DoD's $26.7M contract for nursing services at Brooke Army Medical Center awarded to GIACARE & MEDTRUST JV LLC

Contract Overview

Contract Amount: $26,674,226 ($26.7M)

Contractor: Giacare & Medtrust JV LLC

Awarding Agency: Department of Defense

Start Date: 2019-10-01

End Date: 2020-10-31

Contract Duration: 396 days

Daily Burn Rate: $67.4K/day

Competition Type: FULL AND OPEN COMPETITION AFTER EXCLUSION OF SOURCES

Pricing Type: FIRM FIXED PRICE

Sector: Healthcare

Official Description: REGISTERED NURSING SERVICES; BROOKE ARMY MEDICAL CENTER AND OUTLYING CLINICS, JBSA FORT SAM HOUSTON, TEXAS. 1 OCT 2019 - 30 SEPTEMBER 2020 TASK ORDER (SUBJECT TO THE AVAILABILITY OF FY20 FUNDS).

Place of Performance

Location: JBSA FT SAM HOUSTON, BEXAR County, TEXAS, 78234

State: Texas Government Spending

Plain-Language Summary

Department of Defense obligated $26.7 million to GIACARE & MEDTRUST JV LLC for work described as: REGISTERED NURSING SERVICES; BROOKE ARMY MEDICAL CENTER AND OUTLYING CLINICS, JBSA FORT SAM HOUSTON, TEXAS. 1 OCT 2019 - 30 SEPTEMBER 2020 TASK ORDER (SUBJECT TO THE AVAILABILITY OF FY20 FUNDS). Key points: 1. The contract value represents a significant investment in healthcare support for military personnel and their families. 2. Competition dynamics for this contract are noted as 'Full and Open Competition After Exclusion of Sources', suggesting a potentially competitive but specific bidding process. 3. The firm-fixed-price contract type indicates that the price is set and not subject to upward adjustment based on the contractor's cost experience. 4. Performance is tied to a specific task order for the 2019-2020 fiscal year, highlighting the time-bound nature of the service. 5. The contract falls under the 'Offices of All Other Miscellaneous Health Practitioners' NAICS code, indicating specialized healthcare services. 6. The awardee is a joint venture, which can sometimes indicate a strategy to combine capabilities or meet specific set-aside requirements, though this contract was not a small business set-aside.

Value Assessment

Rating: fair

The total award amount of $26.7 million for one year of registered nursing services at a major military medical center appears substantial. Benchmarking this against similar contracts for nursing services at large federal facilities is crucial for a definitive value assessment. Without direct comparisons of per-diem rates or full-time equivalent costs for comparable nursing roles in similar federal healthcare settings, it's difficult to definitively state if this represents excellent or questionable value. The firm-fixed-price nature provides cost certainty for the government, but the actual cost-effectiveness depends on the quality and efficiency of the services delivered.

Cost Per Unit: N/A

Competition Analysis

Competition Level: limited

The contract was awarded under 'Full and Open Competition After Exclusion of Sources'. This designation implies that while the competition was intended to be open, certain sources may have been excluded based on specific criteria or prior agreements. The exact reasons for exclusion are not detailed, but it suggests a more tailored competition than a completely unrestricted full and open process. The number of bidders is not specified, making it challenging to fully assess the intensity of the competition and its impact on price discovery.

Taxpayer Impact: The 'limited' competition level means taxpayers may not have benefited from the absolute lowest possible price that could have been achieved through a completely unrestricted bidding process. However, the exclusion of sources might have been justified by specific requirements or existing relationships that ensure a certain level of capability or familiarity with the facility's needs.

Public Impact

Military personnel and their families at Brooke Army Medical Center and associated clinics benefit from consistent access to registered nursing services. The contract ensures the availability of essential healthcare support, contributing to the operational readiness of the medical facility. The services provided are critical for patient care, medical procedures, and overall health management within the military healthcare system. The geographic impact is concentrated at JBSA Fort Sam Houston, Texas, serving a key military medical hub. The contract supports a workforce of registered nurses, contributing to employment within the healthcare sector in the San Antonio area.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

The 'Exclusion of Sources' in the competition type warrants further investigation to understand if it limited competitive pressure and potentially increased costs for taxpayers.
Lack of specific performance metrics or quality indicators in the provided data makes it difficult to assess the true value and effectiveness of the nursing services.
The contract is for a single task order, raising questions about long-term planning and potential future sole-source or limited-competition renewals if this provider proves essential.

