July 12, 2018

VNA Care eliminating newborn home visits, 14 positions

Photo/Grant Welker
VNA Care's Worcester headquarters. The company is eliminating at-home visits by nurses to newborns and their families, raising concerns by some.

VNA Care, a Worcester-based nursing agency, is eliminating at-home visits by nurses to newborns and their families amid a drop in reimbursement from insurers.

By the end of July, more than a dozen maternal child nurses who care for 500 or more newborns across the area each year will be reassigned to other patients. Newborns and their families will instead be cared for in medical offices.

"The reimbursement for the program was not meeting the needs. It wasn't covering the costs of the visits," said Holly Chaffee, the president and CEO of VNA Care.

VNA Care, which has more than 1,250 employees treating patients statewide, will continue caring for newborns until they phase out of the system, Chaffee said. Newborns are cared for by maternal child nurses until they reach four months, she said.

The change by VNA Care will eliminate the jobs of about 14 nurses, who have been offered other positions in the company, Chaffee said.

The decision was unwelcome news to Lawrence Rhein, the chief of neonatology at UMass Memorial Medical Center.

At-home care for newborns is critical, Rhein said, especially for those who may be at risk of not gaining a healthy amount of weight or for parents who may have questions for how to work medical equipment to help care for their baby.

"We're sending kids home who are very fragile," Rhein said. "It's an underappreciated service for families."

At-home care is important for sparing families caring from a newborn from having to travel to a doctor's office, Rhein said, instead of a visiting nurse who might stop by two or three times a week to check on a baby's blood pressure, for example.

UMass Memorial Medical Center, which discharges around 650 newborns each year, was notified of the change to drop the service at the end of the month.

"I'm sympathetic to companies that need adequate reimbursement, but short-term, I think it's something that I wish all of us had more notice for other solutions because it has a big impact on how we deliver care," Rhein said. "We're scrambling for solutions."

One registered nurse, Lisa Moore, said the staff began hearing in late May that the maternal child care program would be coming to an end. While visiting families at home, Moore said, she has come across some cases worrisome enough that she's contacted the Department of Children & Families.

"Possible risks at home can't be evaluated at home unless you're in the home," she said.

Moore, who has been with VNA for 18 years, said she and others don't want to take jobs caring for other patients.

"We are passionate about being pediatric nurses," she said. "That's our area of expertise."


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