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FBO DAILY - FEDBIZOPPS ISSUE OF AUGUST 17, 2018 FBO #6111
DOCUMENT

Q -- General Acute Medical Services Manchester VAMC - Attachment

Notice Date

8/15/2018
 

Notice Type

Attachment
 

NAICS

622110 — General Medical and Surgical Hospitals
 

Contracting Office

Department of Veterans Affairs;VAMC Togus;1 VA Center;Augusta ME 04330
 

ZIP Code

04330
 

Solicitation Number

36C24118Q9295
 

Response Due

8/20/2018
 

Archive Date

10/19/2018
 

Point of Contact

James Paulette
 

E-Mail Address

k
 

Small Business Set-Aside

N/A
 

Description

This Sources Sought Notice is to assist the Department of Veterans Affairs, VAMC Manchester in determining prospective offerors for an upcoming acquisition. VAMC Manchester, located at 718 Smyth Road, Manchester NH 03104, is looking for hospitals to provide General Acute Medical Services in accordance with the Performance Work Statement below. Interested hospitals should contact James Paulette, Contract Specialist at 207.623 8411 X2292 or james.paulette@va.gov no later than 4PM on Monday, August 20 2018. B.5. PERFORMANCE BASED WORK STATEMENT B.5.1 BACKGROUND: 1. The Department of Veterans Affairs recognized that veteran s health care services in New Hampshire are not adequate to meet standards for access to acute care services and other vital services as required to be provided by the VA. Therefore, the VA is seeking to establish multiple basic ordering agreements with neighboring hospitals to provide the Veteran community and our providers more options when it comes to acute care. B.5.2 SERVICES REQUIRED: The hospital or Health Care Organization (HCO) shall agree to provide the services as specified to all veterans accepted in transfer or referred from The Department of Veterans Affairs, VA Medical Center Manchester, NH herein after called VA, in accordance with the terms, objectives and conditions of this agreement. Contractor shall provide health services on a non-discriminatory basis to VA beneficiaries in a manner similar to and within the same time availability in which the contractor providers services to any other individual unless otherwise required by VA regulations and the agreement. VA agrees to refer to Contractor only those veterans whose conditions may be cared for within the capabilities of Contractor. VA shall use and pay for a contract ambulance service to transfer patients in compliance with the terms and conditions of the ambulance service s contract with the VA. For transports initiated by the contractor, the contractor shall be responsible for costs incurred for transporting patients between Contractor campuses or from Contractor facility to other health care sites for inpatient treatment when more appropriate care should be provided at the receiving facility. Under no circumstances will the veteran be charged for transportation costs. The VA shall be responsible for costs incurred transports are initiated by the VA. When transporting VA patients to another facility, the contractor shall provide all necessary medical equipment and supplies to ensure safe transport of the patient. The contractor s non-disposable equipment shall be returned within 24 hours. Services to be provided to authorized VA patients will include, but are not limited to: 24 hour emergency /Observation/OBGYN/acute medical/surgical services Provide inpatient hospital care in an acute care setting for the treatment of VA referred patients Provide a network of specialty care providers, who are credentialed and privileged in the contracted hospital, to treat VA-referred patients presenting to the contracted emergency department with a medical emergency as defined in section B.4.9 Operating Constraints. Provide outpatient services of credentialed specialists for the treatment of VA referred patients to provide appropriate and authorized outpatient care related to authorized pre-and post-operative care to veterans treated under the inpatient care agreement. Diagnostic procedures Pharmaceutical and therapeutic services Inpatient mental health services (as appropriate) Provide inpatient mental health care for the treatment of authorized VA referred patients Provide a network of community mental health care providers, who are credentialed and privileged in the contracted facilities, to treat VA referred veterans during authorized inpatient stays. Case Management, discharge planning and placement When decision is made to transfer to HCO, the VAMC Urgent Care (UC) Staff will contact the HCO using agreed upon processes. Upon acceptance by HCO transfer of the patient will be arranged by the VA. A treatment record will accompany patient, which includes a copy of each item listed under paragraph titled Records. Decision to accept patient is the responsibility of the HCO. Each VA inpatient will be admitted to an appropriate service, who will manage the inpatient episode of care. While patient is in the HCO acute care facility, patient progress will be communicated on a daily basis (HCO Case Manager to VA Case Manager Liaison and/or to VA Provider when appropriate, and HCO billing administrative services to VA Fee Basis). Transfers to Higher Level of Care (HLOC) require notification with the VA. Additional Requirements: Contractor shall provide continuous care for authorized veterans and beneficiaries hospitalized at that facility until maximum hospital benefits are achieved or VA providers make arrangements for alternate care to meet the veterans needs. VA