A.09.03_W81K04-18-R-0024-0002.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

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 (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

The purpose of this amendment is as follow s:

A. Updated Performance Work Statement (changes are indicated in red text);

B. Updated Exhibit B, Deliverables, (changes are indicated in red text);

C. Updated Exhibit E, Government Furnished Facilities & Equipment List, (changes are indicated in red text);

D. Updated Exhibit G, Snow and Ice Removal Areas and Priorities, (changes are indicated in red text);

E. Replaced Exhibit K, CBA, w ith Updated Exhibit K, CBA Revision 1, dated 28 August 2018;

F. Updated Attachment 1, Medical Treatment Facility Description and Workload Data, (changes are indicated in red text);

G. Extended proposal due date from 12:00 PM 14 September 2018 to 12:00 PM 28 September 2018;

H. All other terms and conditions remain unchanged.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 61

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 04-Sep-2018

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X W81K0418R0024

X 9B. DATED (SEE ITEM 11)

31-Jul-2018

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer X is extended, is not extended.

Offer 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:

(a) By completing Items 8 and 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram 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 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 telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

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

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

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.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

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

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

04-Sep-2018

CODE

W40M USA HLTH CONTRACTING ACT

CTR FOR HEALTH CARE CONTR

2199 STORAGE ST BLDG 4197 STE 68

JBSA FT SAM HOUSTON TX 78234-5074

W81K04 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W81K0418R0024

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SOLICITATION/CONTRACT FORM

The required response date/time has changed from 14-Sep-2018 12:00 PM to 28-Sep-2018 12:00 PM.

The following have been modified:

ATTACHMENT 1

Medical Treatment Facility Description and Workload Data.

1. General. Blanchfield Army Community Hospital (BACH) is part of the Atlantic Region Medical Command of the US Army Medical Command. This performance work statement (PWS) is for healthcare housekeeping and related services at Blanchfield Army Community Hospital (BACH), Fort Campbell, KY and multiple Medical Treatment Facilities (MTFs) in the health service area (HSA) of BACH. As a performance based contract, the requirements are stated in terms of desired results with associated quality standards. Healthcare housekeeping services shall be performed in a manner that will maintain a satisfactory facility condition and present a clean, neat, and professional appearance.

1.1. Blanchfield Army Community Hospital (BACH) began operation as the United States Army Hospital, Fort Campbell, Kentucky, on August 19, 1942 with an operating capacity of 2,100 beds. Housed in a wood frame structure using a World War II cantonment design, the hospital consisted of 53 two-story brick veneered buildings extending over 73 acres of land. The complex included more than 7 miles of ramps and corridors.

1.2. On September 17, 1982, commensurate with the dedication ceremony for a new facility, the hospital was redesigned as the Colonel Florence A. Blanchfield Army Community Hospital. This hospital is unique in the United States Army Medical Department in that it is the only hospital named after an Army Nurse Corps officer.

1.3. Blanchfield Army Community Hospital, "Pulse of the Eagle,” is one of the largest and best equipped hospitals in this area. BACH has 50 operational beds and spans 675,993 square feet. A caring staff of more than 2,000 personnel provides the highest quality of care. Blanchfield Army Community Hospital's first priority is to provide health service to support the more than 23,000 soldiers at Fort Campbell. The hospital overseas the management of health cares for 82,000 beneficiaries.

2. BACH is a multi-disciplined organization with eleven clinics that provide full service primary care including adult medicine, pediatrics, well-baby/child exams, immunizations, and prenatal care. Exhibit C provides a complete listing of facilities supported by this contract. Outlying buildings include:

Pharmacy Town Center located at building 98A at the intersection of Indiana Ave and 20th Street. This facility was constructed in 1950. It is staffed by both military and civilian medical professionals providing primary pharmacy service for Fort Campbell active duty military, retirees and dependents.

NICOE located at building 2403 at the intersection of Air Assault and Indiana Ave. This facility was constructed in 2014. It is staffed by both military and civilian professionals providing services for the Wounded Warriors program in assisting active duty military in returning back to full duty.

IMSA Warehouse building 2434 located at the intersection of 20th Street and Indiana Avenue. This facility was constructed in 2005. It is staffed by military and civilians. Medical and non-medical supplies are stored at the facility.

Automated Neurological Assessment (ANAM) building 2435 is located at the intersection of 21st Street and Indiana Ave. It is staffed by civilians that provide service to active duty military.

Child and Family Behavioral Service (CAFABS) located in building 2436 near the intersection of 21st Street and Indiana Ave. This building was constructed in 2014. It is staffed by civilians and provides services for active duty military children.

Child and Adolescent Psychiatry (CAPS) located in building 2437 near the intersection of 21st Street and Indiana Ave. This facility was constructed in 2014. It is staffed by civilians and provides services for active duty military children.

Education and Developmental Intervention Services (EDIS) located in building 2439 at the intersection of 21st Street and Indiana Ave. This facility was constructed in 1994. It is staffed by military and civilians and provides service for BACH employees.

DENTAC HQ located in building 2441at intersection of 21st Street and Indiana. This facility was constructed in 1994. It is staffed by both military and civilian that provide administration support to the dental units.

Warrior Care Clinic Medical Company/Third Party Building located in building 2516 located at the intersection of 21st Street and Indiana Ave. This facility was constructed in 2008. It is staffed by military and civilian professionals that provide service for active duty military.

Family Advocacy located in building 2523 located at the intersection of 22nd Street and Indiana Avenue. This facility was constructed in 2006. It is staff by civilians that provide service to active duty military.

