Loren Data's SAM Daily™

FBO DAILY - FEDBIZOPPS ISSUE OF JUNE 22, 2013 FBO #4228
DOCUMENT

Q -- CARDIOTHORACIC SURGERY - Attachment

Notice Date

6/20/2013
 

Notice Type

Attachment
 

NAICS

621111 — Offices of Physicians (except Mental Health Specialists)
 

Contracting Office

Department of Veterans Affairs;Network Contracting Office 9;1639 Medical Center Parkway;Suite 400;Murfreesboro TN 37129
 

ZIP Code

37129
 

Solicitation Number

VA24913R0782
 

Response Due

6/28/2013
 

Archive Date

7/28/2013
 

Point of Contact

Christina (Tina) B Smith
 

E-Mail Address

5-6557<br
 

Small Business Set-Aside

N/A
 

Description

Lexington Cardiothoracic Surgery Contract Statement of Work The Contractor shall provide healthcare resources to the Department of Veterans Affairs Medical Center (VAMC), Lexington, KY for an approximate period of one year from the date of the award with 4 subsequent option years. Contractor shall provide qualified personnel to perform the duties as listed in the statement of work. Duties are to be performed at the contractor facility. Contractor shall perform cardiothoracic surgeries and related services as described in accordance with the contract requirements. All quantities listed are estimates only and are based on past performance. The federal government is not obligated to any specified amount of products and/or services, but shall be obligated to provide payments for all items/services requested in accordance with the solicitation. Prices shall be submitted as an all-inclusive fee to include physician's fee, malpractice insurance, and hospital fees. Hospital fees shall be based on the Prospective Payment System utilizing DRG coding and shall be all inclusive of all supplies and services provided. A threshold length of stay shall be identified and indicated. A per diem rate per day for hospital confinements exceeding the threshold length of stay shall be indicated. Schedule of pricing is shown below. Pricing Schedule DRG DescriptionEstimated # proceduresAll inclusive global unit costTotal Estimated CostThreshold Length of Stay 1Heart Transplant or Implant of Heart Assist System with Major Complication or Co-morbidity (MCC)0 $020 3ECMO or Tracheostomy with Mechanical Ventilation 96+ hours1 20 215Other Heart Assist System Implant1 20 216Cardiac Valve and other Major Cardiothoracic Procedures with Cardiac Cath with MCC11 20 219Cardiac Valve and other Major Cardiothoracic Procedures without Cardiac Cath with MCC13 20 220Cardiac Valve and other Major Cardiothoracic Procedures without Cardiac Cath with CC420 221Cardiac Valve and other Major Cardiothoracic Procedures without Cardiac Cath without CC/MCC220 228Other Cardiothoracic Procedures with MCC120 230Other Cardiothoracic Procedures without CC/MCC120 235Coronary Bypass without Cardiac Catheterization with MCC2020 236Coronary Bypass without Cardiac Catheterization without MCC18 20 238Major Cardiovascular Procedures without MCC2 20 326Stomach, Esophageal & Duodenal Procedures with MCC1 20 327Stomach, Esophageal & Duodenal Procedures with CC1 20 TOTAL BASE TERM Note: Any changes made by Medicare that update, delete or replace DRGs contained in this contract will be reflected accordingly. Pricing on these updates or replacements to DRGs will be calculated in the same manner as existing DRGs. Performance Period & Work Hours BASE TERM-ONE YEAR OPTION TERM - 4 OPTION YEARS The Contractor, shall provide qualified personnel to provide Cardiothoracic (CT) Services in accordance with the terms and conditions of this contract. Contractor's personnel shall be of a quality meeting or exceeding currently recognized national standards as established by the Joint Commission on Accreditation of HealthCare Organizations (JCAHO), and the standards of the American Medical Association (AMA). Emergency services shall be available from the Contractor within one (1) hour of notification by the Veterans Administration medical Center (VAMC) seven (7) days per week, twenty-four (24) hours per day, including all holidays. The Contractor will not be required to furnish non-emergent services during off-duty VA work hours. "VA work hours: Monday through Friday, 8:00 a.m. - 4:30 p.m. "National Holidays observed by the Federal Government: Credentialing/Privileging Requirements Contractor shall provide original or certified copies of documentation required to meet VA credentialing and privileging requirements on providers not presently credentialed in the VA system. Documentation requested includes, but is not limited to: "Application for membership in a