2021-0302 JOFOC 36C261-21-AP-2019 Rosewood CNH NCO 21 HCA APPROVED REDACTED.pdf

ACQ Plan #: 36C261 21 AP 2019 Page 1 of 4

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C261-21-AP-2019

1. Contracting Activity: Department of Veterans Affairs, Regional Procurement Office (RPO) West, Network Contracting Office 21 (NCO 21)

Per VHAPM 837.4, Community Nursing Home SOP Section 4.2.2; 2237’s are not required, as invoicing is done through the 1358 process.

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

VISN 21’s VA Sierra Nevada Health Care System, is in need of Community Nursing Home (CNH) services in Reno, Nevada to replace VA261-16-G-0038, that will expire on 07/31/2021, with Rosewood Rehabilitation Center. The families of the five (5) Veterans who are currently located at the facility who will be affected by the expiring contract do not want to move their family members due to medical hardship on the patients, disruption in treatment plans, and disruption to family members in the local area. Anticipated date of new contract is August 1, 2021 – July 31, 2026.

In accordance with (IAW) FAR 6.302-1, Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements, an open market sole source award will be made to Rosewood Rehabilitation Center, DUNS: 078621777. The type of contract will be a Fixed Price (FP) Indefinite Delivery Indefinite Quantity (IDIQ) with an Economic Price Adjustment (EPA) consisting of five (5) one (1)-year ordering periods.

FAR 13.5 Simplified Procedures for Certain Commercial Items: This procurement will be accomplished IAW FAR 13.5 Simplified Procedures for Certain Commercial Items and specifically FAR 13.501 Special Documentation Requirements, where acquisitions conducted under Simplified Acquisition Procedures are exempt from the requirements of FAR Part 6, but still require a justification using the format of FAR 6.303-2.

3. Description of Supplies/Services Required to Meet the Agency’s Needs: The proposed action is to award a FP IDIQ w/EPA with the rates adjusting only to the current published Medicaid rate, with a nursing home facility capable of furnishing the total medical, nursing, and psychosocial needs of VA beneficiaries.

All nursing homes facility(s) must have current Center of Medicare and Medicaid Services (CMS) certification (Medicare and/or Medicaid) and a State nursing home license.

The VA requires CNHs to have bed capacity to ensure their ability to take referrals when requested. The CNH also must be able to 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.

The per diem rate(s) established in this IDIQ will include the cost of primary medical care, one

(1) provider visit per month and needed consultation, drugs and routine supplies, laboratory, x-ray, and other special services authorized by VA, unless otherwise specifically excepted.

ACQ Plan #: 36C261 21 AP 2019 Page 2 of 4

Full attention shall be given to motivating and educating patients to achieve and maintain independence in the activities of daily living. Every effort shall be made to keep patients ambulatory and to achieve an optimal level of self-care.

The total estimated value of the proposed action is not to exceed (NTE) over the term of the IDIQ for five (5) one-year ordering periods and will allow for increased needs over the government’s estimate.

Total Estimated Annual Cost for facility:

Total Estimated 5-Year Cost for facility:

IDIQ Limit:

4. Statutory Authority Permitting Other than Full and Open Competition: FAR 13.5 Simplified Procedures for Certain Commercial Items; the authority for applying the Simplified Procedures for Commercial Items of FAR 13.5 is 41 USC §1901 and is as implemented by for restricting competition on this procurement via FAR 13.106-1(b)(2).

(1) Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements per FAR 6.302-1;

(2) Unusual and Compelling Urgency per FAR 6.302-2;

(3) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert

Services per FAR 6.302-3;

(4) International Agreement per FAR 6.302-4

(5) Authorized or Required by Statute FAR 6.302-5;

(6) National Security per FAR 6.302-6;

(7) Public Interest per 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 home that is in close proximity to where the Veteran and his/her family resides. Notably, in the VA’s community nursing home program, the Veteran’s placement decision is made by the VA clinician(s)/provider(s), the Veteran, and the Veteran’s family. The placement decision will be based on established VA contracts within the catchment area the Veteran resides. The geographic factor in these circumstances makes this requirement unique and, therefore, not subject to competition.

