Marketing Plan of the Visiting Nurse Association of Omaha/Council Bluffs

Executive Summary 

Visiting Nursing Association (VNA) has become a crucial resource when it comes to the provision of health services and home care to the community members it developed to serve. The firm has a team of over three hundred healthcare professionals and nurses who ensure that the clients get the attention that they deserve at get the home rest so as to recover in the shortest time possible. VNA’s culture has always been to work with patients based on their ability to pay and provide them with health services and homecare to the community members that it has always been motivated to serve. The firm provides its services to the seriously ill people who are in need of palliative care. The firm’s products that are majorly the provision of medical services and drugs are given to the customers with the primary intention of getting them better even if they cannot get cured. VNA gets its products from the volunteers who buy from the store-based retailers, wholesale outlets, and direct form firms. Different promotional events such as price changes and communication influence the purchase behavior of customers of the firm in different ways. The advantage of the products and services of VNA relative to competing products is that the patients get the services and the products while at home. VNA’s main competitors are Alegent Home Health Services, Kindred Health Care, and Physicians Choice which are established healthcare providers with a strong brand. Kindred Healthcare is position four among the healthcare providers. 

II. Situation Analysis 

A. The Internal Environment 

Review of marketing goals and objectives 

With every decade that passes, Visiting Nursing Association (VNA) has become a crucial resource when it comes to the provision of health services and home care to the community members it developed to serve. Presently, the Council Bluffs and the VNA of Omaha are still recognized as the providers of home care because they have built trust in people. VNA was a community health voice one hundred and twenty years back, though presently, it portrays itself as the “Face of Care.” The organization’s marketing goals and objectives have always been to be at the forefront of providing compassionate care giving as well as innovative skilled health services. The organization strives at achieving its goals and objectives by improving the outcomes and coordination for the populace that get services from the providers of home-based care. The organization also intends to drive value and quality in the industry of home-based care. It also intends to be at the forefront of providing compassionate care by leading transformation and innovation in the industry of home-based care in a manner that will result in success. 

VNAA as a firm has the mission to promote innovation, value, and quality in home-based care. Its marketing objectives and goals of always being at the forefront of providing compassionate care giving and innovative skilled health services are consistent with its mission in the sense that innovation and quality in the services that they provide will always make them be at the forefront. The populations of the Americans continue to age as most sick people spend fewer moments in hospitals. Therefore, healthcare demand at home has been growing steadily. As such, the clinical staffs of VNA use the available modern technology to provide an all-inclusive quality care. The VNA services get reimbursement from the Medicaid, Medicare, and charitable contributions that are tax-deductible because the regions that they cover have enormously increased. 

Review of current marketing strategy and performance 

Visiting Nurses Association’s current marketing strategy is its devotion to upholding the independent life of the patients. The firm provides personal care services, companion, and a high quality homemaker to any person who is in need of additional assistance at home with the daily living. Additionally, VNA provides immunization and flu events to the sick people in the community. The firm also engages in projects that reach to the community such as senior conferences and community fundraisers that are conducted annually. VNA has a team of qualified care providers who are energetic professionals who care about developing a comfortable and independent environment that makes it possible for a person to enjoy quality life. The team’s aim is to ensure that the people whom they serve live lives that are easier as well as the lives that enable them to be at home while enjoying the highest independence level that is cost effective. The firm provides the needy people with a care provider who has the understanding and experience to support the person’s needs as well as those of his family members. From preparation of meals and light housekeeping, to medications, sitter services, dressing assistance, continence and toileting care, management of medication, and help with bathing, the firm’s care providers give assistance to people of all classes and ages. The firm assures its customers of its competence and professionalism by informing the customers that it has a team that is fully bonded and insured, well trained and screened as every employee has to undergo a thorough drug testing, physicals, and checks concerning their pre-employment background. The firm ensures the clients of its intention to create short and long term personalized homecare plan as well as a deigned schedule that reflects the clients’ needs, interests, and lifestyle. The strategy of providing multiple services to the individuals who are in dire need of such services has really worked well for the organization and has attracted many people to the organization. The performance of the firm has been steadily increasing as compared to the firms that offer same types of services because VNA is a non-profit entity that gets reimbursement from the Medicaid, Medicare, and charitable contributions that are tax-deductible. 