VA Medical or Dental staff "Complete credentialing & privileging form/VETPRO "Evidence of medical education & training/VETPRO "Evidence of mal-practice insurance coverage in the amounts required within the contract "Licensure - all licenses ever held "Copies of privileges held with other medical staffs/facilities Contractor will be provided copies of current requirements and updates as they are published. Specific questions regarding credentialing and privileging should be directed to the office of Medical Staff Coordinator, Chief of Staff, VAMC Lexington, KY. Pre-Operative Evaluation Process VA patients who are admitted or followed on an outpatient basis will be considered as candidates for cardiac surgery at the contractor's facility. The VA will conduct the initial assessments (history, physical) for the veteran patients. Cardiac catheterization and coronary catheter interventions will also be performed at the VA. If surgery is indicated, all other studies considered necessary including CXRs, EKGs, PFTs, etc., will be carried-out expeditiously at the VA with the exception of typing and cross-matching blood and blood products that will be done at the contractor's facility. The necessary approval process by the VA Chief of Staff or designee should be processed, via the electronic CABG consult in CPRS. The referring VA physician will electronically document the status of the discharge in the patients VA medical record. Referral of a VA patient for cardiac surgery will be made by a cardiologist with a medical staff appointment at the VA. A cardiothoracic surgeon with a medical staff appointment at the VAMC will refer a VA patient for other major chest procedures covered under the contracted services. The referral will be made via the VAMC electronic consult process in CPRS and will be coordinated with the VA CT Surgery Case Manager/COTR. The decision for cardiac surgery will be evidence-based according to accepted clinical practice guidelines. The ultimate clinical decision for cardiac surgery will be made in consultation with a faculty member of the Division of Cardiothoracic Surgery at the contractor's facility with concurrence of the VA Chief of Staff, or designee. The cardiothoracic surgeon shall immediately document the findings and recommendations for each consult using the VAMC electronic charting system (CPRS), in addition to generation of the CT surgery fee consult. Pre-Operative Management of VA Patients Undergoing Cardiac Surgery The VA will provide counseling for patients and their families concerning the arrangements of this contract. Inpatients: Prior to transfer to the contractor's facility "VAMC staff will conduct pre-operative assessment. "A health summary of recent tests, x-rays, etc., as well as a catheterization report will be given to the contractor's physician through the VA CT Case Manager. "The Contractor cardiothoracic surgeon will personally examine the patient at the VA at no additional cost to the VA. Findings will be entered into the patient's CPRS chart. "Contractor will assign a bed to the VA patient and the contractor's nurse accepting the patient will contact the VA nursing staff for report. "Pre-operative teaching/instruction to the patient on clinical and administrative issues will be the responsibility of the VA CT Case Manager. "Patients will be medically prepped (anesthesia) at the contractor's facility. Outpatients: Prior to admission to contractor's facility "VA staff will conduct pre-operative assessment. "A health summary of recent tests, x-rays, etc., as well as a catheterization report will be given to the Contractor CT Surgeon through the VA CT Case Manager. "During the pre-operative process and at the discretion of the contractor's physician, ambulatory patients reporting to the contractor for cardiac surgery may be referred to the contractor's facility to meet with the physician and facilitate contractor's processes at no additional cost to the VA. "Pre-operative teaching/instruction on clinical and administrative issues will be the responsibility of the VAMC CT Case Manager. "Patients will be scheduled with pre-operative Anesthesia at the contractor's facility. Transfers: "The term "transfer" pertains to the physical movement of patients between the two facilities and is not to be construed to replace the required administrative admission and discharge processes at each facility. Emergent inpatients for which cardiac surgical intervention is indicated will be discharged from the VA and admitted to the contractor's facility for the cardiac surgery