2021-0044 JOFOC 36C261-21-AP-0229- CareMeridian HCA Approved - Redacted.pdf

OFOC SOP Revision 10 Page 1 of 5 Original Date: 03/22/11 Revision 10 Date: 09/10/2020

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C261-21-AP-0229

Contract Number: VA261-14-A-0035

1. Contracting Activity:

Department of Veterans Affairs, VISN 21, Network Contracting Office (NCO) 21 for the following VISN 21 locations:

VA Central California Health Care System, 2615 E. Clinton Avenue, Fresno CA 93703-2223 VA Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304-1207 VA Northern California Health Care System, 150 Muir Road, Martinez CA 94553 VA San Francisco Health Care System, 4150 Clement Street, San Francisco CA 94121 VA Sierra Nevada Health Care System, 975 Kirman Avenue, Reno NV 89502-0993

2. Nature and/or Description of the Action Being Processed:

VISN 21 has a need for Community Nursing Home (CNH) services. The proposed action is to extend the current Basic Ordering Agreement (BOA) with the incumbent to continue services without interruption to our Veterans of VA Palo Alto Health Care System (VAPAHCS), VA Central California Health Care System (VACCHCS); VA Northern California Health Care System (VASNHCS); and VA San Francisco Health Care System (VASNHCS) while the Contracting Office completes the Single-Award five (5) year Indefinite-Delivery Indefinite-Quantity (IDIQ) contract to the incumbent CareMeridian, LLC d/b/a CareMeridian, DUNS: 017392718, in accordance with FAR 6.302-1 Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements.

The total estimated cost to extend the VISN Wide BOA is . The period of perform (POP) will be 10/24/2020 – 10/23/2021. The extension will be paid via the 1358 process.

3. Description of Supplies/Services Required to Meet the Agency’s Needs:

The proposed action is to extend the current BOA with the Congregate Living Health Facility (CLHF) capable of furnishing sub-acute, ventilator care, and the total medical, nursing, and psychosocial needs of VA beneficiaries. No other Medicare/Medicaid CNH in the area can provide the much needed level of care required by the Veterans currently receiving services from the Contractor’s facilities, given the families of the Veterans who are currently located at the facilities do not want to move their family members due to medical hardship on the patients, disruption in treatment plan, and disruption to family members within the geographical location of each facility.

All nursing home facilities must have current Center for Medicare and Medicaid Services (CMS) certification (Medicare and/or Medicaid) and a State nursing home license. The Office of Community Care (OCC) has confirmed that services from a Congregate Living Health Facility (CLHF) shall be procured under the VA CNH program even though they are not currently licensed as a CNH in the State of California and Nevada.

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The VA requires CNHs to have a bed capacity that ensures their ability to take referrals when requested. The CNH shall accept VA referrals in a timely fashion (ideally within 24 hours of request).

Provider visits must be provided at the rate of one (1) visit per month. Laboratory, x-ray, and other special services will be available to VA patients as needed. In addition, the care provided will include room, meals, nursing care, and other services or supplies commensurate with the VA-authorized level of care, without extra charge.

This modification will extend the POP from 10/24/2020 – 10/23/2021. A task order will be awarded to each CareMeridian facility, totaling eight (8), for the ordering period to cover CNH services at each facility with an effective date: 10/24/2020 – 10/23/2021.

4. Statutory Authority Permitting Other than Full and Open Competition:

(X) (1) Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements per 41 USC §3304(a)(1) as implemented by FAR 6.302-1;

( ) (2) Unusual and Compelling Urgency per 41 USC §3304(a)(2) as implemented by FAR 6.302-2;

( ) (3) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert Services per 41 USC §3304(a)(3) as implemented by FAR 6.302-3;

( ) (4) International Agreement per 41 USC §3304(a)(4) as implemented by FAR 6.302-4 ( ) (5) Authorized or Required by Statute per 41 USC §3304(a)(5) as implemented by FAR 6.302-5;

( ) (6) National Security per 41 USC §3304(a)(6) as implemented by FAR 6.302-6;

( ) (7) Public Interest per 41 USC §3304(a)(7) as implemented by FAR 6.302-7;

5. Demonstration that the Contractor’s Unique Qualifications or Nature of the Acquisition Requires the Use of the Authority Cited Above (applicability of authority):

As prescribed in VHA Handbook 1143.2, for more than 35 years the CNH Program has maintained two cornerstones: some level of patient choice in choosing a nursing home close to the Veteran’s home and family, and a unique approach to local oversight of CNHs.

