P03_JOFOC for 20 AP 2498 CNH Rosebud Community Hospital REDACTED.pdf

OFOC SOP Revision 09 Original Date: 03/22/11 Revision 09 Date: 04/17/2020

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C259-20-AP-2498, CNH Rosebud Community Hospital, Montana Health Care System

RPOW JOFOC Acquisition Plan Action ID: 2020-07-27T14:54:45

1. Contracting Activity: Department of Veterans Affairs, Network Contracting Office 19

(NCO19), 6162 South Willow Drive, Greenwood Village, CO 80111. 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 Montana Health Care system to Rosebud Community Hospital, located in Forsyth, MT. This will be a 5-year IDC (60 Months). The period of performance will be 1 November 2020 through 31 October 2025.

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 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-0003 expires on 31 October 2020. Rosebud Community Hospital has met all requirements under VA policy/directive established by the Office of Geriatrics and Extended Care. Additionally, they are certified under Centers for Medicare and Medicaid Services (CMS) and licensed by the State of Montana. This will be a 5-year IDC (60 Months). The period of performance will be 1 November 2020 through 31 October 2025. The total estimated value of this contract is $1,700,000.00

Revision 09 Date: 04/17/2020

4. Statutory Authority Permitting Other than Full and Open Competition: 41 USC §3304(a)(1), as implemented by FAR 6.302-1 (a)(2).

(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;

FAR13.5 Simplified Procedures for Certain Commercial Items: The authority for applying the Simplified Procedures for Commercial Items of FAR 13.5 is 41 U.S.C. 1901 and is implemented by for restricting competition on this procurement via FAR 13.106- 1(b)(2).

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 1 Veteran being treated and housed at the Rosebud Community Hospital facility under an existing BOA. Rosebud Community Hospital nursing home facility meets VA standards for quality of care to provide care and treatment to Veterans. They have consistently provided quality care to our Veterans. In accordance with FAR 6.302-1, this requirement for community nursing homes services will be sole sourced to the Rosebud Community Hospital facility. In addition, as stated in paragraph 6 below, no responses were received from any 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 source sought was posted on 24 June thru 06 July. No responses were received from any potential offerors regarding the sources sought notice. A search of the Medicare Nursing Home Compare website https://www.medicare.gov/nursinghomecompare/search.html resulted in 1 Community Nursing Home within the zip code of 59327, where the current CNH is located. The VA Vendor Information Page (Vet Biz) 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 Forsyth, MT. The CNH program requires that any new CNH's that wants to do business with the Government must pass a series of inspections. The CNH must pass a clinical inspection and a life safety inspection. The CNH Program Coordinators would visit the CNH facilities to review the type of services available to Veterans. Once the CNH passes http://www.medicare.gov/nursinghomecompare/search.html

Revision 09 Date: 04/17/2020 these inspections, they can be considered for a contract. As 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.

7. Determination by the Contracting Officer (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 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 no community nursing homes within the zip code of 59327 of Forsyth, MT where the current CNH is located. A sources sought was posted on June 24, 2020 and closed on July 6, 2020. No responses were received from the sources sought notice. The VA’s Vendor Information Page (Vet Biz) was used to determine if any potential Small Disadvantage Veterans owned small business or Veteran-owned small business offerors exist for this requirement. However, the site failed to produce any results for Forsyth, MT. The results of the market research showed there is no other CNH that expressed interest. CNH's are not competed. Based on the CNH program requirements, the Veterans preference is taken into consideration when selecting a CNH. The CNH selection is based on the Veteran needs, proximity to home/residence and family. The CNH Program Coordinator is required to conduct a clinical and life safety inspection to ensure the CNH has the resources available to meet the patients’ needs. The CNH Program Coordinator is responsible for conducting market research and coordinating the required inspections to increase the number of available and qualified CNH's that can pass the Government's inspections before a contract can be established.

Revision 09 Date: 04/17/2020

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

There is 1 Veteran receiving care and treatment at this facility. The Veteran 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, Rosebud Community Hospital, has expressed an interest to continue providing CNH services to the VA and continue in providing care and services to the Veterans.

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 1 facility capable of providing the specialty care and medical needs of the existing Veteran. 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 attempts to inspect a sample of CNH's in the state to provide the Veteran’s with several choices. However, the selection of the CNH is determined on whether the CNH has the resources and program requirements available to meet the Veteran’s need. The CNH Program Coordinator is responsible for conducting market research and coordinating the required inspections to increase the number of available and qualified CNH's that can pass the Government's inspections. The contracting office and CNH Program office will continue to canvas the market for new CNH entrants capable of meeting program requirements.

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.

Digitally signed by Christine R Brand

Christine R Brand 261628 261628 Date: 2020.08.05 11:44:03 -06'00'

Christine R. Brand, MSN, RN Date CNH Program Coordinator Facility: VA Montana Healthcare System

Revision 09 Date: 04/17/2020

DANNY O. FREEMAN Digitally signed by DANNY O.

170000

FREEMAN 170000

Date: 2020.08.19 14:38:04 -06'00'

Jordan, Curtis M.

(RPO)

Digitally signed by Jordan, Curtis

M. (RPO)

Date: 2020.08.21 14:20:26 -06'00'

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.

David J. Digitally signed by David J. Medina 748952 Date: 2020.08.05 12:55:24 -06'00'

David J. Medina Date Contracting Officer Specialized 1 Branch Chief Network Contracting Office 19

b. NCO-19 Director of Contracting REVIEW AND APPROVAL (over $700,000 to $13.5 million): I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and approve for other than full and open competition.

Danny O. Freeman Date Director of Contracting Network Contracting Office 19

c. VHA RPO HCA REVIEW AND APPROVAL (over $700,000 to $13.5 million): I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and approve for other than full and open competition.

Curtis M. Jordan Date Executive Director, RPO West Head of Contracting Activity (HCA)

Medina 748952 08/05/202

08/19/202 http://vaww.pclo.infoshare.va.gov/PMWeb/VHAPM_Part_806.3.aspx