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annual report


A MESSAGE FROM THE VNA

Dear Friends,

Valerie Landell

Long before home health services were identified as a reimbursable service, the Visiting Nurse Association (VNA) provided nursing and support services in the community and in individuals’ homes. Since its formation in 1909, the VNA has worked to prevent illness and to assist patients strickened by chronic diseases along with their family care givers. The commitment to the core mission and community service has remained constant over the years. In 2012, we made approximately 100,000 visits to 4,000 local patients and provided $1.3 million in charity care locally. This past May represented my first year as President/ CEO and I am honored to lead such a wonderful organization that has a substantial impact on individuals’ families and the community. We are extremely proud of the work we accomplished in 2012, but it did not come without its challenges. The VNA experienced significant change in response to the shifting environment driven by health care reform. Out of this challenge came the opportunity to enhance the organization’s infrastructure to better serve our patients and communities.

Melissa Lueke

In 2012, the marketplace experienced an increased focus on preventative care and overall community health. In response, the VNA provided flu vaccinations, health screenings, and education throughout the community to adults and seniors. Increased focus

on quality and improving outcomes led to innovative collaboratiions to improve overall care. The VNA developed a collaborative network of providers to promote smooth care transitions between service lines to provide a better patient experience. We understand how difficult it is for patients to navigate through the healthcare system and the VNA developed processes to ensure that it is easier for patients and their families. I am excited about these, and all of the accomplishments, during 2012. On behalf of the entire VNA staff and Board of Directors, I would like to thank you for your ongoing support. Your support, trust, and commitment to our mission motivate us to innovate, improve and grow so that the VNA continues to be a thriving organization. The VNA is the region’s largest free-standing home healthcare agency and we could not maintain this achievement without our dedicated staff, Board of Directors, the generous support of the United Way, our individual donors and our local philanthropic community. Sincerely,

Valerie Landell Melissa Lueke President & CEO Chairperson Board of Trustees


2012 ANNUAL REPORT | 1

This VNA has been the best care I have ever received! – Irene H.

Our Vision

• T o be a dynamic, viable, independent not-for-profit home health care organization.

• To lead in community skilled health care outcomes preventing institutionalization and avoidable hospitalizations.

Our Mission

The Visiting Nurse Association of Greater Cincinnati and Northern Kentucky provides quality skilled health and personal care services to adults in their home regardless of their financial status.

O  ur goal is to promote health, independence and self-sufficiency through individual and community-based educational and wellness programs.

VNA is by far and away the best! I’ve had one experience with another company. They weren’t even close to the VNA in all aspects. I have a feeling that VNAs in other cities grade out the same. They’re by far the best in home health care! – David M.

• To continually explore new services that improve outcomes and support the mission. • To be recognized as the organization for health/wellness and disease prevention. • To be recognized as the brand leader in all our services through disease management programs, data sharing technology, and collaborations to ensure seamless continuum of care. • To be recognized as the employer of choice in skilled health and personal care services. • To engage the community in generating sufficient revenue from philanthropic investments to insure that all patients are served.


2012 HIGHLIGHTS

PATIENT IMPACT STORIES

Vulnerable Patient Study

Providing Peace of Mind

In 2011, twenty-six large non-profit Medicare certified home healthcare agencies participated in the Vulnerable Patients National Study (“Study”). These agencies collectively provided 96,621 Medicare episodes during 2011 which enabled the researchers to compare and contrast the patient characteristics for each agency. Released in November 2012, the Study determined that the Visiting Nurse Association of Greater Cincinnati and Northern Kentucky’s patient mix represented a larger share of patients with poorly controlled diabetes (14% vs. 7%) and poorly controlled heart failure (17% vs. 6%) compared to the other twentyfive organizations which participated in the Study. Simply put, VNA’s patients were sicker, less stable and more likely to remain frail.

Vern “Bud” Stephens, age 81, needed surgery to repair an abdominal aortic aneurysm, a risky procedure followed by a challenging road to recovery. Upon discharge from the hospital, the VNA team – the Registered Nurse (Brandi Kramer) and Physical Therapist (Leslie VanZant) – promptly responded with the goals of improving Bud’s health outcomes and establishing his independence to lessen the burden on his wife, Joyce, and their five children. Brandi diligently monitored Bud’s cardiac and kidney issues and Leslie provided the intensive physical therapy. The result – Bud quickly recovered and was eventually able to travel to Florida with Joyce for their annual snow bird retreat without missing a beat.