shall be final decision-maker for coverage and responsibility for payment under this agreement. Not all veterans are eligible enrollees and covered by VA under this agreement. The VA shall not pay for hospital services for patients who do not meet utilization review criteria. Patients should be discharged as soon as practical when they no longer meet said criteria. VA retains the right to deny payment for services for patients who no longer meet criteria and to deny payment for days where there are service delays. Contractor shall not bill the veteran or other payer sources for services denied for these reasons. Contractor shall receive pay for services performed under the agreement. The Office of Community Care shall be responsible for reviewing all invoices and when needed, an audit shall be conducted by the contracting officer or contracting officer s technical representative. B.5.3 ORDERING PROCEDURES: 1. The ordering procedures listed below are to be used by both VA and the accepting medical facility to which the order is being placed. Within the context of this agreement, an order is placed when VA contacts the medical facility to place a veteran for an acute medical need. If these ordering procedures are to be deviated from, the accepting medical facility shall contact the COR immediately. 2. Ordering Process: VA makes the decision to admit veteran VA makes call to the medical facility considered for transfer If VA wants to place a veteran directly to emergency department, then a call is made to the accepting medical facility s Emergency Department Accepting medical facility accepts veteran Transportation to accepting medical facility is arranged by VA VA generates all necessary paperwork in accordance with PWS any radiographic needs are either sent via PAX or a copy is made to be sent with the veteran Veteran arrives at accepting facility; physical transfer is completed VA completes notes for transfer Report is called by VA Nursing Staff to accepting medical facility s Nursing Staff Direct Admissions Steps 1-8 above are followed, however if the patient is to be a direct admission the Nursing Supervisor of the accepting medical facility is called Complaint requiring admission is relayed, the supervisor then has the Hospitalist to call the provider back for discussion and acceptance Admitting department at the accepting medical facility calls VA with a bed assignment Return calls and bed assignments need to be accomplished in a timely fashion. No more than 30 mins between initial call and bed assignment VA arranges transportation and paperwork is readied for transfer B.5.4 REPORTING REQUIREMENTS: Contractor Communications The provider or HCO Case Manager shall notify the VA Case Manager Liaison upon the following events: Prior to discharge and for discharge follow up care recommendations Upon death of the patient-provide date and time of death When Home O2, IV infusion, DME, Home Health/Hospice Services, Anticoagulation Therapy, Non Formulary Medication Request, and/or Transportation arrangements are needed back to Manchester VA Medical Center for discharges during normal business hours. Notification shall be done as soon as possible, but no less than 8 hours prior to discharge. Request for DME and Home O2 must have orders, documentation to support the request, and indicate that the patient has been trained on safe equipment use, to fulfill Joint Commission regulations. All non-formulary medication requests must be prior approved by the VA. Documentation submission must include reason why this medication is needed and the medically-necessary reason why a formulary medication cannot be taken. This information will be provided to the VA prior to discharge to allow for continuity of therapy. VA shall review and render a decision. Transferred to other contracted facilities, (i.e. skilled nursing, ICF, acute rehab, other VA facilities, etc.) as soon as possible. Multidisciplinary Patient and/or Family meetings, Palliative or Hospice Care Meetings Significant changes in patient condition and/or when requiring a higher level of care. A Daily census report shall be transmitted to the VA Case Management team office listing all Veteran inpatient admissions and discharges and designating whether the patient is on contract or fee and level of care status Patient Medical Records Requests for release of these records shall be referred to VA. Health records created by Contractor pursuant to treatment furnished under this agreement are the property of the Contractor, and the original medical record created by the Contractor shall remain at the Contractor s site. VA and Contractor shall have full and unrestricted access to a copy of the medical record created for treatment, quality management, statistical assessment and other similar purposes. Contractor shall release copies of its records according to its own policies and those laws and regulations to which those records are subject. Contractor shall furnish to VA those portions of the medical record VA determines it will need for post-hospital care or other documentation requirements. When patient is referred, a comprehensive medical treatment record will be provided at the time of acceptance of the patient by the contractor. When patient is discharged back to the VA or to another facility the following documentation must accompany patient upon discharge: 1. Copy of Discharge Summary 2. Copy of Patient Discharge Instructions 3. Copy of History and Physical 4. Copy of recent labs (all labs