UR Home Care has long history of service

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UR Medicine Home Care has had 10 leaders during its first century. More remarkable is the fact that each of those leaders has been a woman.

“As women we do such a great job,” laughed Jane Shukitis, the organization’s CEO.

Most recently known as Visiting Nurse Service of Rochester and Monroe County Inc., UR Medicine Home Care was founded as the Public Health Nursing Association in downtown Rochester in 1919. PHNA was the first home health care agency in the county and was started as a result of the region’s flu epidemic of 1918, which acknowledged the need for a visiting nurse service organization.

“It was recognized that there wasn’t enough capacity in the small, local hospitals, so the community came together and decided that they really needed to have a program that sent healthcare workers, i.e. nurses, out to the homes to help these families,” Shukitis explained. “A lot of the early work was helping children and families in their homes.”

The past

The service grew during the first half of the 20th century and began to emphasize maternal/child health, nutrition, public education and care for victims of flu and polio. The United Way of Greater Rochester Inc., then known as the Community Chest, began funding the agency, paving the way for substantial growth in the 1930s. The Great Depression had increased the number of patients who could not pay for services.

Growth continued throughout the 1940s and 1950s, particularly as businesses began to pay for their workers’ health care. PHNA became Visiting Nurse Service in 1940.

In 1958, VNS began its Meals on Wheels program, delivering meals to just 25 clients in its first year. Last year, Meals on Wheels delivered 200,000 meals to nearly 1,400 individuals and families in the region. The organization has delivered 11 million meals in Rochester since its inception, and is the third oldest such service in the U.S.

VNS has since added physical therapy services, a home health aide program, occupational and speech therapies, cardiopulmonary, pediatric and infusion therapy programs. The initiation of Medicare and Medicaid programs made funding available for home health agencies for the poor and elderly.

During the 1980s, VNS opened a second location in Greece and created Community Care of Rochester (CCR), a for-profit licensed agency to provide private duty nurses and community health nurses to fulfill staffing and case management needs.

By the 1990s, VNS had moved its headquarters five times, eventually landing at its current location on Empire Boulevard. In 1993, VNS established VNS Friends at Westfall, an adult day services program. The agency also launch a flu vaccine program and in 1995 introduced its HIV/AIDS program, a comprehensive health service that helps individuals diagnosed with AIDS live comfortably and safely in their own homes.

In 1997, VNS announced an affiliation with UR’s Strong Health, which became official in 1999. When Medicare implemented its prospective payment system for all home care providers, requiring a number of operational changes, VNS and CCR moved closer together as CCR converted to a not-for-profit.

During the 1990s, VNS also started a hospice program, one of the first in Rochester.

“It’s really a holistic, complete program that helps families deal with the end of life through support services, not only nursing, physician and pain management, but it’s also bereavement and spiritual care, counseling (and) ongoing bereavement support after the person has passed away,” Shukitis explained. As part of its continuum of care, VNS offers that service in Monroe, Ontario and Yates counties.

The new millennium brought with it the launch of VNS’ telemedicine program to benefit heart failure patients. The Daisy Marquis Jones Foundation awarded VNS a grant to support the agency’s Paraprofessional Career Ladder Program, while a partnership with Monroe County enabled the launch of the Nurse Family Partnership Program.

The present

In the most recent decade of VNS’s storied history, the organization became affiliated with Finger Lakes Visiting Nursing Service, expanding coverage from one county to seven, Shukitis noted. A few years ago the agency officially rebranded as UR Medicine Home Care, creating closer direct ties to URMC.

“One of the reasons why we wanted to make sure our name had a larger scope to it is because we’re not just a visiting nurse,” Shukitis said. “We are healthcare at home. And we bring the excellence and the medicine of the highest order of our university parent and our university partner into the home setting.”

Although UR Medicine Home Care provides many services, Shukitis said that the “heart of who we are and what we’ve been for 100 years is home health care.”

