Redacted JA_36C25923AP0238 CNH Broomfiled CNH.pdf

VHAPG Part 806.3 OFOC Page 1 of 4 Revision: 01 Effective Date: 04/01/23

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C259-23-AP-0238

RPOW JOFOC Tracker: FY24-NCO 19-141

1. Contracting Activity: Department of Veterans Affairs, Network Contracting Office (NCO) 19, 6162

S. Willow Drive, Suite 300, Greenwood Village, Colorado 80111, in support of the Rocky Mountain Regional VA Medical Center located at 1700 N. Wheeling Avenue, Aurora, CO 80045. 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 Indefinite Quantity (IDIQ) for Community Nursing Home (CNH) Services for the Rocky Mountain Regional VA Medical Center, Aurora, CO with Broomfield Skilled Nursing and Rehabilitation Center LLC located in Broomfield, CO.

3. Description of Supplies/Services Required to Meet the Agency’s Needs: The CNH will provide a facility and all services to support short- and long-term care for eligible Veterans. These services include, but are not limited to, rehabilitation, nursing, and clinical care in accordance with the performance work statement (PWS). The current contract, 36C25918D0241, will expire on January 31, 2024. Broomfield Skilled Nursing and Rehabilitation Center LLC has met all requirements under VHA Notice 2020-32 and VHA Notice 2023-07, Community Nursing Home Program (CNHP) and VHA Office of Integrated Veteran Care (IVC) Community Care Field Guidebook, Specialty Programs, Section 1.2, Geriatrics Extended Care (GEC). Additionally, it is certified under Centers for Medicare and Medicaid Services (CMS) and licensed by the State of Colorado. This will be a 5-year Indefinite-Delivery Indefinite-Quantity Contract (IDIQ) (60 months). The estimated period of performance will be February 1, 2024 through January 31, 2029. The total estimated value of this contract is $25,286,147.00. The IGCE amount, $25,286,147.00, will be the maximum ceiling value.

The clause at FAR 52.217-8 Option to Extend Services is included and will be evaluated for this requirement and the specific rates will be those rates in effect each time an option is exercised under this clause.

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):

Currently, there are thirty-three (33) Veterans being treated and housed at Broomfield Skilled Nursing and Rehabilitation Center LLC under the existing contract, 36C25918D0241. The CNH, Broomfield Skilled Nursing and Rehabilitation Center LLC, meets the VA rating on quality-of-care standards to

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Effective Date: 04/01/23 provide treatment to Veterans. Broomfield Skilled Nursing and Rehabilitation Center LLC has had a contract with the VA since 2018. Broomfield Skilled Nursing and Rehabilitation Center LLC has consistently provided this specialty care in a quality manner 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 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 6.302-1, this requirement for community nursing homes services will be sole sourced to Broomfield Skilled Nursing and Rehabilitation Center LLC.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable:

A Sources Sought announcement, 36C25923Q0166, was posted on Contract Opportunities on December 30, 2022, and closed on January 13, 2023. There were no responses to the source sought notice. A search of the Medicare.gov, Vendor Information Pages (VIP), SBA Veteran SB certification (VetCert), and SBA Small Business Dynamic Search was conducted. A search was conducted using Medicare.gov nursing home compare website to find nursing homes in the Broomfield, Colorado area.

There are fifteen (15) Community Nursing Homes within 10 miles of the zip code of 80020 in Broomfield, Colorado. While this shows there are fifteen (15) facilities within the same area code, Broomfield Skilled Nursing and Rehabilitation Center LLC is one (1) of these fifteen (15). There are two (2) other VA contracted facilities. These two (2) facilities are not being considered due to being at capacity and the Veterans’ preference to remain at the Broomfield Skilled Nursing and Rehabilitation Center LLC. The other twelve (12) facilities have not been vetted through the VA process to establish them as VA contracted facilities nor have expressed interest in a contract. Also there are currently thirty-three (33) Veterans at the current facility that do not want to be relocated. They want to stay at that facility and be within close distance to their family. A search of VetBiz using zip code 80020 and the NAICS code 623110, resulted in 0 SDVOSBs/VOSBs. A search of the SBA Veteran SB certification (VetCert) using NAICS code 623110, resulted in 125 SDVOSB/VOSBs. In those 125 results, it was a mixture of Community Nursing Home providers, staffing agencies and other NAICS code 623110 business types and the listing is for all nationwide locations. A VetCert scan on the 125 SDVOSB/VOSB was completed to see if any results were located in Broomfield, CO and came up with 0 (zero) results. A search of the SBA Small Business Dynamic Search was conducted using the NAICS code 623110 and zip code 80020 and had one (1) result, the incumbent contractor, Broomfield Skilled Nursing and Rehabilitation Center LLC.

