VNA Alliance

VNA Alliance (VNAA) is an independent, voluntary, nonprofit home health agency licensed in Pennsylvania. All services are available without regard to race, religion, creed, color, age, ancestry, national origin, sex, sexual preference, lifestyle, socioeconomic status, veteran's status, or handicap. The agency strives to operate in a Christian manner in all interactions with consumers, staff, and the community. The provision of care to consumers recognizes and supports consumers' rights and the inherent worth and dignity of everyone. The agency seeks to provide care to all consumers in need of its services while recognizing its goal to maintain financial viability. Service delivery is based on the belief that quality health care can be delivered using efficient, effective, and ethical business practices. During the 2022-2023 fiscal year, the VNA Alliance completed over 61,000 home health care visits and maintained an average daily census of 494 patients. For fiscal year ending 06/30/2023, a total of $3,710 in services was rendered as benevolent care. Many exciting opportunities and changes occurred at the VNA Alliance over the past fiscal year. The conclusion of the public health emergency (PHE) ushered in a sizable reduction in reportable events. During this time, the VNA Alliance witnessed a 34% reduction the number of reportable events, largely due to a 51% reduction in the number of COVID-19 positive patient and staff cases. Across a five-county region of Northwest PA, over 3,000 individualized patient care plans were created during the past fiscal year, each with the goal of achieving clinically relevant outcomes, or preventing harmful outcomes-for each patient. Our guiding principles of employee development, risk management, strategic planning, and organizational performance ensure VNAA will remain a valuable resource for our community for years to come. VNA Alliance continues to provide a wealth of community services to the residents, organizations and various groups in Mercer, Crawford, Venango and parts of Erie, Lawrence, and Butler Counties. During the past year, two dynamic health fairs were provided to the community residents of St. Paul Homes and the assisted living facility, Juniper Village, of Meadville, PA. Engaging education was provided pertaining to fall reduction, medication management, functional mobility standards and healthy aging strategies. On January 1st, 2023, the home health care world experienced a significant overhaul to the OASIS data collection instrument. As a requirement set forth within the 2014 IMPACT act, CMS was obligated to align the home health data collection instrument, OASIS, with all post-acute care setting requirements-with the goal of standardizing the data collection process across this continuum. OASIS-E ushered in 159 data element changes and 6 new categories of assessment types to the industry. The OASIS data collection tool has seen a change from volume biased care to outcome driven-valued based care prioritizing meaningfulness and acuity over visit count. Understanding health as a multifaceted concept that extends beyond one's genetics or physiology, the updated OASIS-E document incorporated the need for effective communication during care transitions between health care settings to: 1) Improve care coordination 2) Improve quality of care 3) Help subsequent providers reconcile medications 4) Mitigate adverse outcomes related to medications. For several months, the VNA Alliance prepared for this expansive update. Over three hours of OASIS-E training was developed, produced, recorded, and distributed to the VNAA OASIS data collectors for independent study and completion. OASIS-E proficiency was validated and remediation training provided when necessary. During the past year, two VNA Alliance Physical Therapists earned their wound certification credentialling. Also, the VNAA saw one Physical Therapist earn their Vestibular Rehabilitation credentialling. Occupational Therapy was also called upon to elevate their practice this year. Since the onset of the benefit, Medicare home health rules prohibited Occupational Therapy from being the sole qualifying discipline for admission to home health care. In January of 2022, The Medicare Home Health Flexibility Act was passed by Congress, which included a provision that allows Occupational Therapists to perform the initial and comprehensive assessments that are necessary to start home health care services. It must be noted that this provision applies to therapy only cases. The VNAA worked diligently in preparing many of its OT team to be effective and efficient admission clinicians. The entire OT team exceeded agency averages for activity of daily living and mobility magnitude changes, as well as risk adjusted composite outcomes as VNAA admission clinicians. The past fiscal year launched the first Performance Year for the Home Health Value-Based Purchasing (VBP) model. This year, the VNA Alliance launched its "Call us First" campaign with the goal of mitigating unnecessary trips to the emergency room. Many ambulatory care sensitive conditions, such as congestive heart failure and chronic obstructive pulmonary disease, can be effectively managed within the post-acute space, avoiding higher cost centers of care. Our on-call team was enhanced to provide more, after hour, site visit capacity. We expanded our telehealth monitoring system-now covering over 12% of our entire census, compared to 5% one year ago. We hired our first CRNP who addresses our high risk, high volume, problem prone conditions with a fresh level of sophistication and skill. This past year, we also expanded the use of tele rehab virtual visits that function to augment traditional plan of cares with supportive education and guidance. Compared to the previous year, the VNA Alliance experienced an 18% increase in high-risk patients served. Despite the increase in patient complexity-the agency managed to slightly lower its re-admission percentage. The VNA Alliance will continue to work on lowering its claims-based metrics of acute care hospitalization and emergency department use without hospitalization, for these two metrics show the greatest opportunity for improvement. In 2022, 12.9% of our patients sought emergent care at some point during their home health experience, and were not admitted to the hospital. To be ranked with the best agencies in the county, this value would need lowered to 4.7%. Regarding 60-day hospitalizations, our 2022 percentage of 11.6% would need lowered to 7.7% to be considered the "best of the best". The VNA Alliance will continue to strive for excellence in assisting our patients to "age in place." Based on 2022 data, the implementation year for the VBP program, the VNAA has performed in the highest (best performing) quartile within the large cohort pool of 6,838 agencies. (July 2023 Interim Performance Report CMS) The final area of TPS scoring comes from the patient experience, or HHCAHPS survey. "The 5 cs" of the patient survey are: 1) Compassion 2) Communication 3) Care Quality 4) Consumer Report 5) Consumer Loyalty The VNAA has made steady progress regarding its HHCAHPS scoring with the greatest progress in "consumer loyalty," with over 83% of our patients saying they would "definitely recommend" the VNA Alliance! VNA Alliance had the opportunity to sponsor six Golf Outings during the tax year: Kiwanis Club of Greenville (July 2022), Meadville Medical Center Foundation (August 2024), Titusville Area Hospital Foundation (May 2023), Hospice of Crawford County (May 2023), Wesbury Foundation (May 2023), and Kiwanis Club of Greenville (May 2023). Other local sponsorships include supporting the Meadville area Bolts and Bytes 4-H club at the Penn State Cooperative Extension in Crawford County as well as a donation to the Power of the Purse Fundraising event benefiting Good Samaritan Hospice. The cost to the agency for these sponsorships and donations are a total of $4,025 and benefit the local community that we serve. Employees of VNAA were given the opportunity to participate in several mission events organized by the home and community-based agencies of Concordia. In August and September 2022, employees across all Concordia locations in Pennsylvania including VNAA, participated in a donation-based mission to support Midwestern Intermediate Unit IV, a program that services 27 school districts and 3 vo-techs in Butler, Lawrence and Mercer Counties. Employees purchased a total of 274 backpacks with essential school supplies including notebooks, pencils, erasers, markers, glue sticks, binders and folders. VNA Alliance employees participated in the Angel Tree Christmas Mission by sponsoring three children who are experiencing homelessness to purchase and wrap Christmas gifts to provide them with a wonderful Christmas in 2022. These mission events are some of the many ways we serve God by providing for the needs of His people.