A hospital-based hospice program in Kansas is closing its doors, as is the Visiting Nurses Association of Philadelphia.

Holton Community Hospital (HCH) will shut down its home health and hospice department effective December 31st. A range of issues contributed to the decision to end the program, including reimbursement pressures on its home health business and the ascendance of Medicare Advantage, which often pays at a lower rate than traditional Medicare.

The Holton, Kansas-based hospital also cited increased competition in its local community as a reason for the closure.

“This difficult decision was made by the HCH Board of Directors after many years of subsidizing the service to keep it available for our community …,” the hospital indicated in a statement. “The health care industry has faced significant changes in recent years, particularly in payment models for home health services and the expansion of Medicare replacement plans. Additionally, the growing number of competing agencies in our area has led to unsustainable financial challenges for our home health and hospice department.”

HCN stated that communications plans are in place to ensure that all its stakeholders are aware of the closure, including the public, referral sources and vendors, among others. It has already stopped accepting hospice patients and will bring on home health recipients on a case-by-case basis, according to a statement from the hospital.

The organization is working with other local providers to ensure continuity of care for its home health and hospice patients.

Meanwhile in Pennsylvania, the Visiting Nurses Association of Philadelphia is also closing. The 138-year-old institution will cease operations on Oct. 28. It is a provider of hospice, home health and palliative care services.

The nonprofit cited unsustainable financial losses as the reason behind the closure, local news reported.

“VNA, a subsidiary of Public Health Management Corporation (PHMC) since 2022, has been a vital part of the community since 1886, delivering quality care and service,” the agency stated on its website. “We are grateful for the dedication and compassion of the VNA staff, whose impact has been deeply felt by individuals and families across our region. VNA is working to ensure smooth transitions for all patients and families, and to identify opportunities for team members within the PHMC family of services.”