TRANSFORMING CARE. TRANSFORMING LIVES 2015 REPORT TO P. O. B O X WHITE RIVER JUNCTION, VT VNHCARE.ORG

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1 TRANSFORMING CARE. TRANSFORMING LIVES 2015 REPORT TO S TA K E H O L D E R S A N D F R I E N D S P. O. B O X WHITE RIVER JUNCTION, VT VNHCARE.ORG

2 PROVIDING A CONTINUUM OF CARE FOR LIFE VNH provides an array of home-based, interdisciplinary health care services and resources for a broad range of people of all ages, during all stages of life. As a non-profit agency, our motives are not driven by stockholders or dividends; our goal is helping people. CARE FOR LIFE VNH AT A GLANCE As the foremost team of home health experts for southern Vermont and southern New Hampshire, we serve more than 5,000 patients annually and provide over 160 towns in a 4,000-square mile territory with nursing, rehabilitation, and hospice care services, all delivered with proven effectiveness, integrity, and compassion. Becoming the first home health and hospice provider affiliate of Dartmouth-Hitchcock Health and its five hospital affiliates demonstrates our commitment to further improving healthcare for the communities we serve. We are establishing a strong continuum of care by utilizing clinical integration to create a seamless path for patients moving from hospital care to home. Pediatric Palliative Maternal Home Health At VNH, the relationship we have with each client is rooted in respect for the families whose homes we are privileged to enter, for the communities we are honored to serve, and for all the lives we touch. Long-Term In all the services we offer and in everything we do, our commitment since 1907 has been to ensure that local families and patients can count on us and always come home to excellent care. Hospice We wanted to let you know how much we value Alice and the care, helpful ideas and kindness she brings to our home. She always arrives happy, cheerful and somehow knows what to say in all situations. Thank you for adding Alice to our days. -Patient s Family Grief and Spiritual Support COME HOME TO EXCELLENT CARE

3 A YEAR OF BRINGING PLANS TO FRUITION Dear Friends, Colleagues, and Supporters, For Visiting Nurse and Hospice for Vermont and New Hampshire, 2015 was a year where possibility became reality. We re excited to share these developments with you: In addition to visiting more homes in our communities and delivering a wide range of home and hospice care services, we also focused on continued growth and implementing initiatives designed to make our care continuum even better. Our affiliation with Dartmouth-Hitchcock Health was finalized this summer. This new partnership will enhance care transitions across the continuum of care. Additionally, this affiliation puts us in an even better position to fulfill our mission of helping people by improving efficiency and innovation along with creating the opportunity for collaboration and coordination among caregivers. The new VNH headquarters in White River Junction, Vermont is almost finished and we re slated to move in at the beginning of November By relocating our administrative operations to a larger space, we ll save resources and be able to manage the delivery of care to our clients more efficiently. VNH s leadership team has adopted Six Sigma efficiency techniques which will enhance the maturity of workforce culture and values with will further shape the organizations culture and ways of working. Every day, VNH is passionate about helping people it s the reason we re here. That s why expanding and augmenting our services, carefully managing our assets, and reinvesting in our communities is so important. We are excited about the successes in 2015 and look forward to the coming year and to ensuring that people in the communities we serve can always come home to excellent care. BOARD OF TRUSTEES Chairman: Gary Mayo Vice Chairman: Kenneth Parker Corporate Treasurer: Michael Counter Tim Ford Steve Gordon George Hartmann Adam Keller Michael Long Gary Mayo David Munro Kenneth Parker Nancy Philips Marlene Sachs Cynthia Twombly Stephen Whitman EX-OFFICIO MEMBERS Jeanne McLaughlin President & CEO, VNH I want to thank our friends and allies for your ongoing support and for helping us continue to make a positive difference in people s lives today and into the future. Jeanne A McLaughlin President & CEO, VNH COME HOME TO EXCELLENT CARE

