VNS Health and Touro University Create Home Care Nursing Scholarship
VNS Health’s home care nursing scholarships will cover all educational expenses toward an Associate in Applied Science in Nursing degree. In exchange, participants agree to serve as VNS Health nurses for at least two years after graduating.
To help develop the next generation of home care nurses, starting this fall VNS Health will be providing full scholarships for the nursing program at Touro University’s New York School of Career and Applied Studies. The scholarships cover all educational expenses for Touro’s five-semester Associate Nursing Degree program, including the cost of tuition, textbooks and other fees.
In exchange, scholarship recipients pledge to join VNS Health as full-time nurses for at least two years following graduation and will also work at VNS Health as paid interns between semesters. To further prepare them for the unique challenges of home health care, the program’s curriculum includes several innovative courses devoted to home health nursing. These home care-specific courses, which are not typically offered in nursing school, will be taught by VNS Health nurses.
Upon completing all course requirements, participating students will graduate with an Associate in Applied Science (AAS) in Nursing degree, making them eligible to take the New York State exam to become registered nurses
“For years, we’ve been facing a shortage of nurses in the home care workforce,” notes Dan Savitt, CEO of VNS Health. “We felt that establishing a program in which we pay the cost of a student’s education in return for a two-year work commitment is a great way to introduce new nurses to the home care field. We’re confident these new nurses will find it rewarding to be part of the VNS Health team. Ideally, they’ll also decide to stay on and have careers here as home care nurses.”
“Touro University is excited to partner with VNS Health to offer this innovative nursing program, the only one of its kind in the New York City metropolitan area,” adds Dr. Jordan Yakoby, who runs Touro’s nursing program. “Our courses emphasize the transition from student to practicing registered nurse from Day One, as students learn to become home health nurses through specialized training that includes simulations, laboratories, and internships.”
With the fall semester now in progress, the first group of scholarship students has begun attending classes at Touro’s Time Square campus. The plan is to eventually have 20 students entering the program each September and January.
“We’re very excited about getting this initiative underway and building it for the future,” says Michael Bernstein, EVP and Chief Experience Officer at VNS Health, who conceived of and developed the scholarship program. “Touro has an excellent reputation in New York City for preparing future nurses. It’s our hope that students who graduate from the program will then choose to work in their home boroughs, so they can give back to their community as a home care field nurse in neighborhoods that they’re already familiar with.”
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VNS Health Extends Its Safety Net in the Bronx
Under the evidence-based CCBHC model, participating clinics must offer the nine core services shown above—either directly or through a partnering organization.
VNS Health is beginning to deliver truly integrated mental health and substance use disorder (SUD) treatment in its South Bronx clinic under the federal government’s Certified Community Behavioral Health Clinic (CCBHC) model. CCBHCs are a best-in-class approach to delivering behavioral health services, offering rapid access to integrated, trauma-informed, recovery-oriented, person-and-family-centered care.
The enhanced clinic, which is supported by a $4 million federal infrastructure grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), will begin accepting new client referrals this fall.
Under the CCBHC model, the clinic, which has long provided mental health support to children, adolescents and their families, is expanding its services to offer fully integrated mental health and SUD treatment to all individuals in the South Bronx and surrounding communities. CCBHC clinic services are typically reimbursed through Medicaid and Medicare, but will be provided to anyone who needs them, regardless of insurance status or ability to pay.
The VNS Health clinic is one of approximately 500 CCBHCs nationwide focused on improving availability of and access to care, while at the same time ensuring comprehensive coordination between all providers. The evidence-based CCBHC model requires the clinic to offer nine core services (see diagram above), either directly or through a partnering organization.
“Research has shown that providing these combined core services through one integrated hub has a significant positive impact on local communities,” says Alexandra Karydi, Director of Behavioral Health Product Development for VNS Health. “In the South Bronx, there’s a real need for a coordinated approach to people struggling with substance use, many of whom have mental health issues as well. With the CCBHC model, we can help prevent these community members from falling through the cracks of our health care system while also reducing unnecessary hospitalizations and ER visits.”
With conditional approval for its Article 32 License (substance use disorder treatment) in place, VNS Health will be weaving together this new service with its existing mental health services in its Bronx clinic, starting in September. To further support the CCBHC model’s emphasis on rapid access, the VNS Health facility is the only clinic in the area that will be open in the evenings and on weekends, ensuring that working people, children in school, and families can get the help they need, when and where they need it.
“We are thrilled to be able to bring this nationally recognized, evidence-based model of behavioral health care to the South Bronx clients we serve,” says Jessica Fear, Senior Vice President for Behavioral Health. “With the opening of our CCBHC, VNS Health has the opportunity to lead the way in delivering the highest-quality care while simultaneously delivering on our mission of expanding our Behavioral Health portfolio.”
