Alive Hospice Execs: Reports of For-Profit Sale Purely Speculative

Nashville-based Alive Hospice recently responded to speculation that the nonprofit will sell its operations to a for-profit company, a move that has sparked cries of opposition within the local community.

A spate of news reports have indicated that Alive Hospice may be up for sale to a publicly traded for-profit entity.

In the midst of this, nearly 4,000 community members have signed an ongoing petition for Alive to remain a nonprofit organization. The petition cites concerns that a change in ownership could adversely affect quality and access to care among underserved communities.


The hospice indicated that any future considerations will not impede the community’s access to end-of-life care, according to Alive Hospice’s executive committee, speaking on behalf of its governing board.

“The Alive board is committed to acting only in the best interest of the organization we love and its future,” Alive Hospice executives told Hospice News in an email. “We want to emphasize that the comments being made about the board’s actions are purely speculative and seem intended to frighten those who rely on Alive for their care.”

Alive Hospice’s service region spans 12 counties across central Tennessee. While the hospice provides care in facilities and hospitals throughout the area, more than 90% of its patients receive care in the home.


Founded in 1975, Alive Hospice’s annual census hovers close to 5,000 patients. The nonprofit’s services include hospice and palliative care, as well as grief support. Alive Hospice provides bereavement services to roughly 700 adults and children in Tennessee annually.

“As board members, we also are committed to sustaining the legacy of Alive so that generations of Middle Tennesseans will benefit from hospice care into the future, regardless of their ability to pay,” Alive’s executive committee stated.

Meanwhile, a community organization has formed that aims to prevent the hospice from being purchased by a for-profit company.

Five former board members joined the founders of Alive Hospice in filing a complaint with the state’s attorney general earlier this month. In it, they urged state regulators to require the hospice to notify the Tennessee Attorney General a minimum of 45 days prior to any proposed sale of some or all of its assets, including the names of potential for-profit or nonprofit buyers.

The Attorney General’s Office is responsible for assessing these details to ensure that non-profit assets are being protected consistent with Tennessee law, they explained.

In the complaint, the group indicated that the sale of Alive Hospice’s assets to a for-profit entity “appears to be on its first recourse and not a last recourse for Alive’s leadership, thus thwarting the purpose of the Tennessee Nonprofit Corporation Act.”

To date, neither Alive Hospice nor any potential buyers have confirmed that a sale would take place.

Alive Hospice Board of Directors Chair Vicki Estrin indicated that the nonprofit “explores many more potential partnerships than we ever pursue and cannot speak to reports,” calling for calm in the community amid public speculation in local news.

To date, Alive Hospice has not filed a notice with the attorney general. However, “it is the belief of the complainants that, in fact, Alive Hospice is being sold to a publicly traded, for-profit entity,” the group stated.

The group also alleged that Alive Hospice has “exclusively solicited bids from for-profit entities, thus focusing on maximizing sales price and not focusing on the public benefit. This is in contravention of the [attorney general’s] instructions to [s]eek as many purchasers as possible.”

“Like any other nonprofit, our board members are bound to keep certain activities and conversations confidential, and it would be a breach of our duty to Alive to share any such discussions,” Alive’s executive committee said. “This puts us at a distinct disadvantage in the current environment where some members of our community, who are well aware of the restrictions on our ability to speak, use the absence of information to fashion their own version of events.”

The organization provided hospice care to 4,719 patients and families in 2021, as well as 21 pediatric hospice patients. The nonprofit provided 16,233 palliative care visits across six hospitals that year, which was an additional 10,000 visits compared to 2020. Increased patient capacity was fueled by an expanded interdisciplinary team, Alive Hospice indicated in its annual report.

Alive Hospice’s revenue reached $38.87 million in 2021, up from $38.03 million the prior year, according to the annual report. The organization’s IRS 990s in 2019 indicated that Alive Hospice’s program services represented the bulk (88% – 89%) of its income. Fundraising and philanthropic contributions accounted for 11.6% of revenue.

The organization launched its telemedicine program in 2020 in response to the COVID-19 pandemic. Branded as Henry Hooker Alive Connect, the telemedicine program deployed iPads to sustain medical and non-medical services for community members in a time of social distancing.

The telemedicine program doubled Alive Hospice’s virtual reach with as many as 450 users within its first year. Rising demand for virtual care was also fueled by difficulty accessing patients after its service region faced a natural disaster alongside the pandemic.

The region was among those hardest hit by an EF-3 tornado that stretched across 60 miles of the Nashville area in March 2020, according to the National Weather Service. Damage to Alive Hope’s service regions in the area created literal roadblocks to patient homes. The telemedicine grew rapidly that year amid the need to socially distance and access patients in blocked off areas.

The telehospice program continued to expand in 2021 as the hospice received donations from community members.

All told, the nonprofit received $1.4 million that year towards financial support it provides to patients and families in 2021, including telehealth and other services such as a food delivery program that provided 15,062 meals to facility-based residents.

“It has been very heartening to hear from so many people in our community during the past week and learn how much they love Alive,” the executive committee said in an email. “We ask the community to trust that, even though we cannot comment on what is being said, we will never do anything to harm the people or legacy of Alive.”

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