fall 2017 VNH connect NEWS from VISITING NURSE & HOSPICE for VERMONT & NEW HAMPSHIRE Redefining Hospice Care CELEBRATING LIFE WITH WINGS On September 9, more than 400 Monarch butterflies were released at Colburn Park in Lebanon, NH at VNH s 8th Annual Wings of Hope event. It was captivating and magical watching the delicate winged creatures as they launch and softly dance away into the sky. There were smiles and laughter, tears of sadness and joy, and above all a feeling of peace and uplift. (Read more about Wings of Hope on pages 6) WHAT S INSIDE Page 2 Page 3 Page 4 Page 7 A Message from Jeanne Welcoming our Palliative Care Fellows The Unique Caregiver Experience Partnering VNH Nurses with First-Time Moms COME HOME TO EXCELLENT CARE www.vnhcare.org 888.300.8853
connect A MESSAGE FROM JEANNE Another year has flown by! As we prepare to welcome fall, we take a moment to assess all that we have achieved this year, and everything that is still left to do. We are proud to announce that our very own Drs. Cristine Maloney and Dan Caloras were awarded their Hospice Medical Director Certification (HMDC) this summer, reaffirming their commitment to hospice expertise and the exceptional level of care that our clients expect of VNH. VNH is pleased to welcome Dartmouth-Hitchcock Palliative Medicine Fellows who will work with the VNH Hospice team in the community. We are also excited to welcome the Jack Byrne Center for Palliative and Hospice Care to the D-H community this fall. The Jack Byrne Center will be an excellent resource for VNH and other area hospice agencies to provide advanced care and support for patients with life-limiting illnesses and their families. This year, you will find that we have included an insert containing our 2016 Annual Report. This past financial year has been another period of growth and achievement; in the interest of open communication with our community, we would like to share this information about our operating costs and community impact. VNH is very proud to be celebrating its 110th year in service to the 160+ communities we serve. It is a privilege to care for individuals and families; supporting them in their place of residence. VNH is committed to providing the very best care with compassion and intent, regardless of one s ability to pay. Even as we look to the start of a new year, VNH remains dedicated to finding new ways to work with and within our communities more efficiently and effectively, to continue to make a positive difference in the lives of Vermont and New Hampshire residents and families each and every day. Regards, Jeanne A. McLaughlin President and Chief Executive Officer 2 COME HOME TO EXCELLENT CARE
WELCOMING OUR DARTMOUTH-HITCHCOCK MEDICAL CENTER PALLIATIVE CARE FELLOWS VNH is excited to partner with Dartmouth-Hitchcock Medical Center for the outpatient hospice rotation of the Palliative Medicine Fellowship. Outpatient hospice rotation is 6 weeks; each fellow will spend 3 weeks with VNH. They will be introduced to the methods from each organization so that they gain in-the-field experience from multiple points-of-view, and they can establish which methods will work for them in their own longterm practice. The program will introduce the fellows to how the physician supports the hospice team by helping them to understand the roles of each team member, as well as shadowing Dr. Maloney on administrative tasks. The fellows will gain an understanding of hospice admission and how to determine if patients are appropriate for hospice care, work with Dr. Maloney to troubleshoot issues that arise when caring for patients in their homes, perform paperwork duties, and attend Interdisciplinary Team meetings. We are welcoming our first fellow in September, and will host 3 in total throughout the year. JACK BYRNE CENTER FOR PALLIATIVE & HOSPICE CARE The Jack Byrne Center for Palliative & Hospice Care will open this winter, providing comfortable, homelike inpatient care for hospice patients during times of greater need. This state-of-the-art clinical facility will work closely with patients home hospice care teams to provide advanced pain and symptom management until patients are able to return home. As an affiliate of Dartmouth-Hitchcock, we are very excited for this community project to open, it will be an incredible resource to us as well as other hospice agencies in the