P03 - JOFOC 36C259-21-AP-0824 - CNH Windsor Signed RED_Redacted.pdf

VHAPM Part 813.5 Simplified Acquisition Procedures for Certain Commercial Items Attachment 1: Request for Sole Source Justification >SAT-$7M under FAR13.5

PM Part 813.5 SAP for Certain Commercial Items Page 2 of 5 Original Date: 08/30/17 Revision 02 Date: 08/04/2020

( ) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert Services

( ) International Agreement ( ) Authorized or Required by Statute ( ) National Security ( ) Public Interest

6. 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 7 Veterans being treated and housed at the Windsor Health Care Center under an existing BOA VA259-16-G-0036. Windsor Health Care Center facility meets VA standards for quality of care to provide care and treatment to Veterans. Additionally, Windsor Health Care Center facility has had a contract with the VA since 2016. 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 family. The relocating of Veterans is not in accordance with VA policy/directive established by the Office of Geriatrics and Extended Care. In accordance with FAR 13.5, this requirement for community nursing homes services will be a sole source IDC to SSC Windsor Operating Company LLC dba Windsor Health Care Center.

7. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: A Sources Sought Notice, 36C25921Q0148, was issued on 15 December 2020 and closed 23 December 2020. The notice requested basic contractor information from qualified sources to gain knowledge of potential qualified sources and their size classification (HUBZone, 8(a), small, small disadvantage, service-disabled Veteran owned small business, veteran owned small business or large business) relative to NAICS 623110 Nursing Care Facilities (Skilled Nursing Facilities) ($30 Million size standard). No responses were received for the Sources Sought Notice. A search of the Medicare Nursing Home Compare website https://www.medicare.gov/nursinghomecompare/search.html resulted in 7 community nursing homes within 10 miles of Windsor, CO where the current CNH is located. The VA Vendor Information Page (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 Windsor, CO. The CNH program requires that any new CNH considered for a contract, the CNH Coordinator must review the Medicare compare score to determine if the CNH is above or below the required score to determine if a waiver is required or not required before a contract can be considered. Any required waiver should be submitted with the procurement package. As a 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.

8. 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

VHAPM Part 813.5 Simplified Acquisition Procedures for Certain Commercial Items Attachment 1: Request for Sole Source Justification >SAT-$7M under FAR13.5

PM Part 813.5 SAP for Certain Commercial Items Page 3 of 5 Original Date: 08/30/17 Revision 02 Date: 08/04/2020 and Extended Care Office through the Veterans Health Administration Procurement Manual (VHAPM) and VA pulse publishes an annual maximum allowable percentage that are applied to each Resource Utilization Groups IV (RUGS IV) category. The RUGS IV categories 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 categories, the add-on percentages, and the total per diem rate for each level of care. After conducting market 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.

9. Description of the Market Research Conducted and the Results, or a Statement of the

Reasons Market Research Was Not Conducted: As described in Section 7 above, a search of the Medicare Nursing Home Compare website https://www.medicare.gov/nursinghomecompare/search.html resulted in 7 Community Nursing Homes within 10 miles of the zip code of 80550 Windsor, CO where the current CNH is located. A search of the Medicare.gov website for SSC Windsor Operating Company LLC dba Windsor Health Care Center shows that the facility has a 4-Star Overall Rating which the CNH coordinator reviewed and determined to be acceptable and in accordance with the VHA Office of Community Care (OCC) Field Guidebook Specialty Programs section 1.2 (Geriatric Extended Care & Community Nursing Homes) thresholds, which states if a Nursing Home has an overall compare score of 3-5 stars they are eligible and do not require a waiver. A search of VetBiz using zip code 80550 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 80550, yielded no results. A Sources Sought announcement (36C25921Q0148) was posted on 15 December 2020 and closed 23 December 2020. No responses were received to the sources sought. 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 Veteran’s needs. The CNH coordinator determines the number of CNH's that may be required in an area based on future needs.

10. Any Other Facts Supporting the Use of Other than Full and Open Competition: The CNH is currently providing care for 7 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 and moving them would cause undue stress to the Veterans and their family if the government tried to relocate the Veterans to a new nursing home.

11. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: No other CNH expressed interest in this acquisition. The current contractor Windsor Health Care Center has expressed an interest to continue providing CNH services to the VA and continue in providing care and services to the Veterans currently placed there.