Traumatic Brain Injury located in building 2524 located at the intersection of 22nd Street and Indiana Avenue. This facility was constructed in 2008. It is staffed by military and civilian medical professionals that provide service to active duty military.

PAO located in building 2525 at the intersection of 22nd Street and Indiana Avenue. This facility was constructed in 1975. It is staffed by civilian professionals that provide Public Affairs service for all of BACH.

ANAM located in building 2540 located at the intersection of 22nd Street and Indiana Avenue. This facility was constructed in 2008. It is staffed by military and civilian medical professionals that provide service to active duty military.

Chiropractic Clinic located in building 2543 located at the intersection of 23rd Street and Indiana Avenue. This facility was constructed in 2008. It is staffed by military and civilian medical professionals that provide service to active duty military.

Social Work located in building 2544 located at the intersection of 22nd Street and Indiana Avenue. This facility was constructed in 2006. It is staffed by civilian medical professionals that provide service to active duty military.

Facilities/Logistics/EMS located in building 2575 located at the intersection of Screaming Eagle and Indiana Avenue. This facility was constructed in 1953. It is staffed by military and civilian that provides logistic service to

BACH.

Occupational/Public Health located in building 2576 located at the intersection of 23rd Street and Indiana Avenue.

This facility was constructed in 2010. It is staffed by military and civilian medical professionals that provide service to BACH employees.

Embedded Behavioral Health (EBH) located in building 3929 located at the intersection of 49th Street and Indiana Avenue. This facility was constructed in 2013. It is staffed by military and civilian medical professionals that provide service to active duty military.

Patient Administration located in building 3960 located at the intersection of 59th Street and Indiana Avenue. This facility was constructed in 2013. It is staffed by military and civilian that provides administration service to BACH employees.

Animal Health Clinic located in building 5289 located at the intersection of 55th Street and Indiana Avenue. This facility was constructed in 1995. It is staffed by military and civilian medical professionals that provide service to active duty military and retirees.

Animal Quarantine located in building 5290 located at the intersection of 8th Street and Desert Storm. This facility was constructed in 1981. It is staffed by military and civilian medical professionals that provide service to active duty military and retirees.

Taylor Dental Clinic located in building 5580 located at the intersection of 8th Street and Desert Storm. This facility was constructed in 1977. It is staffed by military and civilian medical professionals that provide dental service to active duty military.

Carentan Clinic located in building 5977 located at near the intersection of 8th Street and Desert Storm. This facility was constructed in 2006. It is staffed by military and civilian medical professionals staff that provide service to active duty military.

LaPointe Health Clinic located in building 5979 located at near the intersection of 18th Street and Desert Storm.

This facility was constructed in 2000. It is staffed by military and civilian medical professionals that provide service to active duty military.

Integrated Disability Evaluation System (IDES) located in building 5980 located at near the intersection of 1835th Street and Desert Storm. This facility was constructed in 1963. It is staffed by military and civilian medical professionals that provide service to active duty military.

Medical Management Center (MMC) located in building 6139 located at the intersection of 35th Street and Desert Storm. This facility was constructed in 1958. It is staffed by civilian medical professionals that provide service to active duty military.

Environmental Science/Industrial Hygiene located in building 6903 located at near the intersection of 1835th Street and Desert Storm. This facility was constructed in 1958. It is staffed by military and civilian professionals that provide service to BACH and Fort Campbell employees.

Embedded Behavioral Health (EBH) located in building 6988 located at near the intersection of 1835th Street and Desert Storm. This facility was constructed in 2013. It is staffed by military and civilian medical professionals that provide service to active duty military.

Aviation Health Clinic located in building 7149 located at the intersection of G Avenue and 4th Street. This facility was constructed in 1974. It is staffed by military and civilian medical professionals that provide service to active duty military.

Byrd/Adkins Clinic located in building 7973 located on Thunder Blvd. This facility was constructed in 2011. It is staffed by military and civilian medical professionals that provide service to active duty military and retires.

Embedded Behavioral Health (EBH) located in building 70344 located on Toccoa Road. This facility was constructed in 2013. It is staffed by military and civilian medical professionals that provide service to active duty military.

Epperly Dental Clinic located in building T9182 located at the intersection of 22nd Street and Indiana Avenue. This facility was constructed in 1979. It is staffed by military and civilian medical professionals that provide service to active duty military.

Sterile Processing Department (SPD) is temporarily located in building T9169 co-located on Joel drive with the main hospital building 650. This building is used to process all sterile kits and instruments while the permanent area within the main hospital is renovated.

2. BACH MTFs normal operating hours:

OR, Birthing Unit, ER, Patient Wards, 24 hours, 7 days a week ICU, Inpatient Pharmacy, Laboratory, Radiology

LaPointe Medical Clinic 6:00 am – 4:30 pm, Monday-Friday

Byrd/Adkins Clinic 6:00 am – 4:30 pm, Monday-Friday Aviation Health Clinic 6:30 am – 3:30 pm, Monday-Thursday 6:30 am – 2:30 pm, Friday

BACH Outpatient Clinics 7:30 am – 4:30 pm, Monday-Friday Family Medicine 7:30 am – 5:00 pm, Monday-Friday Family Medicine Acute Care 4:30 pm – 12:00 pm, Monday-Friday

Veterinary Clinic 8:00 am – 4:00 pm, Monday-Friday Animal Stray Impound 9:00 am – 3:00 pm, Monday-Friday

3. BACH Healthcare System Staff: BACH and outlying buildings are staffed with military, civilian, contractor and volunteer employees. Approximate total number of employees is 6,007. Staff is assigned as follows:

Activity/Building Employees Location BACH Main Hospital(including SPD) 1332 Fort Campbell

BACH Command Section 14 Fort Campbell

Kuhn Dental Clinic 46 Fort Campbell

Taylor Dental Clinic 56 Fort Campbell

Epperly Dental Clinic 65 Fort Campbell

Adkins Dental Clinic 47 Fort Campbell Medical Management Center 40 Fort Campbell Integrated Disability Evaluation System 10 Fort Campbell Aviation Health 61 Fort Campbell EBH Bldg. 3929 14 Fort Campbell EBH Bldg. 70344 17 Fort Campbell EBH Bldg. 6988 15 Fort Campbell Occupational Health/Public Health Nursing 14 Fort Campbell Marketing/Public Affairs 14 Fort Campbell Education and Staff Development 13 Fort Campbell EDIS 11 Fort Campbell Chiropractic Clinic 11 Fort Campbell LaPointe Health Clinic 108 Fort Campbell Byrd Clinic 87 Fort Campbell Ambulance Section 28 Fort Campbell Veterinary Center 30 Fort Campbell Stray Animal Impound 4 Fort Campbell Logistics 5 Fort Campbell Facilities 30 Fort Campbell IMSA 20 Fort Campbell

4. Healthcare Statistics

FY2014

FY2015

FY2016

FY2017

BACH Clinic Weekday 2,681 2,743 2,693 2,717 X-Rays, CT Scans and MRI’s 72,448 96,034 154,710 139,240 Prescriptions Filled 741,294 952,593 871,404 869,110 Dental Clinic Visits 89,868 98,313 103,807 96,216 Veterinary Health Clinic 5,306 6,512 5671 6,084

Preventive Medicine/Occupational Health Clinics 9,038 4,526 4044 5,158

Annual In-patient Days 11,378 10,620 10,513 9,289 Annual Discharges 5,216 5,196 5,228 4,929 Internal Transfers N/A N/A N/A N/A Average Length of Stay 2.18 3.3 2.4 1.88 Annual /Average Births 1,788 1,742 1,727 1,599 Annual C-Section 466 453 469 390 Annual Emergency Room Visits 51,679 46,366 44,595 40,461 Annual Outpatient Surgeries N/A N/A N/A N/A Annual Cath Lab Cases N/A N/A N/A N/A Annual Inpatient Surgeries 3,876 3,780 1204 1881 Annual Outpatient Surgeries 699 1046 3230 2471 Annual Beds Occupied 374.40 354,00 436 9,289 Admission 5,328 5,196 5,231 4,931

5. Environmental Service Statistics (Monthly):

Pounds of RMW collected

4,839

Pounds of Linen cleaned

28,640

Dispenser:

Toilet Paper Dispensers 470 Paper Towel Dispensers 1133 Toilet Seat Dispensers N/A Soap Dispensers 1283 Hand Sanitizer 3859

Exterior Glass

Building Quantity Location

0098 5 1st floor

2403 103 1st floor

2434 12 1st floor

2435 11 1st floor

IDES 62 Fort Campbell Warrior Care Clinic 19 Fort Campbell Sustainment Clinic Adult Behavioral Health 12 Fort Campbell Third Party Collection 7 Fort Campbell DENCOM Headquarters 12 Fort Campbell Industrial Hygiene 15 Fort Campbell

2436 9 1st floor

2437 9 1st floor

2439 9 1st floor

2441 30 1st floor

2516 40 1st floor

2523 10 1st floor

2524 9 1st floor

253025 20 1st floor

2540 12 1st floor

2543 25 1st floor

2544 25 1st floor

2575 10 1st floor

2576 20 1st floor

3603 110 1st floor

3929 11 1st floor

3960 11 1st floor

5289 60 1st floor

5290 7 1st floor

5580 45 1st floor

5977 25 1st floor

5979 50 1st floor

5980 110 1st floor

6139 11 1st floor

6903 11 1st floor

6988 9 1st floor

7149 55 1st floor

7973 95 1st floor

70344 11 1st floor

T9169 7 1st floor

T9182 7 1st floor

EXHIBIT B

DELIVERABLES

The contractor shall submit the following deliverables in accordance with the PWS requirements.

1. Phase In Deliverables.

a. Reserved.

b. Facilities Condition Report. The contractor shall submit a written report to the KO and COR not later than five calendar days after the inspection of government-furnished spaces detailing all existing damage within the government-furnished spaces, to include condition, components, and repair requirements, as a matter of record (Ref. PWS 3.2.1.).

c. AT Level I Training Report. The contractor shall submit certificates of completion to the COR, or to the contracting officer if a COR is not assigned, within 30 calendar days after completion of training for each affected CSP and subcontractor CSP (Ref. PWS 1.13.3.3.1).

d. iWATCH Training Report. The contractor shall submit a written report to the COR within 30 calendar days after contract award for each affected CSP and subcontractor CSP. The written report shall include iWATCH training conducted, names of personnel in attendance, and date of training. The contractor shall report iWATCH training of new hires with monthly training reports (Ref. PWS 1.13.3.3.2.).

e. Operations Security (OPSEC) Training. The contractor shall submit course certificates to the COR within five calendar days of completion for each affected CSP (Ref. PWS 1.13.3.6.).

f. DoD Cyber Awareness Training Report. The contractor shall submit course certificates to the COR within five calendar days of completion for each affected CSP (Ref. PWS 1.13.3.4.).

g. Reserved.

h. Healthcare Housekeeping Procedures Manual. The contractor shall submit a written Healthcare Housekeeping Procedures Manual to the KO and COR not later than 15 calendar days after contract award date (Ref. PWS 1.18.).

i. Contractor-Furnished Supplies and Chemical Products for Pre-Approval. The contractor shall submit a written list of contractor-furnished supplies, to include chemical products and applicable SDS, to the COR not later than ten calendar days after contract award date. The contractor shall not use any supplies, cleaning products, or material prior to receiving written approval of the COR and Infection Prevention and Control Committee (IPaC) (Ref. PWS 4.2.1.).

j. GFP Condition and Quantity. The contractor and the COR shall inspect and inventory GFP within 30 calendar days after the start of the phase-in period, and ten calendar days prior to the end of the final performance period.