procedure. Once scheduled for surgery at the contractor's facility, the patient will be transported by VA personnel to contractor's facility the morning of the operation. The attending physicians and the VA Transfer Coordinator will coordinate transfers between the contractor's facility and VA with the assistance of the VA CT Case Manager and contractor's CT Surgery Patient Coordinator. Inpatient Post-Operative Care "Contractor will provide surgical and post-operative care until the patient is discharged or transferred back to the VAMC (if greater than 20 days as a Contractor inpatient). "The VA CT Case Manager as well as the VA Chief of Staff will also be advised immediately when a sentinel event occurs in any referred patient. A sentinel event is defined as an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase, "or the risk thereof" includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. "For referred patients who expire, CONTRACTOR shall immediately notify the VA CT Case Manager with an explanation of the circumstances and probable cause of death. If the CT Case Manager is not available (i.e., during non-business hours), the COR and the Chief of Staff shall be notified. Outpatient Post-Operative/Post-Discharge Care "All care needs that the patient may have upon discharge (i.e. medications, prosthetic items, home health needs, etc.) shall be requested via electronic medical record utilized by the VAMC. The VA will be responsible for providing the identified items to the patient. The VA will not be responsible for any items provided by CONTRACTOR to the patient without prior approval. Upon discharge of a VA referral patient, the CONTRACTOR provider will complete a discharge summary within forty-eight (48) hours. "The CONTRACTOR Cardiothoracic Discharge Planner will notify the VA CT Case Manager upon the patient's discharge from the contractor's facility. The CONTRACTOR Discharge Planner will also supply copies of the operative report and the discharge summary to the VA CT Case Manager. Records must be received within 5 days after discharge and will be placed in the patient's VAMC medical record. A copy of the complete medical record will be provided the VA CT Case Manager upon request. Payment for services will not be made until all records are received by the VA CT Case Manager. Payment will be made within 15 days of the receipt of invoice. "Cardiac surgery patients will have a post-operative visit in the VA CT Surgery Clinic with a cardiac surgeon within one month of discharge from the hospital. Follow-up thereafter will continue in the VA Cardiology Clinic and the Primary Care Physician as necessary. Neither the VA nor the patient shall be liable for payment of any outpatient services rendered after discharge. Performance Standards/Quality The Contractor shall provide qualified personnel to provide Cardio-Thoracic (CT) Services in accordance with the terms and conditions of this contract. CONTRACTOR personnel and services shall be of a quality meeting or exceeding currently recognized national standards as established by the Joint Commission on Accreditation of HealthCare Organizations (JCAHO), the Center for Medicare and Medicaid Services, the American Medical Association (AMA), and other recognized accrediting and professional organizations. VAMC patients who are admitted or followed on an outpatient basis will be considered as candidates for cardiac surgery at the CONTRACTOR's facility. The VAMC will conduct the initial assessments (history, physical, and diagnostic studies) for the patients. Cardiac catheterization and coronary catheter interventions will also be performed by the VAMC. If surgery is indicated, all other studies considered necessary including CXRs, EKGs, PFTs, etc., will be carried-out expeditiously by the VAMC at the VAMC with the exception of typing and cross-matching blood and blood products that will be done by CONTRACTOR at their facility. The necessary approval process by the Veterans Administration (VA) Chief of Staff or designee should be processed via an electronic consult in the VAMC's computerized patient record system (CPRS). The referring VAMC physician will electronically document the status of the discharge in the patients VAMC medical record. A cardiologist with a medical staff appointment at the VAMC will refer a VA patient for cardiac surgery. A CT surgeon with a medical staff appointment at the VAMC will refer a VA patient for other major chest procedures covered under the contracted services. The referral will be made via the VAMC electronic consult