ATT 1 J_A - 36C256-23-AP-1476 - COLONIAL MANOR CNH_Redacted.pdf

Colonial Manor CNH - 36C256-23-AP-1476

Request for Sole-Source Justification/Acquisition Package (Follow-on) Above SAT

VHAPG Part 806.3 OFOC Page 1 of 5 Revision: 01 Effective Date: 04/01/23

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID:36C256-23-AP-1476

1. Contracting Activity: Department of Veterans Affairs, Network Contracting Office (NCO) 16 and Alexandria VA Medical Center (AVAMC), 2495 Shreveport Hwy, Pineville, LA 71360. The 1358 funding and payment process will be utilized.

2. Nature and/or Description of the Action Being Processed: This is a justification and approval for Other Than Full and Open Competition to establish a follow-on Community Nursing Home (CNH) Indefinite Quantity (IDIQ) contract that will continue to service Veteran patients of the AVAMC that currently reside in Pineville, LA catchment area. The follow-on contract will have a five-year ordering period that will be reviewed annually prior to new funding being applied at the discretion of the government.

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

This procurement is for Community Nursing Home (CNH) Services in accordance with FAR

13.5 Simplified Procedures for Certain Commercial Items. The IDC contract will have one

(1) five (5) year ordering period beginning October 1, 2023, through September 30, 2028.

The anticipated estimated cost over the five-year period is .

PL 88-450, PL 106-117, and 38 USC 1720 create the expectation that qualified veterans will receive Community Nursing Home (CNH) services in their community. The AVAMC provides care to Veterans whose primary residence is a nursing home; the Veterans Health Administration (VHA) has a policy that nursing home care may be provided in licensed nursing facilities at the Department of Veterans Affairs (VA) expense.

The VA Community Nursing Home (CNH) Program is designed to assist Veterans and their families in making the transition from an episode of hospital care, nursing home care, or domiciliary care to the community. The primary gal of the CNH Program is to maintain or restore the Veteran to the highest level of health are well-being attained.

The CNH Program has two cornerstones: some level of patient choice in choosing a nursing home in close proximity to their home and family; and an approach to local oversight o CNHs considering of annual reviews and monthly patient visits. Following this approach, the AVAMC has established contracts in various areas throughout the VISN.

This facility needs to be located in a proximity to the Veteran’s home, families and friends.

Contractor is to provide nursing home care in accordance with the Office of Community Care Guidebook-Specialty Programs and VHA Notice 2022-04. The facility must meet all state

VHAPG Part 806.3 OFOC Page 2 of 5

Effective Date: 04/01/23 licensing requirements including the state requirement pertaining to level of medical liability insurance throughout the 5-year period of performance of October 1, 2023, through September 30, 2028.

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

FAR 13.5 Simplified Procedures for Certain Commercial Items. The statutory authority for applying the Simplified Procedures for Commercial Items of FAR 13.5 is 41 U.S.C. § 1901 and is implemented by FAR 13.106-1(b)(2) for restricting competition on this procurement for the reason below:

(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):

The primary goal of the AVAMC is to maintain or restore the Veterans to the highest-level well-being, while assisting Veterans and their families in making the transition from an episode nursing home care to the community, therefore changing facilities at this time is not in the best interest to the Veterans. The current vendor, Colonial Manor, dba Hilltop Nursing Center, is the only source in Pineville, LA at this time that can provide the service without causing current patients to be relocated to a different facility. Currently there are a minimum of eleven (11) patients residing in the facility at any given time. The patients residing in the facility receive proper care and treatment from the facility and the facility is located near family and friends of the residents. Relocating residents to a different facility outside the Pineville, LA catchment area would cause an undue burden on their families due to increase travel time and costs associated with traveling to another facility outside of Pineville, LA.

A search of Veteran Population - National Center for Veterans Analysis and Statistics (va.gov) shows that there are currently 29,146 (estimated) Veterans located in Pineville, LA as of June 2023, which demonstrates a continual need for nursing home services to serve this population. In addition, a five-year contract would provide continual coverage for our Veterans, but the Contracting Officer would evaluate through market research annually to determine if other facilities in the area are capable of providing services.

VHAPG Part 806.3 OFOC Page 3 of 5

Effective Date: 04/01/23

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

There are currently eleven (11) Veterans that have long-term placement in this nursing home that would result in undue hardship if the contract were lost, as Veterans would be farther away from family.

Sources Sought Synopsis: A Sources Sought synopsis (36C25623R0058) was issued to www.sam.gov Contracting Opportunities site on March 29th with responses due April 12th requesting potential sources having skills and capabilities necessary to provide the appropriate level of Community Nursing Home (CNH) care to the beneficiaries of the AVAMC. Colonial Manor (incumbent) was the only response received to the posted Sources Sought.

Other Actions: Searches of the Medicare Compare site will be conducted quarterly in order to determine if any new nursing home facilities enter the marketplace within the catchment area. The CO will continue to monitor and reach out to potential sources as they become available. To date, efforts to identify additional sources (Contractors) in the Pineville, LA catchment area have been unsuccessful.

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

The anticipated value of the contract services over the five-year period is estimated at

. The Medicaid rates that will be paid under IDIQ are determined by law and regulation. The negotiated percentage above Medicaid rates are required to be within guidelines established in the Office of Community Care Guidebook and VHA Notice 2022-

04. This negotiated percentage to the State Medicaid Rate (SMA) rate will remain constant throughout the life of the contract and is changed only when state Medicaid rates are adjusted and will be modified in accordance with the Economic Price Adjustment Clause when necessary. Any modification to the rate will be in accordance with the Medicaid Rate set by law. The prices offered will be determined fair and reasonable by the CO prior to award based upon the published rates and negotiated percentages. In accordance with FAR 13.106- 3(a)(2)(iii), the rates were established by the Centers for Medicare and Medicaid are determined by the Contracting Officer to be fair and reasonable.

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

Market research is dependent on the needs of the patients and resources of the VA Medical Center. It is customarily performed by the Social Worker and the CNH Assessment Team so that agreements are established to maximize patient care needed to fulfill this type of contract. Substantial efforts were made to identify the top-quality facilities in the geographic area by communicating with network professionals. The program office personnel queried the Nursing Home Compare website to determine the availability of nursing homes in the subject area. It was determined that there were no Nursing Homes in a geographically convenient area near Veterans family and friends. Rule of Two could not be met based on market research.