ALLIANCE VISITING NURSES

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. During the 2023-2024 fiscal year, the VNAA completed over 69,000 home health care visits and maintained an average daily census of over 500 patients. For the past 15 years, the VNAA has been the driving force in quality, post-acute, care in Northwest Pennsylvania. As the only 4.5 STAR agency in the region, the VNAA excels in delivering evidence based, effective and efficient health care across a six-county territory. Our mission is simple- helping our neighbors successfully age in place. To achieve our mission, the VNAA has taken a four-prong approach: 1) Improving the quality and efficiency of our home health care: In 13 of the 15 publicly reported quality of patient care indicators, the VNAA surpasses national performance thresholds. 2) Improving our patient's experience with care: On average, less than 4 nurses care for a VNAA patient over the course of their 55-day (on average) episode of care. 3) Strengthening our patient's physical function: Based on CMS data, patients treated by the VNAA are far more likely to improve their balance, strength and aerobic capacity as compared to National and Pennsylvania averages. 4) Preventative Medicine: Addressing our patient's health issues before they require an ED visit or an unnecessary hospitalization. Our patients are more likely to remain in the community following discharge and are less likely to be admitted to the hospital for a potentially preventable condition while receiving home health care. The VNAA has launched specific clinical programs addressing high risk, high volume, problem prone conditions such has CHF, COPD, UTI, sepsis, endocrine risks, and falls. Over the past fiscal year, one in five patients referred to the VNAA dealt with a wound. The VNAA employs Wound Certified PTs and RNs who provide evidence-based care to optimize healing. Our team guided over 96% of this population to a successful outcome-exceeded both state and national trends. Correctly identifying wound ideology while establishing evidenced based care are the key ingredients to wound care success. The VNAA has successfully integrated wound photography with the clinical record to provide a detailed analysis of wound recovery. To aide in achieving our aging in place mission, the VNAA launched its Achieving Clinical Excellence (ACE) initiative during the past fiscal year. The ACE program addresses acute care discharges at risk for early hospitalization. Research has coupled readmission rates to in-hospital and post discharge quality of care. During the past year, the VNAA partnered with Titusville Area Hospital to address hospital recidivism within their shared patient population, or 3.0% of the VNAA patient census. Coordinated discharge planning coupled with a focus on staffing continuity, family engagement and a concentrated look at the first 2 weeks of care led to meaningful results. Over the course of the year, Titusville Area Hospital's re-admission percentage dropped from 25.2% to 11.6%. The VNAA has been proactively preparing for a new key performance indicator-Home Health Within-Stay Potentially Preventable Hospitalization(PPH). In 2025, this new claims based measure will track the number of patients with at least one potentially preventable hospitalization or observation stay during the home health episode. Exaserbations of congestive heart failure or hypoglycemia would fall within the classification of being potentially preventable. For the past fiscal year, 7.9% of our home health episodes experienced a PPH, well below the National and State averages of 9.0% an 9.6% respectively. However, we want to do better. A multidisciplinary task force has been established to develop disease specific, best practice protocols to implement during the first two weeks of care for 6 PPH condtions: 1) CHF 2) COPD 3) Pneumonia 4) DM 5) UTI 6) Sepsis. The clinical pathways incorporate site visits, remote monitoring, phone follow ups and best practice teaching to foster improved outcomes. Our goal is to lower our PPH % below 7% using a team approach. With the addition of respiratory therapy, the expansion of our MSW department, and the continued growth within our remote monitoring system, the VNAA is poised to make improvements in our claims-based metrics. In addition to its commitment to facilitate improved outcomes for its patients, the VNAA is dedicated to the development of exceptional clinicians. This year saw the agency partner with two local Universities, Gannon, and Penn West, in supporting their PT and RN educational programs. This past spring, the VNAA hosted 2 PT students from Gannon University. Both students completed 10-week field experiences offering a firsthand look at the post-acute space of home health care. This past year, VNAA hosted nursing students from Penn West University, affording scores of undergraduates the opportunity to experience a day in the life of the visiting nurse. This past summer, the VNAA hosted a Health Fair on the St. Paul's campus. Topics included effective medication management, fall risk assessment, and functional performance measuring. Identifying risks, before they become events-and acting on them- is one aspect of successful aging. The VNAA is honored to support our community and partnerships to promote health and wellness. This year, the VNAA team successfully prepared for and completed our triannual Accreditation Commission for Health Care (ACHC) recertification. On April 2, 2024, ACHC officially approved our Deemed Status, demonstrating compliance with ACHC standards and the CMS Conditions of Participation. Per ACHC, "This is an achievement of which your organization can be proud, and one that reflects your dedication to delivering safe, high-quality care to those you serve." During the past fiscal year, close to 6,000 VNAA patients were provided the opportunity to share their thoughts concerning their Home Health Care experience via the HHCAHPS survey. Of that total, 29.1%, or 345 patients, completed the survey. Upon review, the VNAA scored above the National data base in each of the 5 key performance indicators. VNAA 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. The VNAA conducted an educational in-service for the Hospice of Crawford County clinical staff titled "Caring for Your Back while Caring for Others". The information covered safe transfer techniques, adaptive equipment needs and mobility strategies for success. Total sponsorships and donations made during fiscal year ended 6/30/24, equated $8,266. Additional funding via distributions to 501(c)(3) members at a total of $4,000,000 have expanded like-minded mission within the geographical communities we serve. Employees of VNAA were given the opportunity to serve by participating in mission events organized by the Missions Committee. Here are the donation, sponsorship and mission event opportunities that VNAA took part in during the fiscal year. VNAA spent $7,125 to sponsor events at these local organizations during the tax year: Active Aging Foundation, Meadville Medical Center Foundation (two events), Titusville Area Hospital Foundation, and Wesbury Foundation - as well as supporting: Commodore Perry Little League, Meadville Baseball, and Meadville Bulldog Hockey. A total of $1,141 in donations were given to American Legion Post 237, Hospice of Crawford County, Wesbury Foundation, and a raffle basket to Garden Way Retirement Community. These mission events are some of the many ways we serve God by providing for the needs of His people.