up to a maximum of two weeks) 5. Rehabilitation Services Discharge Summaries if applicable 6. Copy of Advance Directives (if changed) 7. Copies of all consults 8. Copies of Diagnostic Studies, biopsies and path results, etc. 9. Copy of Medication Administration Record 10. Copies of Imaging studies when appropriate 11. Appropriate transportation and/or facility transfer forms Invoices for patient stays should be submitted within 7-10 days to: Office of Community Care (136F) VA Medical Center (608) 718 Smyth Road Manchester, NH 03104 The Contractor is authorized to retain the health care records for the time period that is specified by its own policies or by state law. The contractor will document on the cover sheet patient is currently receiving care at the HCO and information is needed as soon as possible. Emergency medical information needed immediately for VA patients can be requested by calling or faxing the VA at: (603) 624-4366 ext 6263 Administrative Officer of the Day (AOD) during WHEN hrs (603) 624-4366 ext 6916 Release of information. FAX 603-626-6579 3. Clinical Information Required clinical information includes but is not limited to the following: Inpatient: Administration History and Physical, Discharge Summary, Operative Report (or Procedures Report), images where appropriate (digital whenever possible), treatment plan, completion summaries, medical device information, clinical notes, orders. Outpatient: Completed consult, treatment plan, completion summaries, medical device information, and clinical notes. Diagnostic Tests: Completed reading and results, completed consult and images where appropriate (digital whenever possible) Contractors shall return all required complete clinical information to the VA referral source within the timeframes detailed below: For all routine care completed clinical information and test results must be provided to the VA referral source within 7 business days of the episode of care or prior to referral for further consultation. For all inpatient care, complete clinical information must be provided to the VA referral source within 7 business days of patient discharge or prior to referral for further consultation. For all medical emergency care, complete clinical information must be provided to the authorizing agent or other VA referral source within 48 hours or prior to the need for future medical referral. Evidence that each veteran patient medical record includes: Appropriate patient identification to include name, sex, social security number, and date of birth The patient medical history Evidence of consent for care when consent is required by organizational policy Documentation of care planning activities based on patient problems and needs All appropriate diagnostic and therapeutic procedures, treatments, and tests and results Reevaluation of patient in response to interventions Patients vital signs including assessment of pain Finding of initial assessment and reassessment(s) The description of any safety measures required to protect the patient from injury Description of the patients functional limitations related to care or services provided Specific and appropriate notes on the care or service provided Description of the patients activity restrictions, if any, as related to the care or services provided Statement of any changes in patients condition related to the care or services provided Documents of medication use and medication allergies or sensitivities Legible & Complete physician orders as appropriate Transfer forms, summaries, or copies of any record received from the transferring organization, documentations of patient and family education Other individuals or organizations involved in patient care, referrals to internal and external care providers and community agencies, and dietary restrictions 4. Medical Claims Processing Requirements Medical Claims (invoices) Processing Requirements Medical claims, as used in the context of this agreement, are invoices prepared and submitted by the contractor that consist of the charges of the provider(s) for the health care services rendered to veterans as authorized by VA. Due to the current regulations, the VA will reimburse the entity holding the agreement with the VA only. The entity contracted with the VA shall pay it providers per contracted agreements and services authorized by VA for the veteran. VA will consider solutions that help make this an efficient and timely process. VA pays by claim. Offerors should note that VA cannot pay a claim until the valid claim information, described below as a valid claim submission. A Valid claim submission is processed in the Vista Fee System. For administrative purposes, VA will only accept medical claims (invoices) submitted at the contract rate. The VA will provide information on all rejected claims and necessary corrective actions. On the 3rd rejection of a claim, the VA reserves the right to reduce reimbursement of the contract rate by 2%. Valid Claim Submissions are: HIPAA compliant EDI transaction sets (preferred method), or Completed CMS 1450 (UB92/UB04) or CMS 1500 forms, depended type provided. For VA Policy on submitting EDI claims see: https://www.va.gov/COMMUNITYCARE/providers/info_payments.asp#process For any paper claims, submissions the claim must contain completed standard billing CMS 1450 (UB92/UB04) or CMS 1500 forms, depending on the type of care provided. Offerors are required to provide summary claims data including, but not limited to, number of claims submitted