The Study concluded that “home healthcare agencies receive inadequate reimbursement under the current Medicare Home Health PPS for a large proportion of episodes provided to vulnerable patients”. In other words, these “vulnerable patients” are associated with higher service costs but reimbursement is inadequate. Despite these financial obstacles, the VNA has remained true to its mission and provided, on an annual basis, $1.4 million in Charity Care since 2002.

Feedback from the family tells the story. Bud remembers that “Leslie really pushed me and I really needed that” and daughter Susan is grateful that “the VNA provided me peace of mind during my dad’s recovery”. Speaking for the entire family, Susan says it best – “We are all grateful for Brandi’s and Leslie’s knowledge, compassion, and commitment to helping my dad get back to enjoying life”. WHY the VNA does what is does!


PATIENT IMPACT STORIES

2012 ANNUAL REPORT | 3

Two Decades of Services at Home Ellenor’s overall health began to decline after the death of her parents at the young age of 45. She began to develop multiple health issues which led to frequent falls. Because of her age, Ellenor did not qualify for assistance from the Council on Aging of Southwestern Ohio or any other funding source. However, through the VNA’s long standing partnership with the United Way, the VNA was able to provide invaluable assistance to Ellenor. The VNA provided skilled nursing, occupation and physical therapies, social worker guidance as well as homemaker and personal care services. The VNA nurse regularly monitored Ellenor’s medications; the therapies helped improve her strength; and the social worker provided counseling and referrals to community resources. The homecare aide performed routine housekeeping chores and grocery shopping which stabilized Ellenor’s home environment and addressed her personal care needs. After a recent fall, Ellenor spent 5 months in a nursing home before coming home for physical therapy and occupational therapy from the VNA. “For the last twenty or so years I have been in and out of the hospital. If I didn’t have the VNA and all the services they provide I truly believe I would not be walking or living at home today. They have got me up on my feet time and time again. The VNA is my guardian angel.” Because of the VNA’s interventions, Ellenor, age 68, has avoided a nursing home placement and has been able to stay in the comfort of her own home.


BY THE NUMBERS

2012 Financials* Operating Revenue Government Funds

$5,353,000

Program Service Fees

$1,683,000

Operating Income

$(382,000)

Investment Income

$525,000

United Way

$922,000

Community Support

$389,000

Interest and Dividend Income

$122,000 Unrestricted $3,095,000

Total

$8,469,000

Operating Expenses

Net Assets Temporarily Restricted

$206,000

Permanently Restricted

$210,000

Total

$3,511,000

Program Services

$7,176,000

*unaudited

Management and General

$1,555,000

Fundraising Total

$120,000 $8,851,000


2012 ANNUAL REPORT | 5

2012 Statistics Payment Mix

Age Distribution

Medicare 48%

Age 65+

66%

Medicaid 16%

18-64

34%

Managed Medicare

15%

Free Care & United Way

10%

Gender Distribution

Managed Care

9%

Female 65%

Program Fees

2%

Male 35%

Geographic Distribution

Totals

Hamilton County, Ohio

71%

Kentucky 20% Warren, Clermont, and Butler Counties

9%

Personal Service Hours

87,885

Home Health Visits Total Clients Served

42,429 2,989


2012 DONORS Benefactors $10,000+ Anonymous Anonymous Ettlinger Memorial Fund The Greater Cincinnati Foundation Sustainers $5,000 - $9,999 Grant Thornton, LLP Carl H. & Edyth Lindner Scott Linstruth & Melissa Lueke Richard D. & Debbie Oliver Helen Steiner Rice Fund Roger & Glenda Schorr UC Health Supporters $1,000 to $4,999 Bank of America Doug & Kateri Bolton Tollie H. Chavis Cincinnati Bell CoFre Foundation Joseph Decosimo & Co. Dr. William E. & Marifran Dirkes, Jr. Bradley & Sandra East Fifth Third Bank Thomas & Gail Frickman Frost Brown Todd, LLC Greater Cincinnati Health Council HealthBridge Home Helpers Keating Muething & Klekamp, PLL Kohnen + Patton, LLP Elizabeth Landen McGohan Brabender Powell McHenry The Ohio Heart & Vascular Center Ohio National Financial Services Dan & June Owens PNC Bank Claire Phillips Joseph A. & Susan E. Pichler Fund

