Q– Statement of Objectives – Nursing Home Services – VISN 15-Wide

Notice Type: Special Notice

Posted Date: 11-DEC-17

Office Address: Department of Veterans Affairs;Network Contracting Office (NCO) 15;3450 S 4th Street Trafficway;Leavenworth KS 66048

Subject: Q-- Statement of Objectives - Nursing Home Services - VISN 15-Wide

Classification Code: Q - Medical services

Contact: Michael S CuminsContract Specialist 913-946-1110 mailto:[email protected]

Description: Department of Veterans Affairs

VA Heartland Network

Department of Veterans Affairs Heartland Network

Request for Information (RFI)

Statement of Objectives

Interested sources are sought to provide Veterans Integrated Service Network (VISN) 15, Network Contracting Office (NCO) 15 a draft Performance Work Statement or Statement of Work (description of services) for nursing home care services.

VISN 15/NCO 15 is interested in the nursing home industry s perspective on defining services standards (requirements), how performance of those services should be monitored by Government, actions the Government should take when performance monitoring indicates when standards are not met, and actions the nursing home should take when standards are not met.

The purpose of a Statement of Objectives (SOO), in accordance with Federal Acquisition Regulation (FAR) 37.602, is to:

Allow offerors to use the SOO to develop the Performance Work Statement (PWS) or Statement of Work (SOW), and

State the overall performance objectives and establish the measurable performance standards to be achieved by performance of a contract for nursing home services.

NCO 15 welcomes interested sources with this opportunity and maximum flexibility to propose a PWS or SOW for Community Nursing Home (CNH) services. Services include those that meet federal, state, local and VA guidelines, and reflect the CNH outcomes identified in VHA Handbook 1143.2 (click the hyperlink to open). The approach of using commercial and industry standards and best practices for facilities, services - health, activities, staffing and transportation should result in the best possible health care solutions.

The following SOO outlines the approximate outcomes and results that must be achieved and may be the basis for your preparation of a proposed PWS SOW.

NCO 15 will be looking for

The best possible solutions in the form of a PWS or SOW.

Competitive ideas to meet the objectives outlined in the SOO.

Offerors to propose a PWS that addresses their specific approach to the SOO.

Please note that NCO 15 is NOT looking for vendors to submit technical or price proposals. This SOO is issued for the sole purpose of allowing industry to provide feedback and input pertaining to the following areas:

Contents of SOO - Any proposed changes, questions, additions, considerations or clarifications. Comments are encouraged for all portions of the document.

Contract type - What contract type would work best The standard contract type is an Indefinite Delivery Contract with Task Orders.

NOTE: This is NOT a request for proposal or quote.

Risk Items - Perceived risks associated with the objectives identified, services necessitated and current services provision standards.

In addition, you are asked to identify performance measures, based on commercial practices and / or service level agreements or contract, which identify how the solution will meet VA s objectives.

All participants are given fair opportunity to respond to this requirement (refer to FAR 16.505(b)).

Responses should be sent to e-mail or by fax. Technical and Price Proposals will not be considered.

Please forward all responses to the following email address: [email protected], or by fax to 913-946-1198, attention Michael Cumins. Phone responses cannot be accepted, however clarification of coverage areas may be addressed by phone, directed to 913-946-1110.

Purpose

The purpose of this Statement of Objectives (SOO), in accordance with Federal Acquisition Regulation (FAR) 37.602, is to:

Allow use of the SOO to develop the draft PWS or SOW, and

State the overall performance objectives and establish the measurable performance standards to be achieved by performance of a contract for ADHC services.

Further, the objective of NCO 15 is to develop a PWS or SOW based on Proposed PWS or SOW documents received, or any combination or portions of those received.

Scope

The scope of this SOO is limited to receiving drafts based on the following general goals of the CNH Programs at VISN 15 VA Medical Centers in Kansas, Missouri, and parts of North Eastern Arkansas, and parts of Western Kentucky and parts of Southern Illinois and Southern Indiana, and reflect the desired CNH patient-outcomes shown in VHA Handbook 1143.2 (click the hyperlink to open).

Further, the scope provides that any purchased services through future-contracted entities provided to veteran patients determined eligible for the services at VA expense is based on a fully developed PWS or SOW initially drafted by interested sources and that is developed with the ultimate goal of meeting health care needs and with the significant goal of providing services that reduce the risk of re-hospitalization, declining healthcare, and that, as a minimum, address the following services and activities requirements listed below.

