JOFOC Redacted CNH The Ivy at GF_Missouri River.pdf

OFOC SOP Revision 09 Page 1 of 5

Original Date: 03/22/11

Revision 09 Date: 04/17/2020

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A)

For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C259-20-AP-2894, The IVY at Great Falls, LLC DBA Missouri

River Center

RPOW JOFOC Acquisition Plan Action ID: 2020-09-08T12:57:23

1. Contracting Activity: Department of Veterans Affairs, Network Contracting Office 19 (NCO19), 6162 South Willow Drive, Greenwood Village, CO 80111. This action is funded by a 1358.

Therefore, there is no associated 2237.

2. Nature and/or Description of the Action Being Processed: This procurement is for the establishment of a sole source Firm-Fixed Price Indefinite Delivery Contract (IDC) for community nursing home (CNH) services for the Montana VA Health Care System to The IVY at Great Falls, LLC (DBA Missouri River Center) located in Great Falls, MT. This will be a 5-year IDC (60

Months). The period of performance will be 01 November 2020 through 31 October 2025.

FAR13.5 Simplified Procedures for Certain Commercial Items: This procurement is for the establishment of an IDC utilizing procedures 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. This acquisition does not fall within FAR Part 8 Required Sources of Supplies and Services, therefore the procedures associated with limited sources justification will not be utilized.

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. The current contract 36C25919P0585 expires on 31 October 2020. The IVY at Great Falls, LLC (DBA

Missouri River Center) has met all requirements under the VHA Notice 2019-22, Community

Nursing Home Program (CNHP) and VHA Office of Community Care (OCC) Field Guidebook

Specialty Programs Section 1.2, Geriartric Extended Care (GEC). Additionally, they are certified under Centers for Medicare and Medicaid Services (CMS) and licensed by the State of Montana. This will be a 5-year IDC (60 Months). The period of performance will be 01 November 2020 through 31

October 2025. The total estimated value of this contract is $6,800,000.00.

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 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;

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FAR13.5 Simplified Procedures for Certain Commercial Items: The authority for applying the

Simplified Procedures for Commercial Items of FAR 13.5 is 41 U.S.C. 1901 and is implemented by for restricting competition on this procurement via FAR 13.106-1(b)(2).

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

14 Veterans being treated and housed at The IVY at Great Falls, LLC facility under an existing contract. The IVY at Great Falls, LLC nursing home facility meets VA standards for quality of care to provide care and treatment to Veterans. 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 Veterans and their families. The relocation 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 sole sourced to The IVY at Great Falls, LLC facility. In addition, as stated in paragraph 6 below, there was one response received from a potential offeror regarding the sources sought notice issued for this procurement. However, the CNH program requires that any new CNHs that want to do business with the Government must pass a series of inspections. Therefore, the CNH Coordinator would need to schedule and complete a clinical and life safety inspections to determine if requirements are met; but it would take 60 to 90 days to conduct inspections and evaluate due to Coronavirus (COVID -19) pandemic.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: A sources sought was posted on 24 June 2020 and closed on 06 July 2020;

the current contractor responded. There was one response received from a potential offeror regarding the sources sought notice issued for this procurement. However, the CNH Coordinator would need to schedule and complete a clinical and life safety inspections to determine if requirements are met; but it would take 60 to 90 days to conduct inspections and evaluate due to Coronavirus (COVID -19) pandemic. A search of the Medicare Nursing Home Compare website https://www.medicare.gov/nursinghomecompare/search.html resulted in 5 CNHs within 100 miles and 3 CNHs within 25 miles in Great Falls, MT where the current CNH is located. The VA Vendor

Information Pages (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 Great Falls, MT. The

CNH program requires that any new CNHs 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 would visit the CNH facilities to review the type of services available to

Veterans. Once the CNH passes these inspections, they can be considered for a contract. As part of the acquisition process, a CNH must provide a current state license, insurance and a copy of the state inspection. These documents are provided to the CNH Program coordinator for review and evaluation. The CNH Coordinator will either provide a recommendation to contract or state that the

CNH did not receive a recommendation to contract. A redacted J&A will be posted on Contract

Opportunities.

