Oregon-based Solterra Hospice has seen its average daily census rate triple in the last year. The organization’s leaders attribute the expansion to balanced clinical capacity and strong community collaboration.
Solterra Hospice began serving patients in November 2024 after receiving its Medicare and Medicaid certifications earlier that year. The family-owned organization’s average daily census currently hovers around 75–80 patients, tripling from 25 patients in fall 2025.
Prioritizing small patient caseloads for clinicians allowed for meaningful, sustainable growth, according to Christie Rivelli and Dr. Chris Eilersen, co-founders and co-owners of Solterra Hospice. Eilersen is also the organization’s hospice medical director, and with Rivelli serving as its hospice nurse practitioner and administrator. This clinical strategy opened up opportunities to better reach under-resourced, remote regions, Rivelli said.
“There are areas where [patients] have historically not had anybody willing to go out that far,” Rivelli told Hospice News. “We’ve been able to bridge that barrier for people that would otherwise not be able to return home with hospice care. It helps nurture that relationship with a hospital care management team. Our caseloads are smaller, and our staff are able to spend more time with the patient and for the commute. Our model supports that.”
Solterra Hospice’s service region spans a heavily rural 60-mile radius around Salem, Oregon. The organization’s interdisciplinary care team is spread out across this area in an effort to improve equitable access and support for underserved patient populations, according to Rivelli.
Rivelli and Dr. Eilersen worked for a large hospice provider for nearly a decade before forming Solterra Hospice. Their spouses, John Vaughn and Linda Eilersen, are co-founders and co-owners of the organization.
The organization’s hospice services include bereavement support and a We Honor Veterans program, as well as speech, massage and other therapies. The organization has a dementia care program, Solterra Sunset. The dementia program includes nurse and other healthcare visits to patients during “sundowning” time frames in the evening, when physical and emotional symptoms often worsen and need higher levels of attention.
The hospice works to ensure that clinicians are not overburdened with high volumes of patient visits and travel times, Eilersen said. Having a low and balanced patient caseload has been key to both patient and staff satisfaction, a sticking point in sustainable growth, he said.
Having a balanced clinical capacity also allows the provider a unique opportunity to expand in underserved regions, according to Eilersen. The organization’s strategy has strengthened staff recruitment and retention, allowing the hospice to hire nurses ahead of rising demand.
“Our focus all the time is keeping our caseloads low, so that our case managers are able to really take care of their patients, and that has been sustaining us,” Eilersen told Hospice News. “That is giving us a good reputation in our community. With our reputation, we get the best nurses because their caseloads stay low enough to stay here. There’s job satisfaction in that.”
Smaller, rural-based hospices often do not have sufficient financial resources for marketing and sales budgets, Rivelli said. This issue can create barriers to access, as patients and families lack avenues of awareness around their end-of-life options.
Having dedicated resources for community education makes a significant difference, she stated. Community collaborations play an important role in growth, particularly in rural and underserved areas.
Solterra Hospice has focused on building solid referral relationships across its service region, according to Rivelli.
“We kind of hit an exponential curve, because once we get known and people see us in action, then that relationship stays,” Rivelli said. “We don’t lose them, because they see what we’re doing and how we do it differently. But it’s getting over that barrier of people knowing we exist.”
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