The inspection and inventory shall detail the material condition and quantity of such GFP and determine the exact number, location and serviceability of GFP. The contractor shall notify the KO in writing, of any disagreement regarding the material condition and quantity of GFP within 10 calendar days of completion of inspection (Ref.

PWS 3.1.).

2. Daily Deliverables.

a. Facility Defect Reports: The contractor shall provide a daily written shift report no later than 4:00 pm to the COR identifying all needed maintenance repairs observed by housekeeping personnel. The report would include such facility defects as broken windows, faulty light fixtures, protruding nails, broken moldings, etc. Emergency facilities' defects (broken water pipes, gas leaks, etc.) shall be reported verbally to the COR or AOD within 5 minutes after discovery to facilitate repair and shall be reported in writing by the end of the work shift (Ref. PWS

5.4.1. and 5.4.2.).

3. Monthly Deliverables.

a. Work Schedules.

1. The contractor shall provide to the COR monthly work schedules at least 30 calendar days prior to month of accomplishment. Schedules shall include the date, building, room, time (to include completion time) and tasks (Ref.

PWS 5.3.).

2. Schedules for tasks to be performed by teams (floor stripping, carpet shampooing, etc.) shall also be provided to the government 30 days prior to the month of accomplishment. An example of a work schedule is as follows.

The contractor shall submit schedule changes in writing to the government at least 24 hours in advance of beginning the output (Ref. PWS 5.3.).

Date Bldg. Room Time Task 10/13/2010 3600 1G21 0730 – 0800 Sweep, Mop, Dust

b. Quality Control Inspection Report. The contractor shall submit a monthly written report to the KO and COR not later than 5th calendar day of each month of contractor inspection results and actions in process to improve quality.

Subject reports shall identify the performance/cleaning level based on the inspection performed. They shall also include (1) the type of task (machine scrub, etc.) inspected, (2) the day and shift the task was accomplished, (3) the facility number (4) inspection date/time/result (5) name of the inspector, and (6) action taken if applicable (Ref.

PWS 1.19.4.).

c. Person Hour Reports. The contractor shall submit a written person-hour report to the COR not later than the 5th calendar day of each month. The person-hour report shall include the total number of hours worked by direct labor employees during the previous month (Ref. PWS 1.10.2.1.).

d. Training Reports. The contractor shall provide a monthly, written report of training conducted to the COR not later than 5th calendar day of each month. The training report shall include dates of training conducted, names of CSP’s in attendance, and subjects of training. The contractor shall provide a copy of all lesson plans to the KO and/or COR at least 15 days prior to the scheduled training date (Ref. PWS 1.13.).

e. Personnel Roster. The contractor shall submit a monthly, written updated personnel/CSP roster to the COR not later than the 5th calendar day of each month (Ref. PWS 1.10.2.).

f. RMW Report. The contractor shall submit a monthly, written report of cumulative weights to the COR within five calendar days following the last day of the month (Ref. PWS 5.14.4.1.).

g. Monthly Linen Issue Summary Report: The contractor shall provide a monthly linen report to the COR listing by day the weight of soiled linen sent to the laundry and weight of clean linen received from the laundry. The contractor shall submit the report on the 5th business day of the month following the month of service in the format prescribed in Army Supply Bulletin, SB 8-75-11, Chapter 7 (Ref. PWS 5.15.3.).

h. Linen Cart Weights: The contractor shall record the date and time, cart number, the cart tare weight as written on the cart, and the cart gross weight on the government-furnished form. The contractor shall provide a monthly linen report on a government furnished form to the COR listing by day the weights of soiled linen sent to the laundry and weights of clean linen received from the laundry. The contractor shall submit the report on the first work day of the month following the month of service (Ref. PWS 5.15.25.1.).

4. Annual Deliverables.

a. Supply Usage Report. The contractor shall submit a written supply usage report to the COR not later than the October 31 of each year. The report shall include an itemized listing of contractor-furnished supplies consumed and the cost of the supplies for the previous 12 months. Any changes to the list of supplies/equipment must be approved by the government prior to use or implementation by the contractor (Ref. PWS 4.1.2.).

b. AT Level I Training Report. The contractor shall submit certificates of completion to the COR, or to the contracting officer if a COR is not assigned, within 30 calendar days after completion of annual training for each affected CSP and subcontractor CSP (Ref. PWS 1.13.3.3.1.).

c. Operations Security (OPSEC) Training. The contractor shall submit course certificates to the COR within five calendar days of completion of annual training for each affected CSP (Ref. PWS 1.13.3.6.).

d. DoD Cyber Awareness Training Report. The contractor shall submit course certificates to the COR within five calendar days of completion of annual training for each affected CSP (Ref. PWS 1.13.3.4.).

e. Cleaning Products. The contractor shall submit written list of chemical cleaning products and SDS to the COR no later than 30 days of contract anniversary date for annual review/approval (Ref. PWS 4.2.1.).

