P03_J_A-36C244-23-AP-4798-Spruce Manor-Final Signed-09-08-2023.pdf

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C244-23-AP-4798

1. Contracting Activity: Department of Veterans Affairs, VISN 04, Lebanon VA Medical Center, 1700 South Lincoln Avenue, Lebanon, PA 17042-7529.

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

The Lebanon VAMC has a requirement for a 5-year, sole source, Indefinite Delivery Indefinite Quantity (IDIQ) Contract for Community Nursing Home (CNH) services. The services are currently provided under an IDIQ contract that expires on 09/30/2023. The incumbent Contractor is Spruce Manor Nursing & Rehabilitation Center, LLC., 220 S. 4th Avenue, Reading, PA 19611. The services are still required in this location as there are still Veteran beneficiaries who are residents at this facility. A new replacement IDIQ procurement is being pursued to maintain continuity of care for the Veteran residents.

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

Contractor shall provide CNH services to meet the total medical, nursing, and psychosocial needs of VA beneficiaries and any specialty care services as identified as a particular need in the CNH program. All nursing home facilities in VA’s CNH program must have current Center for Medicare and Medicaid Services (CMS) certification (Medicare and / or Medicaid), a State issued nursing home license, and shall meet VA developed quality of care standards utilizing CMS inspection criteria. Primary care / provider (medical doctor, nurse practitioner, and / or physician assistant) visits will be available at the rate of (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. 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. The estimated amount for this procurement is presented in Table 1 below.

Facility Patients in

Facility Period of

Performance Start Date

Period of Performance End Date

Estimated Amount*

Spruce Manor Nursing & Rehabilitation Center, LLC.

4 10/01/2023 09/30/2028 $4,407,333.00

*NOTE: Rates for Veteran care is based on daily rates – and on the needs of the Veteran admitted.

Due to the dynamic nature of Veteran needs in the catchment area the above estimated amount has been derived from current CNH Spend data and projected forward based on estimated needs for the 5-year term an increase in costs for COVID-19 and Medicare rates is also included. For example: Current Spend Data for CNH Spruce Manor Nursing & Rehabilitation Center, LLC., is $340,663.42 through the end of March 2023.

Calculations are as follows:

$340,663.42 / 12 months = $28,388.62 (12 months of Veteran use) (Monthly Amount).

$28,388.62/ 4 people = $7,097.15 (Average spent per Veteran).

$28,388.62 * 60 months = $1,703,317.10 (Estimated base total for 5-year IDIQ).

($7,097.15 * 5 = $35,485.77) * 60 months = $2,129,146.38 (5 is the Factor for the Estimated Projected increase of Veterans Admitted over the 5-year term).

($1,703,317.10 + $2,129,146.38 = $3,832,463.48) * 15% = $574,869.52 (Estimated Cost Increase over 5 years for Medicare rates and COVID-19).

$3,832,463.48 + $574,869.52 = $4,407,333.00 (Total Estimated Costs for 5-year IDIQ).

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

(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 CNH program is dependent on location and Veteran preference. To fulfill the VA’s mission and the Mission Act. CNH homes must be close to the Veteran’s homes and their social support networks. A network of high-quality CNH providers is required to ensure Veteran access. Relocation of currently placed Veterans is a last resort to all other contractual options. Four (4) Veteran beneficiaries are currently residents at Spruce Manor Nursing & Rehabilitation Center, LLC., and it would be detrimental to their care to relocate them to another facility that may be outside of their community and further away from their social support network. The CNH currently houses four (4) Veterans and has a history of positive performance under the VA CNH program.

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

CNH requirements are normally competed, and NCO4 has a portfolio of CNH contracts that are the result of competitive procurements. An intent to sole source notice was placed on Contract Opportunities and made available to the public. The sole source notice described the nature and time period of the intended acquisition, as well as a rough geographic location of the required services. Future CNH requirements will be competed to the greatest extent possible. This requirement needs to be awarded on a sole source basis because Veteran beneficiaries currently reside at Spruce Manor Nursing & Rehabilitation Center, LLC. Relocating those residents will be detrimental to their health and wellbeing.

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

Reasonable:

The existing IDIQ rates were based upon the most recent Medicare RUG rate updates. Proposed rates under the IDIQ will be based upon most recent Medicare RUG rates. These rates will be used to determine fair and reasonable pricing. Additionally, it is important to note that CNH IDIQs are awarded as zero-dollar obligations with no task orders placed against them. This is due to the fact that these are paid through the local Medical Center via the 1358 financial process. No local funded 2237 purchase request is ever submitted which in turn does not allow the local contracting activity to actually obligate any funding against or under this CNH IDIQ.

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, market research, in accordance with FAR Part 10, was conducted by synopsis of the proposed acquisition, advising industry of the pending acquisition.

Additional Market Research has been conducted on the Facility and is included in the Contract Briefcase.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition:

A contract with this provider is required for Veteran care and continuation of the VA Mission because the incumbent is currently providing care to approximately four (4) Veterans. Relocation of these Veterans is not practical based on their care plans. A contract with this provider is also required to maintain services in this geographic location.

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

This is a sole source replacement acquisition required for continuity of Veteran care. There has never been any written response of other interested sources for this acquisition.

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 VA is unable to take any further steps to remove or overcome any barriers to competition at this time due to current Veteran care and geographically based provider needs.

The NCO4 Medical 1 team is currently working on competitive solicitations to ensure open competition for future procurements in this NAICS code.

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.

Samantha Stringer Date

COR

Lebanon VAMC

SAMANTHA Digitally signed by

STRINGER

SAMANTHA STRINGER

Date: 2023.08.22 08:26:47 -04'00'

Matthew Edwards Date Contract Specialist Network Contracting Office 4

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.

Kevin Balser Date Branch Chief

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.

Dan Shea Date Division 1 Chief

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 $75 million) or approve ($750K to $75 million) for other than full and open competition.

Joseph P. Maletta Date VHA Head of Contracting Activity (HCA)

MATTHEW

EDWARDS 625690

Digitally signed by MATTHEW

EDWARDS 625690

Date: 2023.09.05 15:33:46 -04'00' kevin balser 1496982

Digitally signed by kevin balser 1496982 Date: 2023.09.08 09:58:02 -04'00'

DANIEL SHEA Digitally signed by DANIEL SHEA Date: 2023.09.08 12:24:26 -04'00'

JOSEPH

MALETTA

Digitally signed by

JOSEPH MALETTA

Date: 2023.09.08 17:35:19 -04'00'