Sanctuary at Canyon’s Edge

The Sanctuary at Canyon’s Edge December 2016

Dear Friend, 2016 has been a wonderful, record-setting year for Los Alamos Visiting Nurse Service (LAVNS)! Our mission has not changed: we are as committed as ever to strengthening our services and remaining the leading provider of home health and home-based hospice care in the region. We will soon celebrate our next milestone with a total of 100 patients in our overall census. The number of patients we are seeing is continuing to grow; we have provided 16% more visits in 2016 compared to 2015. And despite the challenge of meeting rapidly changing Medicare and Medicaid regulations, our 2016 revenue looks stronger than ever. We are hiring only the best clinicians to see our patients. We have also contracted with Taos Rehabilitation Services to expand our physical, occupational, and speech therapy services. The response has been overwhelmingly positive. We are pleased that we are now able to promptly meet the needs of people, even in areas that had previously been underserved, such as Espanola and surrounding areas. We are building on our quality reputation, and we are receiving a tremendous number of referrals from providers throughout the entire region. Our hospice census has remained consistently higher in the past several months than the average census in 2015. We have seen a 43% increase in the number of hospice admissions in the past two years. We continue to work with physicians, assisting them in making referrals for hospice care. Because we offer home health services in addition to hospice, we are able to provide a continuum of care. This enables each patient to live more fully, whether recovering from serious illness or facing a life-threatening terminal illness. As we look ahead to 2017, we are grateful for the support of our community. It’s going to be a busy and fulfilling year. Our goal is to stay on the path we have built this year. We plan to continue to grow and to provide excellent and compassionate care throughout this area. Update As you know, in 2015 the board determined that The Sanctuary project as originally envisioned was not a fiscally sustainable model. While it was not the decision we had hoped to make, we believed that our fiduciary responsibility required us to look for a model that would not imperil the core mission of LAVNS to deliver the highest quality home health and hospice services to this community. In the past year we have had further corroboration that the free-standing inpatient hospice house model is increasingly untenable nationwide. The National Hospice and Palliative Care Organization (NHPCO) is the pre-eminent national organization in the hospice world. Recently they published an opinion on the future of inpatient hospice in a dramatically changing healthcare climate. They said that a number of years ago the "common wisdom was that while hospice inpatient facilities were unlikely to break even on the basis of their operating revenue, they nevertheless fulfilled a need for patients and families. In addition, they were seen as visible symbols of service to the community . . . ." That was the climate in which LAVNS's Sanctuary project was born. NHPCO goes on to say "How times have changed!" That model is no longer feasible in the current healthcare climate. They attribute the dramatic changes to the "transformed environment for compliance oversight and increased scrutiny of general inpatient (GIP) level care." The GIP reimbursement is much more generous than other levels of hospice reimbursement for home care or nursing home care, but is being drastically restricted. Without that increased level of reimbursement, the hospice house model is simply not fiscally sustainable. In other words, the Medicare and Medicaid reimbursement formula has changed dramatically, and hospices with inpatient beds are struggling nationwide. Many are closing. These findings are compatible with what the LAVNS board of directors found during our assessment last year, and we have diligently pursued a feasible, sustainable alternative. In that spirit, LAVNS and our partners, Mariposa Senior Living, continue to move toward completing the sale of a portion of the lot for Mariposa's facilities. The contract is expected to be finalized early next year. Currently, a Letter of Intent to sell has been approved by both parties. Mariposa is moving ahead expeditiously on the design of the first phase of their project. The LAVNS Board is pleased with the collaborative attitude of our partners and the potential for broader services to the community that the synergies of our respective core competencies present. A Mariposa/LAVNS non-compete clause is included in the contract. As you can see, 2016 has been a busy and productive year for LAVNS, and we look forward to continuing growth and excellence in 2017. We are grateful for your support. If you have questions or comments please feel free to contact us (505) 662-2525.

Sincerely,

Rosemary Coyne, MSN, RN Joyce Davidson Executive Director President, Board of Directors

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Los Alamos Visiting Nurse Service
2202 Canyon Road
Los Alamos, NM 87544
(505) 662-2525

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