P03-JA_36C259-20-AP-2557 Bent County -Denver CNH-REDACTED FBO posting.pdf

PM Part 813.5 SAP for Certain Commercial Items Page 1 of 4 Original Date: 08/30/17 Revision 02 Date: 08/04/2020

DEPARTMENT OF VETERANS AFFAIRS

SOLE SOURCE JUSTIFICATION UNDER SIMPLIFIED PROCEDURES FOR CERTAIN

COMMERCIAL ITEMS IN ACCORDANCE WITH FAR 13.5

Acquisition Plan Action ID: 36C259-20-AP-2557,Bent County Healthcare Center, DBA Bent County Memorial Nursing Home, Denver Community Nursing Home (CNH), VA Eastern Colorado Health Care System (ECHCS)

JOFOC Tracker #:

1. Contracting Activity: Department of Veterans Affairs, 6162 S. Willow Drive, Suite 300, Greenwood Village, Colorado 80111, in support of the VA Eastern Colorado Health Care System (ECHCS). 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 VA Eastern Colorado Health Care System (ECHCS) to Bent County Healthcare Center, DBA Bent County Memorial Nursing Home located in Las Animas, CO (Bent County). This will be a 5-year IDC (60 Months).The period of performance for this IDC will be 01 March 2021 – 28 February 2026.

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, VA259-16-G-0024, expires on 28 February 2021.

Bent County Healthcare Center, DBA Bent County Memorial Nursing Home has met all requirements under the VHA Notice 2019-22, Community Nursing Home Program (CNHP) and VHA Office of Community Care (OCC) Field Guidebook, Speciality Programs Section 1.2, Geriartic Extended Care (GEC). Additionally, they are certified under Centers for Medicare and Medicaid Services (CMS) and licensed by the State of Colorado. This will be a 5-year IDC (60 months). The period of performance will be 01 March 2021 through 28 February 2026. The total estimated value of this contract is $1,003,188.76, and the estimated value of the 52.217-8 option (6 months), if exercised, would be $

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.

PM Part 813.5 SAP for Certain Commercial Items Page 2 of 4

Revision 02 Date: 08/04/2020

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):

Currently, there is one (1) Veteran being treated and housed at the Bent County Healthcare Center, DBA Bent County Memorial Nursing Home under an existing BOA. Bent County Healthcare Center, DBA Bent County Memorial Nursing Home facility meets the VA rating on quality of care standards to provide treatment to Veterans. Bent County Healthcare Center, DBA Bent County Memorial Nursing Home facility has had a contract with the VA since 2011. They have consistently provided this specialty care in a quality manner to our Veterans. The Veteran 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 Geriatics and Extended Care. In accordance with FAR 6.302-1 this requirement for community nursing homes Services will be sole sourced to the Bent County Healthcare Center, DBA Bent County Memorial Nursing Home facility. In addition, as stated in paragraph 6 below, no responses were received from any other 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 announcement (36C25920Q0543) was posted on 23 July 2020 and closed 14 August 2020 and received zero (0) responses for Bent County, CO area. A search of the Medicare.gov, SBA Small Business Dynamic Search and Vendor Information Pages was conducted. A search was conducted using Medicare.gov nursing home compare website to find homes in the Las Animas, CO area. There are 10 Community Nursing Homes within 100 miles of the zip code of 81054 Las Animas, CO. However, the next closest CNH to zip code 81054 is 34.5 miles away. Also, these facilities have not been vetted through the VA process to establish them as viable options. A search of VetBiz using zip code 81054 and the NAICS code 623110, yielded no results. A search of the SBA Small Business Dynamic Search was conducted using the NAICS code 623110 and zip code 81054 and there were no results. The CNH program requires that for any new CNH to be considered for a contract, the CNH Coordinator must review the Medicare compare score to determine if the CNH is rated at a number above or below the required score that determines whether a waiver is required or not required before a contract can be considered for that CNH. A redacted J&A will be posted on Contract Opportunities.

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 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

PM Part 813.5 SAP for Certain Commercial Items Page 3 of 4

Revision 02 Date: 08/04/2020 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 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:

As described in Section 6 above, a search of the Medicare Nursing Home Compare website https://www.medicare.gov/nursinghomecompare/search.html resulted in 10 Community Nursing Homes within 100 miles of the zip code of 81054 Las Animas, CO where the current CNH is located. A search of VetBiz using zip code 81054 and the NAICS code 623110, yielded no results. A search of the SBA Small Business Dynamic Search was conducted using the NAICS code 623110 and zip code 81054 and there were no results. A Sources Sought announcement (36C25920Q0543) was posted on 23 July 2020 and closed 14 August 2020 and received zero (0) responses for Bent County, CO area.Typically, CNH's are not competed. Based on the CNH program requirements, the Veterans preference is taken into consideration when selecting a CNH based on the Veteran needs, proximity to home/residence and family. The CNH Program Coordinator at the Medical Center reviews the Medicare compare score of various CNH's in a given area to determine the feasibility to meet the Veterans needs. The CNH coordinator determines the number of CNH's that may be required in an area based on future needs.

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

The CNH facility currently provides care to one (1) Veteran, who cannot be relocated due to continuity of care and medical complexity. This CNH is located near the family of the Veteran. We would cause undue stress to the Veteran and family if we tried to relocate the Veteran.

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

No other CNH expressed interest in this acquisition. The current contractor, Bent County Healthcare Center, DBA Bent County Memorial Nursing Home has expressed an interest to continue providing CNH services to the VA and continue in providing care and services to the Veteran currently placed 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:

There is currently only one (1) facility capable of providing the specialty care and medical needs of the existing Veteran. Based on the CNH program requirements, the Veteran preference is taken into consideration when selecting a CNH based on the Veteran’s needs, proximity to home/residence and family. The CNH Program Coordinator at the Medical Center reviews the Medicare compare score of various CNH's in a given area to determine the feasibility to meet the Veterans needs. 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.