The late 1800s was a time of increased urbanization and along with that came increased disease and healthcare issues; with many people unable to afford healthcare. With this growing need for healthcare in the community, home health care was born. 1906 Inspired by Florence Nightingale, Lillian Wald founded public health nursing and was able to attract a prominent philanthropist to support her efforts. These efforts were shared throughout the country and by 1913 there were hundreds of VNA organizations supported by their communities.

1913 The Rochester Women’s club under president Norma Snow and the Ladies Aide of the First Church Congregational founded a VNA to provide Homecare services to residents in Strafford County and Southern Maine. Grace L Reeds was the first visiting nurse with an annual salary of $750.

1920s The Red Cross identifies community health nursing as a critical need and provided a car and a part-time assistant for the visiting nurse.

1930s Healthcare services were provided mainly to the poor with limited funding from insurances, towns and donations.

1940s Beulah Thayer, June Liberty, Helen Nute and Helen McLaughlin were lead women of Farmington Women’s club to help organize the Farmington Visiting Nurse Association.

1950s Besides in-home care Visiting Nurses Associations provide health care services in public schools and hold clinics for the public.

1960s Rochester VNA was incorporated. Rural District Health Council was formed as satellite of Portsmouth rehab center.

1970s Rochester VNA & Rural District Health Council developed maternal child health programs providing clinics in the community. RDHC moved to Farmington, RVNA became Medicare certified.

1980s shortened hospital stays increased need for acute medical in-home. Nurses began on-call 24/7 service. Rochester VNA provide door to door outreach in testing preschool children for lead poisoning. Farmington VNA merged with Rural District Health Council.

1990s RVNA, RDVNA, Tri Area VNA and Squamscott VNA formed the Coalition of Strafford County Agencies to support the provision of homemaking services. Decreasing Medicare funding and for-profit competition called for assessing collaboration of RVNA & RDVNA.

2000s Rochester VNA and Rural District VNA merged into Rochester/Rural District VNS & Hospice, later dba: Your VNA. Your VNA implemented electronic records and the Telehealth program. Personal Care Service Providers (PCSP) and Adult Day Care were added to the program of services.

2010s Rochester District VNA launches the only non-profit hospice program in the area in order to meet the needs of the community. In 2012 RDVNA makes plans to change its name due to the expansion of service area in Rockingham County in NH and the addition of 10 communities in York County, Maine. In 2013, RDVNA will celebrate its 100th Anniversary as Cornerstone VNA, Home. Health. Hospice.

2013 Cornerstone VNA celebrates 100 years of care.



Now Known as Cornerstone VNA

 Rural District Health Council:

The Rural District Health Council originated as a satellite program of the Portsmouth Rehabilitation Center. Mr. Raymond Conley, Executive Director of the Portsmouth Rehabilitation Center proposed that the Center could qualify for Medicare reimbursement (1966) for home visits to persons enrolled in Medicare as it supplied the secondary services and could contract with existing visiting nurse agencies to supply the skilled nursing. After much work his proposal was approved and the Portsmouth Rehabilitation Center became the first rehabilitation center in the country to receive Medicare Certification. The Center’s service area covered Rockingham, Strafford and Carroll Counties in New Hampshire and York County in Maine.

Organized visiting nurse services were lacking in many towns so in 1967 Mr. Conley sought and received a grant to fund a part-time nurse coordinator, Mrs. Cynthia Blood, to organize the Medicare program at the center. Registered Nurses were hired by the hour to visit patients where there was no agency. The organization was formed on January 4, 1967. In 1968 the Public Health Nurse for Strafford County approached Mrs. Blood with the idea of combining five Strafford County towns: Barrington, Strafford, Middleton, Milton and New Durham, where there were no nursing services, to form a visiting nurse agency which would be certified under the umbrella of the Portsmouth Rehabilitation Center. Town officials were contacted and the proposal was discussed. As interest grew, three towns in Rockingham County bordering Strafford County: Northwood, Nottingham and Deerfield, also indicated an interest in the proposal. In 1968 the Rural District Health Council was formed. It was felt that $1.00 per capita and a grant of $7,000.00 would be sufficient to fund the program. A warrant was drafted to see if the towns would vote to join the Rural District Health Council and raise and appropriate the sum of $1.00 per capita in support of the organizations Visiting Nurse Services, and the Selectmen would be authorized to appoint two representatives to the Rural District Health Council. On March 18, 1969 the Council met and learned that all towns except Milton wanted to join the organization. The total population covered by the services was 6,189. The program officially started on May 5, 1969. During the first year of operation 1,303 visits were made to a total of 250 people.

In March 1970 the Council entered into an agreement with the N.H. Bureau of Maternal and Child Health to provide family planning visits. In 1971 the services were expanded with the initiation of monthly Child Health conferences.