process in CPRS and will be coordinated through the VAMC Cardiothoracic Case Manager. The recommendation for cardiac surgery will be evidence-based according to accepted clinical practice guidelines and will be made jointly by the cardiac surgeon and the cardiologist. The ultimate clinical decision by the patient or authorized decision maker for cardiac surgery will be made in consultation with a faculty member of the Division of CT at CONTRACTOR with concurrence of the VA Chief of Staff or designee. The CT surgeon shall immediately electronically document their findings and recommendation for each consult using the VAMC's CPRS, in addition to generation of the CT surgery fee consult. Timeliness of Response: Services shall be available from the Contractor upon notification by the Veterans Administration Medical Center (VAMC): "Elective outpatient cases, 30 days "Urgent/emergent inpatient cases, 24 hours Pre-Operative Management of VA Patients Undergoing Cardiac Surgery: Inpatients: Prior to transfer to CONTRACTOR: "VAMC staff will conduct pre-operative assessment. "A health summary of recent tests, x-rays, etc., as well as a catheterization report will be given to the CONTRACTOR physician through the VA CT Case Manager. "The CONTRACTOR CT Surgeon shall personally examine the patient at the VAMC at no additional cost to the VA. The findings and recommendations shall be electronically documented immediately following the consultation utilizing the VAMC CPRS system. "CONTRACTOR shall assign a bed to the VA patient and the CONTRACTOR nurse accepting the patient shall contact the VA nursing staff for a transfer report. "Pre-operative teaching/instruction to the patient on clinical and administrative issues will be the responsibility of the VA CT Case Manager. "Patients shall be given their preoperative medical preparation and evaluation for anesthesia at CONTRACTOR. Outpatients: Prior to admission to CONTRACTOR: "VAMC staff will conduct pre-operative assessment. "A health summary of recent tests x-rays, etc., as well as a catheterization report will be given to the CONTRACTOR CT surgeon through the VA CT Case Manager. "During the pre-operative process and at the discretion of the CONTRACTOR physician, in coordination with the CT case manager, ambulatory patients reporting to the CONTRACTOR for cardiac surgery are referred to CONTRACTOR to meet with the physician and facilitate CONTRACTOR's processes at no additional cost to the VA. "Pre-operative teaching/instruction on clinical and administrative issues will be the responsibility of the VA CT Case Manager. "Patients shall be given their preoperative medical preparation and evaluation for anesthesia at CONTRACTOR. Transfers: The term "transfer" pertains to the physical movement of patients between the two facilities and is not to be construed to replace the required administrative admission and discharge processes at each facility. Emergency Cath Lab patients for which cardiac surgical intervention is indicated will be accepted to contractor's surgery suite with transfer time under one (1) hour from complication to arrival at contractor's surgery suite. Emergency (for ongoing ischemia) cases must be accepted by the contractor within 24 hours of the initial contact. The attending physicians and the VA CT Case Manager will coordinate transfers between CONTRACTOR and VAMC with the assistance of the CONTRACTOR's CT Surgery Patient Coordinator. Inpatient Post-Operative Care: CONTRACTOR shall provide surgical and post-operative care until the patient is discharged. All care needs that the patient may have upon discharge (i.e., medications, prosthetic items, home health needs, etc.) shall be coordinated with the VA CT Case Manager as early as possible during the patient's stay. The VA will be responsible for providing the identified items to the patient. The VA will not be responsible for any items provided by CONTRACTOR to the patient without prior approval. Upon discharge of a VA referral, the Contractor's provider will complete a discharge summary within forty eight (48) hours. For referred patients who expire, CONTRACTOR shall immediately notify the VA CT Case Manager and VA's COTR of this contract with an explanation of the circumstances and probable cause of death. If the Case Manager or the COTR is not available (i.e., during non-business hours), the Chief of Staff shall be contacted. The VA Chief of Staff and VA CT Case Manager will also be advised immediately when a sentinel event occurs in any referred patient. A sentinel event is defined as