The CNH program requires the CNH Coordinator review the Medicare compare scores and provide a recommendation based on the current score. The CNH Coordinator reviewed the Medicare compare score for Broomfield Skilled Nursing and Rehabilitation Center LLC and determined a waiver was not required. 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.

7. Determination by the CO that the Anticipated Cost to the Government will be Fair and

Reasonable:

The estimated cost is anticipated to be considered fair and reasonable. This determination is based on Medicaid rates established by each state based on national average and also, the annual maximum allowable percentage that is published through the VHA Procurement Guide and VA Pulse by the VA Geriatrics and Extended Care Office. The annual maximum allowable percentage is applied to each Resource Utilization Groups (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, the add-on percentage, and the total per diem rate for each level of care. The facility will not offer services to

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Effective Date: 04/01/23 ventilator-dependent patients as they are not equipped to do so. After conducting research on the current Medicaid and RUGS IV rates, the Contracting Officer (CO) will evaluate the Offeror's rate to determine if the price per diem 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 Nursing Home Compare website https://www.medicare.gov/care-compare resulted in fifteen (15) nursing homes within 10 miles of the zip code of 80020. While this shows there are fifteen (15) facilities within the same area code, Broomfield Skilled Nursing and Rehabilitation Center LLC is one (1) of these fifteen (15). There are two (2) other VA contracted facilities. These two (2) facilities are not being considered due to being at capacity and the Veterans’ preference to remain at the Broomfield Skilled Nursing and Rehabilitation Center LLC. The other twelve (12) facilities have not been vetted through the VA process to establish them as VA contracted facilities nor have expressed interest in a contract. Also there are currently thirty-three (33) Veterans at the current facility and do not want to be relocated.

They want to stay at that facility and be within close distance to their family. A search of NAICS 623110 on VIP resulted in zero (0) nursing homes within the zip code of 80020. A search of the SBA Veteran SB certification (VetCert) using NAICS code 623110, resulted in 125 SDVOSB/VOSBs. In those 125 results, it was a mixture of Community Nursing Home providers, staffing agencies and other NAICS code 623110 business types and the listing is for all nationwide locations. A VetCert scan on the 125 SDVOSB/VOSB was completed to see if any results were located in Broomfield, CO and came up with 0 (zero) results. A search of the SBA Small Business Dynamic Search was conducted Sec. 6using the NAICS code 623110 and zip code 80020 and there was one (1) result, the incumbent contractor, Broomfield Skilled Nursing and Rehabilitation Center LLC. A Sources Sought announcement, 36C25923Q0166, was posted on December 30, 2022 and closed on January 13, 2023 and received zero (0) response.

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 CNHs in each 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.

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

There is no other supporting information, not previously stated, to support the use of other than full and open competition.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition:

The current contractor, Broomfield Skilled Nursing and Rehabilitation Center LLC has expressed an interest to continue to provide CNH services to the VA and continue in providing care and services to the Veterans currently placed and any potential Veterans placed at the facility in the future. No other CNH expressed interest in 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:

Actions that are being taken to foster competition for future acquisitions of these services being acquired are being done by the CNH Coordinators. In accordance with the VHA Office of Integrated Veteran Care (IVC) Community Care Field Guidebook, the CNH Program Office will review the Medicare Nursing Home Compare scores for a sample of CNHs. The selection of the CNH is determined on whether the CNH has the resources and program requirements available to meet the Veterans' needs. The CNH Coordinator will review the Medicare Nursing Home Compare scores to determine if they are eligible for a contract. The Contracting Office, and CNH Program Office will https://www.medicare.gov/care-compare

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Effective Date: 04/01/23 continue to canvas the market for new CNH entrants capable of meeting program requirements.

Based on the CNH program requirements, the Veteran’s preference is taken into consideration when selecting a CNH based on the Veteran’s needs, proximity to home/residence and family.

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.

Elizabeth K. Teska Date Coordinator, CNH Program

ECHCS

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.

Jason Thomas Date Contracting Officer Network Contracting Office 19

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.

Michelle T. Gray Date Director of Contracting Network Contracting Office 19

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 recommend approval (if over $75 million) or approve ($750K to $75 million) for other than full and open competition.

Curtis M. Jordan Date Executive Director, Regional Procurement Office West Head of Contracting Activity (HCA) https://dvagov.sharepoint.com/sites/VHAProcurement/VHAPM/VHAPM_Part_806.3.aspx