2022 Avow Annual Report

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PG. 1

2022

Annual Report to the

Community

Weathering

the Storm with

Compassionate Care

Dear Friend of Avow,

As we continued to navigate the COVID-19 pandemic, a national nursing

shortage and a potential recession in 2022, none of us expected to also

face the wrath of a Category 4 hurricane slamming into our shores.

Despite the devastation and disruption Hurricane Ian unleashed within

our community, Avow stood strong, rising to meet the unprecedented

challenges with unwavering compassion, collaboration and innovation.

In fact, despite all of this adversity, we experienced more admissions and

referrals to our programs in 2022 than at any point in our nearly 40-year

history while also increasing our CAHPS quality scores and enhancing

Frances Georgeson Hospice House facility through completion of a new

family café and pavilion.

This tremendous success in the most daunting of times is a direct

testament to the dedicated people who drive our organization — staff,

volunteers and donors alike. Even as many faced personal losses and

challenges, our team persevered, providing uninterrupted care to our

patients and families. Within hours of the storm’s passing, recovery

teams were deployed to ensure our approximately 600 hospice and

palliative care patients were safe and accessing adequate resources despite

power outages and evacuations. A donation center was established to

collect essential supplies such as clothing, cleaning supplies, personal care

products, food and water. An online giving page was launched to solicit cash

and gift card donations, and meals were delivered to those without power,

transportation or food.

Thank you to everyone who made it possible for us to continue our mission

of delivering compassionate care for the Collier community! From filling

sandbags to ready our campus before the storm to walking up flights of

stairs with oxygen tanks and batteries to reach patients without power

in high-rise condos, our Avow team remained steadfast and maintained

seamless operations. As we celebrate our 40th year of service in 2023, this

devotion and drive coupled with your support will continue to propel us

forward, ready to meet any new challenges that lie ahead.

Jaysen F. Roa

President & CEO

Avow Companies

Chuck Hoffman

Board Chair

Avow Companies

PG. 1

Hospice Care

Providing Compassionate Care and

Support for Those Living with

a Terminal Illness

PG. 2

In addition, to enhance patient care and gain economies of scale, Avow

partnered with Treasure Coast Hospice, St. Francis Reflections Lifestage

Care and Haven Hospice to form Synthase Collaborative — a not-

for-profit alliance to unite hospice, palliative and post-acute care

organizations across Florida. While each organization will retain

autonomy and independence, this strategic partnership allows all four

mission-driven organizations to share best practices, optimize resources

and reduce costs. This includes strengthening Avow’s position to

negotiate with insurers as new value-based payment models emerge. All

together, Synthase Collaborative cares for an average of 2,200 patients

daily and provides care and services to more than 18,000 adults and

children annually across 23 counties in Florida.

“Avow was my saving grace. The Avow team

created a loving presence in our home. I never

felt alone; I knew I could call Avow at any minute

and get help and support right away. Avow lived

up to its mission for George and me: they really

did create peace of mind for both of us.”

— Marilynn, Caregiver

Despite all of the challenges of the past year, Avow was also able to

complete two new facility enhancements:

• Located in the hospice house, Paula’s Place family café serves patients,

their families and Avow staff, providing families a place to sit and enjoy a

meal together prepared by our chefs.

• The Nichols Pavilion, a large outdoor atrium, provides shade and

outdoor space for staff and family to take a break and relax.

In 2022, Avow once again set new records for referrals and admissions — evidence of the trust the community places in our organization. Even

during Hurricane Ian, our team was able to provide uninterrupted care to patients thanks to a large-capacity generator that allowed staff to triage by

phone when it was no longer safe on the roads. We were even able to help neighboring hospices that had lost communication during the storm.