region. Said Jeanne A. McLaughlin, President and CEO of VNH. The Jack Byrne Center will not only provide the most excellent care to patients, but also offer educational and community building programs and services. We look forward to the opportunities that the JBC will afford to individuals and families. For the Upper Valley, the center will provide an alternative to those who need the support and expertise of an inpatient facility during a time of need. SAVE THE DATE for these upcoming introductory public events celebrating the new Jack Byrne Center for Palliative and Hospice Care: FRIDAY, NOVEMBER 3, 2017, 4 PM LIVING FULLY, DYING WELL Public lecture by Ira Byock, MD Dartmouth-Hitchcock Medical Center Lebanon, NH SUNDAY, NOVEMBER 5, 2017, 10 AM 3PM PUBLIC OPEN HOUSE Jack Byrne Center for Palliative & Hospice Care Dartmouth-Hitchcock Medical Center Lebanon, NH www.vnhcare.org 888.300.8853 3
connect VNH HOSPICE AND THE UNIQUE CAREGIVER EXPERIENCE If you were a part of their care team, you were part of their family, really! Heidi Smith Spiritual Care Coordinator Nancy and Archie Davis had been married for 59 years in October, both fiercely independent and passionately inseparable. Since retirement, they had been the kind of couple that were always together, supporting each other through life and health challenges. Like many independent adults, Nancy and Archie did not want anyone to move in with them, or to move in with someone else. Staying in their own home, and being together, was very important to both of them. VNH Hospice care was a perfect fit they have been under the care of a VNH Hospice team in the comfort of their home in Braintree, Vermont, for several years. In hospice care, caregivers and patients often form a strong bond. Caregivers are regularly in patients homes, listening to their daily challenges and providing support in a variety of manners. The care team established a long-term relationship with them, said Dr. Cristine Maloney, MD, HMDC. That s something you get when you do home visits 4 COME HOME TO EXCELLENT CARE
with folks for a long time. You get to know their broader cast of characters their kids, their grandkids, who came to visit them, who didn t come to visit, who they are mad at, who called them today and made their day. There is a real social person-toperson connection. We often feel like we get more than we give to our patients. Nancy and Archie, with 5 children and many more grandchildren, were very family-oriented. If you were a part of their care team, you were a part of their family, really! Heidi Smith, Spiritual Care Coordinator said of Archie, He was so loving; you never left without a hug and a kiss. Their large family knew everyone on the VNH care team even before they were introduced, because Nancy and Archie talked about them so frequently. My favorite part of caring for them was knowing that they trusted me, the family trusted me, said Nancy Curtis, Hospice Nurse. My whole focus is patient comfort and quality of life. The family understood that, and I was honored to have been there for them. Archie was a true gentleman, the kind of man who put everyone else s needs first and lived for his family. He and Nancy would take a vacation together in Wells, Maine each year, with family. A few years back, they couldn t afford to make the trip, and the VNH care team worked together to help make it happen for them. It is a privilege to be there at this time of their life. When you get It is a privilege to be there at this time of their life. It s a blessing. to meet people like this it is just awesome. When I leave the office and I am in their homes and we are talking about their life, their fears and their joys, everything else disappears. It s a blessing, said Heidi. Just this summer, Archie s health deteriorated. After his passing, Nancy asked Heidi to perform the funeral service. I could have talked forever about him, she said. The family was glad that the VNH care team was able to be there to support Nancy, and to celebrate Archie s life. They loved VNH. We were more than just staff, we were family, said Mike, Medical Social Worker. It was an honor to have them as patients. I learned so much from Archie. He would say, Oh, what you ve done for me! And I would say, No, what you ve done for me. He was a great man. BIG NEWS! Drs. Cristine Maloney and Dan Caloras passed their exams and were granted the Hospice Medical Director Certified (HMDC) credential by the Hospice Medical Director Certification Board. This honor recognizes their expertise and commitment to the hospice industry. HMDC designation is granted for six years and is renewed through continued validation of knowledge and re-assessment. VNH is proud to have two HMDC certified doctors committed to improving the quality of life in our community. Less than ½ of the hospice agencies servicing VT and NH have an HMDC certified doctor. VT HMDC 4 Doctors AGENCIES AGENCIES NH HMDC 8 Doctors Sources: hmdc.org and nahc.org www.vnhcare.org 888.300.8853 5
