2022 Avow Annual Report

2022 Annual Report to the Community Weathering the Storm with Compassionate Care

Dear Friend of Avow,

As we continued to navigate the COVID-19 pandemic, a national nursing shortage and a potential recession in 2022, none of us expected to also face the wrath of a Category 4 hurricane slamming into our shores. Despite the devastation and disruption Hurricane Ian unleashed within our community, Avow stood strong, rising to meet the unprecedented challenges with unwavering compassion, collaboration and innovation. In fact, despite all of this adversity, we experienced more admissions and referrals to our programs in 2022 than at any point in our nearly 40-year history while also increasing our CAHPS quality scores and enhancing Frances Georgeson Hospice House facility through completion of a new family café and pavilion.

This tremendous success in the most daunting of times is a direct testament to the dedicated people who drive our organization — staff, volunteers and donors alike. Even as many faced personal losses and challenges, our team persevered, providing uninterrupted care to our patients and families. Within hours of the storm’s passing, recovery teams were deployed to ensure our approximately 600 hospice and

palliative care patients were safe and accessing adequate resources despite power outages and evacuations. A donation center was established to collect essential supplies such as clothing, cleaning supplies, personal care products, food and water. An online giving page was launched to solicit cash and gift card donations, and meals were delivered to those without power, transportation or food.

Thank you to everyone who made it possible for us to continue our mission of delivering compassionate care for the Collier community! From filling sandbags to ready our campus before the storm to walking up flights of stairs with oxygen tanks and batteries to reach patients without power in high-rise condos, our Avow team remained steadfast and maintained seamless operations. As we celebrate our 40th year of service in 2023, this devotion and drive coupled with your support will continue to propel us forward, ready to meet any new challenges that lie ahead.

Jaysen F. Roa President & CEO Avow Companies

Chuck Hoffman Board Chair Avow Companies

Hospice Care

Providing Compassionate Care and Support for Those Living with a Terminal Illness

In 2022, Avow once again set new records for referrals and admissions — evidence of the trust the community places in our organization. Even during Hurricane Ian, our team was able to provide uninterrupted care to patients thanks to a large-capacity generator that allowed staff to triage by phone when it was no longer safe on the roads. We were even able to help neighboring hospices that had lost communication during the storm.

Despite all of the challenges of the past year, Avow was also able to complete two new facility enhancements:

• Located in the hospice house, Paula’s Place family café serves patients, their families and Avow staff, providing families a place to sit and enjoy a meal together prepared by our chefs.

• The Nichols Pavilion, a large outdoor atrium, provides shade and outdoor space for staff and family to take a break and relax.

In addition, to enhance patient care and gain economies of scale, Avow partnered with Treasure Coast Hospice, St. Francis Reflections Lifestage Care and Haven Hospice to form Synthase Collaborative — a notfor-profit alliance to unite hospice, palliative and post-acute care organizations across Florida. While each organization will retain autonomy and independence, this strategic partnership allows all four mission-driven organizations to share best practices, optimize resources and reduce costs. This includes strengthening Avow’s position to negotiate with insurers as new value-based payment models emerge. All together, Synthase Collaborative cares for an average of 2,200 patients daily and provides care and services to more than 18,000 adults and children annually across 23 counties in Florida.

“Avow was my saving grace. The Avow team created a loving presence in our home. I never felt alone; I knew I could call Avow at any minute and get help and support right away. Avow lived up to its mission for George and me: they really did create peace of mind for both of us.”

— Marilynn, Caregiver

Hospice Care by the Numbers

Admissions and Stays

2,360

Number of Admissions:

386

Avg. # of Patients Cared for Each Day:

9 Days

Average Length of Stay:

Median Length of Stay: 83 Days

Visits by Discipline for Hospice Care

In-person, Phone and Virtual visits

4,469

41,110

8,792

7,008

24,586

3,446

1,578 70

Physician/Nurse Practitioner Nursing

Social Work

Chaplain

Home Health Aide

Massage, Reiki, Manual Lymph Drainage

Music Therapy

140,789

Total # of Patient Days:

20,740

In Hospice House/Hospital:

Patients by Level of Care

Routine Home Care: 1,852

General Inpatient (Hospice House): 1,130

Continuous Care (Where the Patient Lives): 232

Respite Care: 6

7.2% 0.2%

57.6% 35%

Hospice Care by the Numbers

Top 5 Admitting Diseases Types

Cancer: 637

Circulatory/Pulmonary/Heart: 389

Heart Disease: 228

Neurological (Alzheimer’s Parkinson’s): 103

COPD: 99

Referral Sources

Hospital: 1,121

Physician: 423

Self/Family: 342

Nursing Home: 307

Other: 167

Expenses

Salaries/Benefits, Occupancy Costs, Supplies and Services, Professional Services, Uncollectible Debt, Miscellaneous

$29,312,090

Palliative Care

Delivering Personalized Care and Comfort to the Seriously Ill

Dedicated to alleviating the physical symptoms and emotional distress of individuals living with serious illnesses such as cancer, heart disease, lung disease and kidney failure, Avow’s Lyon Center Palliative Care Clinic continued to expand and innovate in 2022 to meet the community’s growing needs, serving the most patients in our organization’s history.

Demonstrating a commitment to quality care, Avow also became the first and only palliative care program in Florida to earn certification from CHAP (Community Health Accreditation Partner), an independent, non-profit accrediting body for home and community-based health care organizations. To achieve this three-year certification, our program was extensively evaluated against nationally recognized palliative care standards.

In addition, to help meet the gap in overall palliative care program costs not reimbursed by Medicare, Medicaid and private insurance companies, we launched the Avow Compassionate Care Society in April 2022. This group of community philanthropists have committed to give a minimum of $10,000 annually to support non-hospice palliative care in Collier County.

“If I had to describe Avow’s palliative care service in one word, I would choose ‘easy.’ When I call, the helpful receptionist almost always can get me to the nurse practitioner right away, and she is easy to talk to and just as devoted to making me emotionally comfortable as she is to relieving my physical symptoms. I wish my prognosis was different, but I am at peace with where I am and with the treatments I am receiving from Avow’s palliative care service.” — Jan, Palliative Care Patient

“The nurse learned more about Arthur in one session than other physicians had in seeing him over many visits. She also listened to my needs and concerns and came up with a plan that helped us both. Do you know how rare that is in healthcare these days, to have unrushed, personal time with medical professionals? It’s not an exaggeration when I say that Avow’s palliative care service saved two lives: mine and Arthur’s. Life is so much better now.” — Beverly, Caregiver

Palliative Care By the Numbers

Visits by Discipline for Palliative Care

In-person, Phone and Virtual visits

1,134

273 146 25

Physician/Nurse Practitioner Social Worker Chaplain

Number of Patients

614 Total Number of Visits

1,578

Massage

Where Palliative Care Took Place in Total Visits

Lyon Center Palliative Care Clinic: 636

Home: 610 Virtual: 172 Facility: 82

Bereavement

Helping People Cope with Grief and Loss

To better customize support to meet individuals where they are in their grief process, Avow implemented a new research-based, integrative model of change into our Center for Grief Support in 2022.

Stages of Readiness to Change

Maintenance

Works to sustain desired behavior change

Precontemplation

Unaware of the problem

Each small group is guided by professional facilitators and meets weekly for four weeks. At the end of that period, individuals may repeat the current module or continue on to the next module in the program if they are ready. Group programs are free to the community and hosted in the Center for Grief Support and at other community locations. One-onone support is also available.

Action Practices desired behavior

Contemplation

Aware of the problem & desired behavior change

Preparation

Intends to take action

“Avow cared about the family and about me, and how was I doing after she had passed.”

Chris, Bereaved

Grief Support by the Numbers

The Bereavement Team held a Thanksgiving dinner for those missing their loved one.

Supporting Children Through Loss

Avow Kids Grief Support by the Numbers

926 Youth Participants Groups, events, one-on-one

352 Unique Youth Participants Served

For nearly 40 years, the Avow Kids® program has helped children ages 5-17 move through their unique experience of loss in a safe, supportive environment. As the community need grows, we remain committed to offering a variety of grief support services at no cost to participants, including individual and family counseling, group therapy, workshops, camps and events.

