Redacted JOFOC 36C259-21-AP-1588.pdf

PM Part 813.5 SAP for Certain Commercial Items Page 1 of 4

Original Date: 08/30/17

Revision 03 Date: 02/11/2021

DEPARTMENT OF VETERANS AFFAIRS

SOLE SOURCE JUSTIFICATION UNDER SIMPLIFIED PROCEDURES FOR CERTAIN

COMMERCIAL ITEMS IN ACCORDANCE WITH FAR 13.5

Acquisition Plan Action ID: 36C259-21-AP-1588, Kismet BIG, LLC DBA Lake View Care Center;

CNH for Fort Harrison, Montana

RPOW JOFOC Acquisition Plan Action ID: 2021-05-10T06:06:31

1. Contracting Activity: Department of Veterans Affairs, Network Contracting Office 19 (NCO19), 6162 South Willow Drive, Greenwood Village, CO 80111. Organizational Activity: Montana VA

Health Care System, 3687 Veterans Drive, Fort Harrison, MT 59636. 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 an Indefinite Delivery Contract (IDC) 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 procurement is for the establishment of a sole source Firm-Fixed Price IDC for Community

Nursing Home (CNH) services for the Montana VA Health Care System to Kismet BIG, LLC. This will be a 5-year IDC (60 Months). The period of performance will be 1 September 2021 through 31

August 2026.

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, 36C25919D0068 expires on 31 August 2021. Kismet BIG, LLC (DBA Lake View Care Center) has met all requirements under VHA Notice 2019-22, Community Nursing Home Program (CNHP) and

VHA Office of Community Care (OCC) Field Guidebook Specialty Programs Section 1.2, Geriatric

Extended Care (GEC). 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 September 2021 through 31 August 2026. The estimated total value of this contract will be $3,300,000.00. This requirement will include FAR 52.217-8 option, and the estimated value if exercised would be $330,000.00.

4. Statutory Authority Permitting Restricted Competition:

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

(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

PM Part 813.5 SAP for Certain Commercial Items Page 2 of 4

Revision 03 Date: 02/11/2021

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 six (6) Veterans being treated and housed at Lake View Care Center facility under an existing contract (36C25919D0068). The Lake View Care Center nursing home facility meets VA standards for quality of care to provide care and treatment to Veterans. Kismet BIG, LLC has had a contract with the VA since 2014. 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 their families. In accordance with FAR 13.501, this requirement for community nursing homes services will be sole sourced to Kismet BIG, LLC (DBA Lake View Care

Center) nursing home facility. In addition, as stated in paragraph 6 below, no responses were received from any potential offerors regarding the sources sought notice 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 was posted to Contract Opportunities on February 19, 2021 and closed on February 28, 2021. 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 5 Community Nursing

Homes within the zip code of 59911, 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 Bigfork, MT. The CNH

Program Coordinator will review the Medicare.gov Nursing Home Compare scores of any new CNHs to determine if they are eligible and considered potential participants for a VA contract. These new thresholds are based on the Medicare Nursing Home Compare scores. While some VA CNH Medical

Centers may opt to conduct these inspections; the current COVID-19 pandemic has seen a number of

CNHs impacted by the virus and has caused limited visits to these facilities. In accordance with the

VHA Office of Community Care Field Guidebook, a new CNH participant would be eligible for a

VA contract without a waiver if they have a: 3-5 Overall Stars or 2 Overall Stars with a 4-5 Quality

Measures Stars. As part of the acquisition process, a CNH must provide a current state license, current insurance, current state inspection/survey reports and most current Medicaid rate letter on state letter head. These documents are provided to the CNH Program Coordinator for review and evaluation. The CNH Review Team will review all documents and the Medicare Nursing Home

Compare scores. Upon review, 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 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 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/nursinghomecompare/search.html resulted in 5 community nursing homes within the zip code of 59911 of Bigfork, MT where the http://www.medicare.gov/nursinghomecompare/search.html http://www.medicare.gov/nursinghomecompare/search.html https://www.medicare.gov/nursinghomecompare/search.html

PM Part 813.5 SAP for Certain Commercial Items Page 3 of 4 current CNH is located. A sources sought was posted to Contract Opportunities on February 19, 2021 and closed on February 28, 2021. There were no responses received from any other potential offerors regarding the sources sought notice issued for this procurement. The VA’s Vendor Information Page

(Vet Biz) was used to determine if any potential Service-Disabled Veteran-Owned Small Business or

Veteran-Owned Small Business offerors exist for this requirement. However, the site failed to produce any results for Bigfork, MT. The results of the market research showed 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 Veterans’ needs, proximity to home/residence and family. The CNH Coordinator is responsible for conducting market research and will review the Medicare Nursing Home Compare scores to determine if there are any available and qualified CNHs that are eligible for a contract. The current contract, 36C25919D0068 expires on 31 August 2021.

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

(6) Veterans receiving care and treatment at this facility. The Veterans cannot be relocated due to continuity of care and medical complexity. This CNH is located near the families of the Veterans. It would cause undue stress to the Veterans and families if the Veterans were to be relocated.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: No other CNH expressed interest in this acquisition. The current contractor, Kismet BIG, LLC 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 one facility capable of providing the rehabilitation, nursing, and clinical care of the existing Veterans. Based on the CNH program requirements, the Veterans’ preference is taken into consideration when selecting a CNH based on the Veterans’ needs, and proximity to home/residence and family. The CNH Program usually attempts to inspect a sample of CNHs in a given area to provide the Veterans with several choices. However, due to COVID-19 CDC guidelines and access restrictions, the in-person inspections have been put on hold. As an alternative, 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 Program Coordinator is responsible for conducting market research. They 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 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.

Kelli Antonick Date

Manager, Geriatrics & Extended Care

Facility: VA Montana Health Care System

PM Part 813.5 SAP for Certain Commercial Items Page 4 of 4

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. Medina Date

Contracting Officer

Branch Chief, NCO 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.

Danny O. Freeman 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 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.

Curtis M. Jordan Date

Executive Director, RPO West

VHA Head of Contracting Activity (HCA) http://vaww.pclo.infoshare.va.gov/PMWeb/VHAPM_Part_806.3.aspx VHAV19MedinD Typewritten Text 05/13/2021

VHAV19FreemD Typewritten Text 5/20/2021