The Department of Veterans Affairs intends to negotiate and award a sole source Indefinite Delivery Contract for Nursing Home services with Berlin Nursing and Rehabilitation Center located at 9715 Healthway Dr., Berlin, MD 21811-3500. The purpose of the award is to allow for the placement of Veterans in a facility that is within close proximity to their home or family. The Government intends to negotiate an Indefinite Delivery Contract for the period of one base year plus three option years. The proposed contract action is for services which the Government intends to solicit and negotiate with only one source in accordance with FAR 6.302. This notice is not a request for competitive quotes, proposals or information. Please direct any questions to Georgina Bantum at georgina.bantum@va.gov. DEPARTMENT OF VETERANS AFFAIRS Justification and Approval For Other Than Full and Open Competition Contracting Activity: Department of Veterans Affairs, VISN 05, VA Medical Center Department of Veterans Affairs, VISN 05, NCO Medical Sharing, Baltimore, MD 21201) Agency: Berlin Health Care, LLC., Berlin Nursing and Rehabilitation Center Nature and/or Description of the Action Being Processed: Pursuant to FAR 6.302-1 and 41 U.S.C. 253(c) (1), the VA has a requirement which can only be reasonably met by a single supplier. This action is to establish a new Indefinite Delivery Contract with current contractor Berlin Health Care, LLC to Community Nursing Home (CNH). Services at this time may be deemed to be available only from the original source in the case of a follow-on contract, when it is likely that an award to another source would result in unacceptable delays in fulfilling the agency s requirement and substantial duplication of cost to the Government that is not expected to be recovered through competition. The Baltimore, Perry Point VA Medical Center (PP/ Baltimore VAMHCS) anticipates entering into a sole source acquisition negotiation for eligible Veterans to continue receiving Community Nursing Home (CNH) services located in MD. The Government anticipates awarding a Indefinite Delivery Contract, in accordance with FAR 16.703. A binding contract will be formed, in accordance with the terms and conditions of this IDC, when the Department of Veterans Affairs (VA) agrees non-VA is required and the contractor agrees to accept the patient and provide direct patient care services. Upon acceptance by the Contractor of beneficiaries of VA, all clauses and terms and conditions of this IDC shall apply and become a part of the resultant contract during such time as VA patient remains in the contractor care at the expense of VA. Description of Supplies/Services Required to Meet the Agency s Needs: A Sole source award will be made to Berlin Health Care, LLC for continuous services to Veterans and eligible beneficiaries. Berlin Health Care, LLC, hereafter referred to as CNH will provide care to include: nursing home care to ensure the total medical, nursing, and psychosocial needs of VA beneficiaries. Provider visits, laboratory, x-ray, and other special services for VA patients will be at the same frequency as that provided to other patients at the CNH receiving the same or comparable level of care. This Basic Ordering Agreement cost estimate is as follow: (4)-Four Year Cost Estimate: $581,910.59 COR s IGCE: $581,910.59 Contracting Officer s (CO) Cost Estimate: Placements will be made in contract facilities based in availability of facilities and the desires of the veterans and their respective families. Because it is impossible to determine actual usage of any particular contract facility; the VA uses Indefinite Delivery Contracts. However, based on a usage rate of one Veteran for 365 days, a reasonable estimate for the value of any particular contract would be around $50,000 per year, with many facilities experiencing authorized Veteran populations in excess of 15 per year. Daily rate differ depending on negotiated terms based on the Medicare Rate. Five-(5) Year estimate: $250. Implemented by FAR 6.302-1. The specific paragraph must be cited. Most likely, only the -1 or -2 authorities will be cited. Please be aware that failure to adequately plan for future requirements does not constitute appropriate use of the unusual and compelling urgency statutory authority. (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; Demonstration that the Contractor s Unique Qualifications or Nature of the Acquisition Requires the Use of the Authority Cited Above (applicability of authority): As noted in paragraph 3, CNH services are essential to the provision of planned programming designed to promote social and health related services to aging Veterans in the service area who are no longer able to manage independently or who are isolated without an essential support network to facilitate needed care services. A break in the continuity of care to our Veterans would prove detrimental and negatively impact the wellbeing of the aged Veteran