The long term care company Mission Health Services has acquired Utah-based Angel’s Crossing Home Hospice.

Mission is a nonprofit provider of nursing home, assisted living, short term care, memory care and therapy services. The M&A advisory firm Agenda Health facilitated the transaction. Financial terms were undisclosed. The deal marks Mission’s first foray into the hospice space.

“The sellers made the strategic decision to divest their business to pursue a new venture. Their goal was to reallocate their time, energy and resources towards founding a hospice in a different region of the country,” Spencer Walters, senior director for Agenda Health, told Hospice News in an email. “This transition allowed the sellers to blend their professional expertise with a personally meaningful initiative, while ensuring their Utah hospice continued under capable new ownership.”

Angel’s Crossing serves three counties in Utah. It has a low patient census and sold its license to Mission.

Utah is the “youngest state” in the nation, with the lowest concentration of seniors among its population, However, that demographic is growing rapidly, according to the U.S. Census Bureau. Currently 13% of the state’s population of 2.8 million is over the age of 60, a number expected to rise to 17% by 2030.

About 15,900 Medicare decedents in Utah elected hospice in 2022, a rate of slightly more than 59%.

One factor that attracted Mission Health to this seller was that it had passed the 36-month change-of-ownership threshold required by the U.S. Centers for Medicare & Medicaid Services (CMS).

The “36-month”rule for hospice providers mirrors a regulation that has existed for several years for home health agencies. The final rule forbids any change in majority ownership during the 36 months after initial Medicare enrollment, including acquisitions, stock transactions or mergers.

“The value-add for the buyer was the addition of hospice services to their existing continuum of care within their current market,” Walters said. “The most valuable factor was that the license was outside of the 36 month window, allowing for an immediate transfer of ownership. With the new 36 month rule, there are fewer agencies of this size for groups looking to acquire a license to expand services or coverage which is typically more cost effective than a de novo strategy.”