Positive Signals

The award to a joint venture (GIACARE & MEDTRUST JV LLC) may indicate a strategic approach to service delivery, potentially combining specialized expertise.
The firm-fixed-price contract type offers budget certainty for the government, protecting against cost overruns.
The contract supports a critical healthcare function within a major military medical center, ensuring essential services for beneficiaries.

Sector Analysis

This contract falls within the Healthcare Services sector, specifically focusing on nursing services. The market for healthcare services, particularly within the federal government and military, is substantial and often characterized by a mix of large, established providers and specialized firms. Contracts like this are essential for maintaining the operational capacity of military treatment facilities. Benchmarking against other federal nursing service contracts, especially those awarded by the Department of Defense or Veterans Affairs, would provide a clearer picture of market rates and competitive pricing.

Small Business Impact

This contract was not a small business set-aside (ss: false, sb: false). Therefore, the direct impact on small business contracting goals is minimal. However, the joint venture structure of the awardee (GIACARE & MEDTRUST JV LLC) could involve subcontracting opportunities, potentially benefiting small businesses if they are engaged by the prime contractor. The analysis of subcontracting plans would be necessary to determine the extent of small business participation.

Oversight & Accountability

Oversight for this contract would typically fall under the purview of the contracting officer and the relevant program management office within Brooke Army Medical Center and the Department of the Army. The firm-fixed-price nature of the contract provides a degree of accountability by setting clear financial terms. Transparency is generally facilitated through contract databases like FPDS, where award details are recorded. Specific Inspector General (IG) jurisdiction would depend on allegations of fraud, waste, or abuse related to the contract's performance or award process.

Related Government Programs

TRICARE
Military Health System
Department of Defense Healthcare Services
Nursing Services Contracts
Medical Readiness Contracts

Risk Flags

Limited Competition
Potential for higher costs due to source exclusion
JV operational complexity risk
Dependence on specific task order funding

Frequently Asked Questions

What is this federal contract paying for?

Department of Defense awarded $26.7 million to GIACARE & MEDTRUST JV LLC. REGISTERED NURSING SERVICES; BROOKE ARMY MEDICAL CENTER AND OUTLYING CLINICS, JBSA FORT SAM HOUSTON, TEXAS. 1 OCT 2019 - 30 SEPTEMBER 2020 TASK ORDER (SUBJECT TO THE AVAILABILITY OF FY20 FUNDS).

Who is the contractor on this award?

The obligated recipient is GIACARE & MEDTRUST JV LLC.

Which agency awarded this contract?

Awarding agency: Department of Defense (Department of the Army).

What is the total obligated amount?

The obligated amount is $26.7 million.

What is the period of performance?

Start: 2019-10-01. End: 2020-10-31.

What is the historical spending pattern for registered nursing services at Brooke Army Medical Center?

Analyzing historical spending for registered nursing services at Brooke Army Medical Center (BAMC) is crucial for understanding trends and identifying potential anomalies. Without specific historical data for BAMC's nursing services, we can infer general patterns. Military medical centers often rely on a combination of government-employed staff and contracted services to meet fluctuating demands and specialized needs. Spending can vary year-to-year based on budget allocations, force protection conditions, and the availability of military medical personnel. Contracts for nursing services are common due to the need for flexibility and specialized skills. A review of past contracts awarded to BAMC for similar services, including their values, durations, and competition levels, would reveal whether the $26.7 million award for FY20 represents an increase, decrease, or consistent level of investment compared to previous years. Understanding these patterns helps assess the sustainability of current spending and identify potential areas for cost optimization or increased reliance on contracted support.

How does the award amount compare to the estimated value or budget for this type of service?

The award amount of $26.7 million for registered nursing services at Brooke Army Medical Center (BAMC) for the period of October 1, 2019, to September 30, 2020, represents the government's commitment to procuring these essential healthcare services. To assess if this amount aligns with the estimated value or budget, one would need access to the government's independent government cost estimate (IGCE) or the initial budget allocation for this requirement. Typically, agencies develop an IGCE before soliciting bids to establish a benchmark for fair and reasonable pricing. The fact that this was a firm-fixed-price contract suggests that the government had a clear understanding of the scope and cost expectations. Comparing the award amount to the IGCE, if available, would indicate whether the competition drove the price down to or below the estimate, or if the award was close to the initial projection. Without the IGCE, comparisons to similar contracts for nursing services at other large military treatment facilities can provide a proxy for assessing reasonableness.

What are the specific services included under 'REGISTERED NURSING SERVICES' for this contract?