4 2015 STRATEGIC HEALTHCARE PARTNERS* DATA ANALYSIS AND BENCHMARKING SURVEY HIGHLIGHTS Our quality measurement statistics were gathered by Strategic Health Partners (SHP) and reported through the Home Health Compare (HHC) database. HHC is the official government database for Medicare Certified home health agencies and publicly accessible through medicare.gov. REHOSPITALIZATION WITHIN 30 DAYS: 5.51% VNH VS 8.62% VS 11.47% VT AVERAGE NATIONAL AVERAGE Average length of stay for all home care cases ending in 2015 was 70 days. REFERRAL SOURCES TOP REFERRAL SOURCE FOR HOME CARE IS HOSPITALS. TOP REFERRAL SOURCE FOR HOSPICE IS PHYSICIAN OFFICE. 1,062 PHYSICIANS REFERRED A PATIENT TO VNH IN PATIENT CARE AND SERVICES OVERVIEW 128,554 TOTAL VISITS IN ,538 PATIENTS SERVED 24,596 Long-Term 15,562 Hospice 2,304 Maternal Child Health 86,092 Home Health VISITS BY PROGRAM 486 Long-Term 418 Hospice 420 Maternal Child Health 4,214 Home Health Individual Wellness Clinic 1,541 services provided in Number of flu shots administered by VNH COME HOME TO EXCELLENT CARE

5 A PURSUIT OF EXCELLENCE We are striving to exceed expectations and ensure that we are meeting people s changing health care needs by improving efficiency and lowering costs, championing employee enrichment, and looking at innovative new ways to deliver care. COST There are now approximately 46 million Americans age 65 or older. Based upon a Medicare Advisory Commission survey, home-based health care services like those offered by VNH are gaining popularity as the senior population continues to grow. In fact, 90% of seniors polled in the survey said they would opt to stay in their own homes as they age. In addition to being more convenient for patients, VNH services are considerably less expensive than a stay at a hospital or skilled nursing facility. On average, the cost of a home healthcare visit can be less than half the cost of a day in a skilled nursing facility, and one tenth the cost of a day in the hospital. The combined benefits of affordable care and convenience mean more effective care and higher satisfaction for residents in the communities VNH serves. QUALITY By the end of 2015, 70% of our nurses held a special certification whether it is hospice, wound care, or infusion therapy. This certification validates a clinician s knowledge, skills, and abilities in a defined role and clinical area of practice. To maintain this mark of excellence, our dedicated employees must continue learning and developing their skills. $2,000 $1,500 $1,000 $500 $0 MEDICARE PART A & PART B AVERAGE PAYMENT $1,805 Average cost per day in hospital $373 Average cost per day in skilled nursing facility $145 Average cost per home healthcare visit Ten VNH nurses and clinicians participated in the NHPCO program. ACCESS A 2015 collaboration between VNH and Dartmouth-Hitchcock (D-H) won a Path award. VNH and D-H s Plastic Surgery department joined forces on an experimental program using ipads to connect physician, VNH nurse, and patient. These virtual house calls are making it easier for clients living in rural areas to keep their medical appointments. A patient using an ipad to connect with a DHMC physician. COME HOME TO EXCELLENT CARE

6 THANK YOU FOR YOUR GENEROSITY As you have seen on the preceding pages, many of VNH s programs and services are made possible in large part by contributions from people like you. With your help, we will continue to provide essential care for thousands of children, adults, and families in our service area and help improve the lives of underserved community members. HOW CAN YOU HELP VNH? Attend the annual Wings of Hope Butterfly Release. Now going into its eighth year, this memorial service takes place each September at Colburn Park in Lebanon, NH. All proceeds and donations from Wings of Hope benefit VNH Hospice programs and services provided to all residents, regardless of ability to pay. Make General Contributions that will help VNH continue its 100+ year mission to deliver outstanding home health and hospice care as well as nursing, rehabilitation, and personal care services we provide to more than 160 towns in Vermont and New Hampshire. Make Memorial or Tribute Gifts that allow you to leave a lasting and meaningful legacy in honor of a loved one, a special VNH staff member or a home health aide. Remember us in your will. A simple bequest in a will is a common and easy way of gifting VNH. Your bequest may be for the general charitable purposes of VNH or for a specific program, helping to ensure that VNH is able to continue delivering its unparalleled life-enhancing and life-preserving services to future generations. Donate Outright Appreciated Securities that you have owned for more than one year, and receive a tax deduction for the full fair market value of the securities on the day of transfer to VNH. Thank You! Your generous support helps VNH provide the most skilled and compassionate health care to thousands, regardless of circumstance. We are grateful to you for making this possible. YOU CAN MAKE YOUR GIFT ONLINE NOW AT VNHCARE.ORG/GIVING/DONATE. FOR MORE INFORMATION ABOUT DONATING TO VNH, PLEASE CALL OUR DEVELOPMENT OFFICE AT CONTRIBUTIONS 2015 CONTRIBUTIONS COME HOME TO EXCELLENT CARE

