P03_JOFOC for CNH Midtown Manor 36C259-20-AP-1260 Redacted.pdf

OFOC SOP Revision 08 Original Date: 03/22/11 Revision 08 Date: 04/18/2018

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A)

For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C259-20-AP-1260, Midtown Manor, Salt Lake City VAMC

Tracking ID: 2020-03-05T12:16:09

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 Salt Lake City Health Care system to

Midtown Manor located in Salt Lake City, UT. This will be a 3-year IDC (36 Months). The period of performance will be 1 May 2020 through 30 April 2023.

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 VA259-15-G-0061 expires on 30 April 2020. Midtown

Manor 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 Utah. This will be a 3-year IDC

(36 Months). The period of performance will be 1 May 2020 through 30 April 2023. The total estimated value of this contract is

Revision 08 Date: 04/18/2018

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 are 21 Veterans being treated and housed at the Midtown Manor facility under an existing BOA. The facility resides in a rural area and no other homes are available or capable of providing care in the zip code. Midtown Manor 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 Midtown

Manor 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: No new CNH has expressed interest in doing business with the Government. A search of the Medicare Nursing Home Compare website https://www.medicare.gov/nursinghomecompare/search.html resulted in 18 community nursing homes in Salt Lake City, UT where the current CNH is located. No responses were received from any potential offerors regarding the sources sought notice issued for this procurement. 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 Salt Lake City, UT. The CNH program requires that any new CNHs that want to do business with the Government must pass a series of inspections. The CNH https://www.medicare.gov/nursinghomecompare/search.html

Revision 08 Date: 04/18/2018 must pass a clinical inspection and a life safety inspection. The CNH Program Coordinators meet with the CNH to understand the services that are offered. Once the CNH passes 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 18 community nursing homes in Salt Lake City, UT where the current CNH is located. The VA’s Vendor

Information Page (Vet Biz) was used to determine if potential offerors exist to provide additional competition. However, the site failed to produce any results for Salt Lake City, UT. Results of the market research show there is no other CNH that expressed interest.

CNHs 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 required inspections to increase the number of available and qualified CNHs that can pass the Government's inspections before a contract can be established.

https://www.medicare.gov/nursinghomecompare/search.html

Revision 08 Date: 04/18/2018

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

The CNH is currently providing care for 18 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. We would cause undue stress to the Veteran and family if we tried to relocate the Veteran. It is the responsibility of the CNH Coordinator to visit as many homes as possible in a given area to ensure there are enough CNHs available that qualify to be a contracted CNH. The CNH Coordinator is responsible for scheduling the clinical, facilities and life safety inspections required before a home can be contracted with the VA . While there are 18 CNHs available, they have not been vetted through the VA to determine if they would qualify and meet the VA's standards for a contracted CNH.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: No other

CNH expressed interest in this acquisition. The current contractor, Midtown Manor, 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 eighteen (18) facilities capable of providing the specialty care and medical needs of the existing Veterans. 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 CNHs in a given area to provide the Veterans with several choices. However, the selection of the CNH is determined on whether the CNH has the resources available to meet each Veterans needs. The CNH Program Coordinator is responsible for conducting market research and required inspections to increase the number of available and qualified CNHs 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.

Heather Bittinger Date CNH Program Coordinator

Facility: VA Salt Lake City Healthcare System

13. Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

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

Revision 08 Date: 04/18/2018

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.

Joshua Gallegos Date

Contracting Officer Specialized 1 Branch

Network Contracting Office 19

b. One Level Above the Contracting Officer (Required over SAT but not exceeding $700K): I certify the justification meets requirements for other than full and open competition.

David J. Medina Date

Contracting Officer

Specialized 1 Branch Chief

c. VHA NCO-19 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.

03/31/2020

Danny O. Freeman Date

Director of Contracting

d. 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)