Review of current and anticipated organizational resources 

The Visiting Nursing Association has a team of over three hundred healthcare professionals and nurses who ensure that the clients get the attention that they deserve at get the home rest so as to recover in the shortest time possible. The agency’s professional team that provides the essential care to patients include Orthopedic, Oncology, Neurology, Mental Health, Medical Surgery, Infusion Pharmacy, Diabetic, Alzheimer’s/Dementia, and cardiopulmonary. Such health experts provide proficient homecare services in the areas that include skilled nursing, rehabilitation therapies, home health assistances, fall preventions, and nutritional advice. The future plans of the agency is to ensure that the proficient services for homecare lead the way for the future cohorts in shaping the specialty and nutritional care services, speech and occupational therapies, as well as the physical care services. The firm intends to recruit more medical professionals who can handle all types of illnesses that the clients suffer from in the society since most patients are currently leaving hospitals for homes because of the services that VNA offer free of charge. 

Review of current and anticipated cultural and structural issues 

VNA’s culture has always been to work with patients based on their ability to pay and provide them with health services and homecare to the community members that it has always been motivated to serve. Such services are provided by the firm to all patients regardless of their ages. Its experts also educate people on issues to do with promotional of health and prevention of diseases. Through the guidance of their charitable work, the firm offers its services to every Americans without any discrimination of any nature. Its intention has always been to ensure that every American gets the necessary support in terms of medical and emotional demands. The organization is not for making profit and is largely composed of volunteers who are headed by board of directors. It emphasizes on both short and long term plans of taking care of the patients. It is also notable that the firm and its professional team have regularly embraced change that the medical field requires. The firm extensively trains its experts on medical issues because of the continuous changes that occur in the medical fraternity. The marketing strategy of VNA is essential because of the fact that it lets the clients to be aware of the services that are provided by the firm. The general employee satisfaction and morale is positive because the employees believe the VNA mission stipulates that the staff should be passionate about their work, and thus a person joins the organization when he already knows what is expected of him. It is also imperative to note that the structure of the firm is supportive of the current marketing strategy. Its plan is to reach out to many patients through informing them of the services that are available and the team of professional that will attend to their needs. 

B. The Customer Environment 

Who are the firm's current and potential customers? 

The firm provides its services to the seriously ill people who are in need of palliative care. Such are the individuals whose illnesses are at advanced levels and the medications that they receive at the hospitals are no longer of any help to their ailing bodies. The firm does not focus on any particular region in the provision of its services as the entire sick residents of Omaha are entitled to treatment. VNA’s board of directors plays a crucial role in procuring the necessary medical materials that the medical experts need during their operation. Such materials may entail the drugs, gloves, food, needles, and syringes that are used during the provision of services. The bearers of the financial responsibility are the Medicaid, Medicare, and charitable contributions that are tax-deductible. 

What do customers do with the firm's products? 

The firm’s products that are majorly the provision of medical services and drugs are given to the customers with the primary intention of getting them better even if they cannot get cured. The firm provides multiple services that do not just entail medication such as light housekeeping, sitter services, dressing assistance, continence and toileting care, and management of medication. The services help the individuals who have been neglected by the members of their families or those who do not have relatives who can assist them. Volunteers and various charitable organizations buy products that VNA and the patients need. The products are purchased to be used by the medical professionals in a manner that can provide long term solutions to the patients in the possible scenarios while some services and products are given to the patients just as complements. There are no other factors other than the vital needs of patients such as need for food and drugs that influence the purchase behavior of the firm. VNA must address the way it dispossess its wastes that may include used gloves, needles, syringes, and expired drugs so as to avoid instances of environmental pollution that can result in legal repercussions. The firm currently deals with garbage collectors who dispose their wastes. 

Where do customers purchase the firm's products? 

VNA gets its products from the volunteers who buy from the store-based retailers, wholesale outlets, and direct form firms. Most of the products are procured online in which the owners of the businesses ensure that the products reach the customers after the completion of the processes of transactions. Therefore, there is no need to travel to pick the items. 

When do customers purchase the firm's products? 

Different promotional events such as price changes and communication influence the purchase behavior of customers in different ways. The change in prices can make clients change their loyalty to a particular supply due to the low cost of goods and services. On the other hand, promotional events like adverts will inform customers about the benefits of the products and services and entice them to use the products. Additionally, customer services like delivery at the customers door will save the customer the transportation cost and thereby, he will be convinced to do business with the company that provide delivery services. Conversely, purchase behavior of customers will vary based on uncontrollable influences in a manner that will make them buy and hoard the products when their prices are still low so as to avoid higher prices in future. 

Why (and how) do customers select the firm's products? 