f. Asbestos Awareness Training. The contractor shall submit documentation of completed annual training within 5 calendar days of CSPs annual training (Ref. PWS 1.13.2.).

g. Equipment Inventory. The contractor shall perform annual and periodic inventories the contractor’s property management control system. The contractor shall randomly, and at a minimum quarterly, conduct inventories and inspections of CSP issued CACs. The contractor shall provide a copy of the inventory results to the COR within 5 calendar days after completion of the inventory (Ref. PWS 3.1.1.).

h. HIPAA Training. The contractor shall ensure that all persons receive HIPAA training within 30 days of their assignment to the MTF and annually no later than the 12th month anniversary of their previous training (Ref. PWS 1.13.3.5.).

i. SHARP Training. The contractor shall ensure all CSPs receive SHARP training not later than 60 calendar days after CSP begin performance under this contract. The contractor shall submit documentation of completion of training not later than five days after annual training and not later than 30 days after completion of training for new hires (Ref. PWS 1.13.4.).

j. Inventory Totals. The contractor shall provide inventory totals by item and count within five days of the end of inventory to include the preceding inventory totals (Ref. PWS 5.15.9.).

5. As Required Deliverables.

a. Lost, Damaged, or Destroyed Property. The contractor shall comply with all government rules and regulations, to include FAR 45.104, Responsibilities and Liabilities for Government Furnished Property and Government Property to include obtaining and maintaining a property accountability system for government-furnished property. The contractor shall report verbally and by email all incidents of loss, damage, destruction, or theft of government furnished property immediately to the COR and KO and submit a full written report of investigation no later than five calendar days of occurrence to the COR and KO with the exception of government furnished keys and CACs.

The contractor shall verbally and by e-mail report loss, damage, destruction, or theft of government furnished keys and CACs within one hour of discovery with a written report submitted to the KO and COR within 24 hours. If lost during hours when COR is not available, the oral report shall be given to the AOD, and followed up on the next business day with a written report to the COR (Ref. PWS 3.1.2.).

b. Exposure Control Plan. The contractor shall provide the COR a printed copy of the contractor’s current Exposure Control Plan fully compliant with OSHA Blood borne Pathogen Standard (29 CFR 1910.1030) upon request (Ref. PWS 1.16.1.).

c. Healthcare Housekeeping Procedure Manual Updates. As necessary, the contractor shall update/revise the Housekeeping Procedures Manual and submit the updated/revised document to the KO and COR for review/comments before implementation and no later than 30 days after feedback from the government (Ref. PWS 1.18.).

d. Cleaning Product Changes. The contractor shall submit written requests for changes to approved chemical cleaning products to the COR not later than 30 days prior to implementation. The written request shall include product literature, Safety Data Sheets (SDS), and may require samples for evaluation prior to approval (Ref. PWS 4.2.1.).

e. Contractor Staff Accident and Injury Reports. The contractor shall submit accident, injury and incident reports on contractor’s form. A copy of all accidents, injuries and incidents shall be submitted within one working day of incident to the COR (Ref. PWS 1.16.4.).

f. Quality Control Plan (QCP). The contractor shall submit the updated/revised QCP to the KO and COR not later than seven calendar days for review/comments prior to implementation (Ref. PWS 1.19.3.).

g. AT Level I Training Report. The contractor shall submit certificates of completion to the COR, or to the contracting officer if a COR is not assigned, within 30 calendar days after completion of training for each new CSP and new subcontractor CSP (Ref. PWS 1.13.3.3.1.).

h. Operations Security (OPSEC) Training. The contractor shall submit course certificates to the COR within five calendar days of completion of training for each new CSP (Ref. PWS 1.13.3.6.).

i. DoD Cyber Awareness Training Report. The contractor shall submit course certificates to the COR within five calendar days of completion of training for each new CSP (Ref. PWS 1.13.3.4.).

j. Facilities Condition Report. The contractor shall submit the updated/revised facilities condition report to the KO and COR not later than seven calendar days detailing new damage within the government-furnished spaces, to include condition, components, and repair requirements, as a matter of record (Ref. PWS 3.2.1.).

k. Service/Problem Call Log. Upon request, the contractor shall submit a copy of the Service/Problem Call Log to the COR or KO (Ref. PWS 5.13.1.).

l. Employee Health Certificate. Upon request, the contractor shall submit copies of medical clearances and health certificates for each CSP to the COR or KO for government inspection (Ref. PWS 1.14.1.).

m. Sexual assault. The contractor shall require all CSPs with knowledge of an incident of sexual assault occurring on a Government facility, to include a government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours of gaining knowledge of the incident) report the incident in writing to the government's COR. This reporting policy also applies to sexual assault incidents involving MEDCOM personnel that occur on the contractor’s owned or leased facility under this contract. All incidents shall be reported whether they involve contractor personnel or government personnel, or other individuals, when the incidents occur on a government facility or a government leased facility (Ref. PWS 1.10.5.1.).

n. Sexual harassment. The contractor shall require all CSPs with knowledge of an incident of sexual harassment occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours of gaining knowledge of the incident) report the incident in writing to the government's COR. This reporting policy also applies to sexual harassment incidents involving MEDCOM personnel that occur on the contractor’s owned or leased facility under this contract. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals, when the incidents occur on a Government facility or a Government leased facility (Ref. PWS 1.10.5.2.).

o. Asbestos Awareness Training. The contractor shall submit documentation of completed training within 30 calendar days of CSPs starting work or initial assignment to an asbestos-containing material (ACM) area and within 5 calendar days of annual training (Ref. PWS 1.13.2.).

p. Asbestos Disturbance Reporting. In the event of ACM disturbance in the performance of healthcare housekeeping services, the contractor shall telephonically notify the COR and KO not later than two hours and in writing not later than 24 hours of disturbance (Ref. PWS 1.16.5.1.).

q. Automated Dispenser. The contractor shall provide to the COR upon request the written log containing date of testing, results and corrective action for the automated chemical dispenser(s) (Ref. PWS 4.1.5.).

r. MRI Safety Training. All MRI CSPs will receive safety training by MRI personnel prior to assignment.