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Growing VNS Health’s Personal Care Services So More People Can Live Safely at Home
An interview with Jim Rolla, Senior Vice President, Personal Care—who, in addition to overseeing VNS Health’s more than 6,150 home health aides (HHAs), spearheads the division’s plans for growth.
VNS Health’s Personal Care census has been growing. What’s fueling that growth?
One key thing helping us to grow is that we’ve expanded the network of Medicaid Managed Long Term Care [MLTC] health plans we’re working with—since MLTC plan members make up the bulk of clients cared for by our home health aides. We’re currently contracted with more external health plans than ever before, including three large MLTC plans that we recently signed contracts with. These contracts allow the plans to refer members to VNS Health to get personal care services from our HHAs.
You’ve also expanded your own sales force, haven’t you?
Yes. We recently created a dedicated sales team that operates in the community, reaching out to neighborhood residents who qualify for Medicaid and educating them on the important benefits of personal care services, including how these services will allow them to live safely at home as they get older. We then go on to explain how they can get these services by enrolling in an MLTC plan. These individuals can choose to enroll in any MLTC plan offered in their area, of course—but if they decide to enroll in an MLTC that we’re contracted with, they’re likely to select us as their personal care provider, since they already know us. Over the past year, we’ve increased our client census by about 10% through this approach.
How about VNS Health’s own health plans? Do they have a role in Personal Care’s growth?
Certainly. We supply HHAs to members of VNS Health’s MLTC plan and our integrated Medicare-Medicaid plan, VNS Health Total. Growing these plans is a priority for VNS Health—and as these plans get larger, we stand to get more referrals from them to provide HHA services to their members.
In order to grow, you also need enough HHAs to service your growing volume, don’t you?
That’s true—and we’re doing well in that respect. Our one-year retention rate for newly hired HHAs is currently over 85%. Our bonus incentive program, VNS Health Rewards, has played a big part in that. If an HHA hits certain benchmarks, they get a bonus added to their weekly paycheck. This culture of recognition has been a game changer as far as retaining staff. We’ve also collaborated with the 1199 union to negotiate a contract that’s truly in the best interest of our HHAs. It includes an hourly rate that’s above the minimum home care worker wage as well as excellent benefits.
Do these factors also help in recruiting?
Absolutely. A good compensation and incentive structure obviously helps attract new hires. Plus, most of our new HHAs come through referrals by our own team members. If our aides feel good about their work, they’re more likely to refer friends and family to VNS Health. That said, however, the best way to grow our workforce is by acquiring other home health aide businesses. We’re currently looking at several possible acquisitions, so stay tuned for additional developments on this front.
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VNS Health Opens Walk-in Neighborhood Offices in Far Rockaway and Flatbush
The VNS Health neighborhood offices in Far Rockway and Flatbush are staffed by sales representatives who speak multiple languages. “We want people to know that VNS Health is here, right where they live,” says John Burke, EVP and Chief of Health Plans.
In a move aimed at making VNS Health’s Medicare and Medicaid plans more accessible to residents of underserved New York City communities, the organization’s Health Plans division now has neighborhood offices in Far Rockaway, Queens and East Flatbush, Brooklyn.
The two offices are in highly visible locations with substantial foot traffic and are staffed by sales representatives who speak multiple languages—including Creole in the case of the Flatbush office, an important factor in connecting with that neighborhood’s sizeable Haitian American population.
The Far Rockaway office, located at 21-09 Mott Avenue, has been operating since October 2023, while the Flatbush office, at 897 Flatbush Avenue, opened in mid-spring of this year. “The goal is to have an accessible neighborhood presence in these vital but underserved communities,” says John Burke, Executive Vice President and Chief of Health Plans. “We want people to know that VNS Health is here, right where they live, and that we’re committed to serving them.”
“The Far Rockaway neighborhood office has been a real success story for us, and we anticipate that our Flatbush location will be too,” reports David Robinson, Vice President, Health Plans Sales and Partnership Development for VNS Health. “The Far Rockaway sales team enrolls between 20 and 25 new members a month at this location on average, mostly in our Medicare Advantage plans, EasyCare and EasyCare Plus. But people are also expressing interest in our integrated dual-eligible plan, VNS Health Total, and our Medicaid Managed Long Term Care plan.”
Additional neighborhood offices are coming in the near future, adds Robinson, as VNS Health evaluates other possible sites. “There are a lot of people who would benefit from having a place they can go and have their questions about VNS Health addressed in person,” he says. “It’s all about meeting our members where they are—and this is a great way to do that.”
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VNS Health Enhances Its In-Home Fall Prevention Program
VNS Health’s enhanced fall prevention protocol begins with an in-home assessment by a physical therapist. The PT then designs a customized treatment plan for the client and tracks their progress over the course of multiple sessions.
Falls are the leading cause of fatal and non-fatal injuries among older adults—and more than two-thirds of these falls occur in the home. To help reduce this risk, VNS Health has enhanced its in-home physical therapy program for preventing falls among older New Yorkers.
