The Vineyard Nursing Association has signed an agreement to sell its operations to a large Cape Cod health care consortium.

In an announcement Wednesday morning, Cape Cod Health Care announced that the Visiting Nurse Association of Cape Cod which it owns has entered into an agreement to acquire the nonprofit which is the sole Medicare-certified home health care agency on the Vineyard and also operates on Nantucket.

A regional health system, Cape Cod Health Care owns the Cape Cod and Falmouth hospitals, an array of health centers across the Cape and the visiting nurse association, among others. The consortium has more than 450 physicians and 4,600 employees.

“The stellar reputation and top quality services the VNA of Cape Cod provides make it a good fit for Martha’s Vineyard and Nantucket,” said Vineyard Nursing Association board chairman Michael Goldsmith in the announcement. “We are confident that patients and members of the community will experience the same high level of services they have received from the Vineyard Nursing Association for the last 30 years. The VNA of Cape Cod is, like us, a community-based operation, but also has the experience and the resources to address changes in the rapidly evolving home care market, as well as the financial wherewithal to insure quality care on the Islands for the long term.”

Terms of the agreement include a review of Vineyard Nursing Association’s assets and operations and the completion of regulatory filings and procedures, the release said. The plan calls for VNA of Cape Cod to acquire the Island nonprofit’s unrestricted assets, including its Vineyard Haven building.

“Once the transaction is complete, the VNA of Cape Cod will also assume management of Vineyard Nursing Association and will conduct an operational review and assessment of the business,” the release said. The sale price was not disclosed.

“Our VNA team provides high-quality, evidence-based care to home health and hospice patients in our region,” said Michael Lauf, president and CEO of Cape Cod Healthcare, in the announcement.

“Island residents can now look forward to the same level of services our team provides in the other 29 towns in our service area.”

If the agreement is completed, it will leave the Vineyard with no Island-owned home health care agency for the first time since visiting nurse services began in the 1940s.

VNA leaders announced late last year that the agency was facing dire financial straits and was on track to end the year with a large and unsustainable operating loss. A series of cost-cutting measures went into effect in late November, including administrative pay cuts among senior managers, reduced hours for administrative staff and limited layoffs.

A decline in patient census and reductions in Medicare reimbursements along with changing requirements for home health agencies were blamed. Some 63 per cent of the revenue at the VNA comes from Medicare, the federal health care provider for people over the age of 65. That population group is already significant on the Vineyard and projected to increase dramatically in the next decade.

VNA leaders said at the time they were simultaneously seeking to raise more money and exploring possible partnerships with other agencies.

Beyond Medicare, VNA also receives a mix of funding from private insurance and private pay, the elder service program and Island boards of health.

The agency expanded its services to Nantucket two and a half years ago and bought a new $2 million office building in Vineyard Haven last year. This year the agency has seen a 30 per cent decline in its patient census, with fewer referrals coming from the Martha’s Vineyard Hospital.

“We are struggling,” chief executive officer Robert Tonti told the Gazette for a story in November.

The home health agency has no endowment and no free care fund.

The annual operating budget is about $5 million; there are 90 employees.

There are currently 12,000 home health care agencies in the U.S. and Medicare has a stated goal of cutting that number in half.

“It’s complex,” Mr. Tonti said at the time. “We will have home care on Martha’s Vineyard. It just may look a little different in the future.”