R499--Community Living Centers (CLC) Long Term Care

Form / Attachment / Pricing Sheet

This document is a template for assessing "Immediate Jeopardy" (IJ) situations. It is designed to guide the evaluation of whether an entity has failed to meet federal health, safety, Administration, fiscal, and/or quality regulations, and if such noncompliance has led to or is likely to lead to serious adverse outcomes.

• IJ Component: This section outlines the three key areas to be assessed:
  • Noncompliance: Requires identification of the specific federal regulation(s) and a summary of the issues leading to noncompliance, including actions taken or not taken, and the extent of the noncompliance.
  • Serious injury, serious harm, serious impairment or death: Requires evidence of actual or likely serious adverse outcomes resulting from noncompliance.
  • Need for Immediate Action: Requires an explanation if immediate action is necessary to correct noncompliance that has caused or is likely to cause serious injury, harm, impairment, or death.
• Yes/No: A field to indicate whether the IJ component exists.
• Preliminary fact analysis which demonstrates whether key component exists: A narrative section for detailing the findings and evidence supporting the assessment for each IJ component.

This template is likely an attachment to a solicitation or contract, indicating that the government will use this framework to assess compliance. Bidders should understand these criteria to ensure their operations meet federal regulations and to prepare for potential government assessments related to immediate jeopardy situations. It highlights the critical importance of compliance with health, safety, and quality standards.

Form / Attachment / Pricing Sheet

This document, titled "Attachment B: Table of Surveyor Component Guide," provides a guide for determining the number of surveyors and days required for both Clinical and Life Safety surveyor components based on the Facility Census.

• Facility Census: Categorizes facilities by the number of residents (e.g., 1-50, 51-100, 251+).
• Clinical Surveyor Component: Specifies the number of surveyors and the number of virtual/onsite days needed.
• Life Safety Surveyor Component: Specifies the number of surveyors and the number of virtual/onsite days needed.

This attachment is crucial for bidders to understand the expected scope and resource allocation for surveyor activities, particularly if the opportunity involves providing these services. It helps in estimating personnel and time requirements for proposals.

Form / Attachment / Pricing Sheet

This document is an Excel spreadsheet containing detailed CLIN (Contract Line Item Number) rates for various periods of performance, including the base period and multiple option periods. It serves as a pricing sheet for bidders to understand the cost structure associated with different labor categories and tasks.

• CLINs: Lists specific CLINs such as "CLC Annual Survey," "SCI/D Annual Survey," "Monthly Electronic Feedback Reports," "Kick Off Meeting," "Monthly Meeting," "Quarterly Meeting," "Annual Survey Schedule," "Survey Script," "Contractor Personnel Training Plan & Documents," "Electronic Feedback Mechanism," "Project Work Plan," and "Communication Plan."
• Labor Categories: Specifies various labor categories for each CLIN.
• Hours & Quantity: Provides fields for hours and labor quantity.
• Costing Information: Includes columns for "AVG GSA FSS Price List Labor Category Cost," "Fully Burdened Rate," "Total Direct Labor Costs," "Other Direct Costs," "Quantity," "Cost," "Taxes," and "TOTAL COST."
• Option Periods: Details escalated rates for Option Periods 1 through 5, with a 3% annual escalation applied.

This pricing sheet is crucial for bidders to develop their cost proposals. It outlines the expected labor rates and associated costs for each CLIN across the potential contract duration. Bidders must use this structure to input their own proposed pricing, ensuring alignment with the government's provided framework and escalation assumptions.

Form / Attachment / Pricing Sheet

This document is an Excel spreadsheet titled "Attachment N Estimated Quantities and Pricing Sheet.xlsx". It appears to be a pricing sheet intended for bidders to provide estimated quantities and unit prices for various services related to the opportunity.