The contractor shall submit documentation of completed training to the COR prior to the CSP performing duties in the MRI suite (Ref. PWS 5.9.2.2.).

s. MRI Screening. All CSP's performing duties in the MRI suite are required to be screened by the MEDDAC Occupational Health Provider prior to performing duties in the MRI suite (Ref. PWS 5.9.2.2.).

t. Privacy Act and Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Training. The contractor shall submit course certificates to the COR within five calendar days of completion of training for each new CSP (Ref. PWS 1.13.3.5.).

u. SHARP Training. The contractor shall submit documentation of completion of training not later than five days after annual training and not later than 30 days after completion of training for new hires (Ref. PWS 1.13.4.).

EXHIBIT E

GOVERNMENT FURNISHED FACILITIES & EQUIPMENT LIST

Government furnished facilities for contractor use. The following space is identified and will be provided to the contractor for use as office space, supply and equipment storage. Any other additional storage space for supplies and equipment shall be at the contractor's expense. Not all facilities have a housekeeping closet, contractor shall be required to tote all supplies and equipment each time service is required.

ROOM # IDENTIFICATION LOCATION

1BG06 Office 650-Logistics 1BH10 Storage Space 650-Logistics Warehouse 0AA11 Housekeeping Closet 650-0 Level Corridor 0AB52 Housekeeping Closet 650-0 Level Corridor 0AB75 Housekeeping Closet - Floor Crew 650-0 Level Corridor 1AA25 Housekeeping Closet 650-PAD 1AC13 Housekeeping Closet 650-PTM&S 1BA35 Housekeeping Closet 650-NCD 1BD35I Housekeeping Closet 650-Logistics Warehouse 1BE10 Housekeeping Closet 650-Human Resources 2AA36 Housekeeping Closet 650-LDR 2AB18 Housekeeping Closet 650-LDR 2AC15 Housekeeping Closet 650-Mother Baby Unit 2AC75 Housekeeping Closet 650-Mother Baby Unit 2AE18 Housekeeping Closet 650-New Wing -Mother Baby 2BA49 Housekeeping Closet 650-SDS 2BB87 Housekeeping Closet 650-ICU 2BD37 Housekeeping Closet 650-OR 2BE45 Housekeeping Closet 650-Med Specialty 2BF44 Housekeeping Closet 650-Radiology 2BF39 Housekeeping Closet 650-Radiology 2BG19 Housekeeping Closet 650-PT 2BH21 Housekeeping Closet 650-LAB 2BL05 Housekeeping Closet 650-B Bldg Corridor 2BP18 Housekeeping Closet 650-EC 2CH05 Housekeeping Closet 650-Blue Clinic 2CJ15 Housekeeping Closet 650-Blue Clinic

2CS23 Housekeeping Closet 650-Orthopedics 2CU11 Housekeeping Closet 650-C Bldg Corridor 3CA29 Housekeeping Closet 650-EENT 3CB24 Housekeeping Closet 650-Gold Clinic 3CB53 Housekeeping Closet 650-Gold Clinic 3CE29 Housekeeping Closet 650-DNP 3CF13 Housekeeping Closet 650-Clinical Services 3EA22 Housekeeping Closet 650-New Wing -ABH 4AA08 Housekeeping Closet 650-4AA Corridor 4AB90 Housekeeping Closet 650-Medical Surgical 115 Housekeeping Closet 3929-ABH 107 Housekeeping Closet 2403-NICOE 323 Housekeeping Closet 2403-NICOE 105 Housekeeping Closet 2435-TBI 121 Housekeeping Closet 2436-ABH 107 Housekeeping Closet 2437-CAPS 107 Housekeeping Closet 2439-EDIS 138 Housekeeping Closet 2516-ABH Medical Company 139 Housekeeping Closet 2516- ABH Medical Company 126 Housekeeping Closet 2524-TBI 106 Housekeeping Closet 2530-PAO 107 Housekeeping Closet 2530-PAO 123 Housekeeping Closet 2540-ANAM 126 Housekeeping Closet 2543-Chiropractic BB09 Housekeeping Closet 2544-Social Work Services 106 Housekeeping Closet 2576-Occupational Health 144 Housekeeping Closet 3603-Epperly Dental Clinic 145 Housekeeping Closet 5289-VET Clinic 3 Housekeeping Closet 5290-VET Clinic BB04 Housekeeping Closet 5979-LaPointe Clinic BF01 Housekeeping Closet 5979-LaPointe Clinic CL06 Housekeeping Closet 5979-LaPointe Clinic CL42 Housekeeping Closet 5979-LaPointe Clinic DA07 Housekeeping Closet 5979-LaPointe Clinic DF02 Housekeeping Closet 5979-LaPointe Clinic 3 Housekeeping Closet 5980-IDES 61 Housekeeping Closet 5980-IDES 110A Housekeeping Closet 6139-MMC 110B Housekeeping Closet 6139-MMC 115 Housekeeping Closet 6988-EBH 122 Housekeeping Closet 7149-Aviation Health Clinic 1002 Housekeeping Closet 7973-BYRD Clinic 1118 Housekeeping Closet 7973-BYRD Clinic 2028 Housekeeping Closet 7973-BYRD Clinic T47 Housekeeping Closet T9169-Young Eagle Clinic 119 Housekeeping Closet T9182-Epperly Clinic