The advantage of the products and services of VNA relative to competing products is that the patients get the services and the products while at home. Additionally, the services are very affordable regardless of one’s age and occupation in the society. The services are provided by experts and they entail lots of services that are not offered by the competitors. A customer who is loyal to a brand will find it difficult to use other products that he has never tried. Products whose values are high will always attract customers who want value for their money. 

Why do potential customers not purchase the firm's products? 

VNA’s team of professionals primarily visits patients at their homes. Therefore, the team is not in a position to meet the needs of patients who need care that can only be provided by medical machines. Additionally, the team cannot attend to the patients who prefer being treated in hospitals, rather than at home. Such patients have the feeling that hospitals have all the necessities that a patient can require during the treatment period. The advantage of the competing products that include the life support machines and other medical scanning machines is that they detect the exact disease that the patient suffers from as well as prolonging a patient’s life. The firm’s promotion strategy that focuses on the professionalism of its workers and the services available does not appeal to the non-customers because it does not address the measure it will take in case of emergencies. Therefore, the non-customers prefer hospitals and clinics due to the availability of all the medical requirements that can be used to attend to the sick. VNA can convert the non-customers into customers if it creates mobile clinics that are fully equipped. 

C. The External Environment 

Competition 

VNA’s main competitors are Alegent Home Health Services, Kindred Health Care, and Physicians Choice which are established healthcare providers with a strong brand. Kindred Healthcare is position four among the healthcare providers. As such, it means that the three main competitors have a huge budget that can support their services. They have many members which results in more profits. Their target markets are the old and the sick people. They have great marketing capabilities because of their financial power. They provide walk-in medical care, medical care for non-life threatening injuries and illnesses, and hospice care. The services are offered as per the patients’ ability to pay. The distribution of the services is provided at home and in hospitals. The brand of the three competitors is their main strength while their high costs are their main weakness. The potential future competitor of VNA is the Interim Healthcare that offers a full scope of senior care, home care, staffing services for healthcare, and hospice. Economic Growth and Stability 

The general economic condition of Omaha is experiencing growth because of the industries of transportation, insurance, food processing, agriculture, education, and healthcare. Omaha targets the entire population of Omaha since its pricing depends on a person’s ability to pay. On average, the good economic growth of Omaha that has a median family income of $56,870 makes the majority of the patients in the region to be in a position to pay the medical services. NVA operates in a healthcare industry in which the competition and survival depends on financial strength. Some of the healthcare providers can just be afforded by rich people in the society with most of the providers just accessible to the middle class individuals. Some healthcare providers have merged to become a formidable force in the industry. Such agencies offer services at higher costs because they have machines that are expensively. The marketing challenges that the industry face are difficulty in responding to the price sensitivity of the consumers and how to orchestrate resources in ways that bring value to customers. The industry has been experiencing growth due to the increasing numbers of patients. 

Political Trends 

The changes in elected officials result in new policies for managing the industry. Some of the regulations may include closing down medical clinics and regulating the number of medical volunteers to ensure that citizens subscribe to healthcare. The policy issue that surrounds the health industry is working on measures that will make the healthcare services affordable to many while making it more effective. 

Legal and Regulatory Issues 

The Affordable care Act that was signed into law by President Obama is an extensive revision to the system of healthcare with the intention of promoting quality, increasing access, and enhancing the efficiency of the fragmented and complex efforts patient care. It requires risk sharing among the healthcare providers. Conversely, some federal courts have rejected the law arguing that it is severable. 

Technological Advancements 

Technological advances in the medical sector have made some customers to seek medical aid in hospitals that they consider as most advanced and well equipped with modern medical machines at affordable rates. Such medical institutions provide the customers with the health information that they need and the availability of the accounting machines that can effectively perform transactions. Customers who can afford the services have embraced the advances in technology, and thus VNA has lost some of its customers to such agencies that the clients consider secure. The machines have also made the customer relationship management easier due to the availability of communicating machines. The availability of ambulances for transportation of medical equipments and patients to the required destinations make distribution of the equipments and referral of the patients efficient. The future prescription of drugs by use of computers threatens VNA’s marketing efforts. 

Socio-cultural Trends 

The number of patients that VNA attends to can reduce if the members of the society value hospital services and professionals as compared to how they value the services and experts of VNA though the change will not adversely affect the firm because it is a non-profit entity. The firm will have very few people to attend to if such a case presents itself, and thus the experts will be in a position to reach out to all its clients within a short time. Additionally, the resources will be enough for the few people who will choose not to go to hospitals. The firm is expected to have its staff follow the medical ethics and to ensure that they do not engage in activities that pollutes the environment. The firm is also expected to give back to the society by ensuring that it takes care of the orphans by providing them with homes, food, and clothes apart from the medical services. The ethical and social responsibility issues can make customers to either reject the firm or be loyal to its activities. In future, customers might demand that VNA build community clinics that provide free medical services to patients and also employ the community members. 