The sheet contains line items for:

• CLC Annual Onsite Surveys
• SCI/D Annual Onsite Surveys
• Monthly Electronic Feedback Reports
• Kick off Meeting
• Monthly Meeting
• Quarterly Meeting
• Annual Survey Schedule
• Survey Script
• Contractor Personnel Training Plan & Documents
• Electronic Feedback Mechanism
• Project Work Plan
• Communication Plan

Quantities are listed for a base period and five subsequent periods (Period 1 through Period 5). All unit prices and amounts are currently listed as 0.0, indicating that bidders are expected to fill in their proposed pricing.

This attachment is crucial for bidders to understand the estimated scope of work in terms of quantities for each service item across different periods. Bidders must use this sheet to calculate and submit their proposed pricing, which will likely be a significant factor in the evaluation of their offer.

Form / Attachment / Pricing Sheet

This document is a Business Associate Agreement (BAA) between the Department of Veterans Affairs (VA) Veterans Health Administration (VHA) and a business associate. Its purpose is to establish the requirements for the use and disclosure of Protected Health Information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health (HITECH) Act, and related HIPAA Rules.

• Definitions: Clarifies terms such as Breach, PHI, Business Associate, Covered Entity, and Subcontractor as defined by HIPAA Rules.
• Use and Disclosure of PHI: Outlines permitted uses and disclosures of PHI by the Business Associate, emphasizing compliance with HIPAA Privacy Rule and minimum necessary policies.
• Obligations of Business Associate: Details requirements for safeguarding PHI, reporting breaches (within 24 hours of discovery), providing written reports (within 10 business days), mitigating harm, using compliant subcontractors, entering into BAAs with subcontractors, assisting with individual requests for PHI access/amendment/accounting, and returning or destroying PHI upon contract termination.
• Obligations of Covered Entity: Specifies the VA's responsibilities, including not requesting impermissible uses/disclosures of PHI, notifying the Business Associate of restrictions, obtaining necessary authorizations, and informing the Business Associate of changes to privacy practices.
• Termination: Addresses automatic termination, termination upon review, and termination for cause, including the survival of obligations post-termination.

This BAA is a critical attachment that outlines the strict requirements for handling Protected Health Information (PHI) if the opportunity involves access to or management of such data. Bidders must understand these obligations, including data security, breach notification, and PHI handling procedures, as failure to comply can result in significant penalties. It highlights the sensitive nature of the data involved and the stringent compliance framework required by the VA.

Form / Attachment / Pricing Sheet

This document is a de-identified survey report from the Department of Veterans Affairs Community Living Centers (CLC) Unannounced Survey, serving as a Summary Statement of Deficiencies. It has been de-identified to remove protected health information in compliance with HIPAA and other laws.

• General Information: Includes fields for Facility Name, Onsite/Virtual status, Dates of Survey, Total Available Beds, and Census on First Day of Survey.
• VA Regulation Deficiency: Details specific regulatory violations. In this instance, §51.120 (n) Medication Errors is cited.
• Findings: Describes the observations, interviews, and record reviews that led to the deficiency. For medication errors, the finding indicates a failure to administer nasal spray as recommended for one out of four residents reviewed.
• Level of Harm: Assesses the severity of the deficiency, noted here as 'No Actual Harm, with potential for more than minimal harm.'
• Residents Affected: Quantifies the impact, stated as 'Few.'

This document provides insight into the operational standards and potential deficiencies related to a facility's medication management practices. While not a direct requirement for proposal submission, it may inform bidders about the operational context and quality expectations for CLC services, particularly concerning medication administration and regulatory compliance.

Form / Attachment / Pricing Sheet

This document is a template for the Department of Veterans Affairs Community Living Center Survey Report. It outlines the structure and content required for reporting on unannounced surveys of Community Living Centers.

• General Information: Includes survey group, facility name, modality, dates, bed count, census, medication error rate, CLC Medical Director, and CLC Nurse Leader.
• Pre-Survey Information: Details survey team activities and preparation, including selected care areas for review.
• General Description and Observation of Community Living Center: Requires descriptions of current census, services, population served, capacity, vendor's assessment of cultural transformation (person-centered care), and observed positive practices.
• F-Tag Findings: Includes specific F-Tags (e.g., Example-F 656 for Comprehensive Care Plan), applicable regulatory language, scope/severity, HATCh Model category, and statements of deficiency.

