Where Most Needed

The Vermont Assembly of Home Health Agencies is appealing to the Vermont Supreme Court to overturn a grant of a certificate of need to the for-profit Professional Nurses Service of Winooski.  Until now, the 12 nonprofit home health agencies have been the exclusive providers of home health care in the state. 

The argument is a simple one: the for-profit claims that people are not being adequately served, while the nonprofits say that for-profit competitors will take away the easiest-to-serve clients, leaving them unable to survive, since currently they are required to serve all in need in their respective geographical areas. 

The home health business is large enough to attract attention from would-be for-profit ventures.  The twelve nonprofit agencies have a combined revenue of over $90 million and employ over 2,000 staff, from their Form 990 reports (eleven of the twelve were found; the twelfth may be under a different name or organized under a different section).  A summary of the Form 990 data is here (PDF, 68 Kb), showing for each agency the revenue, director compensation, total administrative staff compensation, and number of staff. 

Here are the agencies:
VNA of Chittenden and Grand Isle Counties     EIN 03-0179603  Form 990
VNA and Hospice of Vermont and New Hampshire  EIN 03-6006494  Form 990
Central Vermont Home Health & Hospice         EIN 03-0186089  Form 990
Rutland Area VNA & Hospice                    EIN 03-0185024  Form 990
Franklin County Home Health Agency            EIN 23-7076401  Form 990
Addison County Home Health & Hospice          EIN 23-7032401  Form 990
VNA and Hospice of SVHC                       EIN 03-0302664  Form 990
Orleans, Essex VNA & Hospice                  EIN 23-7418021  Form 990
Lamoille Home Health & Hospice                EIN 03-0224616  Form 990
Manchester Health Services                    EIN 03-0182056  Form 990
Dorset Nursing Association                    EIN 03-0217139  Form 990
Caledonia Home Health Care & Hospice          (Not Found)    

The trend toward for-profit home health seems to be widespread.  Here is a story from West Virginina about the sale of a nonprofit home-health agency operated by Highland Hospital Association (EIN 03-0185024 Form 990).  In this case, the selling organization focuses primarily in mental health care, and the sale of the visiting nurse subsidiary will finance other expansion. 

It also looks as though all this activity remains a bit under the radar.  An article from the 2001 Home Health Care Services Quarterly reported that there have been few studies that compared the performance of for-profit and nonprofit home health care.