Telehealth – Man taking blood pressure / Tunstall

October 20, 2016; Newsday (Long Island, NY)

The Visiting Nurse Association of Long Island, a nonprofit provider of home health services for 102 years, has been acquired for $4.6 million by Amedisys, a publicly traded for-profit company based in Louisiana.

Amedisys’ Tender Loving Care brand already has facilities in Hicksville and Medford, Long Island, and will now access the entire region from Queens and Brooklyn through Nassau and Suffolk.

The 2014 annual report for Visiting Nurse’s 2013 fiscal year lists such programs as Maternal Child Health and Telehealth Monitoring, where a patient’s biometrics can be monitored, sending the information to the clinician in real time. They delivered 200,000 meals to homebound residents, and offered Fall Prevention. The nonprofit was accredited by the Community Health Accreditation Program and certified by state and federal agencies.

For years, the IRS Form 990 for Visiting Nurse was filled out by hand, suggesting a thrifty, if not meticulous, approach to accounting. The 2013 form showed a net income of $1.8 million against revenue of $14.9 million, but by 2014 their frugality could not compensate for changes in the medical field and they had a deficit of $1.3 million. New York’s Senator Charles Schumer stepped in during February of 2015 to request $1.6 million in Vital Access Provider dollars from the federal Centers for Medicare and Medicaid Services (CMS). Vital Access Provider funds can be made available to hospitals and other medical care agencies under financial stress. This move was unsuccessful, and Visiting Nurse declared bankruptcy. Paul Kusserow of Amedisys stated that some assets were purchased through the bankruptcy, and some still held by the agency were bought directly.

Kenneth Cerini of Cerini & Associates, an accounting and consulting company that works with many nonprofits on Long Island, said, “There are plenty of government-funded nonprofits that don’t have a lot of cash reserves. If there are delays in how you get paid, that’s going to impact cash flow.” He indicated that the shift to managed care and tighter government funding has put pressure on the nonprofits in the health field.

Home healthcare is one of the largest-growing services nationwide, with nonprofit and for-profit models addressing the need. Partly because of the tremendous growth, and partly because of the numerous fundamental changes occurring simultaneously, the home healthcare industry is volatile, with many more changes sure to come.—Marian Conway