connect vnh I am Jennifer Frost joined VNH in early 2017 Jennifer Frost Advanced Practice Registered Nurse (APRN) WINGS OF HOPE 2017 Families, friends, VNH staff, and the community came together to celebrate life and remember lost loved ones. In addition to the butterfly release ceremony, the day featured inspirational reflections from VNH employees and performances from vocalist Kattie Russ, the Kurn Hattin Select Choir, and Scottish Highland bagpiper Matt Phelps. VNH is honored to serve so many during some of the most difficult days at the end of life. Our programs and services are provided to all, regardless of ability to pay, in more than 160 Vermont and New Hampshire communities. Proceeds from Wings of Hope support VNH Hospice care across the region. We hope to see you next year! To view photos of this year s event, visit: www.vnhcare.org/wingsofhope As an APRN, what is your role in pain and symptom management? I help in the prevention and management of pain and other symptoms that cause suffering, whether physical (such as difficulty breathing, constipation or nausea) or emotional (such as anxiety, depression, or restlessness). I maintain a caseload of hospice patients, but also serve as a consultant to our team as well as to staff at the facilities where some of our patients reside. By educating them about hospice, end-of-life care, and optimal ways to assess and treat symptoms, especially if/when those symptoms are not responding well to traditional approaches. What is your favorite part of your job? It s hard to pick one favorite part! Certainly, one of my favorite aspects lies in the privilege of being able to hear the stories that patients and their loved ones share. It is an honor to be invited into someone s home and care for them at what can be a difficult time, and I always feel very grateful for the time they are willing to give and the wisdom and stories they are willing to share. What do you enjoy doing in your free time? I enjoy spending time with my family, hiking, running, cross-country skiing anything outdoors! 6 COME HOME TO EXCELLENT CARE
FOUR OF OUR MOTHER AND BABY GRADUATES ON MAY 16, 2017 SUPPORTING FIRST-TIME MOTHERS AND BABIES IN WINDSOR AND WINDHAM COUNTIES VNH celebrated its first eight Nurse-Family Partnership (NFP) mother and baby graduates from Windham and Windsor counties earlier this year. The NFP program helps transform the lives of vulnerable first-time moms and their babies by providing consistent access to comprehensive, compassionate and supportive care. From pregnancy through the child s second birthday, VNH nurses make regular home visits and continue to care for mother and child. Each first-time mom benefits from the knowledge and support of their nurse partner, and is equipped to make healthy and positive decisions for their child throughout the critical early stages of child development. As a nurse, I love the opportunity to engage and support first time mothers as they progress through pregnancy and childbirth growing to be the best mothers, said VNH s NFP Supervisor Rita Laferriere, APRN, MS. NFP nurses provide support and education on: Education and support throughout pregnancy Making the transition to daycare Answering questions about caring for a child and its daily needs Breastfeeding support and counseling A child s growth with a focus on play and development Family planning Healthy habits for mom and child Dental Care Safety Nutrition Making the transition to daycare Health routines Dealing with temper tantrums Potty training Partnering first-time mothers with caring nurse home visitors empowers them to provide responsible and competent care for their children and to build a better future for their families through improvements in health, education, and economic self-sufficiency. We look forward to continuing to grow the program in our area and celebrating many more graduates. MOMS WHO HAVE PARTICIPATED IN THE NFP PROGRAM HAVE SAID: We have a bond with our NFP nurse, like she is part of our family. I feel at peace because I know that I have support and someone I can turn to for advice and information. 115 CLIENTS 92 BABIES BORN 1,700 NFP VISITS Statistics from April 2014 May 2017 www.vnhcare.org 888.300.8853 7