ITEM DESCRIPTION MFG MODEL SERIAL # QTY LOCATION

Chairs/w arms 3 1BG06

Desks 3 1BG06

Chair/w arms 4 1BD09

Desk w/hutch 1 1BD09

Chair 1 1DC04

Desk 1 1DC04

Telephone 1 1BD09

Telephone 1 1BD05

Telephone 1 1DC04

Metal Lockers 1 unit 1BD05

File Cabinet 1 1BD05

Keys for Trash Compactors 2 Keys

1BG06

Monitor DELL 2208WFPT 017859 1 1BG06A

Monitor DELL P2411HB OF8NDP 1 1BD09

Red Linen Cart 1 1DD02

Gray Trash Container 1 1DD02

Stainless Steel Linen Carts 10 1BD09

Stainless Steel Basket Carts 4

1BD09

Linen Bag Holders 2

1BD07

Computer Transource 702500Q670034

ECN:017797

MIR-800HM 1 1BD09

Printer Hewlett- Packard 7025015267142

ECN:002550

Q5928A 1 1BD09

Computer Transource 702500Q670034

ECN:017859

MIR-800HM 1 1BG06A

Printer Hewlett- Packard 7025015267142

ECN:003727

Q5927A 1 1BG06A

Scale Fairbanks 667000Q670000 ECN:0A0158 1 1BD09

Scale Fairbanks 667000Q670002 ECN:013047 1 1BD07

Scale Arlyn Scales 667000Q670001 ECN:006471 1 1DC04

VOCERA BADGES K5EN163306AF 1 1BG06

K5EN1633087B 1 1BG06

K5EN1632FC9C 1 1BG06

K5FB17335149 1 1BG06

K5EN16330689 1 1BG06

K5FB17334D5E 1 1BG06

K5FB173352D2 1 1BG06

PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT (PWS)

BLANCHFIELD ARMY COMMUNITY HOSPITAL

FORT CAMPBELL, KY

SECTION 1

1. General. This PWS is for healthcare housekeeping and related services at Blanchfield Army Community Hospital (BACH), Fort Campbell, KY, and multiple Medical Treatment Facilities (MTFs) in the health service area (HSA) of BACH. As a performance based contract, the requirements are stated in terms of desired results with associated quality standards. Healthcare housekeeping services shall be performed in a manner that will maintain a satisfactory facility condition and present a clean, neat, and professional appearance.

1.1. Description of Services. The contractor shall furnish all personnel, training, labor, equipment, tools, supplies, management, administration, and services, except as may be expressly set forth as government furnished, and otherwise do all things necessary to perform and provide the work efforts described in the PWS.

1.2. Background. Blanchfield Army Community Hospital is a general medical and surgical hospital sited at building 650B in Fort Campbell, KY and is part of the US Army Medical Command (MEDCOM). It is accredited by the Joint Commission (JC). The mission of BACH is to provide world-class medicine to the military personnel and their families in safe, clean, and aesthetically pleasing MTFs. Blanchfield Army Community Hospital is located on an approximate 70 acre site bordered by Oak Grove, KY and Clarksville, TN.

1.2.1. The main hospital consists of 4 buildings joined to make one hospital: building A contains five levels; B, C and E buildings contain two levels. The main hospital includes six operating room suites, 50 total beds, seven labor rooms to include four Triage rooms and two transition nurseries. Clinics and services include: emergency room, laboratory, obstetrical/gynecology, ophthalmology/optometry, orthopedics, pharmacy, physical therapy, radiology, MRI, cardiology, and behavioral health. The command suite and other administrative support functions such as:

outpatient records, outpatient pharmacy, admissions and dispositions, primary care unit, and specialty care clinics are located within the complex. There are an additional 32 MTFs in the HSA of BACH located on Fort Campbell.

Exhibit C provides a complete listing of facilities supported by this contract.

1.3. Objective. The contractor shall provide healthcare housekeeping services that prioritize infection control while optimizing cleaning practices in support of BACH’s mission of providing quality healthcare in safe, hygienic, and aesthetically-pleasing MTFs.

1.4. Scope. The contractor shall provide healthcare housekeeping services to BACH to include all MTFs within the HSA of Fort Campbell, KY. Requirements for this effort are determined by square feet (SF) of designated spaces to be cleaned. The estimated SF quantity for BACH and multiple MTFs in the HSA is 675,993 SF. There may be reduced or additional SF for newly constructed buildings and/or building expansions that will require services as they are completed or a reduction of SF for facilities closing as a result of consolidation of services.

1.4.1. The following projects currently undergoing construction or renovation:

Project Estimated Completion Estimated SF

OR/PACU/ICU 2/2019

BLDG 2526 11/2018 7583

Inpatient Behavioral Health 11/2018 8743

1.4.2. Reserved.

1.5. Ordering Period. The ordering period is five years from date of contract award, unless the Option to Extend Services is exercised, allowing the ordering period to be extended by up to six additional months. Task Orders (TO) will be funded by annual appropriations and each task order will not exceed one year except when authorized by law.

