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.