While this document is a template for reporting, bidders responding to opportunities involving Community Living Centers may find it useful to understand the types of assessments and data the VA collects. It provides insight into the performance standards and areas of focus during VA surveys, which could inform service delivery and proposal development.

Form / Attachment / Pricing Sheet

This document provides the "Scope and Severity Rating Descriptions" used to classify deficiencies. It outlines a system for rating the severity of identified issues, ranging from "Potential for Minimal Harm" to "Immediate Jeopardy."

• Ratings with Potential for Minimal Harm (A-C): Describes deficiencies with no more than a minor negative impact.
• Ratings with Minimal Harm or Potential for Actual Harm (D-F): Describes deficiencies that result in minimal discomfort or potential negative effects on a resident's highest functional status.
• Ratings with Actual Harm (G-I): Describes more serious deficiencies that have negatively affected a resident's ability to achieve their highest functional status.
• Ratings with Immediate Jeopardy (J-L): Describes the most serious deficiencies that place a resident in immediate jeopardy, potentially causing serious injury, harm, impairment, or death, requiring immediate corrective action.
• Definitions of Scope (Isolated, Pattern, Widespread): Clarifies the extent of a deficiency's impact.
• Scope and Severity Grid: A visual grid correlating deficiency levels (Level 1-4) with scope (Isolated, Pattern, Widespread) and the corresponding rating (A-L).

This document is crucial for understanding the criteria used to assess performance or compliance within the context of the opportunity. Bidders can use this to gauge the potential impact and seriousness of any requirements or potential findings related to the scope and severity of deficiencies.

Questions & Answers / Clarifications

This document provides clarifications regarding Life Safety Surveys for Community Living Centers (CLC), addressing specific interpretations of NFPA codes and CMS requirements.

• Fire Drills at Unexpected Times: VHA facilities are not required to conduct fire drills at "unexpected times" as mandated by CMS. They can conduct drills on the same shift, day, or hour as previous drills, aligning with NFPA 101, 19.7.1.6.
• Fire Drills within CLC Location: A fire drill conducted in a building that includes a CLC counts for the CLC if CLC staff respond according to the facility's fire response plan, regardless of the fire's simulated origin.
• Transmission of Fire Alarm Signal: During fire drills, transmission of a fire alarm signal to a remote station or fire department is not required. Between 9 p.m. and 6 a.m., a coded announcement can substitute for audible alarms.
• Sprinklers in Closets/Casework: Sprinklers are not required in casework (wardrobes/lockers) in VHA CLCs, as they are considered furniture and not part of the structure, provided the room's sprinkler protection covers the space.
• Exit Discharge Characteristics: VHA permits existing exit discharges to be non-paved surfaces (grass, dirt, gravel) if they are level and maintained, and provide safe access to a public way. Paved surfaces are not mandated.
• Cooking Facilities: Therapy cooking facilities in healthcare occupancies do not require protection under NFPA 96 or NFPA 101, unless they are commercial cooking or open to the corridor with specific occupancy limits.

This document clarifies existing regulations and interpretations, which may impact how facilities are surveyed and what compliance measures are expected. Bidders involved in CLC operations or life safety compliance should be aware of these specific VHA interpretations of NFPA and CMS standards.

Form / Attachment / Pricing Sheet

This document appears to be a list of Veterans Affairs (VA) facilities, detailing their last survey dates and deferred survey due dates. It is likely used for tracking and scheduling facility inspections or compliance checks.

• Facility Name (including CLC designation where applicable)
• City and State of the facility
• Last Survey Date
• Deferred Survey Due Date (indicating the next scheduled survey)

While this document does not directly outline requirements for a specific solicitation, it provides critical information about the operational status and inspection schedules of various VA facilities. Bidders may find this useful for understanding the context of opportunities related to facility maintenance, inspections, or services that require interaction with these facilities. The 'Deferred Survey Due Date' column indicates when a facility is next scheduled for a survey, which could be relevant for understanding potential future needs or ongoing compliance requirements for contractors working with the VA.