Period of Performance

The preferred period of performance is one base year with four (4) potential option periods of one year each (FAR 52.217-9).

Background

NCO 15 has traditionally issued Basic Ordering Agreements with established PWS or SOW requirements, applicable to VA Medical Centers in five states Indiana, Illinois, Kentucky, Missouri and Kansas. Basic Ordering Agreements are no longer considered appropriate.

Each state maintains its own unique individual licensure, staffing, facility, and medical direction requirements, among other requirements. The state requirements, being applicable to facilities contracting with the state, are not necessarily applicable to the provision of services to non-state customers, e.g. private pay and other methods of purchased services.

Constraints

This is a no cost request for market research via the development of at least one draft PWS or SOW by interested parties which would be used by NCO 15 to develop the final PWS or SOW.

The referenced Handbook 1143.2 is a guideline for CNH services for VA oversight and requirements within the CNH Programs and is not specifically directed for description or creation of PWS or SOW formats for purchased services. Therefore, interested sources are charged with translating VA requirements within the handbook and applying other applicable federal, state, and local requirements and commercial practices to develop one, or more, draft PWS or SOW.

Configuration

Any Proposed PWS or SOW should be formatted in a manner that flows per the types of services that an offer would consider reasonable for the VA to request of a CNH contractor.

The format should address all aspects of care and the overall requirements that a potential offeror would expect to see in a Request for Proposal asking for a price and technical proposal for the listed services and that those services requirements would be typical for similar providers of such services in the same state of the offeror.

Quality Control

The VA Utilizes Quality Assurance Surveillance Plans (QASPs) to monitor contractor performance. The VA requests that the draft PWS or SOW include a QASP as a separate document that indicates what aspects of the PWS or SOW should be monitored. The QASP should indicate how those aspects should be monitored, how often monitoring should occur.

Additionally, the QASP should indicate recommended consequences for both negative performance and positive performance monitoring findings. In other words, should a reward or penalty occur If so, what should that be

Special Notes

The VA reserves the right to select a draft PWS or SOW, or any portion or combination of several drafts, that are in the best interest of the Government.

The VA reserves ownership of all submitted draft PWS or SOW documents received, except those with price information, which will be returned immediately without further review.

All submitted documents will be safeguarded from unauthorized disclosure and author identification throughout the review process. Any PWS or SOW documents developed from drafts may include all, some or none of the or portions of them, and with drafter/author identification(s) excluded.

STATEMENT OF OBJECTIVES

No specific requirement exists and a Performance Work Statement or Statement of Work has not been developed.

This Statement of Objective (SOO) is considered as a tool in the development of a Performance Work Statement or Statement of Work.

The draft will discuss and consider all aspects of providing nursing home care that a veteran patient would need for short term stays (e.g. post-surgical rehabilitation or short inpatient respite periods), long term stays, and hospice.

The draft will also consider how a nursing home would evaluate patient-to-nursing home suitability.

What factors are involved in making determination of whether the nursing home could accept the patient for care or not accept the patient

Where would those evaluations take place

Who would perform the evaluations

Other

The draft will discuss how the patient would be transported to the nursing home for placement, transported to the patient s medical appointments outside of the nursing home facility whether to a Government (VA Medical Center) hospital or clinic, or to a non-Government hospital or clinic.

Miscellaneous transportation should be discussed social outings sponsored by the nursing home or other sponsors trips to the patient s home/visits other.

The draft will discuss care provider services physician, nursing, nurse aides, therapists, pharmaceutical, lab, x-ray, etc.

Frequency of medical services contact with physicians, nurse practitioners, physician s assistants

Location/place.

Services.

Physical and mental assessments.

Orders - medications, therapy, lab-work/tests or other treatment services or device prescriptions.

Documentation and follow-up

Handling emergencies physical and mental

Diabetic, stroke, behavioral (difficult patient) care, limitations

Podiatry

Renal issues dialysis

Cancer

Other

End of life care

The draft will discuss how the nursing home will coordinate with VA clinical staff. What types of situations would the nursing home consider to warrant coordination efforts related to care What types would not warrant coordination

The draft will discuss social services.

The draft will discuss all administrative and billing matters. The Government has an interest in cost control and prevention of medical billing fraud and oversight matters.

