title: Driving change versus reacting to chaos: one VNA's story.
abstract: Fluctuations in the current home care environment--increased competition, reimbursement reforms, and the impact of managed care--are a source of anxiety for many providers. One VNA carved a strategic plan for itself despite the chaos, motivated by a desire to lead rather than be led.
authors.affiliation: M.R. Weiser & Co. LLP, NY, USA.
authors.forename: D
authors.initials: D
authors.lastname: Dorsky-Flynn
authors.forename: O M
authors.initials: OM
authors.lastname: Keenan
mesh_terms: D003152:Community Health Nursing; D004465:Economic Competition; D018574:Home Care Agencies / Q000191:economics / Q000458:organization & administration / Q000639:trends*; D007591:Joint Commission on Accreditation of Healthcare Organizations; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration; D009518:New York; D015279:Organizational Culture; D010934:Planning Techniques; D012051:Reimbursement Mechanisms; D014481:United States