population who require assisted services and supportive environment. Recompleting the services would result in a change in services to the existing Veterans who already are enrolled and receiving service based on medical necessity for years. Veterans with long term psychiatric conditions or organic brain dysfunctions would likely experience a decline in functioning or experience an exacerbation in their level of functioning mentally, emotionally, and physically resulting from a disruption or change in vendor. A decrease in stability could potentially lead to irreversible harm or even death. (Note: stability with respect to such medical treatment as may be necessary to assure, within reasonable medical probability that no material deterioration of the condition is likely to result from or occur during the transfer of an individual from a vendor). Consistency in their therapeutic milieu is warranted. The primary goal is to maintain or restore the Veteran to the highest attainable level of health and well-being, thus Veteran treatment should be focused on stabilizing symptoms as much as possible. The benefit of a supportive environment would serve both Veterans and their caregivers. The CNH Program is the Maryland Health System non-medical Community Nursing Home purchased care program serving over 700 Veterans. With a huge Veteran demand and lack of funding, a waiting list of over 300 Veterans has prompted a need for ADHC agencies capable of service larger amounts of Veterans with quality care. CNH is a premier Community Nursing Home facility that has proven its superb care quality and dependability with our Veterans. CNH meets our expectations on the geographic catchment area of the entire State of Maryland: Catchment Area: Entire State of Maryland (with the exception of Prince George County, Montgomery County, Charles County, Calvert County, St. Mary s County and Northern Virginia Arlington County, Alexandria, Fairfield, Prince William County, Loudon County). There are also fiscal ramifications that will ensue. These include initial assessment fees ($100.00) for each Veteran and additional tie-consuming administrative issues. The primary goal of the VAMC is to maintain or restore the Veterans to the highest level of well-being, while assisting Veterans and their families in ensuring the total medical, nursing, and psychosocial needs of VA beneficiaries on a daily. Therefore, changing Community Nursing Home agencies at this time is not in the best interest to the Veterans and the Government. Discontinuation of the current contract services will cause an unacceptable delay in fulfilling the agency s requirement for Veteran support and cause substantial duplication of cost to the Government that is not expected to be recovered through competition. The current facility have and will continue to meet all state licensing requirements including the state requirement pertaining to level of medical liability insurance. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: A notice of Intent to sole source will be published on FedBizOpps. Determination by the Contracting Officer that the Anticipated Cost to the Government will be Fair and Reasonable: In order to determine whether the contractor s proposed price is fair and reasonable, the Contract Specialist will review the proposed rates against VHA Benchmark rates. If the contractor s proposed price appears to be questionable for reasonableness, a justification from the contractor will be required in order to determine whether the proposed price is fair and reasonable before award. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted: Research was conducted on a limited basis due to the limitation of the geographic area. Research was conducted to establish Community Nursing Home contract services located throughout the local VA s catchment area to provide Community Nursing Home services to Veterans near or as near as possible to family or friends. Market research for future agreements is dependent on the needs of the patient s population in the catchment area and resources availability of the VA Medical Center. The objective is to maximize patient care while maintaining compliance with VA regulations. Any Other Facts Supporting the Use of Other than Full and Open Competition: Continuing service is critical to Veterans to sustain a quality of life at an acceptable level Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: Not Applicable for this requirement. 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: The Contracting Office has identified way to improve and increase competition for the medical services in areas where competition can be considered. Approval not to compete does require VA Director and Chief of Staff approval prior to acquiring the medical services. The procurement action will be posted to the Government Point of Entry. Any responses will be referred the GEC coordinator for future consideration and marker research of source availability.
