Three Connecticut Hospice Providers Merge

Connecticut-based Foothills Visiting Nurse & Home Care has merged with Salisbury Visiting Nurse Association (VNA). Also joining in the merger is VNA Northwest which Foothills acquired in January for an undisclosed sum. The combined organization will be branded as Visiting Nurse & Hospice of Litchfield County.

The merging organizations provide hospice, home health care and personal care services. Foothills Executive Director Michael Caselas will lead the new nonprofit. Members from each of the organizations’ boards will serve on the board of the combined agency. Their daily hospice census ranges from 40 to 50 in addition to their home health and personal care population.

Overlap in the companies’ service areas and preservation of their financial health were part of the impetus for the merger.


“We’ve always been kind of friendly competitors, and the distance between our agencies is not great. All the executive directors [of the three organizations] knew each other, and some of the board members also knew each other. We started off with just phone calls and planning sessions to talk about it in theory, and then became more worthwhile to pursue it further,” Caselas told Hospice News. “There’s also increased competition, and the financial status of some of the agencies was starting to feel the pinch of competition from larger players. Expenses have been going up every year and reimbursements are either staying the same or shrinking.” 

Hospice utilization in Connecticut exceeded 48% among Medicare decedents in 2018, according to the National Hospice & Palliative Care Organization, making it 30th in the nation among the states. Utah led in utilization at 60.5%. The national average is slightly higher than 50%.

The merger will reduce duplication of services in the same region, creating new efficiencies in the consolidated agency, including a drop in back office expenses and savings in insurance, technology, electronic medical record systems and on-call systems. This will allow the Visiting Nurse & Hospice of Litchfield County to reinvest the savings in enhancing patient care, according to Caselas.


Caselas also indicated that joining forces would better position the provider to participate in value-based payment programs such as the Medicare Advantage hospice carve-in and the Primary Care First Serious Illness Population model forthcoming in 2021.

“All three agencies have been caring for the residents of northwest Connecticut independently for a century or more. As community-based organizations, our missions and philosophies are the same. By working together, Visiting Nurse & Hospice of Litchfield County is even better equipped to provide the local, personalized services our families, neighbors, friends and that we ourselves want.” Caselas said. “We intend to perpetuate the ideals that have made our individual agencies such vital contributors to our communities. That isn’t changing. People come first, and we aren’t working together so much to change, but rather to sustain and extend the level of care with our combined talent and resources.”

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