Hospice Provider Androscoggin Acquires Care & Comfort, Moves Into Behavioral Health

Maine-based Androscoggin Home Health Care + Hospice has acquired home and behavioral health care company Care & Comfort for an undisclosed sum. The behavioral health component represents a new business line for Androscoggin, a move fueled by a demonstrated need for those services in their home state.

The deal is slated to close Feb. 1. Care & Comfort opted to sell upon the retirement of its founder Susan Giguere. The company’s president and CEO, Mike Stair, will take on an executive role at Androscoggin.

The decision to buy was predicated on four key factors, according to Androscoggin CEO Ken Albert, including Care & Comfort’s strong reputation in the community, the company’s financial performance, low employee turnover and the staff’s positive perception of the organization.

“Susan Giguere started the company 31 years ago with a computer on a table in her home and has really focused on being an extraordinary employer and producing a quality product,” Albert told Hospice News. “Based on our due diligence from a financial and legal perspective, they checked all the boxes. They’ve done a really good job building an employee base and building a good reputation here.”

Hospice utilization in Maine reached 51.4% among Medicare decedents in 2018, according to the National Hospice & Palliative Care Organization. This was just about the national average of slightly more then 50%. Utah had the highest rate that year at 60.4% utilization. The U.S. Census Bureau reported that 1 in 5 people in Maine were 65 and older in 2019, making up 21.2% of the state’s population. 

Care & Comfort’s footprint includes five locations providing care in 13 Maine counties. Androscoggin is a nonprofit provider, whereas historically Care & Comfort has been a for-profit company. Post-acquisition, Care & Comfort will move forward as an Androscoggin brand with nonprofit status.

The CEOs of the two organizations have known each other for several years, Albert said.

Albert, who is a lawyer and a registered nurse by training, met both the Giguere family and Stair through his previous capacity as a regulator and as legal counsel for health care companies. Before joining Androscoggin, he was director of the Maine Division of Licensing and Regulatory Services, which was later folded into the state’s Center for Disease Control & Prevention, where Albert served as director and chief operating officer.

Before the government role, Albert was an attorney with the firm Norman, Hanson and DeTroy, also located in Maine.

The two companies initiated discussions of the transaction prior to the pandemic, but COVID-19 and shifts in the regulatory landscape temporarily delayed the deal. They revisited the negotiations starting in June 2021. 

The acquisition marks Androscoggin’s return to the behavioral health space. The company has offered these services in the past. The decision to bring those services into their portfolio followed a community health needs assessment that the Internal Revenue Service requires hospitals to perform every two years, Albert said.

These assessments have ranked behavioral health among the top 10 most pressing needs in each of Maine’s counties during the last three two-year cycles. The need has only grown. For all counties, the 2021 assessment identified behavioral health as the No. 1 or No. 2 community health need, particularly in rural areas.

The new business line opens up a new range of potential referral partners for Androscoggin, as well as an attractive Medicaid reimbursement structure. The company will receive Medicaid payments via medical homes and behavioral health homes, which are designed to lower costs and improve care quality for patients with chronic and complex health needs.

“The behavioral home model for reimbursement is very appealing to us,” Albert said. “We are clearly looking to expand into [licensed clinical social workers and licensed clinical professional counselors] and other behavioral health services as a means of being a partner to our other referral sources for a full-range of home based services, including behavioral health.”