Hospice Care by the Numbers

20,740

In Hospice House/Hospital:

140,789

Total # of Patient Days:

9 Days

Median Length of Stay:

83 Days

Average Length of Stay:

386

Avg. # of Patients

Cared for Each Day:

2,360

Number of Admissions:

Admissions and Stays

4,469

41,110

8,792

7,008

24,586

3,446

1,578

70

Physician/Nurse Practitioner

Nursing

Social Work

Chaplain

Home Health Aide

Massage, Reiki, Manual Lymph Drainage

Music Therapy

Art Therapy

Patients by Level of Care

Routine Home Care: 1,852

General Inpatient (Hospice House): 1,130

Continuous Care (Where the Patient Lives): 232

Respite Care: 6

Visits by Discipline for Hospice Care

In-person, Phone and Virtual visits

57.6%

35%

7.2%

0.2%

PG. 3

PG. 4

Hospice Care by the Numbers

Top 5 Admitting Diseases Types

Cancer: 637

Circulatory/Pulmonary/Heart: 389

Heart Disease: 228

Neurological (Alzheimer’s Parkinson’s): 103

COPD: 99

43.7%

26.7%

15.6%

6%

8%

Referral Sources

Hospital: 1,121

Physician: 423

Self/Family: 342

Nursing Home: 307

Other: 167

7%

48%

18%

13%

14%

Salaries/Benefits, Occupancy Costs,

Supplies and Services, Professional

Services, Uncollectible Debt,

Miscellaneous

Expenses

$29,312,090

Palliative Care

Delivering Personalized Care and

Comfort to the Seriously Ill

PG. 5

“If I had to describe Avow’s palliative care service in

one word, I would choose ‘easy.’ When I call, the helpful

receptionist almost always can get me to the nurse

practitioner right away, and she is easy to talk to and

just as devoted to making me emotionally comfortable

as she is to relieving my physical symptoms. I wish my

prognosis was different, but I am at peace with where I

am and with the treatments I am receiving from Avow’s

palliative care service.” — Jan, Palliative Care Patient

“The nurse learned more about Arthur in one session

than other physicians had in seeing him over many visits.

She also listened to my needs and concerns and came

up with a plan that helped us both. Do you know how

rare that is in healthcare these days, to have unrushed,

personal time with medical professionals? It’s not an

exaggeration when I say that Avow’s palliative care

service saved two lives: mine and Arthur’s. Life is so

much better now.” — Beverly, Caregiver

Demonstrating a commitment to quality care, Avow also became the

first and only palliative care program in Florida to earn certification

from CHAP (Community Health Accreditation Partner), an independent,

non-profit accrediting body for home and community-based health

care organizations. To achieve this three-year certification, our program

was extensively evaluated against nationally recognized palliative care

standards.

In addition, to help meet the gap in overall palliative care program costs

not reimbursed by Medicare, Medicaid and private insurance companies,

we launched the Avow Compassionate Care Society in April 2022. This

group of community philanthropists have committed to give a minimum of

$10,000 annually to support non-hospice palliative care in Collier County.

Dedicated to alleviating the physical symptoms and

emotional distress of individuals living with serious

illnesses such as cancer, heart disease, lung disease and

kidney failure, Avow’s Lyon Center Palliative Care Clinic

continued to expand and innovate in 2022 to meet the

community’s growing needs, serving the most patients

in our organization’s history.

Expenses

Salaries/Benefits, Occupancy Costs,

Supplies and Services, Professional Services,

Uncollectible Debt, Miscellaneousneous

$659,119

Palliative Care By the Numbers

1,134

273

146

25

Physician/Nurse Practitioner

Social Worker

Chaplain

Massage

Visits by Discipline for Palliative Care

In-person, Phone and Virtual visits

PG. 6

Where Palliative Care

Took Place in Total Visits

Lyon Center Palliative Care Clinic: 636

Home: 610

Virtual: 172

Facility: 82

41%

5%

12%

42%

Number of Patients

614

Total Number of Visits

1,578

Bereavement

Helping People Cope with

Grief and Loss

To better customize support to meet individuals where

they are in their grief process, Avow implemented a new

research-based, integrative model of change into our

Center for Grief Support in 2022.

“Avow cared about the family

and about me, and how was

I doing after she had passed.”

Chris, Bereaved

Each small group is guided by professional facilitators and

meets weekly for four weeks. At the end of that period,

individuals may repeat the current module or continue on

to the next module in the program if they are ready. Group

programs are free to the community and hosted in the Center

for Grief Support and at other community locations. One-on-

one support is also available.

