P03 - Redacted JNA.pdf

VHAPM Part 813.5 Simplified Acquisition Procedures for Certain Commercial Items Attachment 1: Request for Sole Source Justification Template >SAT-$7.5M under FAR13.5

PM Part 813.5 SAP for Certain Commercial Items Page 2 of 5 Original Date: 08/30/17 Revision 03 Date: 02/11/2021

(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.

Acquisition Requires the Use of the Authority Cited Above (applicability of authority):

Currently, there is 1 Veteran being treated and housed at St Home under an existing IDC 36C25919D0069. St facility meets VA standards for quality of care to provide care and treatment to Veterans. St Hospital and Nursing Home facility has had a contract with the VA since 2014. They have consistently provided quality care to our Veteran. 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 Geriatrics and Extended Care. In accordance with FAR 13.5, this requirement for community nursing homes services will be a sole source IDC to Teton County Hospital District dba St . 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 Sources Sought Notice, 36C25921Q0146, was issued on 04 January 2021 and closed 04 February 2021. No responses were received to the source sought. The notice requested basic contractor information from interested parties to gain knowledge of potential interested parties 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). A search of the Medicare Compare website https://www.medicare.gov/care-compare/ resulted in 1 community nursing home with 25 miles of Jackson, WY 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 Jackson, WY. The CNH program requires the 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.

PM Part 813.5 SAP for Certain Commercial Items Page 3 of 5 Original Date: 08/30/17 Revision 03 Date: 02/11/2021

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 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 rates are fair and reasonable. If not, the Government will negotiate a change in the rate based on the allowable add-on percentage established by the Office of Geriatrics and Extended Care. 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 Compare website https://www.medicare.gov/care-compare/ resulted in 1 Community Nursing Home within 25 miles of the zip code of 83001 Sheridan, WY where the current CNH is located. The CNH Coordinator reviewed the Medicare compare score and determined a waiver was not required. A search of VetBiz using zip code 83001 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 83001 and there were no results. A Sources Sought announcement (36C25921Q0146) was posted on 04 January 2021 and closed 04 February 2021. 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 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 is currently providing care for one Veteran in this facility who cannot be relocated due to continuity of care and medical complexity. This CNH is located near the family of the Veteran and moving them would cause undue stress to the Veteran and their family if the government tried to relocate the Veteran to a new nursing home.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: No other CNH expressed interest in this acquisition. The current contractor, St 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

PM Part 813.5 SAP for Certain Commercial Items Page 4 of 5 Original Date: 08/30/17 Revision 03 Date: 02/11/2021 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, Veteran needs, proximity to home/residence and family. The CNH Program usually attempts to inspect a sample of CNH's in a given area to provide the Veterans with several choices but there has been a hold on doing these in person inspections due to COVID and access restrictions. However, the selection of the CNH is determined on whether the CNH has the resources available to meet each Veteran's needs. The CNH Program Coordinator is responsible for conducting market research and required inspections to increase the number of available and qualified CNH's. The contracting office and CNH Program office will continue to canvas the market for new CNH entrants capable of meeting program 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.

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

a. Contracting Officer Certification (required): I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

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b. One Level Above the Contracting Officer (Required over SAT but not exceeding $750K): I certify the justification meets requirements for other than full and open competition.

c. VHA RPO HCA Review and Approval: I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and approve ($750K to $7.5 million (or $15.0 million for acquisitions described in FAR 13.500(c)) for other than full and open competition.