Form / Attachment / Pricing Sheet

This document, titled "Attachment F Updated VA F-Tag-Crosswalk," serves as a crosswalk between regulatory groupings and specific tag numbers, referencing the Code of Federal Regulations (CFR) and applicable standards (CMS, VHA, N/A). It appears to be an informational tool for understanding compliance requirements.

• Regulatory Groupings: Categorizes requirements (e.g., Resident Rights, Quality of Care, Infection Control).
• Tag #: Unique identifiers for specific regulations.
• SQC Tag?: Indicates if the tag is part of the Survey & Certification (SQC) program.
• Tag Title: A brief description of the regulatory requirement.
• CFR: The specific section of the Code of Federal Regulations.
• Standard(s): Identifies the governing standard (CMS, VHA, or N/A).
• Comments: Provides additional context, clarifications, or notes on applicability, particularly for VHA.

This document is relevant for bidders as it details the specific regulatory requirements and standards that must be met by healthcare providers, particularly those operating under the VA (VHA). Understanding these crosswalks is crucial for developing proposals that align with compliance mandates, especially in areas such as resident rights, quality of care, infection control, and physical environment standards. It helps bidders identify the precise regulatory framework governing the opportunity.

Solicitation / RFP / RFQ

This document is a solicitation (SF 1449) for commercial products and services. The U.S. Department of Veterans Affairs, OPAL | Strategic Acquisition Center, is issuing this solicitation.

This solicitation references FAR 52.212-1, 52.212-4, and 52.212-3. FAR 52.212-5 is attached. Addenda are also attached.

Several attachments are provided, including:

• Attachment A: HATCh Intro VA CLCs

• Attachment B: List of VA CLCs and SCI-D

• Attachment C: Corrective Action Request Procedure and Form

• Attachment D: Survey Observation Record

• Attachment E: Table of Surveyor Component Guide

• Attachment F: Updated VA F-Tag-Crosswalk

• Attachment G: Survey Due By Dates

• Attachment H: VA-Joint Commission LSC Clarifications Document

• Attachment I: Scope and Severity Ratings

• Attachment J: Immediate Jeaporday Template

• Attachment K: CLC Survey Report Template

• Attachment L: CLC Deidentified Survey Report Template

• Attachment M: Business Associate Agreement

• Attachment N: Estimated Quantities and Pricing Sheet

• Attachment O: Detailed Price Cost Sheet

• The estimated value is $24.5 Million.

• The solicitation number is 36C10G24R0017.

• Offer Due Date: June 12, 2026, 14:00 EDT.

• The solicitation incorporates by reference FAR 52.212-1 and FAR 52.212-4. FAR 52.212-3 and FAR 52.212-5 are attached.

This acquisition is unrestricted. It is set aside for Small Business.

• The issuing office is the U.S. Department of Veterans Affairs, OPAL | Strategic Acquisition Center, Fredericksburg, VA.
• Payment will be made by the U.S. Department of Veterans Affairs Financial Services Center.
• Bidders are required to complete blocks 12, 17, 23, 24, & 30 of the SF 1449 form.

Form / Attachment / Pricing Sheet

This document is an Excel spreadsheet containing survey observation records for a Community Living Center (CLC) or State Veterans Home, related to an operational support contract. It serves as a template for surveyors to record their observations during site visits.

The document includes several sheets designed for data collection:

• CLC Description: Basic information about the CLC, including name, location, bed count, and census data.
• Entrance: Details for the initial entrance conference, including team introductions and process explanations.
• Team Lead, Surveyor One, Surveyor Two, Surveyor Three, Life Safety Surveyor: These sheets are structured for individual surveyors to record scores and comments based on specific criteria. Criteria include timeliness, professional behavior (attire, badge, interactions), observation of meals, resident council and family interviews, medication observations, resident care observations, staff interviews, and review of nursing competency for special populations.
• Daily Debriefs: A section to record notes on professional behavior and daily conferences, including feedback and discussion of observations.
• Exit: Details for the exit conference, similar to the daily debriefs, summarizing findings and providing feedback.

