VNA Annual Report 2012

annual report

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 forma-tion 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 approxi-mately 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 orga-nization that has a substantial impact on individuals’ fam-ilies 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.

In 2012, the marketplace experienced an increased focus on preventative care and overall community health. In response, the VNA provided flu vaccina-tions, 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 President & CEO

Dear Friends,

Melissa LuekeChairpersonBoard of Trustees

Valerie Landell

Melissa Lueke

A MESSAGE FROM THE VNA

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.

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

Our Vision • To 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.

• 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 ANNUAL REPORT | 1

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.“

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

”

2012 HIGHLIGHTS

Vulnerable Patient Study In 2011, twenty-six large non-profit Medicare certified home healthcare agencies participated in the Vulner-able Patients National Study (“Study”). These agencies collectively provided 96,621 Medicare episodes during 2011 which enabled the researchers to compare and contrast the patient charac-

teristics 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 twenty-five organizations which participated in the Study. Simply put, VNA’s patients were sicker, less stable and more likely to remain frail.

The Study concluded that “home healthcare agencies receive inad-equate 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.

PATIENT IMPACT STORIES

Providing Peace of Mind Vern “Bud” Stephens, age 81, needed surgery to repair an abdominal aortic aneurysm, a risky procedure followed by a challenging road to recov-ery. 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.

Feedback from the family tells the story. Bud remem-bers 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!

2012 ANNUAL REPORT | 3PATIENT IMPACT STORIES

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.

2012 Financials*

BY THE NUMBERS

Operating Income $(382,000)

Investment Income $525,000

Net Assets

Unrestricted $3,095,000

Temporarily Restricted $206,000

Permanently Restricted $210,000

Total $3,511,000

*unaudited

Operating Revenue

Government Funds $5,353,000

Program Service Fees $1,683,000

United Way $922,000

Community Support $389,000

Interest and Dividend Income $122,000

Total $8,469,000

Operating Expenses

Program Services $7,176,000

Management and General $1,555,000

Fundraising $120,000

Total $8,851,000

2012 ANNUAL REPORT | 5

Payment Mix

Medicare 48%

Medicaid 16%

Managed Medicare 15%

Free Care & United Way 10%

Managed Care 9%

Program Fees 2%

Geographic Distribution

Hamilton County, Ohio 71%

Kentucky 20%

Warren, Clermont, and Butler Counties 9%

Age Distribution

Age 65+ 66% 18-64 34%

Gender Distribution

Female 65%

Male 35%

Totals

Personal Service Hours 87,885

Home Health Visits 42,429 Total Clients Served 2,989

2012 Statistics

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 DONORS

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 AdkinsJames AglamesisDonna AhlrichsLisette AnhoferAnonymousCarol AquinoGeoff ArbuckleJoyce AsfourEtta AvantTodd & Ann BaileyLarry BakerStanley L. BakerGeorge & Shirley BaldorffJoyce BalesCharles & Lucy BallardStella BarkerSister Immaculate BeckerGregory & Christina BedelHeather BellauHerbert BetzJack BinkleyRuth BlairRichard & Eleanor BlockRichard & Patricia BodnerBarbara A. BogganoAnn Bolds-SewellMarion K. BrownElizabeth ByrdGrace CasperTodd CastelliniRegina ClinebellAlbertine CobbRose ColsonLee Cowan

2012 ANNUAL REPORT | 7

Kathy CreerStephanie CrellinTim CrowleyRobert CzerwinskiBoyd & Betty DaltonDr. William & Carolyn Dalton, IICecilia DamoEstelle DavisKenneth & Johnie DavisBernadette DayMichael DunawayDonald DuveJerome & Jean EichertRuby EmmelhainzGeorge B. FeeAlan FershtmanDavid FesmanHarold & Helen FryDwight GardnerClara GentherJack GilbertLynne Meyers GordonEdward GriesserLaura HamptonGinger HarrisRuth HartmanSister Mary HarveyMary Sue HautzConnie HeintzCatherine HillBetty J. HollenbeckAlvera Hood MemorialOrson & Judith HornsbyBirdie HortonHarry & Jeanna HorwitzRodney HughesMarie JacobsHazel JamesCandyse Jeffries, DMDMartha Jones