Rosewood Rehabilitation Center currently has five (5) veterans supporting VISN 21 in their location.

The nursing homes meet VA exclusion review quality of care standards. The nursing home has had a contract with the VA for one (1) year or more and has consistently provided excellent care to our Veterans. It would cause medical hardship on the patient to move them, may disrupt treatment plans, and may be disruptive to family members if relocated to a different facility.

The current veterans requires continued care at the nursing home facility beyond the current contract’s expiration date and for an unknown period of time in the future. To avoid disruption to the patient, the VA must enter into a new contract with the current contractor.

ACQ Plan #: 36C261 21 AP 2019 Page 3 of 4

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

a. A query of the Veterans Information Pages (VIP) was generated using PSC “Q402,” NAICS “623110” Key Words “Community Nursing Home Services”, and States Searched “Nevada” which produced zero (0) Service-Disabled Veteran Owned Small Businesses (SDVOSBs) or Veteran Owned Small Businesses (VOSBs). A query on Medicare.gov | Nursing Home Compare confirmed there are a total of 12 licensed nursing homes within a 25-mile radius from the center of the 89512 zip code, including Rosewood Rehabilitation Center.

a. A notice of intent to sole source will be posted prior to solicitation to allow any other interested companies to provide a response for consideration. In accordance with FAR 13.501(a)(1)(iii), this action will be synopsized at award on the contract opportunities website and the justification will be made publicly available.

7. Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable:

Fair and reasonable pricing will be determined IAW FAR 13.106-3(a)(2). Pricing will be evaluated to be fair and reasonable based on a comparison to the Independent Government Cost Estimate (IGCE), State Medicaid rates and CNH SOP Benchmarks for add-on percentages per levels of care. The Government estimate was prepared based on established Medicaid RUG rates for various levels of care and established VA nursing home rates based on VA national guidelines for determining cost for VA nursing home contracts.

8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted:

The contract specialist conducted market research using Medicare’s website for nursing homes, reviewed available acquisition history and searched through the VA’s Veteran Information pages.

Another form of market research conducted by the VA, is the on-going, periodic outreach with local potential vendors conducted by the Contracting Officer Representative.

A search of the Dynamic Business Small Business database returned zero (0) results. A search of the Medicare.gov website returned twelve (12) results within a 25 mile radius of zip code 89512.

SAM.gov search returned (2) results within the Reno, NV area.

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 close to the Veteran’s home and family. The geographic factor is these circumstances makes this requirement unique and, therefore; not subject to competition. Since the Veterans are currently residing in the incumbent’s facility(s), the VA does not intend on disrupting their care to place them at a different facility (s) 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 Contractor, Rosewood Rehabilitation Center is willing to continue to provide services for the veterans in place.

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 where the Veteran and his/her family play a role in determining which nursing home facility will provide treatment for the Veteran, ACQ Plan #: 36C261 21 AP 2019 Page 4 of 4 the opportunity to increase competition is limited. The VA will continue to conduct Market Research and outreach to identify are CNH facilities within designated catchment areas. When new facilities are identified a competitive solicitation may be issued per designated catchment areas.

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

Dixie Langus Program Manager

13. Approvals in accordance with the VHAPM Part 806.3 JOFOC 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.

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

b. One Level Above the Contracting Officer (Required over SAT but not exceeding $750K): I certify the justification meets requirements for other than full and open competition.

Brooke C. Robison Date Director of Contracting 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 $75.0 million) or approve ($750K to 75 million) for other than full and open competition.

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

Gary T Basile 228349 Digitally signed by Gary T Basile 228349 Date: 2021.04.12 11:45:44 -07'00'

Dixil R. Langus 353623

Digitally signed by Dixil R.

Langus 353623 Date: 2021.04.12 13:33:11 -07'00'

12 APR 21

Brooke C. Robison 1615983

Digitally signed by Brooke C.

Robison 1615983 Date: 2021.04.12 20:52:31 -07'00'

CURTIS M.

JORDAN 597130

Digitally signed by CURTIS M.

JORDAN 597130

Date: 2021.04.14 16:12:57 -06'00'