“While no one else had lost a little brother like me, it was easy to see that everyone in the group shared the same kind of difficult feelings. There were lots of activities to bring us together, including times to share our feelings and to write our own group song about our experiences. It was perfect for me — I felt understood and not alone, like I wasn’t the only person to feel sad and lost.”

— MarkCoe,Jr.,AvowCampMendingHeart® Teen Attendee

Expenses

Salaries/Benefits, Occupancy

261 Youth Support Group Sessions

40 Youth Camps or Events

Costs, Supplies and Services, Professional Services, Uncollectible Debt, Miscellaneous $357,004 Grants, Donations & Other Funding $214,000

Supported or Sponsored in Part By:

In addition to individual donors, the following companies and organizations generously supported Avow Kids in 2022:

Marco Lutheran Church

The Avow Kids team served more children in 2022 than ever before. In addition to coordinating field trips and activities throughout the year, we hosted several community events to support children who have experienced loss, including the following:

Avowloween

was held October 21 on the Avow campus and featured a “trunk or treat” as well as Star Wars characters courtesy of the Everglades Squad Legion and a North Collier Fire Control fire truck. The children also enjoyed games, face painting, a photo booth and a visit from Nugget the mini horse. We collaborated with local school counselors to promote this fun family event, and more than 210 kids ages 17 and under attended.

Our annual Mother’s Day Dinner was held on May 6 to provide children with a safe space to honor their deceased moms and to celebrate the mother figures in their lives.

To bring cheer to the community at the end of a difficult year of great loss, we held our Winter Festival on December 20. More than 300 parents and children came out to enjoy holiday crafts, music, cookies and outdoor games along with gifts from Santa.

Sidney A. Swensrud Foundation Shoen Foundation

Partners in Care (PIC)

Demand remained high in Collier County for the specialized care available through Avow’s Partners In Care: Together For Kids pediatric palliative care Medicaid waiver program. The children participating in this special program have congenital and/or chronic disease conditions with complex medical, psychological, spiritual and motor skills needs. The children are primarily serviced through the state’s Children’s Medical Services, supplemental to other care they receive.

This program served 21 children in 2022 who received direct care, while many of their family members received supportive care. The children had planned art and music therapy sessions to address specific aspects of their individual and unique disease process. Avow’s board-certified music and art

PIC Support

PIC Patients 21

Expenses

PIC Care Sessions

Salaries/Benefits, Occupancy Costs, Supplies and Services, Professional Services, Uncollectible Debt,

We continued our efforts to honor and serve Southwest Florida military Veterans in 2022. More than 1,200 Veterans were pinned and honored throughout the year. In addition, the documentary film Avow Presents: Life Lessons in the Military, produced by the Avow Communications Department in 2021, won two prestigious Telly Awards in 2022 as well as an Award of Distinction in the 27th Annual Communicator Awards. The film highlights the stories of 17 Veterans from various generations and backgrounds, including Avow employees and volunteers, and was filmed on the Avow campus

ourhospicepatientswereVeterans.

Employee Advancement

Promoting Professional Growth and Development

As Avow employees stepped up to meet the unprecedented challenges of 2022, our organization continued to invest in their professional growth and development.

In addition to our existing tuition reimbursement program, we launched a new Avow Nursing Scholarship Program to assist employees with advancing their education in the field of nursing while also improving staff retention and clinical expertise. Thanks to the generosity of donors during the Avow Foundation 2022 Nurses Week campaign, this new scholarship helps to support our employees enrolled in nursing degree programs. In October, we awarded the first scholarship to Ashley Russetto, APRN, who is pursuing her doctorate degree in nursing.

Avow won two of eight Awards of Excellence during the Florida Hospice & Palliative Care Association (FHPCA) Forum in Orlando in June:

• The Hospice Story Award recognizes a person or organization that best captures a meaningful hospice experience with an original creative work. Avow board-certified music therapist Jillian Iurlano worked with patient Jodi Allen to turn a prayer she had written into a song and music video as a gift to her family before her passing.