III. SWOT Analysis 

A. Strengths 

Strength 1: Showed around 5% annual growth over the past four years . 

Strength 2: Offer the widest variety of services within the Industry 

The growth of the firm increases its financial strength and makes it capable of reaching as may patients as possible. Additionally, its widest variety of services makes it get a wide customer base and reach out to the patients who are not accommodated by the competitors. 

B. Weaknesses 

Weakness 1: Having so many products is viewed at large that if you do everything how can you be good at one single thing. 

Weakness 2: Being not for profit and catering to Safety Net limits cash availability for growth and expansion. 

The many products that the firm provides denies it a chance to specialize in any field in which it can be recognized with as its best area, and thus it becomes difficult for the firm to meet the needs of the patients that require an area of specialization. On the other hand, the competitors are known for their strength when it comes to specialization. 

C. Opportunities (external situations independent of the firm—not strategic options) 

Opportunity 1 : Baby boomers entering retirement and golden years. New large generation entering the age where you’ll need more medical attention 

Opportunity 2: Expanded growth of service team will allow expansion of service area . 

Many people are in the old generation and they need medical care at affordable rates and VNA should be their best option. Additionally, the firm can reach out to may people because its staff have developed both in terms of experience and expert and the increase in their number. The time horizon of opportunity one is the gap between adulthood and old age. The time horizon of opportunity two is the number of years the firm has taken ever since it was established in the 1840s. 

D. Threats (external situations independent of the firm) 

Threat 1: Immunization shortages 

Threat 2: Economic downturn which affects government grants and investment income 

Immunization shortages make the firm not to be in a position of providing immunization to patients, and thus it loses the customers who need immunization to other firms. Additionally, the economic downturn makes the firm to lack the financial support that it requires to provide its products and services. It misses customers who are below the age of five who need immunization. The economic downturn can last for longer than expected. 

E. The SWOT Matrix 

Strengths	Opportunities
-120 Years in the industry are the oldest and in the field which gives them brand recognition.  -Showed around 5% annual growth over the past four years.  -Offer the widest variety of services within the Industry	- Community growth, the Omaha/Council Bluffs Metro area has seen an average growth of around 13% annually since 2000. Healthcare is a population business the more people the more need for your services.  - Baby boomers entering retirement and golden years. New large generation entering the age where you’ll need more medical attention.  - Expanded growth of service team will allow expansion of service area.
Weaknesses	Threats
- Having so many products is viewed at large that if you do everything how can you be good at one single thing.  - Being not for profit and catering to Safety Net limits cash availability for growth and expansion  - Limited availability for rural communities outside of Omaha/Council Bluffs location.	- Expanded competition, oversaturation of the market which could reduce patient head count.  - Economic downturn which affects government grants and investment income.  - Depletion of the talent market, which could cause a lapse in service and lower standards.  - Immunization shortages .

F. Developing Competitive Advantages 

The a hundred and twenty years of operation has earned VNA reputation of service and relationship longevity with the customers, and thus it can engage in growing the community by offering its low cost products. It is notable that the firm’s capabilities and advantages are grounded in the basic principles of operational excellence, product leadership, and customer intimacy. The capabilities are made apparent to customers through the firm’s promotions. It is possible for the firm to convert its weaknesses into strengths, and threats into opportunities. The firm does not have any major liabilities. 

G. Developing a Strategic Focus 

The overall strategic focus of the marketing plan of VNA is to reach out to the customers and make them feel that the organization belongs to them. The firm’s strategic focus follows the diversification marketing in which it intends to show customers that it does not engage in the provision of one product but multiple services and products. The firm has managed to attend to the current issues that affect its clients through its numerous products that are not offered by the competitors. The patients who have several problems and want them sorted out under one roof will look for VNA. 

IV. Marketing Goals and Objectives 

A. Marketing Goal A: Community outreach projects including senior conferences that are educative 

Objective A1: A one month education to community members about health eating habits that ensures the people take care of their diet in a manner that prevents the acquisition of some diseases. The nutritionals and nurses will do the supervision. 

Objective A2: Engaging the community members in conducting the activities that run for one month like cultivations that are supervised by the project managers. 

