C41 - Redacted - JNA - Rawlins CNH.pdf

VHAPM Part 806.3 Other Than Full and Open Competition (OFOC) SOP Attachment 2: Request for Sole Source Justification Format >SAT

OFOC SOP Revision 10 Page 1 of 4 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: 36C259-20-AP-5147, Rawlins Health and Rehabilitation Nursing Home Tracking ID: 2020-11-06T05:50:30

1. Contracting Activity:

Department of Veterans Affairs Network Contracting Office 19 6162 South Willow Drive, Suite 300 Greenwood Village, CO 80111

Organizational Activity:

Cheyenne VA Medical Center 2360 E. Pershing Blvd.

Cheyenne, WY 82001

2237: This action is funded by a 1358.

2. Nature and/or Description of the Action Being Processed This procurement is for the establishment of a new sole source Firm-Fixed Price Indefinite Delivery Contract (IDC) for community nursing home (CNH) services on behalf of the Cheyenne VA Medical Center (VAMC).

3. Description of Supplies/Services Required to Meet the Agency’s Needs: The CNH will provide all facilities and services to support short- and long-term care for Veterans. These services include rehabilitation, nursing, and clinical care in accordance with the performance work statement. This will be a five-year IDC (60 Months). The period of performance will be March 01, 2021 to February 28, 2026. The total estimated value of this contract is

4. Statutory Authority Permitting Other than Full and Open Competition: 41 USC §3304(a)(1), as implemented by FAR 6.302-1 (a)(2).

(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): Currently, there are three Veterans being treated and housed at the Rawlins Health and Rehabilitation nursing home under an existing IDC. Rawlins Health and Rehabilitation nursing home facility meets VA standards for

OFOC SOP Revision 10 Page 2 of 4

Revision 10 Date: 09/10/2020 quality of care to provide care and treatment to Veterans. Empers at Rawlins LLC, Rawlins Health and Rehabilitation nursing home facility has had a contract with the VA since 2019. They have consistently provided quality care to our Veterans. The Veterans at this facility cannot be moved without causing a disruption in the continuity of care and undue stress to both the Veteran and family.

The relocating of Veterans is not in accordance with VA policy/directive established by the Office of Geriatrics and Extended Care. In accordance with FAR 6.302-1, this requirement for community nursing homes services will be a sole source IDC to Empers at Rawlins LLC, Rawlins Health and Rehabilitation. In addition, as stated in paragraph 6 below, no responses were received from any potential offerors regarding the sources sought notice issued for this procurement.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: A Sources Sought Notice, 36C25921Q0026, was issued on October 16, 2020 and closed October 28, 2020. The notice requested basic contractor information from qualified sources to to gain knowledge of potential qualified sources and their size classification (HUBZone, 8(a), small, small disadvantage, service-disabled veteran owned small business, veteran owned small business or large business) relative to NACIS 623110 Nursing Care Facilities (Skilled Nursing Facilities) ($30 Million size standard). Zero responses where recived for the Sources Sought Notice.

A search of the Medicare Nursing Home Compare website https://www.medicare.gov/nursinghomecompare/search.html resulted in one community nursing home with 50 miles of Rawlins, WY where the current CNH is located. The VA Vendor Information Page (VetBiz) was used to determine if potential offerors exist who would be able to provide the services required. However, the site failed to produce any results for Rawlins, WY. The CNH program requires that any new CNH's that want to do business with the Government must pass a series of inspections. The CNH must pass a clinical inspection and a life safety inspection. The CNH Program Coordinators meet with the CNH to understand the services that are offered. Once the CNH passes these inspections, they can be considered for a contract.

7. Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable: The Medicaid rates are used as the basis for pricing the CNH contracts. The Medicaid rates are established by each state based on national average. The VA Geriatrics and Extended Care Office through the Veterans Health Aministration Procurment Manual (VHAPM) and VA pulse publishes an annual maximum allowable percentage that are applied to each Resource Utilization Groups IV (RUGS IV) category. The RUGS IV categories identify the different levels of treatment.

The add-on percentages are added to the basic Medicaid rate then applied to each RUGS IV category.

The Medicaid rate and the VA add-on percentage make up the per diem rate paid for each Veteran.

The line item structure will illustrate the different RUGS IV categories, the add-on percentages, and the total per diem rate for each level of care. After conducting market research on the current Medicaid and RUGS IV rates, the CO has determined that the results are determined to be fair and reasonable when the add-on percentage agreed upon by both parties is at or under the maximum allowable percentage established by VA. The add-on percentages do not change through the life of the contract.

8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted: The current contract 36C259-19-P-0182 expires on February 28, 2021 Rawlins Health and Rehabilitation has met all requirements under VA policy/directive established by the Office of Geriatrics and Extended Care. Additionally, they are certified under Centers for Medicare and Medicaid Services (CMS) and licensed by the State of Wyoming. As described in Section 6 above, market research, in accordance with FAR Part 10, was conducted by synopsis of the proposed acquisition, advising industry of the pending acquisition and soliciting inquiries from interested parties. Also a search of the Medicare Nursing Home Compare

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Revision 10 Date: 09/10/2020 website https://www.medicare.gov/nursinghomecompare/search.html resulted in one community nursing home (the current contractor), within 50 miles of Rawlins, WY. The VA’s Vendor Information Page (VetBiz) was used to determine if potential offerors exist to provide additional competition. However, the site failed to produce any results for Rawlins, WY. Results of the market research show there are no other CNH in the area that expressed interest. Based on the CNH program requirements, the veteran’s preference is taken into consideration when selecting a CNH based on the Veteran’s needs, proximity to home/residence and family. The CNH Program attempts to inspect a sample of CNH's in each area to provide the Veteran with several choices. However, the selection of the CNH is determined on whether the CNH has the resources available to meet the Veteran’s needs.

The CNH Program Coordinator, a government employee, is responsible for conducting market research and required inspections to increase the number of available and qualified CNH's that can pass the Government's inspections.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition: The CNH is currently providing care for three Veterans in this facility who cannot be relocated due to continuity of care and medical complexity. This CNH is located near the families of the Veterans and moving them would cause undue stress to the Veteran and their family if the government tried to relocate the Veteran to a new nursing home.

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

Empers at Rawlins LLC, Rawlins Health and Rehabilitation 542th St Rawlins, WY 82301

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:

There is currently only one facility capable of providing the care and medical needs of the existing Veterans. Based on the CNH program requirements, the veteran’s preference is taken into consideration when selecting a CNH based on the veteran’s needs, proximity to home/residence and family. The CNH Program attempts to inspect a sample of CNH's in each area to provide the Veterans with several choices. However, the selection of the CNH is determined on whether the CNH has the resources available to meet each Veteran's needs. The contracting office and CNH Program office will continue to canvas the market for new CNH entrants capable of meeting program requirements for veterans in different location for future veterans. This requirement is requested to be for five years to mitigate the stress to the veterans of possible having to move. There is a continuing need in this location to have a CNH in place. Having a contract in place for five years will reduce the administrative burden of renewing a contract every year.

OFOC SOP Revision 10 Page 4 of 4

Revision 10 Date: 09/10/2020

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.

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.

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.

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.