HCR - Dialysis Industry Day

INDUSTRY DAY TELECONFERENCE DIALYSIS TREATMENT CHIP-IN, TULSA, OK Dept. of Veterans Affairs (VA), Eastern Oklahoma VA Health Care System (EOVAHCS) Page 2 of 2 The purpose of this amendment is to extend the time for industry to response with their interest and answers to the below questions. The date for responses is now 4/30/26 @ 4:30 MST 1. Unit of Issue & Pricing Structure 1.1 What unit of measure does the industry routinely use to price inpatient hemodialysis services? Per session? Per hour?

Per treatment modality? Is it normal industry practice to distinguish standard, after-hours, and delay-related charges? 1.2 If session is used for the unit of measure, what is the industry standard for duration in terms of hours for the following?

Intermittent Hemodialysis (IHD) Prolonged Intermittent Renal Replacement Therapy (PIRRT) 1.3 What ancillary activities are typically included in the industry on a per-session(unit) rate? Examples: setup, breakdown, machine priming, reporting, documentation, consumables, machine disinfecting. 1.4 Is it standard industry practice to bill for delay in treatment due to hospital issues? 2. Patient Care Technician (PCT) 2.1 Is it a standard industry practice for a PCT to be a part of the service delivery?

If yes, what percentage of the unit cost are customarily attributed to the use of a PCT? If not, what instances would determine whether a PCT is necessary for the provision of services? 2.2 Do vendors commonly staff inpatient dialysis with a PCT in addition to an RN? 2.3 If it is determined that use of a PCT is necessary, what does industry consider average cost allocation for a PCT per-session(unit) rate? What cost structures are typical?

Would including a PCT normally be included or added to the session (unit) cost? Â 2.4 What staffing models does the industry routinely use for inpatient dialysis services in comparable hospital settings, of similar size, scope, and complexity as the JMIVAMC facility? RN-only model? RN + PCT model? 3. Equipment, Space, and Biomedical Technician Requirements 3.1 Is your company capable of providing all dialysis machines, reverse osmosis (RO)/water treatment systems, and consumables as required?

3.2 Does the required 8×8 storage room meet industry expectations for storing all required dialysis equipment and consumables? 3.3 Is it standard industry practice to include a certified Biomedical Technician (CBET) as part of their staffing model for preventive maintenance and repairs when providing services on site at medical facilities? If yes, is this included in per-session (unit) pricing? If yes, does the biomed require additional space beyond the 8 X 8 storage room already referenced?

What does industry standard for equipment maintenance and repairs process look like when providing services on site at a medical facility? Is it standard practice for your equipment to remain onsite at the customer's facility? 3.4 What equipment brands/models does the industry routinely use? What are the space, power, and water requirements for equipment? 4. Scheduling, Coverage, and Response Time Expectations 4.1 Is your company capable of being available 24/7/365 with on-site arrival within 240 minutes?

4.2 Is after-hours work, with >25% of the pricing unit occurring between 8:00PM and 6:00AM, consistent with how after-hours services are defined within the industry? 4.3 Does the industry have standard or recommended practices for forecasting inpatient dialysis staffing demand and contingency plans to ensure continuity of service? 4.4 What staffing challenges has the experience in remote or hard-to-fill areas like Tulsa, OK for inpatient dialysis?

5. Market Capacity, Competition, and Small Business Participation 5.1 Please provide your socioeconomic status for NAICS code 621492. Are you capable of provide inpatient dialysis services stated in the PWS under PSC Q531? Are you capable of providing inpatient dialysis services in Tulsa, OK? Is your company registered in SAM?

If your company is an SDVOSB or VOSB: Are you verified in the SBA s VetCert portal? *If set-aside for SDVOSB/VOSB, certification of the limitations on subcontracting will be required in response to a subsequent solicitation. 6. Implementation, Transition, and Quality Assurance (QA) 6.1 What transition-in timeline would be required for contractor staff to complete the following:

Secure the staff required to provide services. Install the equipment required to provide services.  Test water systems required to provide services. Complete credentialing documentation, background investigation packages, and TMS training required to provide services. 6.2 The PWS currently requires quarterly Quality Assurance (QA) participation from contractor Biomed Tech.

Are there any recommended or standard Quality Assurance (QA) /Quality Improvement (QI) metrics the industry routinely uses to report in inpatient dialysis contracts? 6.3 What challenges does the industry experience and/or anticipate in documenting inpatient dialysis care within the VA electronic health record (EHR)? 7. Lessons Learned Questions These often produce extremely valuable insights. 7.1 Based on your experience, what aspects of inpatient dialysis contracts most frequently lead to performance challenges?

7.2 Are there any PWS sections that may unintentionally increase cost, reduce competition, or create operational barriers? 7.3 What industry innovations (equipment, staffing, workflow) could improve delivery of inpatient dialysis services for VA facilities?