VA261-16-G-0016-001.pdf

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C261-19-AP-4860 Purchase Request/2237 Number: 612-20-1-1999-0010

1. Contracting Activity:

Department of Veterans Affairs, VISN 21, Network Contracting Office (NCO) 21 for VA Northern California.

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

VISN 21’s VA Northern California, is in need of Community Nursing Home (CNH) services in the state of California by issuance of a task order under Basic Ordering Agreement (BOA) VA261-16-G- 0016 with Lone Tree Convalescent Hospital, Inc. The current order will expire on 9/30/2019. The families of the Veterans who are currently located at the facility who will be affected by the expiring BOA task order do not want to move their family members due to medical hardship on their patients, disruption in treatment plans, and disruption to family members in the local area.

In accordance with FAR 6.302-1 Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements, a sole source award will be made to Lone Tree Convalescent Hospital, Inc DUNS: 095653242. The task order will be issued under a noncompetitive basis.

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

The proposed action is to award an IDIQ Contract with a Nursing home facility capable of furnishing the total medical, nursing, and psychosocial needs of VA beneficiaries.

All nursing home facilities must have current Center for Medicare and Medicaid Services (CMS) certification (Medicare and/or Medicaid) and a State nursing home license.

The VA requires CNH’s to have bed capacity to ensure their ability to take referals when requested. The CNH also must be able to accept VA referals in a timely fashion (idealy within 24 hours of request).

Provider visits must be provided at a 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 IDC 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.

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.

It is estimated that the expenditure for the Lone Tree Convalescent Hospital will be for FY20. The BOA was projected for annually.

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

(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;

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.

According to the nursing home Compare website, there are 21 nursing homes within 25 miles, with the sole home with a VA contract being the Lone Tree Convalescent Hospital. 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.

Lone Tree Convalescent Hospital currently has veterans being treated at the nursing home facility under existing task orders due to expire by September 30, 2019. The nursing home meets VA exclusion review quality of care standards. The nursing home has had a BOA in place with the VA for several years and has consistently provided excellent care to our Veterans. It would cause medical hardship on the 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 beyond the current BOA task order expiration date 9/30/2019, and for an unknown period of time in the future. To avoid disruption to the patients, the VA must enter into a new contract with the current contractor.

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

A querry of Vet Biz using NAICS 623110 with “community nursing home” as a keyword, produced zero (0) Service Disabled Veteran Owned Small Businesses (SDVOSB) in California. A querry on nursing home compare confirmed there are 20 other nursing homes within a 25 mile radius of the Lone Tree Convalescent Hospital.

In accordance with FAR 6.305(a), this justification will be made publicly available and posted to the Government Point of Entry (FBO) as the exceptions listed in FAR 5.202 do not apply.

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

Fair and reasonable pricing will be determined in accordance with FAR 15.403-3. Pricing will be 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:

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.

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. While there are other CNH facilities in the vicinity, Lone Tree Convalescent Hospital, Inc is able and willing to provide care for those Veterans. Since there are Veterans currently residing in the incumbent’s facility, the VA does not intend on disrupting their care to place them at a different facility as it would not be in the Veterans’ best interest.

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

The listed contractor, Lone Tree Convalescent Hospital, Inc 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 plays a role in determining which nursing home facility will provide treatment for the veteran, the opportunity to increase competition is limited. Further, the recently enacted Mission Act is going to convert these services from requiring federalcontracts to non-contract veteran care centers.

Consequently, within the next few years after full implementation of the Mission Act, there will no longer be a need to obtain competition in the context of the Federal Acquisition Regulation.

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.

Miriam Hoereth Date Business Manager, Geriatrics and Extended Care VA Northern California 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.

Date

Network Contracting Office (NCO) 21 iam Hoereth

September 20, 2019

David J. Alvarez 1745405

Digitally signed by David J. Alvarez 1745405 Date: 2019.09.30 15:58:25 -07'00'

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.

Date

Chief Network Contracting Office (NCO) 21

Stephanie G. San Juan 1726180

Digitally signed by Stephanie G.

San Juan 1726180 Date: 2019.09.30 15:18:19 -07'00'