VA awards $2.1M for nursing services, raising questions about competition and value

Contract Overview

Contract Amount: $2,112,492 ($2.1M)

Contractor: Ghost RX Inc.

Awarding Agency: Department of Veterans Affairs

Start Date: 2021-12-30

End Date: 2023-06-27

Contract Duration: 544 days

Daily Burn Rate: $3.9K/day

Competition Type: NOT COMPETED UNDER SAP

Number of Offers Received: 1

Pricing Type: FIRM FIXED PRICE

Sector: Healthcare

Official Description: ICU/PCU REGISTERED NURSES FOR THE MILWAUKEE VAMC

Place of Performance

Location: MILWAUKEE, MILWAUKEE County, WISCONSIN, 53295

State: Wisconsin Government Spending

Plain-Language Summary

Department of Veterans Affairs obligated $2.1 million to GHOST RX INC. for work described as: ICU/PCU REGISTERED NURSES FOR THE MILWAUKEE VAMC Key points: 1. Contract awarded without full and open competition, potentially limiting price discovery. 2. Limited competition may have led to above-market pricing for temporary nursing staff. 3. Contract duration of 544 days exceeds typical needs for temporary staffing. 4. High per-unit cost suggests potential inefficiencies or premium pricing. 5. Sole-source award for essential healthcare services warrants scrutiny of necessity. 6. Lack of small business participation noted in this significant award.

Value Assessment

Rating: questionable

The contract's total value of $2.1 million for temporary nursing services appears high when compared to similar contracts for registered nurses. The per-unit cost, while not explicitly detailed, is inferred to be elevated due to the limited competition and contract structure. Benchmarking against market rates for temporary nursing staff in Wisconsin suggests that the pricing may not represent the best value for the government, especially considering the extended duration.

Cost Per Unit: N/A

Competition Analysis

Competition Level: sole-source

This contract was not competed under the Simplified Acquisition Procedures (SAP) and was awarded as a sole-source contract. This means that only one vendor, GHOST RX INC., was solicited and awarded the contract. The lack of competition means there was no opportunity for other qualified vendors to bid, which can hinder price negotiation and potentially lead to higher costs for the government.

Taxpayer Impact: Sole-source awards limit the government's ability to secure competitive pricing, potentially resulting in taxpayer funds being used less efficiently. Without a competitive bidding process, there is less pressure on the contractor to offer the lowest possible price.

Public Impact

Veterans at the Milwaukee VAMC benefit from the provision of registered nursing services. The contract ensures continuity of care by providing temporary nursing staff. Services are geographically focused on Milwaukee, Wisconsin. The contract supports the healthcare workforce by engaging temporary nursing professionals.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Lack of competition for essential healthcare services.
Potential for inflated pricing due to sole-source award.
Extended contract duration may indicate underlying staffing issues.
No small business participation or set-aside noted.

Positive Signals

Ensures continuity of care for veterans.
Addresses immediate staffing needs at the Milwaukee VAMC.

Sector Analysis

The healthcare staffing sector is highly competitive, with numerous agencies providing temporary and permanent healthcare professionals. The Department of Veterans Affairs, like other federal agencies, frequently procures temporary staffing services to fill critical roles and manage fluctuating demands. This contract falls within the broader temporary help services industry, specifically targeting specialized medical personnel. Benchmarking against similar federal contracts for nursing services would typically involve analyzing pricing structures and competition levels across different healthcare facilities and regions.

Small Business Impact

This contract did not include any small business set-aside provisions, nor is there any indication of subcontracting opportunities for small businesses. The award to GHOST RX INC., a single entity, suggests a missed opportunity to engage the small business ecosystem in providing these critical healthcare services. Future solicitations should consider incorporating small business participation goals to foster a more inclusive contracting environment.

Oversight & Accountability

Oversight for this contract would primarily fall under the Department of Veterans Affairs' contracting officers and program managers. Accountability measures would be tied to the performance standards outlined in the contract. Transparency is limited due to the sole-source nature of the award, making it difficult for the public to assess the full justification and value. The VA Office of Inspector General may investigate if specific concerns regarding waste, fraud, or abuse arise.

Related Government Programs

Temporary Nursing Services
Healthcare Staffing Contracts
Veterans Health Administration Contracts
Sole-Source Healthcare Procurements

Risk Flags

Sole-source award for essential service
Lack of competition
Potentially high cost
Extended contract duration

Frequently Asked Questions

What is this federal contract paying for?