B. Marketing Goal B: Annual community fundraising 

Objective B1: The contribution of the community members to be conducted every weekend for a period of one month with a target of half a million dollars. The money raised should be for buying the medical equipments and the entire process of fundraising to be monitored by the members of the board. 

Objective B2: Collecting the views of the community members in deciding the projects that should be implemented by the funds. The collection of the views should run for a period of one month and be conducted by the staff members who are responsible for projects. 

V. Marketing Strategy 

A. Primary (and Secondary) Target Market 

The primary target market is the sick old people who live both in the urban and rural regions of Omaha who belong to the low class and find it difficult to access the expensive healthcare. The basic needs of such people and their preferences are food and medication. They mostly consume what has been made available to them. Conversely, the secondary target markets are people who have not reached the aging bracket but cannot afford expensive healthcare. Most of them live in the rural regions with a few of them living in urban centers. Their basic needs are food shelter, and clothing, though they would prefer to afford smart phones, vehicles, and good houses. Their small wages allows them to buy food and clothes. They normally eat the types of meals that they can afford even if it does not constitute a balanced diet. 

B. Product Strategy 

The firm’s brand name is Visiting Nurse Association of Omaha. Its main features are the provision of medical services at the rates that patients can pay and training of its staff to meet the professional demand. The Annual revenue growth of VNA has remained consistent at an avg. of 5% since 2012. Its positioning strategy is to expand fundraising and community outreach efforts. Its supplemental products or services include preparation of meals and light housekeeping that is done by the staff so as to add the firm value. 

C. Pricing Strategy 

The overall pricing strategy and objectives of VNA are keeping patients out the hospital not just through care but with pricing that works with patients based on their ability to pay. The prices of the firm are not fixed as that of the competitors. Such a strategy makes it possible for the company to reach out to very many customers who are poor. The low charges have made the firm to have a low consistent growth of five percent. The firm uses the financing pricing tactics. 

D. Distribution/Supply Chain Strategy 

VNAs supply chain strategy is directly from the firm to the patients. On the other hand, the firm gets the products directly from the donors and its suppliers without engaging the middlemen. Such a strategy is to ensure that the products’ costs remain low. The lack of intermediaries ensures that the firm increase time, place, and possession utility. 

E. Integrated Marketing Communication (Promotion) Strategy 

Overall Integrated Marketing Communication (IMC) strategy is through Internet advertisement in which the members of Omaha can access the products that the organization offers. Additionally, it uses verbal communication between its staff and the patients. The IMC objective is to ensure that information is always available to clients in the Internet at any given time. Moreover, the use of Internet and verbal communication are cheaper ways of communication. The firm uses its website for advertisement. On the other hand, lots of information about it is available in the Internet. The firm’s publicity strategy is to visit patients in hospitals and help them alongside their doctors. The firm ensures that its products are always available, and therefore it keeps in touch with suppliers and takes its low cost products to patients’ homes. 

VI. Marketing Implementation 

Structural Issues 

The overall approach to implementing a marketing strategy should be one that brings all the stakeholders together. The firm should inquire from the customers their preferences and then offer and advertise the products that are of the customers’ preferences ( Doole & Lowe, 2008 ). The firm can implement its marketing strategy by having marketing professionals who can move from one point to another and inform the customers about the firm’s products. The firm can sponsor its employees in various institutions for training on marketing. Training employees improves their skills while employee buy-in and motivation encourages hard work among employees and can help in implementing the marketing strategy. Internal communication and promotion of the marketing strategy is effective in relaying the crucial information to the top management and the junior staff on the implementation processes. Additionally, coordination with other functional areas helps with the provision of information and helpful additional ideas. 

Tactical Marketing Activities 

Specific Tactical Activities	Person/Department Responsible	Required Budget	Completion Date
Product Activities	Skilled homecare; Infusion Pharmacy	$10,100	13 th December, 2016
Pricing Activities	Care at home: Medications	$2,000	30 th December, 2016
Distribution/Supply Chain Activities	Transportation from the firm to patients; Transportation from suppliers to the firm	$8,500	21 st February, 2016
IMC (Promotion) Activities	Internet communication	$1,000	17 th February, 2016

