Clarion Forest VNA Grateful for Community’s Support in Challenging Times

Ron Wilshire

Ron Wilshire

Published April 8, 2018 4:40 am
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CLARION, Pa. (EYT) – The mission of the Clarion Forest Visiting Nurse Association (VNA) is to provide care to people, regardless of the patient’s ability to pay to the extent that funds are available, but now that is getting harder and harder to do.

(Pictured above: Hospice volunteers Marjie and Skip Young participate in Annual Memorial Service. Clarion Forest VNA held their 24th Annual Memorial Service at the Trinity Point Church of God last fall.)

“While for many years, the donations we received have been adequate to fulfill our mission that has changed over the last four years,” said VNA Executive Director Jill Over (pictured below).

“In the fiscal year that ended December 31, 2017, we show a loss of more than $250,000.00. And, this follows three years of less severe losses.”

Jill Over, CEO 007

The VNA is grateful for the generous support provided by the people of its service area.  Aware of the cuts in funding at several different levels, exploreClarion.com organized a special challenge to raise additional funds. exploreClarion.com established a GoFundMe page and has committed to matching the first $1,000.00 donated.

The campaign is part of the inaugural exploreClarion.com Charity Challenge.

“When exploreClarion asked if we would consider being the first recipient of funds from what they hope to make an annual fundraiser, I was humbled and hopeful,” said Over. “Most of our pleas go to those who have utilized our services in the past, and this will get our message out to a larger group of people, and people that may need us to be here in the future.”

While VNA has a simple mission in providing services to people regardless of their ability to pay, the changing in existing funding is making the mission more and more difficult without additional funding.

The mission may be simple, but the facts are complicated.  Please take the time to read the facts about the Clarion Forest VNA’s operation and the very real challenges it is facing.

What is the VNA?

The VNA is a freestanding not-for-profit agency that provides home health and hospice care to the people that live in the communities we serve. Being freestanding means we aren’t owned by the government or by any other health care provider or system. Being not-for-profit means we are overseen by a Board of Directors. The members of the board are all volunteering their time and each one lives in an area we serve. Most of our patients live in Clarion and Forest Counties and a few live in surrounding counties.

Majority of funding

The majority of our revenue comes from government programs, such as Medicare, Medical Assistance, and the Veterans’ Administration. We also accept payment from commercial insurances Aetna, Blue Cross, UPMC, and others. Additionally, we receive approximately $20,000.00 each year from United Way of Clarion County and smaller sums from various other donors that, in a typical year, total $50,000.00 to $60,000.00.

Changes in funding

There is more than one cause for what is occurring:

Home health and hospice are costly to provide (except when compared to the cost of providing care in a nursing home or hospital). The Medicare program has given very small increases in payment for the past several years, commercial insurance pays contracted rates which often don’t cover the cost of a visit, Medical Assistance barely pays HALF of the cost of a visit.

The VNA has traditionally accepted all contracts because we want to serve those in need. Many home health agencies, often for-profits, “pick and choose” what insurers they will do business with. Some limit the number of Medical Assistance patients that are admitted to service or take no Medical Assistance patients at all.

Affordable Care unintended consequences

The Affordable Care Act has had a couple of “unintended consequences” that have had a negative impact. Many people that have commercial plans, either through an Exchange or an employer, have seen the plan’s deductible go up. The VNA has, for the first time in our more than 45-year history, had to resort to working with a collection agency to collect unpaid deductibles. Additionally, VNA is receiving an increased number of referrals where Medical Assistance is the payer. As stated above, this has a definite negative effect on our finances.

Increase in mandates

Increase in mandates: In 2017 alone, the VNA has had to work to comply with five new Medicare Conditions of Participation. If we have not complied by mid-January 2018, we will lose our ability to bill services to Medicare. These have taken a tremendous amount of work to prepare for and, once in place, they each require increased paperwork from the people that see the patients in their homes. This has all happened with no increase in reimbursement. Additionally, the Medicare Advantage plans and commercial insurers are conducting many more audits than in the past, which requires many man-hours of labor to send those charts to the reviewer and can result in the denial of payment to the VNA for services already rendered.

Decrease in number of allowable days for Hospice

Our hospice program, while admitting about the same number of patients each year for the last five years, has seen a decrease in the number of DAYS of care we provide to people. This is happening to hospices across the country. Hospice is reimbursed for each day of care provided to a patient. Shorter patient stays in the hospice program means less income. While we continue to provide excellent care to our patients (we’re in the top 10 percent of hospice providers, according to a national data management company SHP), the decrease in funding has made us make hard choices.

The decrease in funding forced us to close Serenity House, a residence for hospice patients. It is also the case that when a patient is admitted in the very last days or hours of life, it hurts our ability to establish a trusting relationship with the patient and family we are caring for. It is challenging to change what is often a chaotic, fearful time into a more peaceful experience when there is not enough time.

More than a feeling

Finally, this is more a “feeling” than a provable fact. But, among rural providers of any kind of health care, it is a belief that the policymakers do not value the providers in rural areas and would generally prefer that small providers become part of larger systems. For instance, for many years rural home health providers have had a three percent “add-on” to the payment received from Medicare. This was developed in recognition that our staff drives many more miles, thereby adding mileage and time expense, to see the same number of patients that an urban/suburban provider can see in a day. This additional payment is scheduled to end December 31, 2017, if Congress doesn’t renew it. It is December 11 today, and so far it has not been renewed.

Donate to Clarion Forest VNA

A GoFundMe account has been set up for Clarion Forest VNA to help defray the change in funding. To donate, visit
https://www.gofundme.com/help-clarionforest-vna-survive-cuts.

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