The Victorian Order of Nurses says it is closing in six provinces and will operate only in Ontario and Nova Scotia as part of a restructuring of the non-profit charitable organization.

VON said restructuring means its programs in Alberta, Saskatchewan, Manitoba, New Brunswick, Prince Edward Island and Newfoundland and Labrador will end.

A total of 352 of 6,446 employees are affected by the restructuring, including a 23 per cent reduction at its head office.

The organization provides a range of health and home-care services to people of all ages.

VON has been considering the decision for more than two years, said president and CEO Jo-Anne Poirier.

"This was a very a difficult but necessary decision to ensure that VON remains viable as an organization," Poirier said on a teleconference call on Wednesday. "I think that we were at a crossroads where we needed to become leaner and more efficient in order to provide quality services that our partners can afford."

VON was established in 1897. Its services include visiting nursing, adult day programs, foot care clinics, seniors' exercise programs, elder abuse intervention teams, detox centre home support and seasonal flu programs.

Poirier said the amount the organization owes is sealed as part of a court order. The company went into receivership to protect employee wages.

The Canadian Nurses Association said it is saddened and concerned over the VON news of restructuring and closures in six provinces. It called VON Canada's longest-standing home and community health-care charity.

"CNA understands how challenging it is to provide health care that meets the growing and changing needs of Canadians, especially as funding declines," CEO Anne Sutherland Boal, said in an emailed statement.

"To keep Canadians connected to the health services they need, care providers, communities and governments will have to work together to fill any gaps that are created by the loss of VON."

The VON restructuring is a troubling symptom of the challenges the health-care system faces in responding to the needs of a larger cohort of aging adults in the community, said Prof. Ivy Lyn Bourgeault of the University of Ottawa's Telfer School of Management.

"I suspect that this wasn't the most pleasant day at the office for some folks, not to mention to clients who won't have their home-care provider," Bourgeault said.

Most of the activities offered to clients of home and community care are essential tasks needed to maintain their independence at home.

"It does become really challenging and disruptive for clients when the care provider that has been taking care of them shifts and changes," Bourgeault said.

New Brunswick Health Minister Victor Boudreau said he's confident the government will be able to find other service providers to deliver VON's services in the province.

VON Canada's web page states it has 5,000 staff and 9,000 volunteers in more than 1,200 communities across the country.​