The discussion will disclose how the nursing home will bill for services provided by the nursing home facility.

Methods, billing source (by the facility or management firm), billing corrections and resubmissions.

The disclosure will detail billing by others - attending care givers if not already included in facility rates. Sample pricing format/structures may be submitted with the draft, however

DO NOT INCLUDE PRICE INFORMATION all submitted documents will be returned via USPS mail immediately if prices or costs are found within them.

YOU MAY include price variables information anything that would affect pricing.

The disclosure will discuss methods to prevent double-dipping , that is, billing to the VA and to another pay source patient, private insurance, Medicare, Medicaid, other.

The draft will discuss oversight assessments, findings, penalties, placement holds and other actions conducted by other federal, state or local agencies.

Notifying VA of surveys, findings, including derogatory, and corrective action plans.

Notifying VA of For Cause or Immediate Jeopardy inspections/assessments and actions, including specific notification of veteran patient association with this type of instance.

Handling VA placement hold situations.

Notification of sentinel events, e.g. death.

Handling of other legal matters powers of attorney, do not resuscitate orders, patient family and VA notifications.

Provision of special, non-standard, equipment e.g. bed/mattress, mobility devices, feeding pumps, short-term rental devices, etc.

Periodic patient assessments/reassessments

If assessment warrants elevated or reduced care level, actions, cost issues

The draft will detail nursing facility operations and management to the extent of signature authority for signing contracts, contract modifications, and similar legal matters.

The draft will discuss patient oversight to include records management.

VA s access to paper or electronic records for VA patients

Nursing home requests for VA services for veteran patients in the nursing home

How requests would be made, to whom.

Methods to avoid missed or unsatisfied requests.

The draft will discuss services by other than nursing facility employees. For example, if the attending physician is not an employee of the nursing home, that physician would be a subcontractor to the contract.

Discuss the handling of subcontractors.

Differentiation between services providers employees versus contracted-out staff (subcontractors), such as lab services, x-ray.

Application of labor laws and applicable flow-down Federal Acquisition Regulations clauses to subcontractors e.g. Service Contract Labor Standards (formerly Service Contract Act), minimum wage requirements

Discuss knowledge of contractor-responsibility for all services, including those performed by a subcontractor.

The draft will discuss patient absence due to hospitalization or other absence (see Item 3 miscellaneous transportation), room/bed hold for short absences versus discharge.

The draft will discuss specific capabilities, security and safety, rehabilitation, nutrition, medications, psycho-social needs, pharmaceutical resources and practices, assistance in daily living and the overall expectations of the care provided, e.g. long term (end of life), specific short term rehabilitation goals to return patients to their home, behavioral.

Discuss younger patient capabilities, e.g. younger than elderly or senior citizen .

Treatment of severe behavioral issues, combative or PTSD or similar, Alzheimer s, dementia, wondering patients.

Payments. VA standard payment method is electronic funds transfer of payments. Once-Monthly billing is standard practice, to be received by the VA by the 10th of the following month. Net 30 payment is standard. Prompt payment discounts are welcome. Discuss expected payment processes.

The nursing home industry is characteristically unique in that the normative industry standard reveals regular and recurring changes of ownership. Changes of ownership, while executed during the period of performance while the Government contract is in place, may create opportunities which adversely impact terms of patient placement (existing and new patients alike), contract management, billing and payments. The formal process (refer to Federal Acquisition Regulation (FAR) Subpart 42.12), exists for a Government contractor to request the Government to recognize a new owner as successor to the Government contract. The process is lengthy and requires written agreement, certificates, terms, documents and signatures of both seller and buyer before the Government may review the request for potential approval. This process is called a Novation Agreement.

Due to the length of time, and the fact that no guarantee of novation by the Government exists, the draft will discuss a method of mutually ending the contract due to sale. In other words, a method of mutually ending a contract due to sale. The method should discuss time, billing, placement/discharge, and payments. The method should also discuss contract close-out and release of claims.

DISCLAIMER

This RFI is issued solely for information and planning purposes only and does not constitute a solicitation. All information received in response to this RFI that is marked as proprietary will be handled accordingly. In accordance with FAR 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this RFI.

This RFI seeks responses only from nursing home facilities that are physically situated in VISN 15 geographic coverage areas, or ownership offices of those facilities.

Link/URL: https://www.fbo.gov/spg/VA/LeVAMC/VAMCKS/9211/listing.html