VII. Evaluation and Control 

Formal Controls 

Additional human resource will be important for carrying out the activities of advertising. Research will be necessary in finding out the areas that need more focus during marketing and the activities that should be engaged in at length ( Ferrell & Hartline, 2014 ). The financial resources will be used in paying the manpower and channels of advertising. Executing the marketing plan will require management training so that the staff members who are responsible for the marketing plan get equipped with effective management skills that are essential for implementing the marketing plan. Management commitment to the plan and to the employees is critical for executing the marketing plan because it makes all the employees of the firm to be interesting in ensuring that the plan becomes successful. Revised employee evaluation or compensation systems ensure that compensation only goes to the hardworking employees. Enhanced employee authority is crucial for the marketing plan because it ensures that workers have the courage to come up with innovative ideas and present them to the authority with the confidence that the ideas will be implemented. Internal communication activities ensure that the important information reaches its destination without any distortions. Such communication is necessary for effective implementation of the marketing plan. . Revised employee evaluation or compensation systems will be effective when measuring the marketing performance because employees will work hard to ensure that the marketing plan is implemented for them to be rewarded. Employee evaluation or compensation systems also ensure that workers put more effort to implement projects in the community that can attract more customers for the firm. The overall performance standards can then be measured through customer satisfaction, increased market share, and customer retention. Distribution performance standard will be measured through direct distribution performance between the agency and its suppliers and between the agency and the customers. IMC (promotion) performance standards will be measured through brand awareness among the clients. 

Informal Controls 

Employee commitment can influence the full implementation of the marketing strategy in the sense that the employee will have great interest of ensuring that the project he started becomes successful when it is finally implemented ( Ferrell & Hartline, 2014 ). Lack of employee interest can also lead to the failure of the implementation of the marketing strategy. Employee commitment can be enhanced by rewarding the hardworking people in the staff through pay increase. A staff that values organizational values will always work towards ensuring that the values are upheld. A good relationship among workers will also motivate the employees to work as a team and achieve the set goals of the team. Such issues that relate to employee social control can be enhanced by motivating the employees that work as a team and achieve the firm’s marketing plan and values. As a cultural control, organizational culture emphasizes on the adherence to the firm’s culture by any employee who gets hired ( Shankar & Carpenter, 2012) . An organization can have a culture of training its employees and offering them management positions and increased salaries after the completion of their training. Such a culture can always be enhanced by having a management body that ensures that the culture does not diminish. 

C. Implementation Schedule and Timeline 

Month	December				January				February
Activities Week	1	2	3	4	1	2	3	4	1	2	3	4
Product Activities
Skilled homecare
Infusion Pharmacy
Pricing Activities
Transportation to patients
Medications
Distribution Activities
Transportation from the firm to patients
Transportation from suppliers to the firm
IMC Activities
Internet communication
Transportation from suppliers

Marketing Audits 

The marketing activities of VNA will be monitored by analyzing its increased area of coverage and the number of customers it will be serving ( Doole & Lowe, 2008 ). The firm will provide a timeline of one year after the implementation of its marketing plan to confirm if it has increased on its five percent annual increase of its profits. Additionally, it will take record of its customers on a monthly basis and compare it with the previous records to confirm if there is any increase in the number of the customers. Such records will be taken by the nurses who regularly visit homes. If it is determined that the marketing strategy does not meet expectations, then the firm should restructure the marketing team and bring on board new marketers with new marketing ideas. If the marketing plan, as currently designed, shows little likelihood of meeting the marketing objectives, then it is imperative for the marketing team to change tact and stop raising funds from community. They should carry out activities that will attract donors. 

References 

Doole, I., & Lowe, R. (2008). International marketing strategy: Analysis, development and implementation . London: Cengage Learning. 

Ferrell, O. C., & Hartline, M. D. (2014). Marketing strategy: Text and cases . Mason, OH: South-Western/Cengage Learning. 

Shankar, V., & Carpenter, G. S. (2012). Handbook of marketing strategy . Cheltenham, UK: Edward Elgar Pub. 

Visiting Nurse Association. Annual Reports. Retrieved from http://www.thevnacares.org/why-vna/annual-report/ 

Visiting Nurse Association. Care in your Home. Retrieved from http://www.thevnacares.org/index.php/care-your-home/skilled-home-care 

Visiting Nurse Association. Care in your Home. Retrieved from http://www.thevnacares.org/index.php/care-your-home/companion-care 

Visiting Nurse Association. (n.d). History. Retrieved from http://www.thevnacares.org/index.php/why-vna/history 

Visiting Nurse Association. Care in your Home. Retrieved from http://www.thevnacares.org/care-your-home/ 

Visiting Nurse Association. (n.d). Advancing Quality, Value and Innovation in Home-Based Care. Retrieved from http://www.vnaa.org/mission-vision-values