“This home-based approach offers a convenient and highly effective way to reduce seniors’ fall risk, making it a great referral option for primary care physicians and nurse practitioners in the community who want to protect their aging patients,” says Sandy Merlino, Vice President for Business Development at VNS Health. “Besides helping older New Yorkers live safely in their homes, this program relieves stress on family caregivers who may be concerned about their loved ones falling—which also means fewer calls by the family to the doctor or NP’s office.”
The enhanced fall prevention protocol begins with an in-home assessment by a VNS Health physical therapist who evaluates the patient on eight different factors related to fall risk. The PT will then work with the patient to implement a customized treatment plan, tracking their progress throughout. Once the patient has completed the program, the PT will do a reassessment and provide them with an updated exercise plan they can continue doing on their own with support from family members.
“In this program, our physical therapists act as eyes and ears in the home for doctors and NPs who want to reduce their patients’ risk of falling,” says Joe Gallagher, VNS Health’s Director of Operations Support Services. “Depending on the patient’s needs, the PT will provide balance and strength training, address environmental issues like stairs, clutter and uneven surfaces, evaluate the patient’s footwear, collaborate with a VNS Health nursing supervisor to review medications for potential fall-related side effects and also collaborate with an occupational therapist as needed, and have the patient’s vision checked.”
VNS Health’s fall prevention program is typically covered by Medicare, Medicaid, and other long-term care insurance plans for eligible patients who receive a referral, adds Gallagher. “This program is to everyone’s benefit,” he notes. “The patient is better equipped to live safely at home, their physician and family members rest easier, and insurers can avoid paying for unnecessary emergency department visits or hospital stays.”
CDC Adds New Code for Sepsis Aftercare Based on VNS Health Research
In a step that will have national impact as far as improving outcomes for the 1.7 million Americans who survive a sepsis episode each year, the CDC announced in July that it is including a new “Encounter for Sepsis Aftercare” diagnostic code in the latest update of its International Classification of Diseases (ICD-10) list. The new code, z51A, which takes effect on October 1, will alert home care nurses and other post-acute providers that, in addition to other conditions a patient is being treated for, the patient also recently had sepsis.
The need for this new code first surfaced in a study published in 2020 by VNS Health researchers. The investigators reviewed the records of 165,000 sepsis survivors who entered home care nationwide and found that their sepsis history was noted in their admission assessment just 7% of the time—despite the fact that sepsis survivors have a one-in-five risk of being rehospitalized within 30 days of discharge, and a 30% readmission rate overall. Between one-third and one-half of these readmissions are due to sepsis recurrence, which is also one of the most important risk factors for one-year mortality among sepsis survivors.
“Clearly, this is a population that needs close monitoring after discharge,” says Dr. Kathryn Bowles, Director of the VNS Health Center for Home Care Policy & Research and Professor and van Ameringen Chair in Nursing Excellence at the University of Pennsylvania. “But for this to happen, we first need to identify them as sepsis survivors.”
Looking for a potential fix, the researchers zeroed in on how hospitals and home care agencies were coding sepsis patients during the transition from hospital to home. “Because these sepsis cases have been resolved from the hospital’s perspective, hospital staff had no way to code for sepsis in the patient’s discharge notes,” explains Dr. Bowles. “As a result, home care providers may not know that their patient is a sepsis survivor and in need of close monitoring to prevent a potentially fatal relapse.”
Following the study’s publication, Dr. Bowles, the study’s principal investigator, and her team led an effort to convince the CDC of the need for a new diagnostic code that defines sepsis aftercare as a separate condition—an effort that culminated in a formal presentation by the team to a CDC committee in March of 2023. “The presentation went extremely well,” Dr. Bowles recalls. “The committee was very accepting of our rationale.”
The VNS Health Research Center and Penn Nursing are currently conducting an NIH-funded study in which they’re encouraging hospital providers to include patients’ sepsis history in their discharge notes, and the results have been encouraging: The study recorded a 78% success rate for improved sepsis communication between VNS Health and one major New York City hospital group. Once the sepsis aftercare code is implemented, it’s anticipated that communication between acute and post-acute care will be further enhanced, enabling post-acute providers to consistently target sepsis survivors for evidence-based care.
As an example of such care, in the same study the VNS Health team is also disseminating a front-loaded home care protocol that their research shows significantly reduces readmissions among sepsis survivors. This protocol includes starting home care within two days of discharge; receiving a second visit from a home care nurse during the first week of home care; and seeing an outpatient provider within seven days of discharge. The study found that sepsis survivors who received this pattern of care had readmission rates 7% lower than patients who did not get timely attention.
“Our original records review showed that only 28% of sepsis survivors nationwide admitted to home care received the protocol cited in our study,” Dr. Bowles notes. “Between this new code and raising awareness of how vitally important it is to provide timely attention to sepsis survivors post-discharge, our hope is that this number will increase dramatically, and sepsis survivors will get the care they need.”
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