P03_JA over SAT-Updated-Hamilton Arms Center OPCO LLC-Final Signed-05-23-2023.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-3031

1. Contracting Activity: Department of Veterans Affairs, VISN 04, Lebanon VA Medical Center, 1700 South

Lincoln Ave., 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 04/30/2023. The incumbent Contractor is Hamilton Arms Center OPCO, LLC., 336 S. West End, Lancaster, PA. 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*

Hamilton Arms Center

OPCO, LLC.

7 05/01/2023 04/30/2028 $6,509,649.00

*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 Hamilton Arms Center OPCO, LLC., is $660,399.17 through the end of September 2022.

Calculations are as follows:

$660,399.17 / 12 months = $55,033.26 (12 months of Veteran use) (Monthly Amount).

$55,033.26 / 7 people = $7,861.89 (Average spent per Veteran).

$55,033.26 * 60 months = $3,301,995.85 (Estimated base total for 5-year IDIQ).

($7,861.89 * 5 = $39,309.47) * 60 months = $2,358,568.46 (5 is the Factor for the Estimated Projected increase of Veterans Admitted over the 5-year term).

($3,301,995.85 + $2,358,568.46 = $5,660,564.31) * 15% = $849,084.65 (Estimated Cost Increase over 5 years for Medicare rates and COVID-19).

$5,660,564.31 + $849,084.65 = $6,509,648.96 (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. Seven (7) Veteran beneficiaries are currently residents at Hamilton Arms Center OPCO, 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 seven (7) 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. 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 Hamilton Arms Center OPCO, 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 rate updates. Proposed rates under the IDIQ will be based upon most recent Medicare 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:

There are several nursing homes in the Lancaster County, PA area that might be able to provide needed services. However, awarding to one of those facilities will result in the residents currently residing at Hamilton Arms Center OPCO, LLC., having to relocate to a new facility.

Relocation and change in the care they are receiving could have detrimental effects on the health and stability of those Veteran beneficiaries. In preparation for the sole source procurement for these services a Notice of Intent to Sole Source was posted to Federal Business Opportunities. No vendors responded to or raised objections or concerns related to the Government proposed sole source solution.

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 (7) Veterans. Relocation of these Veterans is not possible based on their care plans. A contract with this provider is also required to maintain services in this geographic location. Additionally, this J&A is reviewed and approved only at the local NCO team Branch Chief level due to this being a zero-dollar obligation as explained in #7 above. No higher-level reviews above the Branch Chief/Contracting Officer level are required for this.

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:

Due to the requirement for continuity of care no further steps will be taken to compete this specific requirement.

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.

__________________________ __5/18/2023_________

Gianna Bleyer Date

COR

Lebanon VAMC

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 Network Contracting Office 4 https://dvagov.sharepoint.com/sites/VHAProcurement/VHAPM/VHAPM_Part_806.3.aspx