Visiting Nurse Association closing its doors

Visiting Nurse Association closing its doors

BY PRU SOWERS

KONK LIFE STAFF WRITER

Battered by financial instability over the past few years and walloped by the impact of Hurricane Irma, the Visiting Nurse Association & Hospice of the Florida Keys (VNA) will cease operations by Feb. 28.

The non-profit community organization has been providing home health care, palliative and hospice care in Monroe County since 1984. Thirty-one patients and 22 full- and part-time employees will be affected.

A perfect storm of financial hits forced the 34-year-old nursing care organization to close its doors.  Declining patient levels led to an affiliation with Haven, a North Florida hospice provider, in 2015. The Gainesville-based company provided financial and administrative support to VNA. But patient numbers did not climb enough to provide the financial cushion needed. Currently, VNA’s client base includes 20 hospice patients and 11 home health patients.

Hurricane Irma was the straw that broke VNA’s back, according to Kim Sovia-Crandon, VNA Interim Administrator and Director of Development. She called the hurricane a “brutal beating,” not to its building on William Street but to its operations.

“We lost patients. We lost staff. People relocated and people were displaced. When you don’t have any affordable housing, it’s hard to hire anybody,” she said, adding, “2017 was an extremely hard year for us.”

Patricia Vernon, Haven Manager of Marketing & Communications, said the decision to close VNA was made the week of Jan. 15 and announced on Jan. 22. VNA will close for good on or before Feb. 28, she said. The organization is currently working to transition its patients to other hospice care companies serving Monroe County.

“Even though we worked well [with VNA] as a team, the financial stresses continued,” Vernon said. “They tried to see if they could continue on, but they couldn’t.”

The 10 full-time and 12 part-time VNA employees have been offered jobs with Haven or severance packages. The employment opportunities would involve moving to northern Florida, where Haven serves 18 counties.

While the number of hospice and palliative patients in Florida is growing between 1-2 percent every six months, that growth is well below the double-digit increases the industry saw a few years ago. Paul Ledford, president and CEO of the Florida Hospice & Palliative Care Association, said several factors contributed to VNA’s failure. First, the Florida Keys are designated as a “rural” area in terms of reimbursement by Medicare, which is the largest payment source for hospice, palliative and home health care in Florida. As a result, the reimbursement rate to VNA was below higher population-density areas such as Miami. And while wages were constricted at VNA, staff housing costs kept rising, leading to hiring challenges.

Then, Ledford said, several other hospice care organizations, including VITAS Healthcare, the largest hospice care company in the world, were competing with VNA for clients. Those providers were spread out over larger markets and could absorb losses better. Ledford said a hospice organization in the Florida Keys needs a client base of between 25 and 30 to break even.

“If that’s all you have, that’s enough for one small hospice program. It’s not enough for three. It’s a loss machine at that point,” he said, adding, “They [VNA] were in trouble when Haven took them over. Then they had the storm. It just became too steep a hill to climb.”

Because VNA had been providing services in Monroe County for so long, it became a respected fixture in the Key West community. It’s July 4 picnic and fireworks event at the Casa Marina Key West hotel was the highlight of its fundraising program, attended by hundreds of residents each year. And thousands of local families were the beneficiary of its care providers during some of the most difficult times of their lives. Key West City Commissioner Clayton Lopez said VNA nurses helped his family through the hospice care and loss of his father in 1995.

“They were just wonderful. We were blessed, to say the least. Those guys came through like angels,” he said after hearing of VNA’s closure.

VNA Interim Director Sovia-Crandon said the mood inside the organization is difficult, particularly since the care provider has been a part of the Monroe County community for so long.

“It [closure] is just devastating to us,” she said.

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