REDACTED JOFOC_Bella Terra of Billings MT.pdf

PM Part 813.5 SAP for Certain Commercial Items 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-2679, CNH Bella Terra of Billings, Montana VA Health Care System

RPOW JOFOC Acquisition Plan Action ID: Tracker # 2021-06-03T13:58:01

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. Organizational Activity: Department of Veterans Affairs, VISN 19, Montana VA Health

Care System, 3687 Veterans Drive, Fort Harrison, MT 59636.

3. 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 Bella Terra of Billings, located in Billings, MT. This will be a 5-year IDC (60 Months). The period of performance will be 1 September 2021 through 31 August 2026.

4. 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. This will be a new contract. Bella Terra of Billings 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. The total estimated value of this contract is $2,000,000.00, and the estimated value of the 52.217-8 option, if exercised, would be $200,000.00.

Revision 03 Date: 02/11/2021

5. 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

6. Demonstration that the Contractor’s Unique Qualifications or Nature of the

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

Bella Terra of Billings nursing home facility meets VA standards for quality of care to provide care and treatment to Veterans. In accordance with FAR 13.501, this requirement for community nursing homes services will be sole sourced to Bella Terra of Billings 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.

7. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: A sources sought was posted on April 28, 2021 and closed on May 11, 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 six (6) Community Nursing Homes within a range of 15.5-mile radius of the zip code 59102, where the bona fide need for a new CNH is. 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 Billings, 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 life safety and clinical 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.

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

Revision 03 Date: 02/11/2021

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.

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

Reasonable: The State Medicaid rate are used as the basis for pricing the CNH contracts.

The Medicaid rate is 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/care. The Medicaid rate is added to the add-on percentages to determine the basic per diem rate, then the basic per diem rate is applied to each RUGS IV category. The basic per diem rate and the additional VA add-on percentage make up the per diem rate paid for each Veteran. The line item structure will illustrate the basic rate and the per diem rate for each RUGS IV category that is made up of basic rate and the VA add- on percentage 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 per diem rates (price paid each level of care) is 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. In the case a CNH does not accept Medicaid, a per diem rate is negotiated based on market research of what is paid on the commercial market for similar care.

9. 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 one (1) community nursing homes within the zip code of 59102 of Billings, MT where the CNH is located. A sources sought was posted on April 28, 2021 and closed on May 11, 2021. No responses were received from the sources sought notice. The VA’s Vendor Information Page (Vet Biz) was used to determine if any potential Service-Disabled Veteran-Owned Small Business (SDVOSB) and Veteran-Owned Small Business (VOSB) offerors exist for this requirement.

However, the site failed to produce any results for Billings, MT. The results of the market research showed there is no other CNH that expressed interest. 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 VA CNH Program Coordinator is responsible for conducting market research. The CNH Coordinator will review the Medicare Nursing Home Compare score to determine if the CNH is eligible for a contract without a waiver.

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

Revision 03 Date: 02/11/2021

Antonick, Kelli

10. Any Other Facts Supporting the Use of Other than Full and Open Competition: This CNH has not contracted with the VA before but has expressed interest in doing business with the Government. The CNH Coordinator has verified the facility meets the criteria in order to establish an IDC with the VA.

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

CNH expressed interest in this acquisition. Bella Terra of Billings, 1807 24th street West, Billings MT, 59102, has expressed an interest to provide CNH services to the VA and provide care and services to Veterans.

12. 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 in this area to Veterans who would like to be placed near their families. 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. In accordance with the VHA Office of Community Care Field Guidebook, the CNH Program Office will review the Medicare Nursing Home Compare scores for a sample of CNH’s. 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.

13. 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 Antoni c k, Kelli Date: 2021.06.11 10:59:16

__________________-_06_'0_0' ______________________ ____________ Kelli Antonick Date Manager, Geriatrics & Extended Care Facility: VA Montana Healthcare System

Revision 03 Date: 02/11/2021

Garcia 472657

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.

Jessica L.

Digitally signed by Je ssica L. Garcia 472657 Date : 2021.06.14

_______________1_1_:2_4:_47_-_0_6'_00_' _____ __________________ Jessica L. Garcia Date Contracting Officer Specialized 1 Branch 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.

DANNY O. Digitally signed by DANNY O.

FREEMAN 170000

_F_R_E_E_M_A__N__1_7_0_0_0_0__D_at_e:_2_02_1._06_.1_5 1_1_:43_:3_6 -06'00' ___________________ 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

597130

Digitally signed by CURTIS M. JORDAN 597130

_______________Da_te: _202_1.0_6.1_6 1_7:5_5:47_-0_6'0_0' _________________________________________________________________________________________________ Curtis M. Jordan Date Executive Director, RPO West Head of Contracting Activity (HCA)

06/15/202 https://dvagov.sharepoint.com/sites/VHAProcurement/VHAPM/VHAPM_Part_806.3.aspx