While this document is a template for survey observations, its presence suggests that the contracting agency will be conducting site visits and performance evaluations as part of the contract. Bidders should understand that adherence to operational standards, professional conduct, and resident care protocols will likely be assessed. The detailed criteria within the survey sheets may indicate areas of focus for contract performance and compliance. This template helps bidders anticipate the types of performance metrics and observational standards that will be applied during contract execution.

Form / Attachment / Pricing Sheet

This document outlines the procedure and provides the form for Corrective Action Requests (CARs). It details the process for communicating major concerns or continuous issues with contractual compliance and performance to the contractor, and how the contractor must respond by identifying root causes and corrective actions with implementation dates.

• Procedure: Describes the step-by-step process from identification of a concern to its resolution, including notification, contractor response, government review, and acceptance/rejection of corrective actions.
• CAR Form: Includes fields for:
  • Submission details (Date, Submitted by, Due Date)
  • Contract reference, Activity, Task, Deliverable
  • Description of Concern
  • Contractor Response for Root Cause Analysis and Corrective Actions
  • Target Date for Completion
  • Government Receipt and Response (Acceptable/Not Acceptable Plan)
  • Government Determination of Effectiveness

This document is crucial for understanding the formal process the government will use to communicate performance or compliance issues. Bidders should familiarize themselves with the CAR procedure and the required content of the CAR form to ensure they can effectively respond to any identified concerns during contract performance. It highlights the importance of timely and thorough root cause analysis and corrective action planning.

Form / Attachment / Pricing Sheet

This document lists Veterans Affairs (VA) Community Living Centers (CLC) and SCI/D Long Term Care Centers, organized by VISN (Veterans Integrated Service Network). It serves as a reference for identifying facilities that may be relevant to the opportunity.

• VISN Number
• Facility Name (including CLC and SCI/D designation where applicable)
• Facility Address
• City, State, and Zip Code
• Phone Number
• A "Purple Highlight" indicates CLCs with a SCI/D Long Term Care Center.

This list provides potential bidders with a comprehensive overview of VA facilities that operate CLCs and SCI/D Long Term Care Centers across various VISNs. This information is crucial for understanding the geographic distribution and contact details of these centers, which may be relevant for service delivery, partnership opportunities, or understanding the scope of potential future solicitations related to these types of care.

Form / Attachment / Pricing Sheet

This document, "Attachment A HATCh Intro VA CLCs.pdf," is an introductory guide to the VA Community Living Center (CLC) model of resident-centered care. It serves as an educational resource for VA staff, aiming to bridge the gap between theory and practice, set expectations for CLC values and culture, and provide a resource for staff.

• Resident-Centered Care: Emphasizes individualized care driven by resident needs, preferences, and "what matters most."
• Foundational Models: Integrates principles from CONCERT (Center for Enhancing Resources & Training), Age-Friendly Health System (AFHS), and Patient Priorities of Care (PPC).
• HATCH Model: Utilizes the Holistic Approach to Transformational Change as a framework, focusing on six domains including work practices, care practices, and environment of care.
• Culture Transformation: Details the shift from a medical model to a resident-centered model, prioritizing resident autonomy and home-like environments.
• Work Practices: Outlines practices such as daily huddles, interdisciplinary decision-making, and creating supportive work environments.
• Care Practices: Describes providing dignified, respectful, and compassionate care, including individualized plans, liberalized diets, and meaningful activities.
• Environment of Care: Focuses on creating clean, safe, and home-like environments with designated spaces and warm aesthetics.
• Leadership: Emphasizes influencing outcomes, engaging stakeholders, continuous learning, and fostering innovation.
• Guiding Principles and Regulations: Explains core concepts like HATCH, CONCERT, AFHS, PPC, Whole Health, Whole Person, Whole Team, and VA QAPI.
• Community Interaction: Details welcoming community and volunteers and providing opportunities for resident participation.
• VA Core Values: Outlines the "I CARE" values (Integrity, Commitment, Advocacy, Respect, Excellence).
• Supplemental Appendices: Includes "Questions to Ask Ourselves" to encourage empathy and a "Pre and Post Knowledge Check" for staff assessment.