“That is primarily nursing and therapy and personal care assistance to people in their homes with all levels of complexity and need,” she explained.

Many years ago, Shukitis said, the agency provided basic nursing care like dressing changes and therapy through typical exercise programs.

“Now we are very sophisticated in the complexities,” she said. “The kinds of patients we take care of today are the same kinds of patients that were in acute care hospitals 10 years ago. These are the folks we’re caring for in the home.”

Today’s patients are on ventilators in their homes, have home infusions of long-term antibiotics or chemotherapy or nutritional supplements. Patients often are fragile; Congestive heart failure and diabetes are common and need close monitoring.

Most of UR Medicine Home Care’s patients are referred to the agency by doctors or following a hospital stay.

“Most of what we do is short-term, usually between 30 and 60 days,” Shukitis said. “The nursing piece is the core to help get people better and back to the baseline and then they’re discharged.”

With the growth of the organization’s offerings came the need for more workers. UR Medicine Home Care has some 720 staffers, 200 of whom are nurses, 115 therapists, 170 home health aides and 20 social workers.

“On any given day across the seven counties we’re taking care of 1,500 people for primary core services,” Shukitis said. The organization made more than 172,000 visits for its certified home health care agency in 2017.

UR Medicine Home Care has more up its sleeve. The organization has started a foundation to enhance the function of fundraising, advancement, development and expansion, said foundation board chairwoman Fran Weisberg.

“The mission of the new foundation is to have a more strategic focus and to have a very deliberative plan,” said Weisberg, former Lifespan of Greater Rochester Inc. president and CEO, who also led United Way for more than two years. “Now is the moment, in the whole healthcare world, to really focus on the needs of elders, their caregivers and other people who need these services.”

Weisberg, who has worked with and known Shukitis for three decades and herself has a passion for aging and long-term care, said she believes that most older adults want to stay in their own home.

“With the aging of the population and more people wanting to stay at home,” she said, “now is the moment for UR Medicine Home Care to thrive and expand.”

The agency has been known for its innovation, Weisberg added, and with the new foundation will continue to develop innovative ways in which to help people age in place.

“We want to expand services for both the older adult and their caregiver,” she said. “And it’s up to us to create the innovation to make sure the services of the future meet the needs of the aging population.”

The future

With its UR affiliation and the ability to access experts, technology and information, UR Medicine Home Care has chosen to add pediatric care into the mix.

“We’re going back to our roots in that we’re launching a pediatric home care program in partnership with Golisano Children’s Hospital,” Shukitis explained. “As a system affiliate of the University of Rochester, one of the large components of patients served is pediatrics through Golisano Children’s Hospital.”

Although UR Medicine Home Care for some time served children, the service was halted about a decade ago in order to focus on adults, Shukitis noted.

“But today, as we continue to change and evolve and think about how do we meet the needs of the community and align our services with the University of Rochester Medical Center, we believe that going back to pediatrics is the right thing to do,” she said.

Janine Merville will serve as associate director of pediatrics for UR Medicine Home Care, which is expected to move forward this fall. The pediatrics division will serve children who are not already affiliated with another home care service in Rochester, Shukitis said.

“We’re going to be starting with what we call NICU graduates, so the children who are graduating out of the neonatal intensive care unit, and children who are coming out of the hospital with more short-term needs,” she added. “Our vision is to create a comprehensive program with services that meet the needs of all of the dynamics that happen within a family that has a seriously ill child.”

Shukitis’ vision for the program is to grow it to a point where the agency is serving other family needs such as transportation, sibling support, tutoring support, family counseling or spiritual support. As a result, she said, she expects the agency to grow its staffing over the next several years.

“As we continue to evolve we’ll continue to have new, innovative ways of providing care. The future of healthcare more and more is moving into the home, where people want to be,” Shukitis said. “It’s not our father’s VNS anymore. It’s a very highly sophisticated program of providing care at home.”

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