Precontemplation

Unaware of the problem

Contemplation

Aware of the problem &

desired behavior change

Preparation

Intends to take action

Action

Practices desired behavior

Maintenance

Works to sustain desired

behavior change

Stages of Readiness

to Change

PG. 7

The Bereavement Team held

a Thanksgiving dinner for those

missing their loved one.

PG. 8

Bereavement Sponsors

Salaries/Benefits, Occupancy Costs, Supplies and

Services, Professional Services, Uncollectible Debt,

Miscellaneous

Expenses

$322,060

Grief Support

by the Numbers

Individual

Sessions (virtual

and in-person)

450

New Groups

Started

32

Total Groups

for 2022

919

Approximate

Unique Individuals

Served

1,600

Avow Kids Grief Support

by the Numbers

Expenses

Salaries/Benefits, Occupancy

Costs, Supplies and Services,

Professional Services,

Uncollectible Debt, Miscellaneous

$357,004

Grants, Donations

& Other Funding

$214,000

®

Supporting Children

Through Loss

For nearly 40 years, the Avow Kids® program has

helped children ages 5-17 move through their unique experience

of loss in a safe, supportive environment. As the community need grows, we

remain committed to offering a variety of grief support services at no cost to participants,

including individual and family counseling, group therapy, workshops, camps and events.

“While no one else had lost a little brother like me, it was easy to see that everyone

in the group shared the same kind of difficult feelings. There were lots of activities to

bring us together, including times to share our feelings and to write our own group song

about our experiences. It was perfect for me — I felt understood and not alone, like I

wasn’t the only person to feel sad and lost.”

— Mark Coe, Jr., Avow Camp MendingHeart® Teen Attendee

PG. 9

352

Unique

Youth

Participants

Served

261

Youth

Support

Group

Sessions

40

Youth

Camps

or Events

926

Youth

Participants

Groups, events,

one-on-one

The Avow Kids team served more children in 2022 than ever

before. In addition to coordinating field trips and activities

throughout the year, we hosted several community events to

support children who have experienced loss, including the following:

Our annual

Mother’s Day Dinner

was held on May 6 to provide

children with a safe space to

honor their deceased moms

and to celebrate the mother

figures in their lives.

To bring cheer to

the community at the end

of a difficult year of great loss,

we held our Winter Festival on

December 20. More than 300

parents and children came out

to enjoy holiday crafts, music,

cookies and outdoor games

along with gifts from

Santa.

Avowloween

was held October 21 on the

Avow campus and featured a “trunk

or treat” as well as Star Wars characters

courtesy of the Everglades Squad Legion

and a North Collier Fire Control fire truck.

The children also enjoyed games, face

painting, a photo booth and a visit from

Nugget the mini horse. We collaborated

with local school counselors to promote

this fun family event, and more than

210 kids ages 17 and under attended.

Supported or Sponsored

in Part By:

PG. 10

In addition to individual donors, the following companies and

organizations generously supported Avow Kids in 2022:

Marco Lutheran Church

Sidney A. Swensrud Foundation

Shoen

Foundation

Partners in Care (PIC)

Providing Support for Children

with Complex Conditions

Demand remained high in Collier County for the specialized care available

through Avow’s Partners In Care: Together For Kids pediatric palliative care

Medicaid waiver program. The children participating in this special program

have congenital and/or chronic disease conditions with complex medical,

psychological, spiritual and motor skills needs. The children are primarily

serviced through the state’s Children’s Medical Services, supplemental to

other care they receive.

This program served 21 children in 2022 who received direct care, while

many of their family members received supportive care. The children had

planned art and music therapy sessions to address specific aspects of their

individual and unique disease process. Avow’s board-certified music and art

therapists worked with the children to improve verbal and non-verbal skills,

regulate emotion, learn coping skills for relaxation and improve motor skills

for a better quality of life.