In 1971 Milton was again invited to join the program as the Council received many requests for service in that area. The Board also asked Farmington to join as its nursing service was not certified. Both towns voted against joining. However, the original seven towns approved the funds to continue the program.

On January 11, 1973 it was voted to separate the funds of the Rural District Health Council from those of the Portsmouth Rehabilitation Center. It was also voted to relocate in one of the member towns. The Council received a grant of $6,000 from the Bi-State Community Home Health Agency to accomplish this goal. In 1973 Farmington and Milton voted to join the Council and it was voted to locate the office in Farmington with the move accomplished on April 15, 1973.

Well Child Clinics sponsored by the RDHC in cooperation with NH State Department of Public Health were held monthly with other clinics scheduled throughout the year. A new addition to the clinic was a dental clinic for ages 3-6. RDHC worked closely with Strafford County Prenatal and Family Planning Assoc. as well as Exeter Area Family Planning Assoc., making home visits to patients enrolled in the clinics.

In addition to the health screening clinics held in Northwood, Barrington and Farmington, a program was started in Milton at the Health Center and the caseload proved this to be a needed service. These screenings were conducted once a month at each site.

A nurse was available 24 hours a day, 7 days a week for reassurance and to answer any questions that a patient or family had. Individual home care continued to be increasingly the place of choice to receive health care services.


Rochester Visiting Nurse Association:

The Rochester Visiting Nurse Association was founded in 1913 by the Rochester Women’s Club and the Ladies Aide of the First Church Congregational. The home care program served the southern Maine and Strafford County regions including Barrington, Lee, Newmarket, Madbury, Rochester, Dover, Middleton, Rollinsford, Durham, Milton, Somersworth, Farmington, New Durham, Strafford NH and Lebanon and Berwick, Maine. Norma Snow proposed the founding of the association with an initial grant of $661.16.

Services of the VNA were offered to the School Board whereas the nurse would visit the various schools of the city regarding health. As it was found that many children did not have toothbrushes, the association procured and distributed toothbrushes to those children who could not afford them. The Association in this way became not only an alleviator of pain but also a preventer of disease.

The Agency was incorporated in 1967; Medicare certified in 1975; Maine licensed in 1987. Money in the budget was received from professional fees, grants and public and private donations. Children’s services were provided to income eligible citizens of Rochester, East Rochester and Gonic.

The MCH Program provided medical and nursing care and services to over 160 low-income children. Services included hearing and vision screening, physical exams, lead screening, immunizations, and anemia testing. The MCH staff also provided anticipatory guidance to parents related to growth and development and child rearing. In 1991 a grant was received from the Division of Children and Youth that was used to promote parenting skills. RVNA was actively involved with the Rochester Area Family Support Team. This local group worked to promote coordination of services for children of this area. The MCH Program assisted with the growth of new programs in cooperation with other area health care and family centered agencies and organizations to assist with the ongoing needs of families in our community.

The RVNA worked with the Rochester Municipal Employees Wellness Committee with the goal to reach out to employed individuals to make them aware of the services available to them and their families through the RVNA, while at the same time providing a community service.

Rochester Visiting Nurse Association built the reputation of being a family-centered care agency. Since 1913 they strived to keep families together during illness. RVNA’s goal was to provide community members and caregivers with the necessary skills to promote health and self-reliance.



1992 – 1993 – Crisis in homemaking funding in Strafford County led to discussions and formation of the Coalition of Strafford County Agencies September 1, 1993. Rochester VNA, Rural District VNA, Squamscott Home Health and Tri-Area VNA combined efforts to provide homemaking services – receiving county and state funding.

The Strafford Regional Hospice Network was formed as a joint project between RVNA, RDVNA, Squamscott Home Health and Strafford Hospice. This association’s goal was to provide Medicare approved hospice services in a more advantageous manner. The process never moved to completion and disbanded after three years of discussion and planning.

Rochester District VNA provided hospice care from 1993 through 2006. At that point, the Board voted to discontinue our hospice program to focus on home care since the nonprofit Seacoast Hospice had a very good hospice program in the area.


Rochester/Rural District Visiting Nurse Association & Hospice d.b.a. Your VNA.

“There is nothing permanent except change.” Heraclitus

This statement is most fitting in describing health care today.

The Board of Directors of Rochester VNA & Rural District VNA & Hospice spent many hours working steadily through 1998 – 1999 assessing their ability to continue meeting the needs and improve the service in their communities and to respond successfully to the challenges of the Medicare payment system. In May of 1999 both Board of Directors voted for the merger of Rochester VNA and Rural District VNA to enhance community health services by consolidating resources and expertise. Effective on January 1, 2000 Rochester VNA and Rural District VNA & Hospice merged and became Rochester/Rural District VNS & Hospice.

The staff supported the decision to merge and for their Executive Director, Linda Hotchkiss, and said it all with a plaque to her with their picture that said, “It’s easy to cross a new bridge when you know the supports are strong”.

