In January, the Vineyard Nursing Association announced it had signed an agreement to sell its operations to Cape Cod Health Care, a large consortium which owns the Visiting Nurse Association of Cape Cod. Last week that agreement fell through and the Cape Cod group did not purchase the business or any of its operational assets. Instead, when the VNA closed its doors on March 11, the off-Island agency rolled Vineyard patients over to their own program. Cape Cod Health Care plans to open an office on the Vineyard by April 1.
Robin Lord, director of communications for Cape Cod Health Care, said in a statement to the Gazette this week that signing a letter of intent in January triggered a review period.
“Much as you wouldn’t want to buy a new house without first conducting an inspection of it, it would be unheard of for any successful organization to acquire another organization that is in financial trouble without carefully reviewing its operations, financials and potential vulnerabilities,” Ms. Lord said.
Even after the letter of intent expired on March 5, Ms. Lord said the two parties continued to seek an agreement.
“The two parties continued to try and reach a definitive deal up until the time the VNA board decided to cease operations,” she said. “The parties signed the letter of intent recognizing the Vineyard Nursing Association’s financial struggles and with the hope that there would be a way to make sure that a Medicare-certified home health agency continued to operate on both Martha’s Vineyard and Nantucket.”
The VNA is the sole Medicare-certified home health care agency on the Vineyard. Late last year, VNA leaders announced that the agency was on track to end the year with a large operating loss. Cost-cutting measures went into effect in late November.
This week, Amy Houghton, director of business and development for the VNA, said purchasing of the VNA’s building played a role in the Cape Cod group’s decision. Last year, the VNA purchased a $2 million office building in Vineyard Haven.
“The Cape Cod VNA decided the building wasn’t going to meet their needs, business-wise, and it was a business decision for them not to take the building,” she said. “Once the building was off the table, then pretty much the deal was off the table.”
But patient care was never off the table, she said. Ms. Houghton said it was always the VNA’s intention to transfer patients to the Cape Cod VNA in March.
“That was our goal, back in the initial negotiations and through the process, that’s what we had hoped would happen,” Ms. Houghton said. “In order to make that happen, we worked very closely with the Cape Cod VNA. They met with our aides and nurses to understand how we operate on the Vineyard.”
Ms. Houghton described the Cape Cod VNA business model as a more mobile system, working out of their homes and cars. On the Vineyard, though, the VNA building served as a community center, she said, where nurses could receive assignments, staff meetings were held and classes were conducted. The VNA building is now for sale.
At the time of its closure, the VNA served 35 private care patients, 62 certified medicare or private insurance patients and 100 patients in elder services.
Ms. Houghton said it became clear the week before the closure that the VNA of Cape Cod would not be purchasing the business, and the VNA began to prepare to close its doors.
“Knowing that they were a strong and very reputable organization, it seemed that the best scenario was to close our doors so we could move into that transition instead of taking more time,” she said. “As long as your doors are open you’re accruing payroll. The liability for the VNA would increase . . . when you have 90 employees, one week makes a difference in terms of the payroll.”
Staff was informed of the transition at an all-staff meeting the week prior to the closure and given a letter that Friday notifying them of the change. Staff members were all paid through March 11.
Nearly all of the employees have been hired by the Cape Cod group, Ms. Houghton said, except for the administrative staff.
“They’ve tried to make it as easy as possible,” she said. Ms. Houghton will not be transitioning to the new organization.
On the Vineyard, six out of seven nurses transferred over as well as 35 home health aides and physical therapists. Ms. Houghton said the VNA and Cape Cod worked together to ensure seamless patient care.
“We worked with them all along to make sure that somebody didn’t wake up without a nurse showing up at their house at 8 a.m., if that was needed,” she said.
The nurses are receiving assignments from Cape Cod VNA administrators out of the Harbor View Hotel in Edgartown. The Cape Cod VNA plans to move into a new space April 1 somewhere on the Vineyard.
Ms. Houghton and three other administrative members are still working to help with the process. A donation was made by the Cape Cod VNA to assist in the transition, she said.
“Hopefully there will be an ability to be paid for some, if not all, of the work” done during the transition, she said.
Ms. Houghton and staff members have been working to settle several ancillary programs run through the VNA, such as employer drug testing and a chronic disease management program.
“Our goal is to make sure all things the VNA has done and historically been a leader in are not dropped, and we find a good home for all those things,” Ms. Houghton said.
The VNA handled all of the pre-employment drug testing for 27 organizations on the Island, which was something that Cape Cod VNA was not able to pick up, Ms. Houghton said.
“We have been working over the last 10 days or so to make sure there’s a home for that, so people don’t have to go off-Island,” she said.
New pre-employment testing will be done at the county sheriff’s office beginning April 1.
The chronic disease management program, funded through a grant from the Martha’s Vineyard Hospital, will be managed by Island Health Care. A nurse connected with that program will continue to work with the program participants.
Meanwhile, Ms. Houghton and the board are dissolving the nonprofit.
“There are a lot of legal requirements and directions that have to be taken from the Attorney General’s office, and making sure that things that are donated to the agency are transferred on to another nonprofit with a like-minded view,” she said.
Patient care remains a priority.
“The folks that are giving the care are the same people and it’s going to take a little transition time for people to get accustomed to some of the nuances of having an administrative head on the Cape instead of here,” she said.