VA257-17-R-0092-00004000.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE

OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

BY

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) none 00004 01-08-2018 /A 36C257 Department of Veterans Affairs SAO West / NCO 17 Medical Sharing Branch II 11495 Turner Rd.

El Paso

TX

79936

To all Offerors/Bidders

VA257-17-R-0092

05-05-2017

X X X See CONTINUATION Page X The purpose of this amendment is to: (1) Add Central Texas VA Health Care System (CTX); (2) Revise the Performance Work Statement (PWS) to include respite care and escort services; (3) Revise listing of counties be solicited for; and (4) Refresh existing solicitation provisions and clauses to their latest version.

Frank Gamboa III

CONTINUATION PAGE

(1) Add Central Texas VA Health Care System (CTX). See attached CTX PWS and CTX Price/Cost Schedule.

(2) Add CLIN 006 INPATIENT RESPITE SERVICES at the rate of $150.00 per day and Add CLIN 007 ESCORT SERVICES at the rate of $12.00 per hour. *Does not apply to CTX.*

The following paragraph is hereby added to PERFORMANCE WORK STATEMENT; B. Requirements; 1. General.

INPATIENT RESPITE SERVICES: The Contractor shall provide all necessary personnel, nursing care, room and board associated with the full range of nursing home services in performing the requirements of this contract. Contractor's facility shall be geographically located within the STHVCS region to service veterans residing in those areas. A patient admitted for respite care services is subject to the applicable standards of care for that care setting. For those facilities with different types of care such as assisted living it should be understood that patients receiving respite care are placed under the VA Contract Nursing Home Contract and should therefore be placed in the nursing home section of the facility.

ESCORT SERVICES: The nursing facility will insure patients who are considered high risk for wandering or elopement are accompanied by a responsible individual during absences from the facility for VA authorized appointments. Facilities are encouraged to use family, friends, sponsors, civic groups or charitable organizations as resources for escort services. If escort services cannot be obtained from these sources, the facility must provide or purchase the appropriate escort services for VA patients being transported to VA authorized appointments. The VA may be billed at the rate established by the corresponding CLIN for instances requiring the facility to provide or purchase the service.

(3) Updated Counties being solicited:

Central TX (CTX) VA counties and anticipated number of awards:

McLennan 1 Bell 1

North TX (NTX) VA counties and anticipated number of awards:

Dallas 1 Denton 1 Ellis 1 Hopkins 1 Johnson 1 Parker 1 Smith 1 Tarrant 1 Wise 1 Young 1

South TX (STX) VA counties and anticipated number of awards:

Bexar 3 Comal 1 Gillespie 2 Guadalupe 1 Karnes 1 Kendall 1 Medina 1 Uvalde 1

Texas Valley Costal Bend (VCB) VA counties and anticipated number of awards:

Aransas 1 Cameron 7 Hidalgo 6 Jim Hogg 1 Jim Wells 1 Maverick 1 Nueces 4 Webb 1

(4) Refresh solicitation clause/provision below:

52.212-5 (NOV 2017)

52.212-3 (NOV 2017)

See attached document: CTX PWS.

See attached document: CTX Fee Schedule.

End of Document