The quality of care for the Veteran is accomplished through placement in a nursing homes that i s in close proximity to where the Veteran and his/her family resides. Notably, in the VA CNH program, the Veteran’s placement decision is made by the VA clinician, the Veteran, and the Veteran’s family.

The placement decision will be based on established VA contracts in the area. The geographic factor in these circumstances makes this requirement unique and, therefore, not subject to competition.

CareMeridian, LLC d/b/a CareMeridian is currently providing a much needed service to fifty-nine Veterans within VISN 21’s catchment area, in sub-acute/ventilator care facilities. The facilities meet VA exclusion review quality of care standards. CareMeridian has provided CNH services to VA beneficiaries for more than nine (9) years and consistently provided excellent care to our Veterans. It would cause medical hardship on the patients to move them, may disrupt treatment plans, and may be disruptive to family members if relocated to a different facility.

The current Veterans require continued care at the sub-acute/ventilator care facility beyond the current contract’s expiration date and for an unknown period in the future. To avoid disruption to the patients, the VA must extend the current BOA to continue services past the expiration, which is 10/23/2020.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable:

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The CO conducted market research using Medicare.gov | Nursing Home Compare, reviewed available acquisition history and searched the Veteran Information Pages (VIP) for SDVOSB or VOSB Contractors capable of providing nursing home services and sub-acute services.

Online research included a review of the CareMeridian website (www.caremeridian.com) for general information, ALS Association website (www.alsa.org), California Department of Health Care Services (www.dhcs.ca.gov) and Centers for Medicare & Medicaid Services (www.cms.gov), including a search for “average inpatient rates”, “daily rate for inpatient services” and “high acuity” with no results confirming rates for comparison purposes. CMS lists Adult Subacute Care rates for several provider facilities, with a range of $700.24/day - $1,120.55/day for REGULAR Services with Ventilator.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition:

VHA Handbook 1143.2 allows for a level of Veteran choice in choosing a nursing home and sub-acute ventilator care faciltiy close to the Veteran’s home and family. The geographic factor in these circumstances makes the much needed service unique and, therefore, not subject to competition.

Since the Veterans are currently residing in the incumbent’s facility, the VA does not intend on disrupting their care to place them at a different facility as it would not be in the Veteran’s best interest.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition:

The incumbent Contractor is willing to continue providing the much needed services for the Veterans within the facilities. CareMeridian has provided services for Veterans within VISN 21’s catchment area for more than nine (9) years, moving the Veterans currently in place would affect patient care.

11. A Statement of the Actions, if any, the Agency May Take to Remove or Overcome any Barriers to Competition before Making subsequent acquisitions for the supplies or services required:

Based on the inherent nature of the service and in line with VA policy were the Veteran and his/her family play a role in determining which nursing home and/or sub-acute/ventilator care facility will provide treatment for the Veteran, the opportunity to increase competition is limited.

12. Requirements Certification:

I certify that the requirement outlined in this justification is a Bona Fide Need of the Department of Veterans Affairs and that the supporting data under my cognizance, which are included in the justification, are accurate and complete to the best of my knowledge and belief.

Date

13. Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

a. Contracting Officer or Designee’s Certification (required):

I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

Amy M.

Butler 675514

Digitally signed by Amy M. Butler 675514 Date: 2020.10.22 15:28:47 -07'00'

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Revision 10 Date: 09/10/2020

Gary T. Basile Date Contracting Officer Network Contracting Office (NCO) 21

b. One Level Above the Contracting Officer (Required over SAT but not exceeding $700K):

I certify the justification meets requirements for other than full and open competition.

Brooke C. Robison Date Director of Contracting (DoC), Network Contracting Office (NCO) 21

c. VHA RPO HCA Review and Approval: I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and recommend approval (if over $68 million) or approve ($700K to $68 million) for other than full and open competition.

Curtis M. Jordan Date Executive Director, Regional Procurement Office West Head of Contracting Activity (HCA)

22 OCT 20

Gary T Basile 228349

Digitally signed by Gary T Basile 228349 Date: 2020.10.22 13:44:30 -07'00'

Brooke C. Robison 1615983

Digitally signed by Brooke C.

Robison 1615983 Date: 2020.10.22 20:56:40 -07'00'

CURTIS M. JORDAN

597130

Digitally signed by CURTIS M.

JORDAN 597130

Date: 2020.10.23 13:50:50 -06'00'