• The Synergy Award recognized employees in the Frances Georgeson Hospice House, Patient Access, Treasures and Communications Departments for collaboration between the interdisciplinary teams and administration, including a special wedding held for an Avow hospice patient as well as efforts to help young parents celebrate moments with their month-old baby before she passed.

Community Recognition for Avow Founder Glenna Hayhoe

In November, the Association of Fundraising Professionals (AFP) Collier-Lee Chapter honored Avow founder Glenna Hayhoe as its 2022 Outstanding Philanthropist and Avow Veteran Volunteer Jessica Stearns with Distinguished Volunteer during its National Philanthropy Day celebration.

In December, Glenna was recognized by The Women’s Foundation of Collier County as a Woman of Initiative at its Women Rock Philanthropy luncheon. The award honors dynamic women who have helped change the community through their passion, leadership, innovation, time, talent and dedication.

Motivated by a passion for caring for those at the end of life, treating each person with dignity and respect, and not allowing anyone to die alone, Glenna and her late husband Bruce started Avow in 1983. At age 91, she continues to volunteer regularly, epitomizing the heart of hospice and inspiring our staff and volunteers alike.

Our dedicated team of Avow volunteers rose to meet the challenges of 2022, contributing 5,305 direct patient engagement hours and 4,195 non-clinical hours—significant increases over 2021! These dedicated members of the Avow family selflessly support their Collier neighbors during difficult transitions, providing comfort and companionship. They also lend a hand in our offices, retail shops and at special events.

Each year, our Treasures Resale Shops contribute much needed revenue to the Avow Foundation, helping Avow provide hospice care, palliative care, adult and children’s bereavement services, and Veterans services for anyone in the community, including those who cannot pay for care.

In 2022, we closed the Davis Boulevard and Park Shore Treasures stores and opened a new, larger North Naples Treasures store located at 9765 Tamiami Trail North in the Naples Park neighborhood. In addition to providing expanded retail space, the building has two apartments, which we will use to provide affordable housing for staff, including both permanent full-time staff as well as seasonal traveling nurses that help address area health care staffing shortages.

Gross Revenue

$868,909

Transactions

24,897

For information on donations or to volunteer, visit avowtreasures.org

Avow Foundation

Donors Continued to Deliver in 2022

When Hurricane Ian ushered in unimaginable devastation throughout our community, Avow’s loyal supporters immediately answered the call for help:

• Twenty donors gave more than $3,000 in in-kind gifts, including gift cards, appliances and goods delivered to our donation center.

• Tamiami Hyundai/Ford donated two vehicles valued at $44,714 — a minivan for Avow Kids and a small SUV that was used during the hurricane by staff who had been flooded out.

• In all, more than 50 individuals and organizations donated cash totaling $31,107, with gifts ranging from $25 to $10,000. In addition we officially opened The Nichols Pavilion in 2022 — a large, shaded outdoor atrium designed to provide a place of respite for our hospice house families and staff.

The new Paula’s Place family café located inside the hospice house also opened in 2022 and was made possible by the family of Paula M. Flanagan.

“When Avow President & CEO Jaysen Roa heard about my situation, he invited me and my family to move into one of the two apartments above the Avow Treasures resale shop in Naples. Until Hurricane Ian, I had never had to worry about having a roof over my head or a safe place to live. Avow’s stepping in to give my family a home meant so much to us. That single act of generosity exemplifies the spirit of our corporate culture – and its heart. That can’t be bought at any price. I thank those who supported Avow during this time of difficulty.” — SuzanneParsons,AvowHumanResourcesDirector

Foundation Funding Sources

Private contributions: $2,658,433 (Individuals, DAFs, Family Foundations)

Planned Gifts Realized: $1,308,821

Institutional Grants: $257,500

Corporate Partners: $66,004

Total Giving $4,290,758

1.5% 6% 30.5%

62%

“Because of Avow’s assistance during Hurricane Ian, I was able to deliver care to those who really needed us without the worry over my own vehicle. I am thankful that Avow treats me with the same kind of care we offer patients. It’s a circle of loving support that winds throughout the organization. Thank you to the donors who supported Avow during this time.”