1.6. Commercial Standards/Advisory Recommendations. The following commercial standards and advisory recommendations are applicable to this effort:

1.6.1. Association for the Healthcare Environment (AHE) Practice Guidance for Healthcare Environmental Cleaning manual.

1.6.2. International Sanitary Supply Association (ISSA) and Cleaning Industry Management Standard for Green Buildings (CIMS-GB). The contractor shall maintain ISSA CIMS-GB certification throughout the contract period.

1.6.3. Advisory recommendations of the Association of PeriOperative Registered Nurses (AORN).

1.6.4. Advisory recommendations of the Centers for Disease Control and Prevention (CDC) and The Healthcare Infection Control Practices Advisory Committee (HICPAC), "Guidelines for Environmental Infection Control in Health-Care Facilities”.

1.6.5. Clinical Nursing Skills and Techniques, 8th edition, Perry, Potter, Ostendorf.

1.6.6. American National Standards Institute/Association for the Advancement of Medical Instrumentation publication (ANSI/AAMI) ST65:2008.

1.7. Hours of Operations. As healthcare operations include a wide range of services from inpatient to outpatient care, the housekeeping program must accommodate differing work hours. Normal operating hours are 6:30 am – 5:00 pm local time, Monday through Friday, except where otherwise specified in this PWS. In some areas, due to the volume of personnel, type of operation, or other considerations, cleaning shall be accomplished at times other than during normal operating hours. See Exhibit D for details of building/room by square footage, type of services, and operational hours and shifts.

1.8. Holidays. The following is a list of legal federal holidays as referred to elsewhere in the contract and PWS:

New Year’s Day, January 1st Martin Luther King’s Birthday, 3rd Monday in January Presidents’ Day, 3rd Monday in February Memorial Day, last Monday in May Independence Day, July 4th Labor Day, 1st Monday in September Columbus Day, 2nd Monday in October Veteran’s Day, November 11th Thanksgiving Day, 4th Thursday in November Christmas, December 25th

1.8.1. The contractor shall provide healthcare housekeeping services on federal holidays as a regular working day in the Labor and Delivery, Mother Baby Unit, Newborn Intensive Care Unit, Emergency Room (ER), Dining Facility, Pathology, Radiology, Medical Surgical Ward, Psychiatric Ward, Surgical Processing Department, Intensive Care Unit and Pediatric Ward.

1.8.2. Military training holidays are not considered federal holidays. The contractor shall provide healthcare housekeeping services on military training holidays as a regular working day. The failure of the contractor to provide healthcare housekeeping services on military training holidays is considered a violation of the terms and conditions of this contract.

1.8.3. Any of the above federal holidays falling on a Saturday will be observed on the preceding Friday; holidays falling on a Sunday will be observed on the following Monday.

1.9. Key Personnel. The contractor shall provide sufficient management to ensure that this task is performed efficiently, accurately, on time, and in compliance with the requirements of this document. Specifically, the contractor shall designate a single manager to oversee this task and supervise staff assigned to this task. The contractor shall provide sufficient contract service providers (CSPs) experienced in the conduct of similar hospital operations. Key personnel consist of the executive housekeeper (EH) and assistant executive housekeeper (AEH).

1.9.1. Executive Housekeeper. The contractor shall provide an executive housekeeper to serve solely at BACH and the multiple MTFs in the HSA of BACH. The executive housekeeper shall serve as the onsite manager and represent the contractor in performing all duties to ensure compliance with the provisions of the contract.

1.9.1.1. Certification and Experience Requirements. The executive housekeeper shall meet or exceed the following:

Certified by the AHE as a Certified Healthcare Environmental Services Professional (CHESP) or the International Executive Housekeeper's Association (IEHA) as a Certified/Registered Executive Housekeeper (C/REH). All certifications shall be maintained active and current throughout the term of the contract. The executive housekeeper shall possess a minimum of five years housekeeping experience with a minimum of two years of specific hospital housekeeping experience. Specific experience shall indicate that the executive housekeeper has directly managed and performed in a MTF of comparable size and services as BACH or the equivalent civilian MTF.

1.9.1.2. Absence from Duty. The contractor shall provide oral followed by written notification to the Contracting Officer’s Representative (COR) for any unscheduled absence of the executive housekeeper no later than two hours after commencement of the designated shift. For scheduled absences, the contractor shall notify the COR in writing at least seven calendar days before any scheduled absence. Extended absences; e.g., four or more consecutive weeks, or the ongoing use of substitute personnel at the MTF, may constitute nonperformance.

1.9.2. Assistant Executive Housekeeper (AEH). The contractor shall provide an AEH. The AEH shall serve as the acting on-site manager in the absence of the executive housekeeper and shall represent the contractor in performing all duties to ensure compliance with all provisions contained in this PWS. The AEH shall be capable of temporarily assuming executive housekeeper duties during his or her absence.

1.9.2.1. Certification and Experience Requirements. The AEH shall possess at least one year of experience in healthcare housekeeping services within the last three years in an MTF of comparable size and services as BACH (not general housekeeping). He/she shall meet or exceed comparable industry certification (CHESP, C/REH).

1.9.3. Replacement of Key Personnel. All proposed replacement of key personnel shall be submitted in writing to the Contracting Officer (KO) and the COR at least 15 calendar days prior to the proposed replacement. All proposed replacements shall meet the minimum qualifications of the person being replaced.

1.9.4. Availability of Key Personnel. The EH or the AEH shall be available to meet with the COR on site during normal operating hours within one hour of notification. The contractor shall provide the KO and COR phone numbers for the EH and AEH during duty and non-duty hours (to include evenings, holidays, and weekends). After duty hours, the EH or AEH shall be available on site within two hours of notification.

1.10. Miscellaneous Contract Service Personnel (CSP)…