The designation 'REGISTERED NURSING SERVICES' for the contract at Brooke Army Medical Center (BAMC) encompasses a broad range of clinical and patient care activities performed by licensed registered nurses (RNs). While the specific details would be outlined in the Statement of Work (SOW) or Performance Work Statement (PWS) attached to the contract, these services typically include direct patient care such as administering medications, monitoring vital signs, wound care, patient education, and assisting physicians with medical procedures. RNs also play a crucial role in patient assessment, developing care plans, coordinating with other healthcare professionals, and ensuring adherence to medical protocols and safety standards. For a military medical center like BAMC, these services would extend across various departments, potentially including emergency rooms, intensive care units, surgical wards, medical-surgical units, and outpatient clinics, catering to the healthcare needs of service members, veterans, and their families.

What is the track record of GIACARE & MEDTRUST JV LLC in performing similar federal contracts?

Assessing the track record of GIACARE & MEDTRUST JV LLC is vital for understanding their capability to successfully execute this $26.7 million contract for registered nursing services. As a joint venture, its performance history might be a composite of its individual member companies' experiences or specific projects undertaken as a JV. To evaluate their track record, one would typically examine past federal contract awards to this entity, focusing on contracts with similar scopes of work (e.g., healthcare staffing, nursing services), similar dollar values, and performance ratings (e.g., past performance evaluations from the Federal Awardee Performance and Integrity Information System -FAPIIS). A review of their history would reveal their experience with government contracting regulations, their ability to meet performance standards, and any history of disputes, corrective actions, or contract terminations. Without specific data on GIACARE & MEDTRUST JV LLC's past performance in the public domain, a definitive assessment cannot be made, but this would be a key area for due diligence by the contracting agency.

What are the potential risks associated with relying on a joint venture for critical healthcare services?

Relying on a joint venture (JV) like GIACARE & MEDTRUST JV LLC for critical healthcare services presents several potential risks. Firstly, the management structure and operational coordination between the JV partners can be complex, potentially leading to communication breakdowns or conflicting priorities that could impact service delivery. Secondly, the financial stability and resource allocation of the JV depend on the contributions and stability of its individual members; if one partner faces financial difficulties, it could jeopardize the entire venture's ability to perform. Thirdly, accountability can sometimes be diffused in a JV structure, making it harder to pinpoint responsibility if performance issues arise. Lastly, the integration of different corporate cultures and systems between the JV partners might create inefficiencies or challenges in adapting to the specific requirements of a demanding environment like Brooke Army Medical Center. Ensuring robust oversight and clear lines of responsibility within the JV agreement is crucial to mitigate these risks.

How does the 'Exclusion of Sources' clause impact the fairness and competitiveness of the procurement?

The 'Full and Open Competition After Exclusion of Sources' clause signifies a procurement process that, while intended to be open, has specific limitations on eligible bidders. This means that certain potential sources were intentionally excluded from bidding, likely based on predefined criteria outlined in the solicitation. The impact on fairness and competitiveness is nuanced. On one hand, excluding sources might be necessary if only a limited number of contractors possess highly specialized skills, certifications, or security clearances required for the service, or if there are existing relationships or past performance requirements that narrow the field. This can ensure that the awarded contractor is highly qualified. On the other hand, excluding sources inherently reduces the pool of potential bidders, which can diminish competitive pressure. This reduced competition might lead to higher prices than could have been achieved in a completely unrestricted market. The fairness hinges on whether the exclusions were justified, transparent, and applied consistently according to established procurement regulations.

Industry Classification

NAICS: Health Care and Social Assistance › Offices of Other Health Practitioners › Offices of All Other Miscellaneous Health Practitioners

Product/Service Code: MEDICAL SERVICES › NURSING, NURSING HOME, EVAL/SCREEN

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION AFTER EXCLUSION OF SOURCES

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Solicitation ID: W81K0412R0025

Pricing Type: FIRM FIXED PRICE (J)

Evaluated Preference: NONE

Contractor Details

Address: 6245 N FEDERAL HWY STE 201, FORT LAUDERDALE, FL, 33308

Business Categories: Category Business, Corporate Entity Not Tax Exempt, Economically Disadvantaged Women Owned Small Business, Hispanic American Owned Business, Joint Venture Economically Disadvantaged Women Owned Small Business, Joint Venture Women Owned Small Business, Limited Liability Corporation, Minority Owned Business, Self-Certified Small Disadvantaged Business, Small Business, Special Designations, U.S.-Owned Business, Woman Owned Business, Women Owned Small Business

Financial Breakdown

Contract Ceiling: $26,674,226

Exercised Options: $26,674,226

Current Obligation: $26,674,226

Contract Characteristics

Commercial Item: COMMERCIAL ITEM

Cost or Pricing Data: NO

Parent Contract

Parent Award PIID: W81K0419D0021

IDV Type: IDC

Timeline