Protiviti, Inc. Melody Sawyer Richardson Senior Star Craig C. & Marcia Standen Mary Stern The Christ Hospital The Health Collaborative USI Insurance Valuation Research Corporation VITAS Innovative Hospice Care VonLehman & Company, Inc. David & Ginger Warner Wells Fargo Insurance Services USA, Inc. Western & Southern Financial Group Dr. Robert & Betsy Wones George E. & Nancy Yund Sponsors $500 - $999 Rob & Dulany Anning Bill & Stacey Bie Dr. George M. & Linda S. Callard John A. Carr Chemed Foundation Ethel Cooper Kathleen Downey Glenn & Barbara Groh John & Theresa Henderson Judge Nathaniel Jones Laurie Nippert Leonard Dr. Santosh G. Menon Keith D. & Terri Meyer James & Ann Monroe, Jr. Norbert & Linnea Nadel John & Francie Pepper John & Mary Fran Piepmeier George & Rita Ramage John & Clarissa Rentz Dr. G. James & Ruthann Sammarco Truist Jack & Susan Wendell Mark & Valerie Zummo

Friends $100 - $499 25th Hour Frank & Joy M. Albi Sandra Jo Anderson Thomas P. Atkins Alan & Charlotte Bath Betsy Baugh Leonard & Barbara Berenfield Paul & Lois Bergmann Mary M. Besanceney William H. Breeze Eva Bruno Frederick & Patricia Bryan III Richard & Betsy Buck William Burwinkle Mark & Jean Calkin Michael Capone Tracy Carl John & Kathleen Carnes Tony & Carrie Caruso Norma L. Clark Congregation of Divine Providence Ernie & Vicki Cook Bill & Caroline Cox Bill & Judy Crawford Russell L. Crews Charles & Karrie Crowther William O. & Kathy DeWitt, Jr. Jim & Angela Dealy Debora Del Valle Laura A. Delaney Richard & Mary Dostel, Sr. David Duke Joyce Elkus E. Allen & Sandy Elliott Marcia Endres Brenda Faul Dr. Leo Munich & Alice Fegelman Kevin Fewell Cherie Fine Michael Flood


2012 ANNUAL REPORT | 7 Ed & Julie Formica R. Stephen & Alice Gabbard James & Joan Gardner Mary Gehring Bart Ginocchio Shelley Goering Annetta Graham Rhonda Gregg David E. Groves HFS Transport, LLC Frederick D. & Priscilla Haffner Robert & Dorothy Hare Jerry & Lynda Harvey Ronald & Deborah Hayes The Hennessey Group Inc. Tom & Melinda Hepfner Andrew J. Hogan Jane A. Huelsebusch Scott Isenhart Johann Family Fund Eric Johnson Jim Johnson Wendy Knight Hill & Ashley Kohnen Randy & Tonya Krueger Robert Lambert Gary & Valerie Landell Ann Ingalls Lawrence Daniel W. & Minor LeBlond Jane Lentz William & Jean Loos Ronald & Alice Lubbe Dave & Linda Macke Michael & Christa Mattis Tom McCormack William A. McClain Eleanor S. McCombe Tom McCormack Don & Debbie McMullen Linus Meder Christian L. & Amy Meininger

Joan Mettey Molina Healthcare of Ohio, Inc. Estelle Morgan Dorothy Morris Andrew & Becky Moss Marjorie Motch Betty Muirheid Al Nelson Bruce & Neda Nutley Marilyn Z. Ott Daniel Owens John W. & Marianne Peck Fund People Working Cooperatively Kay Pettengill Larry Plum & Patricia Andow-Plum Michael & Kathy Rademacher Robert C. Ries The Rieveschl Foundation Tom Rotz Marianne R. Rowe Fund Robert & Carol Scallan Jason Schenk Art & Evelyn Schiltz Frances Schloss Erik & Christie Schmidt Patricia Schrier Holger & Trudy Schwab Theodore Schwartz John Shepherd Jeremy Simpson James & Gay Smith Barry & Mary Smyth Spirit of Cincinnatus, Inc. Marianne Stamper Mr. & Mrs. John F. Steele, Sr. Bud & Joyce Stephens Jason & Laura Stitt Carolyn W. Sullivan Jean Sutphin Nydia Tranter Stephanie Tunison

Robert & Carolyn Wehling Ryan & Debbie Welker Ralph & Katherine Whitehead Trisha Wilson Kristin Worthington Donors $1 - $99 Norma Adkins James Aglamesis Donna Ahlrichs Lisette Anhofer Anonymous Carol Aquino Geoff Arbuckle Joyce Asfour Etta Avant Todd & Ann Bailey Larry Baker Stanley L. Baker George & Shirley Baldorff Joyce Bales Charles & Lucy Ballard Stella Barker Sister Immaculate Becker Gregory & Christina Bedel Heather Bellau Herbert Betz Jack Binkley Ruth Blair Richard & Eleanor Block Richard & Patricia Bodner Barbara A. Boggano Ann Bolds-Sewell Marion K. Brown Elizabeth Byrd Grace Casper Todd Castellini Regina Clinebell Albertine Cobb Rose Colson Lee Cowan