$32,001

PIC Patients

21

PIC Care Sessions

486

PIC Support

Expenses

Salaries/Benefits,

Occupancy Costs,

Supplies and Services,

Professional Services,

Uncollectible Debt,

PG. 11

Honoring

Veterans

Serving Those Who Served Our Country

PG. 12

We continued our efforts to honor and serve Southwest Florida military

Veterans in 2022. More than 1,200 Veterans were pinned and honored

throughout the year. In addition, the documentary film Avow Presents: Life

Lessons in the Military, produced by the Avow Communications Department

in 2021, won two prestigious Telly Awards in 2022 as well as an Award of

Distinction in the 27th Annual Communicator Awards. The film highlights

the stories of 17 Veterans from various generations and backgrounds,

including Avow employees and volunteers, and was filmed on the Avow

campus

I

n 20

22,

26.5

% (6

04)

of o

ur h

osp

ice patie

nts w

ere V

eter

ans

Employee

Advancement

Promoting Professional Growth

and Development

As Avow employees stepped up to meet the unprecedented challenges of 2022, our

organization continued to invest in their professional growth and development.

In addition to our existing tuition reimbursement program, we launched a new Avow

Nursing Scholarship Program to assist employees with advancing their education in

the field of nursing while also improving staff retention and clinical expertise. Thanks to

the generosity of donors during the Avow Foundation 2022 Nurses Week campaign, this

new scholarship helps to support our employees enrolled in nursing degree programs. In

October, we awarded the first scholarship to Ashley Russetto, APRN, who is pursuing her

doctorate degree in nursing.

Avow won two of eight Awards of Excellence during the Florida Hospice & Palliative

Care Association (FHPCA) Forum in Orlando in June:

• The Hospice Story Award recognizes a person or organization that best captures a

meaningful hospice experience with an original creative work. Avow board-certified music

therapist Jillian Iurlano worked with patient Jodi Allen to turn a prayer she had written into

a song and music video as a gift to her family before her passing.

• The Synergy Award recognized employees in the Frances Georgeson Hospice House,

Patient Access, Treasures and Communications Departments for collaboration between

the interdisciplinary teams and administration, including a special wedding held for an Avow

hospice patient as well as efforts to help young parents celebrate moments with their

month-old baby before she passed.

PG. 13

Community Recognition for

Avow Founder Glenna Hayhoe

PG. 14

In November, the Association of Fundraising Professionals (AFP) Collier-Lee

Chapter honored Avow founder Glenna Hayhoe as its 2022 Outstanding

Philanthropist and Avow Veteran Volunteer Jessica Stearns with

Distinguished Volunteer during its National Philanthropy Day celebration.

In December, Glenna was recognized by The Women’s Foundation of Collier

County as a Woman of Initiative at its Women Rock Philanthropy luncheon.

The award honors dynamic women who have helped change the community

through their passion, leadership, innovation, time, talent and dedication.

Motivated by a passion for caring for those at the end of life, treating each

person with dignity and respect, and not allowing anyone to die alone, Glenna

and her late husband Bruce started Avow in 1983. At age 91, she continues

to volunteer regularly, epitomizing the heart of hospice and inspiring our

staff and volunteers alike.

Our dedicated team of Avow volunteers rose to meet the challenges of 2022,

contributing 5,305 direct patient engagement hours and 4,195 non-clinical

hours—significant increases over 2021! These dedicated members of the

Avow family selflessly support their Collier neighbors during difficult transitions,

providing comfort and companionship. They also lend a hand in our offices,

retail shops and at special events.

*Calculated using https://independentsector.org/resource/value-of-volunteer-time/

If you are interested in

volunteering at Avow, visit

avowcares.org/volunteers

or call (239) 261-4404.

New Volunteers

Added

50

Active

Volunteers

108

Volunteers By

the Numbers

Direct Patient

Hours

5,305

Non-Clinical

Hours

4,195

Estimated savings

through volunteer work

$156,237.64*

PG. 15

VOL

UNT

EER

S!

Gross

Revenue $868,909

Each year, our Treasures Resale Shops contribute much

needed revenue to the Avow Foundation, helping Avow provide

hospice care, palliative care, adult and children’s bereavement services, and Veterans

services for anyone in the community, including those who cannot pay for care.