This document provides foundational information about the VA's approach to resident-centered care within its Community Living Centers. Understanding these principles, models (like HATCH), and values is crucial for any vendor proposing to provide services or support related to VA CLCs, as it outlines the expected philosophy, operational practices, and cultural expectations for care delivery.

Solicitation / RFP / RFQ

This solicitation is for an Indefinite Delivery/Indefinite Quantity (IDIQ) Fixed Price (FP) contract to provide survey services for VA Community Living Centers (CLCs) and Spinal Cord Injury/Disorders (SCI/D) Long Term Care Centers. The contractor will conduct surveys in accordance with the Centers for Medicare and Medicaid (CMS) process and applicable federal regulations.

• Conduct annual and "for cause" surveys of CLCs and SCI/D Long Term Care Centers.

• Utilize CMS survey processes and protocols, including the State Operations Manual (SOM) Appendix PP.

• Perform onsite surveys, including direct resident care observation, physical environment assessment, and medical record review.

• Identify and report substandard and Immediate Jeopardy (IJ) deficiencies.

• Provide various reports, including survey reports, electronic feedback mechanisms, and quarterly reports.

• Develop and maintain plans such as a Program Work Plan, Communication Plan, and Contractor Personnel Training Plan.

• Conduct meetings (Kickoff, Monthly, Quarterly) and provide survey schedules.

• Contract Type: Indefinite Delivery/Indefinite Quantity (IDIQ) Fixed Price (FP).

• Period of Performance: 12-month base period and four 12-month option periods.

• Minimum Guarantee: $40,000.

• Maximum Ceiling Amount: TBD at time of award.

• Proposal Submission Deadline: Friday, June 12, 2026, at 3:00 PM ET.

• Questions Due: Tuesday, May 12, 2026, at 3:00 PM ET.

• Proposals must be submitted electronically to the Contract Specialist and Contracting Officer.

• Evaluation Factors: Technical (most important), Past Performance, Cost/Price, and Veterans Preference. A Best Value Tradeoff analysis will be used.

• Solicitation is UNRESTRICTED or SET ASIDE for WOMEN-OWNED SMALL BUSINESS (WOSB) ELIGIBLE UNDER THE WOMEN-OWNED SMALL BUSINESS PROGRAM.

• NAICS Code: 541611 (Administrative Management and General Management Consulting Services).

• Size Standard: $24.5 Million.

• The solicitation includes FAR and VAAR clauses incorporated by reference.

• Specific attachments are listed in Section D, including PWS, survey guides, and templates.

Solicitation / RFP / RFQ

The Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Geriatrics and Extended Care (GEC) Program Office requires the services of an independent survey company/contractor to conduct surveys at VA-owned and operated Community Living Centers (CLCs) and Spinal Cord Injury/Disorders (SCI/D) Long Term Care Centers. The contractor will utilize the Centers for Medicare and Medicaid (CMS) process, adhering to Title 42 Part 483 of the Code of Federal Regulations and the Long-Term Care State Operations Manual (SOM) Appendix PP.

• Conduct surveys at approximately 134 CLCs and 5 SCI/D Long Term Care Centers.

• Utilize the CMS process for CLCs and SCI/D Long Term Care Centers.

• Surveys will be unannounced.

• Survey modality (onsite or virtual) will be determined by the GEC Program Office based on public health emergencies.

• Contract Type: Indefinite Delivery/Indefinite Quantity (ID/IQ) Fixed Price (FP).

• Period of Performance: Twelve (12) month base period and four (4) twelve (12) month option periods.

• This notice is a pre-solicitation announcement. No proposals or quotes are being requested at this time.

• No other information is available until the issuance of the solicitation.

• Set-Aside: WOSB (Women-Owned Small Business)

• Product Service Code: R499

• NAICS Code: 541611 (Management Consulting Services)

• The Government is not obligated to award a contract, pay for preparation costs, or issue a solicitation based on this notice.