Visiting Nurse Services Explore Merger Into a Single Agency

By JAMES KINSELLA
Gazette Senior Writer

The Vineyard's two major visiting nurse services are in talks about a potential merger, the Gazette has learned.

Representatives from the Visiting Nurse Service, which is part of Martha's Vineyard Community Services, and the Vineyard Nursing Association Inc. are contemplating whether to combine the entities.

The talks come against a backdrop of a money squeeze inside both operations, given the failure of federal Medicare funding to keep pace with nursing expenses on the Island, among other things. Both organizations rely on fund-raising to fill the gap.

Robert Tonti, interim chief executive officer of the Vineyard Nursing Association, confirmed this week that the talks are under way.

"Yes, we are talking to Community Services. Talks have been going on since this past January," Mr. Tonti said, adding:

"We're meeting about once a month and we continue to make progress. If something were to happen it would happen next year, and we're not exactly sure when. We're really trying to review everything to make sure that a combined organization would be in the best interest first of the community - and that it would make sense to both Community Services and to the VNA."

Mr. Tonti said if the two nursing services do combine into one, it is not yet clear exactly what sort of single agency will emerge.

"We're looking at different structures. We want to make sure that any organization makes sense financially and from the standpoint of the services they provide. All the options are open at this point," he said.

Susan Wasserman, a board member at Community Services, said yesterday that if the merger is completed, the combined nursing operation would become an independent organization.

Ms. Wasserman said the meetings have progressed from the general to the particular, including financial details. "We're now looking at more specific numbers," she said. "The conversations have been open and cordial," she also said.

Because the Visiting Nurse Service is interwoven with other Community Services programs, board members must examine how the departure might affect the programs.

Ms. Wasserman said combining the two entities is expected to result in a more efficient operation. "You hope there's some economies of scale," she said.

At the same time, Ms. Wasserman said, the meetings have revealed that the two nursing organizations are different creatures. She said board members want to retain what is positive about each organization.

She emphasized that nothing final has been decided.

The idea of combining the two nursing organizations is not new. A decade ago, Ms. Wasserman said, representatives from each organization met to talk about a possible combination, but nothing came of it.

She attributes the more recent interest at Community Services in the self-assessment conducted at the organization by the Heller School. The assessment revealed that many Vineyard residents did not know that two nursing organizations existed on the Island. Some who did know about the two organizations were not sure how one differed from the other.

Ms. Wasserman said she is less concerned with the name that appears on the door of a combined organization than with the level of service the organization could provide.

Between them, the two nursing organizations provide health care services to thousands of Vineyard residents, including many elderly people, young mothers, and lower-income households.

Vineyard Nursing Association, which has existed for 20 years, makes about 14,000 visits a year and has an annual revenue flow above $1 million. In its most recent fiscal year, which ended last December, the agency essentially broke even, after factoring gift money into its bottom line. The nonprofit organization is headquartered at the Martha's Vineyard Hospital in Oak Bluffs.

The company employs about 30 full-time people, mostly nurses and home health aides. Additional nurses and aides are tapped on a per diem basis as needed.

About 85 per cent of the patients served by Vineyard Nursing Association are elderly.

Vineyard Nursing Association also includes the Women's Health Network, which provides services for lower-income women between the ages of 40 and 65. Half of them do not speak English. The network arranges for the women to be screened for breast and cervical cancer and cardiovascular disease.

The Visiting Nurse Service, which has existed for more than 35 years, is one of the oldest programs at Community Services, which was founded in 1961. The service is based at the Community Services complex in Oak Bluffs, across from the Martha's Vineyard Regional High School.

According to the Community Services federal tax filing for the fiscal year ended June 2004, the service accounted for $924,000 in revenue, about 20 percent of Community Service's $5.2 million in revenue that year.

The service operates three programs: a home health agency, a health promotion program and a nursing clinic.

The home health agency provides services to people who are homebound due to injury or illness. The agency uses a variety of workers, including nurses, aides, physical therapists and social workers to help individuals regain their health and become as independent as possible.

The Visiting Nurse Service's health promotion program serves Vineyard residents who need assistance in meeting their health care needs.

The program offers nursing visits to newborns and their mothers. Also, through arrangements with the boards of health in Aquinnah, Edgartown, Tisbury and West Tisbury, the program provides free monthly clinics in those towns; the clinics offer blood pressure checks and education on disease prevention.

The program also cooperates with elementary school nurses to provide childhood immunizations, holds semi-annual lead screening clinics for children, and conducts annual influenza immunization clinics.

A third program, the nursing clinic, provides services to the other two programs as well as drug screening services for Vineyard workers.