7. Determination by the Contracting Officer (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 VHA PM and VA pulse publishes an annual maximum allowable percentage that are applied to each RUGS IV category. The RUGS IV category 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 category and the add-on percentage and the total per diem rate for each level of care. After conducting research on the current Medicaid and RUGS IV rates, the CO has determined that the https://www.medicare.gov/nursinghomecompare/search.html

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Revision 09 Date: 04/17/2020 prices 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: As described in Section 6 above, a search of the Medicare

Nursing Home Compare website https://www.medicare.gov/nursinghomecompare/search.html resulted in 3 community nursing homes within 25 miles in Great Falls, MT where the current CNH is located. The CNH Coordinator would need to complete a clinical inspection and life safety inspection to determine if the services provided by these CNHs would meet the VA's CNH Program requirements. 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

NAICS 623110 Nursing Care Facilities in the State of Montana. A sources sought notice was posted in Contract Opportunities for this procurement on 24 June 2020 and closed on 06 April 2020; the current contractor responded. Results of the market research showed there was one potential offeror that expressed interest. However, the CNH Coordinator would need to schedule and complete a clinical and life safety inspections to determine if requirements are met; but it would take 60 to 90 days to conduct inspections and evaluate due to Coronavirus (COVID -19) pandemic. Typically, CNHs are not competed. Based on the CNH program requirements, the Veterans’ preference is taken into consideration when selecting a CNH based on the Veterans’ needs, proximity to home/residence and family. The CNH Program Coordinator is required to conduct a clinical and life safety inspection to ensure the CNH has the resources available to meet the patients’ needs. The CNH Program attempts to inspect a sample of CNHs in a given area to provide the Veterans with several choices.

The CNH Program Coordinator is responsible for conducting market research and required inspections to increase the number of available and qualified CNHs that can pass the Government's inspections before a contract can be established.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition: The CNH services 14 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. We would cause undue stress to the Veterans and their families if we tried to relocate the Veterans.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: The CNH coordinator did not submit another CNH for this location to be considered. The current contractor, The IVY at Great Falls, LLC (DBA Missouri River Center) has expressed an interest to continue providing CNH services to the VA and continue in providing care and services to the Veterans. There was one potential offeror that expressed interest but must go through a series of inspections as required by the CNH Program and the CNH Coordinator would need to schedule and complete a clinical and life safety inspections to determine if requirements are met; but it would take 60 to 90 days to conduct inspections and evaluate due to Coronavirus (COVID -19) pandemic.

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 (1) facility capable of providing the specialty care and medical needs of the existing Veterans. Based on the CNH program requirements, the Veterans’ preference is taken into consideration when selecting a CNH based on the Veterans’ needs, proximity to home/residence and family. The CNH Program attempts to inspect a sample of CNHs in a given 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 CNH Program Coordinator is responsible for conducting market research and required inspections to increase the number of available and qualified CNHs that can pass the Government's inspections. The contracting office and

CNH Program office will continue to canvas the market for new CNH entrants capable of meeting program requirements.

https://www.medicare.gov/nursinghomecompare/search.html

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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.

Christine R. Brand, MSN, RN Date

CNH Program Coordinator

Facility: Va Montana 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.

David J. Medina Date

Contracting Officer

Branch Chief, NCO-19

b. VHA NCO-19 REVIEW AND APPROVAL (over $700,000 to $13.5 million): I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and approve for other than full and open competition.

Danny O. Freeman Date

Director of Contracting

Network Contracting Office 19

c. VHA RPO HCA REVIEW AND APPROVAL (over $700,000 to $13.5 million): I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and approve for other than full and open competition.

Curtis M. Jordan Date

Executive Director, RPO West

Head of Contracting Activity (HCA) http://vaww.pclo.infoshare.va.gov/PMWeb/VHAPM_Part_806.3.aspx VHAV19MedinD Typewritten Text 09/14/2020

VHAV19FreemD Typewritten Text 09/15/2020

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