7 2015 ANNUAL FINANCIAL REPORT Charges for Provided Non-Reimbursed Charges Medicare and Medicaid Third-party payers Uninsured patients Subtotal Non-Reimbursed Charges NET REVENUE FROM PATIENT CARE Expenses Salaries and Benefits Direct Costs Mileage Reimbursements Operating Expenses Total Expenses PATIENT CARE OPERATING GAIN $24,878,272 (3,852,918) (903,175) (35,800) (4,791,893) $20,086,379 $11,942,183 $3,599,461 $816,453 $3,599,461 $20,833,733 ($747,354) Federal and state government payers limit reimbursement for services. Third party payers contract for services at rates below cost, so VNH has billing adjustments that represent shortfalls in covering the actual cost of care. VNH serves all who qualify, regardless of their ability to pay. BALANCE SHEETS DECEMBER 31, 2015 AND 2014 ASSETS Current Assets: Cash and cash equivalents Patient accounts receivable, less allowances for uncollectible accounts of $664,634 in 2015 and $601,504 in 2014, respectively Other receivables Prepaid expenses Total Current Assets Intangible assets Assets limited as to use Property and equipment, net TOTAL ASSETS Current Liabilities: Accounts payable and accrued expenses Accrued payroll and related expenses Deferred revenue TOTAL CURRENT LIABILITIES Net Assets: Unrestricted Permanently restricted TOTAL NET ASSETS TOTAL LIABILITIES AND NET ASSETS 2015 $4,152,142 3,012, , ,540 7,784, ,000 13,794, ,044 $22,192,976 $1,268, , ,866 $2,925,674 19,236,975 30,327 19,267,302 $22,192, $3,042,065 3,647, , ,947 7,427,594-14,184, ,346 $22,067,553 $1,268, , ,310 $3,122,612 18,914,614 30,327 18,944,941 $22,067,553 COME HOME TO EXCELLENT CARE

8 RECOGNIZING VNH VOLUNTEERS Thanks to all who give their time, talent, service, energy, and passion! All of us at VNH extend our gratitude to our community volunteers, Board members, and members of our Community Relations and Development Committee for participating in a variety of activities that support our patients and their families in the homes of our patients, at the Wings of Hope Butterfly Release, or through various committees and awareness activities. IN 2015, OUR 86 VOLUNTEERS PROVIDED THE FOLLOWING: 1, PATIENT CARE HOURS ADMINISTRATIVE HOURS Those who can, do. Those who can do more, volunteer. -Anonymous THANKS TO ALL OF OUR VOLUNTEERS WHO SERVE WITH DEDICATION AND ENTHUSIASM INTERESTED IN VOLUNTEERING? PLEASE CALL Volunteer Recognition Luncheon April 20, 2016 COME HOME TO EXCELLENT CARE

9 SERVICE AREA VNH cares for more than 5,000 people each year, making over 130,000 home visits to people of all ages and at all stages of life. Topsham Newbury Groton Landaff Easton Brookfield Corinth Haverhill Bradford Benton Granville Chelsea Woodstock Braintree Vershire West Piermont Randolph Fairlee Hancock Warren Fairlee Tunbridge Orford Ellsworth Strafford Rochester Bethel Thetford Wentworth Royalton Rumney Campton Pittsfield Sharon Lyme Stockbridge Plymouth Norwich Dorchester Groton Barnard Hanover Pomfret Hartford Hebron Killington Canaan Lebanon Orange West Bridgewater Alexandria Lebanon Woodstock Enfield Grafton Hartland Plainfield Plymouth Danbury Grantham Reading West Springfield Windsor Wilmot Windsor Cornish Croydon New Andover Cavendish London Ludlow Weathersfield Claremont Sunapee Newport Salisbury Baltimore Sutton Weston Chester Springfield Unity Newbury Andover Goshen Landgrove Warner Peru Charlestown Lempster Acworth Bradford Londonderry Grafton Bellows Falls Henniker Langdon Winhall Windham Washington Hillsboro Athens Alstead Marlow Windsor Jamaica Stratton Townshend Westminister Stoddard Walpole Glastonbury Wardsboro Brookline Putney Somerset Dover Newfane Surry Westmoreland Keene Searsburg Wilmington Marlboro Dummerston Brattleboro Hinsdale Chesterfield Swanzey Stamford Readsboro Halifax Whitingham Guilford Vernon Winchester Richmond VNH VISITING NURSE and HOSPICE f or VERMONT and NEW HAMPSHIRE P.O. BOX 1339 WHITE RIVER JUNCTION, VT VNHCARE.ORG