In 2022, we closed the Davis Boulevard and Park Shore Treasures stores and opened a new, larger North Naples

Treasures store located at 9765 Tamiami Trail North in the Naples Park neighborhood. In addition to providing expanded retail

space, the building has two apartments, which we will use to provide affordable housing for staff, including both permanent full-time

staff as well as seasonal traveling nurses that help address area health care staffing shortages.

Transactions 24,897

PG. 16

For information on donations or to volunteer, visit avowtreasures.org

Avow Foundation

Donors Continued to

Deliver in 2022

When Hurricane Ian ushered in unimaginable devastation throughout

our community, Avow’s loyal supporters immediately answered the call

for help:

• Twenty donors gave more than $3,000 in in-kind gifts, including gift

cards, appliances and goods delivered to our donation center.

• Tamiami Hyundai/Ford donated two vehicles valued at $44,714

— a minivan for Avow Kids and a small SUV that was used during the

hurricane by staff who had been flooded out.

• In all, more than 50 individuals and organizations donated

cash totaling $31,107, with gifts ranging from $25 to $10,000.

In addition we officially opened The Nichols Pavilion in

2022 — a large, shaded outdoor atrium designed to provide

a place of respite for our hospice house families and staff.

The new Paula’s Place family café located inside the hospice

house also opened in 2022 and was made possible by the family

of Paula M. Flanagan.

“When Avow President & CEO Jaysen Roa heard about my situation,

he invited me and my family to move into one of the two apartments above the

Avow Treasures resale shop in Naples. Until Hurricane Ian, I had never had to

worry about having a roof over my head or a safe place to live. Avow’s stepping

in to give my family a home meant so much to us. That single act of generosity

exemplifies the spirit of our corporate culture – and its heart. That can’t be

bought at any price. I thank those who supported Avow during this time of

difficulty.” — Suzanne Parsons, Avow Human Resources Director

PG. 17

62%

1.5%

1.5%

6%

30.5%

Total Giving $4,290,758

Private contributions: $2,658,433

(Individuals, DAFs, Family Foundations)

Planned Gifts Realized: $1,308,821

Institutional Grants: $257,500

Corporate Partners: $66,004

Foundation Funding

Sources

PG. 18

Expenses

Salaries/benefits, supplies, programs,

professional services, uncollectable debt, misc.

$32,048,453

2022 COVID

Expenses

$224,104

Total

Expenses

$32,272,557

“Because of Avow’s assistance during Hurricane Ian, I was able to deliver care to those who really needed us without the worry over my

own vehicle. I am thankful that Avow treats me with the same kind of care we offer patients. It’s a circle of loving support that winds

throughout the organization. Thank you to the donors who supported Avow during this time.”

— Phil Justice, Avow Lead Home Health Aide/Certified Nursing Assistant

How to Donate

Volunteer or Choose to Donate

Not-for-profit hospices are required to have a percentage

of care hours provided by volunteers. When you volunteer

with Avow, you can make a difference in the lives of

our community members in Southwest Florida who are

going through one of life’s most complex transitions. Lend a

hand in Avow’s clinical operations, offices, retail shops or at

special events.

$650

Funds art therapy/

music therapy/

massage therapy/Reiki

treatments for one

hospice patient

Complementary Therapies

$750

Purchases 30 essential

oil kits for home

health aides to deliver

aromatherapy services

$1,250

Provides 10 visits

from complementary

therapies staff

Center for Grief Support

Funds adult support group meeting space for

10 sessions in the Center for Grief Support on

Avow’s campus

$250

Enables five monthly virtual memorial

ceremonies to come to life

$500

Provides 100 hours of group or individual

support to bereaved persons

$5,000

PG. 19

Funds seven days of

end-of-life care for

a patient

without insurance

$1,250

Funds publishing of

2,000 copies of Veteran

benefits and resources

for Hospice and

Palliative Care

$5,000

Hospice Program

Giving Opportunities

Purchases supplies for

ten Veteran salute kits.

650 kits are distributed

annually

$500

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