— PhilJustice,AvowLeadHomeHealthAide/CertifiedNursing Assistant

Expenses

Salaries/benefits, supplies, programs, professional services, uncollectable debt, misc. $32,048,453

2022 COVID Expenses $224,104

Total Expenses $32,272,557

How to Donate

Volunteer or Choose to Donate

Not-for-profit hospices are required to have a percentage of care hours provided by volunteers. When you volunteer with Avow, you can make a difference in the lives of our community members in Southwest Florida who are going through one of life’s most complex transitions. Lend a hand in Avow’s clinical operations, offices, retail shops or at special events.

Complementary Therapies

$650 Funds art therapy/ music therapy/ massage therapy/Reiki treatments for one hospice patient

Hospice Program Giving Opportunities

Purchases supplies for ten Veteran salute kits. 650 kits are distributed annually $500

$1,250 Provides 10 visits from complementary therapies staff Center for Grief

Funds seven days of end-of-life care for a patient without insurance $1,250

Support

$250

$750 Purchases 30 essential oil kits for home health aides to deliver aromatherapy services

Funds publishing of 2,000 copies of Veteran benefits and resources for Hospice and Palliative Care $5,000

Funds adult support group meeting space for 10 sessions in the Center for Grief Support on Avow’s campus

Enables five monthly virtual memorial ceremonies to come to life $500 Provides 100 hours of group or individual support to bereaved persons $5,000

$100 Covers one day of keeping the doors of Aunt Janet’s House open – the home of the Avow Kids program

Palliative Care

$500

Pays for 50 art supply kits for Avow Kids art therapy groups

$1,500

Covers the cost of one child’s annual participation in the Avow Kids program

$5,000

Sends 15 grieving teenagers to Avow’s overnight Teen Camp MendingHeart®

$85 Donor support required for every $100 of our costs for providing palliative care

$5,000

Provides 15 visits from specialized physicians, nurse practitioners, social workers, and chaplains which are not otherwise payable by Medicare, Medicaid, or personal insurance

$10,000 Join

Care Society

Other Ways to Give

• Cash, Credit, or Check

• Stock Donation or IRA Charitable Rollover

• Wills and Other Planned Gifts

More info

• Phone – (239) 649-3683

• Email – Foundation@avowcares.org

• Website – AvowCares.org/Donate-now

• Cryptocurrency

• Honor a Legacy and Name a Space on the Avow Campus

• Scan this QR code Avow Foundation’s mission is to solicit, receive and administer grants, gifts, loans, contributions and donations exclusively for the benefit of Avow Hospice, Inc., Avow Care Services, Inc., Avow Real Estate, Inc. and Avow Foundation, Inc. to provide Hospice, Palliative Care, Community Counseling, and other Post-Acute Home Based Services and Children’s Support Services to those residing in Florida. Financial and other information about Avow’s charity purpose, programs and activities can be obtained by contacting the Chief Financial Officer, 1095 Whippoorwill Lane, Naples, FL 34105, 239-261-4404. Visit avowcares.org/donordisclosures for state specific registration information.

BOARD OF DIRECTORS

• Chuck Hoffman, Chair

• Rev. Kathy Schillreff, Vice Chair

• Darren Gersch, Treasurer

• Patrick Neale, Secretary

• Jaysen Roa, President & CEO

• Russell Budd

• Gerald Lanz

• Roger Lipitz

• Patrick Martin

• Chip Olson

• Cindy Shingler

• Cherry Smith

AVOW EXECUTIVE LEADERSHIP TEAM

• Jaysen Roa, MHA, MBA.....................................................................................................President & CEO

• Phyllis Hall................................................................................................................Chief Financial Officer

• Rebecca Gatian, RN, DHA, MBA................................................................................Chief Clinical Officer

• Kerri Ervin, RN, MJ, MS...............Chief Compliance Officer and Senior Vice President of Engagement

• Annalise Smith, MHSA, CFRE...........................................................................Chief Philanthropy Officer

• Cynthia Nehrkorn, MD........................................................................Vice President of Medical Services

Our Mission: We create peace of mind by providing compassionate care and support to those who need us.SM

Our Vision: To be our community’s choice for support through life’s transitions.SM

Our Core Values: Innovation - Integrity - Collaboration - Celebration - Education