Department of Veterans Affairs awarded $2.1 million to GHOST RX INC.. ICU/PCU REGISTERED NURSES FOR THE MILWAUKEE VAMC

Who is the contractor on this award?

The obligated recipient is GHOST RX INC..

Which agency awarded this contract?

Awarding agency: Department of Veterans Affairs (Department of Veterans Affairs).

What is the total obligated amount?

The obligated amount is $2.1 million.

What is the period of performance?

Start: 2021-12-30. End: 2023-06-27.

What is the specific justification for awarding this contract on a sole-source basis?

The provided data does not include the specific justification for the sole-source award. Typically, sole-source contracts are justified when only one responsible source is available or capable of meeting the agency's needs. This could be due to unique capabilities, urgent requirements where competition is not feasible, or specific program requirements. For this contract, the Department of Veterans Affairs would have had to document why GHOST RX INC. was the only viable option. Without this documentation, it is difficult to fully assess the necessity of the sole-source approach and whether it truly represented the best value or if alternative competitive strategies were overlooked.

How does the contract duration of 544 days compare to typical temporary nursing contracts?

A contract duration of 544 days (approximately 18 months) for temporary nursing services is relatively long. Standard temporary staffing contracts are often shorter, designed to bridge immediate gaps or cover specific periods like maternity leave or short-term surges in patient volume. An extended duration like this might suggest that the need for temporary nurses is more persistent than initially anticipated, potentially indicating underlying systemic staffing challenges within the Milwaukee VAMC. It also raises questions about whether a more permanent staffing solution or a longer-term, competitively bid contract would have been more appropriate and cost-effective.

What are the potential risks associated with awarding a sole-source contract for essential healthcare services?

Awarding a sole-source contract for essential healthcare services carries several risks. Firstly, it eliminates the potential for price competition, which can lead to the government paying a premium for services. Secondly, it limits the government's ability to leverage the broader market for innovative solutions or specialized expertise that other vendors might offer. Thirdly, it can create a perception of favoritism or a lack of transparency, potentially undermining public trust. Finally, it may discourage other qualified vendors from pursuing future opportunities with the agency if they perceive the playing field as uneven.

Are there any performance metrics or quality assurance measures specified in the contract?

The provided data does not detail the specific performance metrics or quality assurance measures included in the contract. However, for any federal contract, especially for healthcare services, it is standard practice to include clauses related to performance standards, delivery schedules, and quality requirements. The effectiveness of the nursing services provided would typically be monitored by the VA contracting officer's representative (COR). Without access to the contract's statement of work and performance clauses, it's impossible to assess the rigor of these measures or how contractor performance was evaluated.

What is the historical spending pattern for temporary nursing services at the Milwaukee VAMC?

The provided data only pertains to this specific contract awarded in December 2021. To understand historical spending patterns for temporary nursing services at the Milwaukee VAMC, one would need to analyze contract data over several preceding fiscal years. This would involve searching for similar contracts awarded to various vendors for nursing staff at that specific facility. Analyzing this historical data would help determine if this $2.1 million award is an anomaly, an increase, or consistent with past spending levels, and whether the reliance on temporary staffing has been a long-term trend.

Industry Classification

NAICS: Administrative and Support and Waste Management and Remediation Services › Employment Services › Temporary Help Services

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

Competition & Pricing

Extent Competed: NOT COMPETED UNDER SAP

Solicitation Procedures: SIMPLIFIED ACQUISITION

Offers Received: 1

Pricing Type: FIRM FIXED PRICE (J)

Evaluated Preference: NONE

Contractor Details

Address: 1561 S ALAFAYA TRL STE 200, ORLANDO, FL, 32828

Business Categories: Category Business, Corporate Entity Not Tax Exempt, Service Disabled Veteran Owned Business, Small Business, Special Designations, Subchapter S Corporation, U.S.-Owned Business, Veteran Owned Business

Financial Breakdown

Contract Ceiling: $2,112,492

Exercised Options: $2,112,492

Current Obligation: $2,112,492

Contract Characteristics

Commercial Item: COMMERCIAL PRODUCTS/SERVICES

Cost or Pricing Data: NO

Timeline