Eli's Hospice Insider

But closures are also taking place in the turbulent hospice environment.

There’s a lot of uncertainty in hospices’ Medicare reimbursement future, and that may be leading to a lot of mergers, acquisitions and closures.

Recent hospice-related deals include:

• In Idaho: The Ensign Group Inc. has acquired Life’s Doors Hospice, Life’s Doors Home Health, and Life’s Doors Home Care Solutions in Boise, the Mission Viejo, Calif.-based post-acute parent says in a release. Life’s Doors will be operated by Cornerstone Healthcare Inc., Ensign’s home health and hospice operating company, and merged with Horizon Home Health and Hospice.

Ensign operates 10 home health agencies and seven hospices across nine states, including locations in Oregon (Connected Home Health), Dallas (Custom Care Hospice), Salt Lake City (Symbii Home Health and Hospice), Denver (Homecare Solutions), and Iowa (Careage Home Care).

• In Hawaii: Islands Hospice will expand to Maui with its first Neighbor Island inpatient care home in Kahului, reports the Pacific Business News. Competitor Hospice Maui challenged Islands Hospice’s Certificate of Need, but the CON was confirmed in court, the newspaper says. Hospice Maui plans to open its own inpatient care facility — its first — in Wailuku in July 2015, the News adds. Both facilities will contain five patient rooms.

• In Kentucky: Hospice of the Bluegrass in Lexington has pared its staff by 121 people, via layoffs and attrition, reports the Herald-Leader newspaper. The hospice is also closing a palliative care center that serves 157 patients, and reducing its inpatient beds at St. Joseph Hospital by 30 percent to 12, the Herald-Leader notes. And the hospice is reducing beds at the Greg and Noreen Wells Hospice Care Center in Hazard from 12 to six. Finally, the hospice that serves 32 counties in the state has consolidated some offices.

An 11 percent reduction in reimbursement since 2009 has caused the “adjustments,” hospice officials say.

• In Pennsylvania: Cabot-based Concordia Lutheran Ministries has purchased the nonprofit Cedars of Monroeville hospice for $3.8 million, according to The Pittsburgh Times newspaper. The Cedars hospice center opened in 2010 and filed for bankruptcy in 2013, the paper says.

• In New Jersey: In Vineland, Inspira Health Network has announced the closure of its Bridgeton Hospice Inpatient Unit, reports the South Jersey Times. The hospice facility opened in 2006, but low volume and high costs are causing the health system to move its hospice inpatient care into its hospitals, Inspira tells the newspaper.

• In Tennessee: Smoky Mountain Home Health & Hospice has opened a sixth location, reports the Claiborne Progress newspaper. The agency hopes to better serve Claiborne County from its new New Tazewell office. The 32-year-old company covers 13 counties in upper East Tennessee.