Ginny JumpLoraine KaestleJean KiefferGladys KingMarian KleimanRichard KugeleAlice KuhlmannGeraldine LaumannMichelle LeachDorothy LoperLumen Marketing ConsultancyRuth S. MackeNancy MaloneBernice MannHandy MatthewsRobert & Joan McCoyDon & Debbie McMullenPauline McQuinleyDonna MedlockNancy MeissAugust MiserocchiRon & Joyce MorganAnnie MukesAlbert MulhollandMisty NahayKathleen NiklasBarbara O’ConnorVirginia OttenLincoln & Frances PaveyWilliam & Nancy PhelanAdam & Laura PleimanRussell PolandJoseph & Ann PriorDonald & Dorothy PurcellRosemary RahnBarbara ReedDr. James & Susan RoebkerKaren RollNina RoperPaula Rose

Edward S. & Nancy G. RosenthalJeff & Susan RouthBill & Cathy SciannambloElaine SemancikBob & Hester Sensel, Jr.Shirley SkilesSteve SmooklerHelen SpencerRobert & Marlene St. ClairMargaret A. StevensShirley StewartThelma StoneWarren & Myla StrunkEileen SuttonJohn TafaroRobert Nelson TatePhyllis TaylorRalph & Eleanor Tedeschi Bill & Vicki ThatcherGeorge & Linda Trebbi, Jr.Guillermo & Rosa TrinchetShyam VaidhyanathanDerek Van AmerongenLarry & Anne Van Kirk, IIILottie WaltersFred & Sue WellerRuth WendlingKenneth & Vicki WheelerAlfred & Ginny White, Jr.Alverna WhiteClaire WilgerMyrna WilsonRay & Norma WiltshireRose WingertWilliam & Betty WolfeLarry & Jan WoodDonald & Karen ZimmermanJohn ZinkeDonald A. Zix

2012 DONORS

Executive Committee

Melissa Lueke Chair Executive VP & CFO Meridian Bioscience, Inc. Doug Bolton Vice Chair Managing PrincipalCassidy Turley Keith D. Meyer SecretaryPartnerKohnen & Patton C. Bradley East Treasurer Principal Joseph Decosimo & Company

Valerie Landell President & CEO Visiting Nurse Association Thomas Frickman Principal LaurAl Properties

Deborah M. Hayes, RN, MS NEA-BC Chief Hospital Officer & Chief Nursing Officer The Christ Hospital

George E. YundManaging MemberFrost, Brown & Todd LLC

Other Trustees Tollie H. Chavis Senior VP InvestmentsUBS Financial Services

William Dirkes, M.D., M.B.A. President Sentral Clinical Research Services

Daniel R. Fagin Chief Operating OfficerJewish Federation of Cincinnati

Nancy GraeterNational Account Director, Commercial Managed CareBoehringer Ingelheim

Theresa Henderson Community Volunteer

Thomas G. LindemanPartner, Advisory PracticeErnst & Young Clarissa Rentz, APRN-BC Community Volunteer

Mike RobinsonPresidentLaVerdad

Erick SchmidtVP & Managing PrincipalMcGohan Brabender, Inc.

Annette Tarver Managing ConsultantBlackwell Consulting Services Robert G. Wones, M.D. VP & Chief Quality & Medical Informatics OfficerUniversity of Cincinnati Medical Center

2012 ANNUAL REPORT | 9BOARD OF TRUSTEES

SERVICE AREA

Home Health Ohio Home Health Kentucky Personal Services

Non-Profit Org.U.S. Postage

PAIDCincinnati, OH

Permit No. 29542400 Reading RoadCincinnati, OH 45202

601 Washington StreetNewport, KY 41071

513-345-8000www.theVNA.org