In February 2001 the agency name was changed from R/RDVNS & Hospice to R/RDVNA & Hospice D.B.A. Your VNA and now to Rochester District VNA.

As well as our skilled nursing, home care aides, rehabilitative therapies, medical social workers and homemaking services we have specialty services which include certified wound/ostomy nurses, psych nurses, lactation consultant, diabetic educator nurse, intravenous nurse, hospice nurses and newborn – post-partum / pediatric nurses. We also have volunteers that help to complete our circle of caring. Our adult screening clinics provide patients with blood pressure checks, blood sugar checks and cholesterol screening as well as diabetic foot care and medication set-ups.

As a merged agency Rochester District VNA continues to provide high quality, compassionate, cost effective home and community health care services. Our goal is to assist patients and their families to make informed decisions leading to maximum health and independence.

Rochester District Visiting Nurse Association opened its adult day care center in 2007. Our Adult Day Care Center addresses a community challenge by providing a safe environment where an individual can remain in their community, with friends and people who know them. It improves their quality of life. It allows chronically ill people to continue living at home and still receive needed care. It also provides respite for at home caregivers who need some additional support and time away from care responsibilities. The Adult Day Care provides health, social and support services for adults with impaired physical, mental and/or social abilities. It helps disabled individuals, their families and caregivers in ways that more immediately gives them day-to-day happiness, increased independence and improved access to care.

Since Seacoast Hospice was the only nonprofit Hospice in the area and the for-profit Beacon Health purchased it in 2010, the Board unanimously agreed that we should reinstate our hospice license. Restarting our Hospice Program together with our Home Care Program helped patients to stay in their homes where they want to be, and still receive quality health care. January 2011 we began admitting patients to our hospice program and by the end of the year we had admitted ….patients.

The goals of our Hospice Program are to keep as many of our patients in their homes where they prefer to be, surrounded by the people who love them, with good pain control and an excellent support system in their last days of life. Our team of trained professionals is available 24 hours a day to provide medical attention, pain and symptom management, emotional and spiritual support tailored to the patient’s individual needs and wishes. Within our power, we are committed to providing the best hospice and palliative care experience available – to help people cherish and emphasize life, by helping patients and those who love and care for them to live each day to the fullest. Quality hospice care empowers the patient and family to have the best possible experience at such a difficult time. We offer our patients at the end of life the ability to continue care through Rochester District VNA, with staff they are familiar with and have come to care about. Providing care under our hospice program completes our circle of caring from perinatal to end-of life care.

Healthcare reform continued to change and as we entered 2012 the organization was realizing growth potential and the need to meet the demands of the community and the while navigating the challenges of healthcare reform. The Board of Directors and the leadership at Rochester District VNA determined that some changes were needed in order to continue to expand and provide for the needs of the community more effectively. One of these changes included a name change. The organization needed a name that was less geographically restricted and more reflective of the comprehensive services that we provide to our patients. Significant research ensued with focus groups and surveys for the Board of Directors, employees and community members to cultivate a new name to align specifically with the organization’s mission and vision. A new name was chosen…one that better reflected the scope of our service area without limitations and was steeped in the tradition of the Granite State. The new name was voted and approved by the Board of Directors on July 26, 2013. Cornerstone VNA was the chosen name; representing our past, present and future of strength, stability and longevity deigned to meet the future demands of healthcare and members of the communities we serve.

It was also determined that in order to best meet the needs of our referring hospitals we needed to expand our care by providing services to all of the communities served, including Maine. By September 2012 we had received our homecare and hospice license to provide care in Maine and by January 2013 we expanded our services to meet that demand.

The Board of Directors also determined the need to close the Adult Day Center due to lacking participation in the program. For five years the program made a difference in many people’s lives, allowing them a safe supportive environment while still being able to stay home with caregivers. March 2013 the center closed.


Cornerstone VNA

We launched our 100th anniversary on January 4th 2013.  It was a year of celebration and recognition of providing trusted, compassionate and expert care in 25 communities.

In January 2013, we began to expand our private duty services and re-named this program our Life Care program. The goal of the Life Care program is to provide private duty services 7 days per week/24 hours per day, allowing patients to stay safely in their home while providing support and respite for caregivers.

Expansion planning for Cornerstone VNA continued in 2013. On-going research and development took place to guide with our expansion plan into the Portsmouth area. The Ad Hoc Business Development committee, comprised of Board members and management, presented a business plan to start servicing the Greater Portsmouth Seacoast area by January 2014.

Today, Cornerstone VNA serves 35 communities in Rockingham, Strafford, Belknap and Carroll Counties in New Hampshire and York County in Maine providing skilled nursing, rehabilitative therapies, social work, and volunteer and support services through five distinct programs: Home Care, Hospice Care, Palliative Care, Life Care-Private Duty and Community Care.