JOFOC NCO21 CNH Delmar Gardens Ceiling Increase - HCA Approved.pdf

VHAPG Part 813.5 Simplified Acquisition Procedures for Certain Commercial Items Attachment 1: Request for Sole Source Justification Template >SAT-$7.5M under FAR13.5

Effective Date: 02/01/2022 Page 1 of 4

DEPARTMENT OF VETERANS AFFAIRS

SOLE SOURCE JUSTIFICATION UNDER SIMPLIFIED PROCEDURES FOR CERTAIN COMMERCIAL

ITEMS IN ACCORDANCE WITH FAR 13.5

Acquisition Plan Action ID: 36C261-24-AP-1703 JOFOC Tracker ID: FY24 - NCO 21 - 1053

1. Contracting Activity: Department of Veterans Affairs (VA), Regional Procurement Office West

(RPOW), Network Contracting Office (NCO) 21, on behalf of the Veterans integrated Service Networks (VISN) 21 VISN 21, Veterans Affairs Southern Nevada Healthcare System (VASNHCS).

2. Nature and/or Description of the Action Being Processed: This procurement is Community Nursing Home (CNH) services in accordance with 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. The action being process is an out-of-scope, ceiling increase modification to a five-year Indefinite Delivery Indefinite Quantity (IDIQ) CNH contract where Delmar Gardens of Green Valley, the current contractor, is providing services in Henderson, Nevada through contract number 36C26120D0074, expiring April 27, 2025. The ceiling increase is needed to provide continuity of services under the established IDIQ period of performance. The requirement for a ceiling increase is due to increased demand for nursing home services and the additional number of eligible veterans being placed at this facility.

3. Description of Supplies/Services Required to Meet the Agency’s Needs: The proposed modification is to increase the maximum contract threshold of the IDIQ contract 36C26120D0074 in the amount of $2,500,000, from $5,000,000 to $7,500,000. The period of performance will remain unchanged, where the current task ordering for ordering period four expires April 27, 2024 and ordering period five will begin April 28, 2024 and expires April 27, 2025. There is a continued need for service as there are currently 16 veterans residing at Delmar Gardens. The modification would allow Delmar Gardens to continue providing uninterrupted community nursing home services that meet total medical, nursing, and psychosocial needs of VA beneficiaries:

• All nursing home facilities must have a current Center for 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 endure their ability to take referrals when requested. The CNH can 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 VA-authorized level of care, without extra charge.

• The per diem rate(s) established in this IDC 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.

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• Full attention shall be given to motivation and education 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

4. Statutory Authority Permitting Restricted 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. Competition is restricted on this procurement for the reason below:

(X) Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements

( ) Unusual and Compelling Urgency ( ) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert

Services ( ) International Agreement ( ) Authorized or Required by Statute ( ) National Security ( ) Public Interest

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, VHA Community Nursing Home Oversight Procedures, 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 VA, 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.

Delmar Gardens of Green Valley is providing care for 16 veterans at their facility. The nursing home meets VA exclusion review quality of care standards. The nursing home has had this contract vehicle in place with the VA since 2020 and has consistently provided excellent care to our Veterans. It would cause medical hardship on the 16 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 nursing home facility. Delmar of Green Valley is the only firm capable of providing the service described in section 3 above without the Veteran’s Health Administration experiencing unacceptable delays in fulfilling its requirements. The VA must increase the contract ceiling to avoid disruption to the patients.

Effective Date: 02/01/2022 Page 3 of 4

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

A notice of the proposed contracting action as represented within this justification document will be made in accordance with FAR Subpart 5.2.

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

Rates and established performance periods remain unchanged as previously awarded under the established IDIQ ordering periods. Fair and reasonable pricing was determined in accordance with FAR 13.106-3(a)(2). Pricing was evaluated to be fair and reasonable based on a comparison to the Independent Government Cost Estimate (IGCE) and established Medicare Resource Utilization Group (RUG) rates and or Medicaid rates. The Government estimate was prepared based on established Medicare 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:

No additional market research was conducted since there are currently veterans residing at this CNH and this is a short-term measure to continue providing CNH services to those veterans. The current contract expires April 27, 2025.

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. Since there are Veterans currently residing in the incumbent’s facility, the VA does not intend on disrupting their care in order 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:

Delmar Gardens of Green Valley, the current contractor, will continue to provide services for the veterans residing there.

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:

The maximum contract threshold increase is meant to support the remaining ordering periods four and five of the IDIQ. Based on the inherent nature of the service and in line with VA policy where the veterans and his/her family play a role in determining which nursing home facility will provide treatment for the veteran, the opportunity to increase competition is limited. Notwithstanding the foregoing limitations, the Government intends to conduct market research, and post Request for Proposals (RFP) in subsequent acquisitions for community nursing home providers to replace current expiring long-term contracts, so that when new beneficiaries are brought into the program, they will have more available choices thereby increasing competition.

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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.

Kareema Snowden Date Nurse Manager Geriatrics and Extended Care Speciality VA Southern Nevada Healthcare System

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.

Emily Trinh Date Contracting Officer, HCR II Network Contracting Office 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.

Nicholas Kluch Date Director of Contracting

Network Contracting Office 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 approve ($750K to $7.5 million (or $15.0 million for acquisitions described in FAR 13.500(c)) for other than full and open competition.

Curtis M. Jordan Date Executive Director, Regional Procurement Office West Head of Contracting (HCA) https://dvagov.sharepoint.com/sites/VHAProcurement/VHAPM/VHAPM_Part_806.3.aspx