)

• Reinstall network drops that were removed as part of the project

• Furnish replacement network drops to modernize the space for an optimal patient care experience

• Install replacement network drops either in the same location or in a different location within the equipment suite when required for equipment layout changes

• Run new conduit and data lines when relocation of network drops is required for equipment layout changes

• Furnish and install additional network drops only when required to meet the specifications of the new equipment

• Re-installation of nurse call components that were removed as part of the project

• Installation of a new nurse call system.

4 Electrical rough-in work includes installing conduit/cable raceways/trays, pulling wire, mounting junction boxes, and grounding. The wire is not connected to any switches, outlets, or devices.