and total amount billing in the Monthly Report. B.5.5 QUALITY ASSURANCE: 1. The contractor will be required to submit a quarterly quality report (Quarterly Quality Assurance/Care Coordination Report) which includes the following but is not limited to depending on the services: Number of patients treated by Diagnostic Category Inpatient Length of Stay Nosocomial infection rates Deaths Procedures Patient Concerns Unresolved issues should be communicated at time of service Adverse Events and Clinical Complications Elopement/AMA discharges Discharge / Placement locations Falls Restraint usage (medical and behavioral) Catheter-associated urinary tract infections Surgical site infections VA patient is missing from contractor s facility requires immediate notification 2. Accreditation and Performance standards: The VA is accredited by The Joint Commission (TJC). As part of this accreditation, VA contractors must be accredited by TJC or equivalent. Contractor personnel shall be subject to the same quality assurance standards; meeting or exceeding current recognized national standards as all regular VA employees. The contractor personnel shall perform the services in accordance with the ethical, professional and technical standards of the VA. The contractor shall provide a copy of documentation to support their accreditation. Any changes or challenges to accreditation status, during the period of performance must be immediately reported to the Contracting Officer. All care required by this agreement shall be provided in accordance with the most recent Standards of the Contractor s Professional Accreditation. Changes in accreditation status shall be communicated to the Contracting Officer, Contracting Officer s Representative (COR) and the VA Office of Quality Management with 5 business days. Certificates of Insurance coverage shall be sent to the Contracting Officer. Policy renewal statements, showing the agreement number, shall be sent to the Contracting Officer during the term of the agreement. The Contract Number shall be noted on this documentation. The Contract may be terminated for Default due to lack of insurance. The contractor must be licensed in the state the contractor facility resides and Medicare approved. Laboratories must be inspected and approved by CAP or TJC for laboratory services. Radiological services must be performed in a radiology department that meets all State, Nuclear Regulatory Commission (NRC) and local regulatory standards. All providers rendering healthcare to VA veteran patients shall be board certified or board eligible, hold appropriate privileges in the contractor s facility and be licensed in a State, Territory or Commonwealth of the United States or the District of Columbia. All other personnel assigned to provide healthcare to VA veterans shall, when required by the State of NH, maintain an active license in good standing. No unlicensed, non-Medicare approved, uncertified or unaccredited entity or person shall perform services under this agreement. The VA shall not pay for providers on the OIG Exclusionary List or the List of Excluded Individuals/Entities. All licensed independent practitioners providing care to VA veterans, as well as ancillary staff, (e.g. anesthesiologist, radiologists, pathologists, etc.) shall be credentialed and privileged according to TJC or equivalent standards. The credentialing process shall include primary source verification of the individual s professional, education, training, licensure, certification and review of health status, previous experience, including any gaps greater than 30 days in training and employment, clinical privileges, professional references, malpractice history and adverse actions or criminal violations. Each clinician shall be screened through the appropriate State Licensing Board (SLB) and the National Practitioner Data Bank (NPDB). The VA shall be permitted, upon request, the right to review the credentialing and privileging files along with the clinical competency documentation upon request. The contractor must notify the Contracting Officer immediately of any changes in the licensure or status of hospital or HCO, any legal governmental action initiated against the contractor for professional negligence, violation of law, bankruptcy, lapse or material change in liability coverage, any other problem or situation that might impair the ability of the contractor to carry out its obligations under the agreement. The Contractor shall immediately notify VA of any merger, acquisition, subcontracts or affiliation agreement that may affect contractor s capability to comply with the provisions of this agreement. Notification shall also be made for any legal or governmental action initiated against the contractor or its providers (employees or subcontractors).
 

Web Link

FBO.gov Permalink
(https://www.fbo.gov/spg/VA/ToVAMROC402/ToVAMROC402/36C24118Q9295/listing.html)
 

Document(s)

Attachment
 

File Name: 36C24118Q9295 36C24118Q9295.docx (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4543589&FileName=36C24118Q9295-000.docx)

Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4543589&FileName=36C24118Q9295-000.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: Manchester VAMC;718 Smyth Road;Manchester, New Hampshire

Zip Code: 03104
 

Record

SN05038956-W 20180817/180815231431-6d26bd2b078e04f43d68883f5c8cd9d2 (fbodaily.com)
 

Source

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

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