2012 DONORS Kathy Creer Stephanie Crellin Tim Crowley Robert Czerwinski Boyd & Betty Dalton Dr. William & Carolyn Dalton, II Cecilia Damo Estelle Davis Kenneth & Johnie Davis Bernadette Day Michael Dunaway Donald Duve Jerome & Jean Eichert Ruby Emmelhainz George B. Fee Alan Fershtman David Fesman Harold & Helen Fry Dwight Gardner Clara Genther Jack Gilbert Lynne Meyers Gordon Edward Griesser Laura Hampton Ginger Harris Ruth Hartman Sister Mary Harvey Mary Sue Hautz Connie Heintz Catherine Hill Betty J. Hollenbeck Alvera Hood Memorial Orson & Judith Hornsby Birdie Horton Harry & Jeanna Horwitz Rodney Hughes Marie Jacobs Hazel James Candyse Jeffries, DMD Martha Jones

Ginny Jump Loraine Kaestle Jean Kieffer Gladys King Marian Kleiman Richard Kugele Alice Kuhlmann Geraldine Laumann Michelle Leach Dorothy Loper Lumen Marketing Consultancy Ruth S. Macke Nancy Malone Bernice Mann Handy Matthews Robert & Joan McCoy Don & Debbie McMullen Pauline McQuinley Donna Medlock Nancy Meiss August Miserocchi Ron & Joyce Morgan Annie Mukes Albert Mulholland Misty Nahay Kathleen Niklas Barbara O’Connor Virginia Otten Lincoln & Frances Pavey William & Nancy Phelan Adam & Laura Pleiman Russell Poland Joseph & Ann Prior Donald & Dorothy Purcell Rosemary Rahn Barbara Reed Dr. James & Susan Roebker Karen Roll Nina Roper Paula Rose

Edward S. & Nancy G. Rosenthal Jeff & Susan Routh Bill & Cathy Sciannamblo Elaine Semancik Bob & Hester Sensel, Jr. Shirley Skiles Steve Smookler Helen Spencer Robert & Marlene St. Clair Margaret A. Stevens Shirley Stewart Thelma Stone Warren & Myla Strunk Eileen Sutton John Tafaro Robert Nelson Tate Phyllis Taylor Ralph & Eleanor Tedeschi Bill & Vicki Thatcher George & Linda Trebbi, Jr. Guillermo & Rosa Trinchet Shyam Vaidhyanathan Derek Van Amerongen Larry & Anne Van Kirk, III Lottie Walters Fred & Sue Weller Ruth Wendling Kenneth & Vicki Wheeler Alfred & Ginny White, Jr. Alverna White Claire Wilger Myrna Wilson Ray & Norma Wiltshire Rose Wingert William & Betty Wolfe Larry & Jan Wood Donald & Karen Zimmerman John Zinke Donald A. Zix


BOARD OF TRUSTEES

2012 ANNUAL REPORT | 9

Executive Committee Deborah M. Hayes, RN, Melissa Lueke MS NEA-BC Chair Chief Hospital Officer & Executive VP & CFO Meridian Bioscience, Inc. Chief Nursing Officer The Christ Hospital Doug Bolton George E. Yund Vice Chair Managing Member Managing Principal Frost, Brown & Todd LLC Cassidy Turley Keith D. Meyer Other Trustees Secretary Partner Tollie H. Chavis Kohnen & Patton Senior VP Investments UBS Financial Services C. Bradley East Treasurer William Dirkes, M.D., M.B.A. Principal President Joseph Decosimo Sentral Clinical Research & Company Services Valerie Landell Daniel R. Fagin President & CEO Chief Operating Officer Visiting Nurse Jewish Federation of Association Cincinnati Thomas Frickman Nancy Graeter Principal National Account LaurAl Properties Director, Commercial Managed Care Boehringer Ingelheim

Theresa Henderson Community Volunteer Thomas G. Lindeman Partner, Advisory Practice Ernst & Young Clarissa Rentz, APRN-BC Community Volunteer Mike Robinson President LaVerdad Erick Schmidt VP & Managing Principal McGohan Brabender, Inc. Annette Tarver Managing Consultant Blackwell Consulting Services Robert G. Wones, M.D. VP & Chief Quality & Medical Informatics Officer University of Cincinnati Medical Center

SERVICE AREA Home Health Ohio Home Health Kentucky Personal Services


2400 Reading Road Cincinnati, OH 45202 601 Washington Street Newport, KY 41071 513-345-8000 www.theVNA.org

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VNA Annual Report 2012