Newly appointed Affinity Hospice CEO Chris Smith wants to build the company as a national player, extending beyond its current regional footprint.

Affinity Hospice serves more than 1,300 patients daily through 23 locations across Georgia, Alabama, Virginia, South Carolina and Arkansas. Now, Smith seeks to build density in this current service region before branching out into new and contiguous markets.

Smith came to Affinity from Endeavor Schools, a national education management company, where he served as COO. Prior to that, he held leadership roles at AccentCare, Care Hospice, Seasons Hospice & Palliative Care and Jordan Health Services (now Elara Caring). He currently serves on the boards of Cypress Basin Hospice and the Seasons Hospice Foundation.

Hospice News sat down with Smith to discuss his plans for Affinity, the keys to growth and what he foresees for the industry in 2026.

Can you tell me a little bit more about your own background and how you came to work in hospice?

In 2011 I actually started with AccentCare in the home health division. Two years after that, I had a personal experience with hospice. The blessing of meeting a family and talking about hospice with them, and kind of talking that through the journey, really affected me. I really kind of fell in love with less of the transactional, curative care and more with slowing down and having really meaningful conversations towards the end of life.

So a couple of years later, I was blessed to be able to join Seasons Hospice. I joined Seasons on the sales side and was national director of business development for the central United States. But I always had thoughts in mind about: How does the organization run? How does the business run? How does productivity work? How does clinical kind of integrate into everything, or more foundationally, and how does everything integrate into that?

So I really started to learn about the business. In 2017 I had the opportunity to morph into operations, where I was the VP of operations at Seasons in the central United States. I was promoted to senior vice president a couple of years later, and then Seasons was acquired by AccentCare in 2021

So I got to rejoin AccentCare as a welcomed alumni on the hospice side of life, and then spent five years there as the SVP at the head of the hospice division. Until just a year ago, I transitioned to the COO of a private education company, and then blessed to be back into hospice now at Affinity.

What are your top priorities as you come into this new role?

We’re really making sure that clinical quality and compliance are at its utmost and foundational. I think that you can’t grow as an organization overall until those are solidified. And I really feel like Affinity has a great foundation for that.

We’re going to be looking towards growth and expansion both in the Southeast, and how this looks strategically over the next five years or so, growth into more of a national-based company, rather than regional. But I think overall, those are my two priorities as I look just in the near future and how we need to progress.

You touched on this going from regional to national, but what are some of your plans for growing the organization?

I think really kind of spreading the density in where we are now, and then strategically branching out from there. So I don’t see us growing from a base of those five states predominantly in the Southeast to planting a flag in California or Washington initially. So I think it’s, how do we densify the current area where we are, and then continually build out to more of a national player.

You mentioned compliance. Could you maybe give a few examples of some of the most significant compliance issues you’re looking at?

I think more of it is just what’s the changing landscape across the United States, as far as audits, being able to make sure that we’re staying up with the overall trends.

It’s making sure that we’re very compliant for [the Hospice Outcomes and Patient Evaluation Tool (HOPE)], since HOPE has now been introduced just a few days ago, or has gone live just a few days ago, to make sure that we stay up on being able to meet those standards.

So I don’t think there’s anything really internally. I’ve actually been very pleased about the overall processes and things that they have in place with making sure that compliance is a backbone of the organization. But I think staying up with things nationally is going to be very important for us.

What do you see as the major headwinds you’re facing as you work towards these goals?

I’m really excited about the industry overall. I think it’s a growing industry, just looking at overall adoption, seeing an increase year-over-year in hospice-eligible patients that are coming through. T

There’s always going to be governmental and regulatory pressures that come through. There’s always stroke-of-the-pen risks with Medicare cuts. Our partners in home health have had some of that over the last couple of years.

I do think hospice is a lower cost option towards the end of life, as you look at acute care hospitalizations versus what we can provide. So I always think it’s going to be an opportunity, a positive opportunity for growth. I think there’s things to pay attention to, but quite honestly, I’m excited to be back in the industry.

That flows right into my next question, which is kind of the opposite: What are the biggest opportunities and tailwinds you see for hospices in 2025?

I think increased utilization as more people get familiar with hospice, more advocates for hospice appear in the communities themselves.

When hospice first came about, it was considered somewhat of something people didn’t want to talk about. Right now, people really want a perfect end-of-life journey, and so being able to provide that is going to be a really golden opportunity for us. It’s been a blessing over the last couple of years where Medicare has given the hospice benefit an increase.

So again, if that continues, it’s just the only kind of positivity that we see for hospice expansion across the U.S.

What do you foresee for Affinity Hospice, or even the hospice market in general, for 2026?

I see significant steps forward for Affinity. I’m excited about the overall organization again, having quality and compliance as the backbone of how we operate. I think it separates us from a lot of other providers across the U.S.

I see market expansion over the next 12 to 18 months, being very selective, but making sure that we expand our footprint and introduce ourselves into new communities. I think just solidifying our operational model and becoming a provider of choice in our local communities is what we’re focused on.

Can you talk a little bit about how you plan to execute that market expansion? Are you looking at acquisitions or de novos?

I think over the next 12 to 18 months, we’re going to focus on de novo expansion. That’s not to say that if we had some M&A activity that made sense for us in that densification, expansion of our geography, that we would look at those things. But I think we want to grow a little bit organically in the next 12 to 18 months, and then start to look at strategic relationships from there.