an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase, "or the risk thereof" includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. The CONTRACTOR CT discharge planner shall notify the VA CT Case Manager upon the patient's discharge from CONTRACTOR facility. The CONTRACTOR CT discharge planner shall also supply copies of the operative report and the discharge summary to the VA CT Case Manager within 5 days after discharge. Payment for services will be made within 15 days of the receipt of all invoices by the VA Fee Office patient and review and approval of records relevant to the cardiac surgery stay by the COR. For purposes of this agreement an outlier case will be defined as a case that exceeds three times the Medicare geometric mean average length of stay of 6.8 days or a case wherein the patient is able to be readmitted to the VAMC but is not due to lack of available bed or other circumstances beyond the control of CONTRACTOR. Once a case reaches an outlier status the case will be reimbursed at 60% of the DRG per diem for the days in excess of 20. Delays in readmission to the VAMC will be referred to the Contractor Chief of Staff who will then contact the VA Chief of Staff to resolve the transition of the patient to the VAMC. Re-operation during the early post-operative period (72 hours) for complications related to the initial procedure shall be included in the original charge. Outpatient Post-Operative Care: Cardiac surgery patients will have the initial post-operative appointment scheduled at Contractor facility at the surgeon's desired date with a chest x-ray and any required labs to be included in the original charge. A follow-up visit in the VA CT Surgery Clinic with a CT surgeon within one month of the Contractor post-operative appointment will be scheduled as directed by the surgeon. Follow-up thereafter will continue in the VA Primary Care and Cardiology Clinics or other VAMC clinics as necessary. Should the patient be erroneously scheduled for a post-operative visit at UK Medical Center after the initial visit as referenced in the preceding, neither the patient, nor the Lexington VAMC shall be liable for the services rendered. Quality Assurance Monitoring: The VA CT Case Manager will have access to all medical information about the VA patients at the contractor's facility. The contractor's NISQIP or CSQIP coordinator shall provide the VA Chief of Staff with semi-annual reports which will include, but not be limited to: "Pre operative risk stratification "Infection rates which are calculated according to standards provided by nosocomial infection surveillance by the Center of Disease Control (CDC) "Average length of stay "Mortality/Morbidity rates "Complication Rates "Readmission occurrences "Rate of return to the operating room "Documentation of CT surgery morbidity & mortality educational and performance improvement initiatives "Patient satisfaction data to include specific patient complaints as well as quantitative data. The data reported will support re-credentialing of CONTRACTOR CT surgeons at the VA. Outcome and process oriented quality data specific to each attending surgeon will be utilized. The aggregate reports shall be of CONTRACTOR's overall cardiac program but will also specify results for VA patients. No later than by the end of the first month of each quarter, reports reflecting the prior quarter's data will be submitted to the COR via email. Patient Satisfaction Patient complaints pertaining to quality of care and other issues are to be reported to the VA Patient Advocate, the COR, and the Contractor for resolution. Complaints should be reported immediately, but no later than 24 hours, so prompt review and action may be taken.
 

Web Link

FBO.gov Permalink
(https://www.fbo.gov/spg/VA/NaVAMC/VAMCCO80220/VA24913R0782/listing.html)
 

Document(s)

Attachment
 

File Name: VA249-13-R-0782 VA249-13-R-0782 Sources Sought.docx (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=825198&FileName=VA249-13-R-0782-000.docx)

Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=825198&FileName=VA249-13-R-0782-000.docx

 

Note: If links are broken, refer to Point of Contact above or contact the FBO Help Desk at 877-472-3779.
 

Place of Performance

Address: VAMC Lexington;1101 Veterans Drive;Lexington, KY

Zip Code: 40522-2236
 

Record

SN03094987-W 20130622/130620235109-2eaec627870e9805fac81289243e36d4 (fbodaily.com)
 

Source

FedBizOpps Link to This Notice
(may not be valid after Archive Date)

---

| FSG Index  |  This Issue's Index  |  Today's FBO Daily Index Page |