VNH 2016 ANNUAL FINANCIAL REPORT FOR THE YEAR ENDING DECEMBER 31, 2016 Hospice 637 VNH was there when I desperately needed help. I want to age in my own home, and your services help me do that. VNH Patient PATIENTS SERVED 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. CHARGES FOR CARE PROVIDED $26,440,219 Non-Reimbursed Charges Medicare and Medicaid ($3,981,435) Third-party payers ($625,467) Subtotal Non-Reimbursed Charges ($4,606,902) Net Revenue from Patient Care $21,833,317 MCH 202 LTC 480 Hospice 48,537 MCH 1,958 LTC 18,049 Total 5,434 PATIENT VISITS Total 142,462 Homecare 4,115 Homecare 73,924 EXPENSES Salaries and Benefits $12,275,645 Direct Care Costs $3,923,325 Transportation $761,947 Operating Expenses $5,445,306 Total Expenses $22,406,223 Patient Care Operating Gain ($572,906) NO-COST OR LOW-COST COMMUNITY WELLNESS SERVICES 660 FLU SHOTS ADMINISTERED 1,269 INDIVIDUAL CLINIC SERVICES PROVIDED Blood Pressure, Foot Care, and Community Grief Support Groups MCH Maternal Child Health LTC Long-Term Care VNH COME HOME TO EXCELLENT CARE 888.300.8853 VNHCARE.ORG
DECEMBER 31, 2016 AND 2015 CONSOLIDATED BALANCE SHEETS ASSETS 2016 2015 Total Current Assets $8,881,690 $7,784,779 Assets Limited As To Use $14,922,609 $13,794,153 Intangible Assets $210,833 $275,000 Property and Equipment, Net $3,617,070 $339,044 Total Assets $27,632,202 $22,192,976 LIABILITIES AND NET ASSETS 2016 2015 Total Current Liabilities $3,666,547 $2,925,674 Long Term Debt, excluding current portion $2,729,614 Total Liabilities $6,396,161 $2,925,674 Net Assets Unrestricted $21,205,714 $19,236,975 Permanently Restricted $30,327 $30,327 Total Net Assets $21,236,041 $19,267,302 Total Liabilities and Net Assets $27,632,202 $22,192,976 MEDICARE REVENUE $19,246,960 Medicare $ 15,959,452 NH Medicare $135,898 VT Medicare $3,151,610 VNH COME MEDICARE REVENUE TOTAL REVENUE $24,730,655 Private Insurance $3,015,567 Private Pay $118,667 Grafton County* $61,821 OTHER REVENUE SOURCES $5,488,761 OTHER REVENUE SOURCES Other Operating Revenue HOME TO EXCELLENT CARE 888.300.8853 VNHCARE.ORG $5,066 Investment Income Grants $277,627 $1,136,432 Town Funding $568,710 Contributions $286,557 Bequests $18,314 *Program Specific
Non Profit Org US Postage PAID Wht Riv Jct, VT Permit No. 73 88 Prospect St, White River Junction, VT 05001 Contact Us: 888.300.8853 vnhcare.org TDD: 800.735.2964 Donate: Online at vnhcare.org or mail check to: PO Box 881, Brattleboro, VT 05302 Volunteer: Visit vnhcare.org Connect through our website: www.vnhcare.org vnh in the community TUNBRIDGE WORLD S FAIR VNH was excited to return to the Tunbridge World s Fair on September 14-17. The World s Fair is a non-profit agricultural and educational fair that has been hosting families from all over VT and NH since 1880. Our nurses offered free blood pressure checks, healthy eating advice, and a heart healththemed cornhole game for the kids. We hope you stopped by our booth look for us next year! COMMUNITY CLINICS WALK TO END ALZHEIMER S As a community healthcare provider, VNH is committed to providing free or low-cost wellness and foot care clinics, as well as grief counseling and other support groups. These services provide many of the most vulnerable residents in our communities access to regular check-ins, help managing chronic conditions, and sometimes most importantly someone they can regularly talk to about their health and well-being. VNH is expanding these clinics to now provide services at the Brattleboro Senior Center. To find an upcoming clinic near you, visit vnhcare.org/clinics. VNH proudly sponsored the Upper Valley Walk to End Alzheimer s on Sunday, September 24, in honor of our many clients who have fought and those who are still fighting this terrible disease.thank you for joining us in honoring them through your walk with Team VNH Cares, or with your donation to the Alzheimer s Association.