Florida Awards Chapters Health CON for Pinellas County Expansion

Florida-headquartered Chapters Health System recently received a green light to advance on expansion plans across the state’s west central coast.

In August, post-acute care provider Chapters set its sights on expanding its hospice business into Florida’s Pinellas County. The Florida Agency for Health Care Administration (AHCA) recently awarded the company a certificate of need (CON) to begin offering hospice services in that region.

The company already offers home care services in that county.

Adding hospice to its existing home health presence was a “natural extension” of its service portfolio for patients and their families in the community, according to Chapters Health President and CEO Andrew Molosky.

“At Chapters Health, we are always looking for opportunities to increase and expand access to quality health care for a greater number of individuals in our communities who are faced with advancing age, complex medical conditions and end-of-life issues,” said Molosky in a company announcement. “With this mission in mind and the knowledge that there was an unmet need, we applied and were awarded the CON for Pinellas County.”

Chapters Health System provides hospice, palliative and home health services throughout Florida, as well as durable medical equipment and pharmacy services. Hospice and palliative care brands affiliated with Chapters include Chapters Health Palliative Care, Good Shepherd Hospice, Hospice of Okeechobee, HPH Hospice, and LifePath Hospice.

Last year, Cornerstone Hospice & Palliative Care affiliated with Chapters, making the combined organization the nation’s largest nonprofit hospice provider and six largest overall.

With the affiliation, Chapters grew its footprint to 30 counties across Florida, as well as eight in Georgia. Chapters and its affiliates have a combined staff of more than 2,500 employees and upwards of 1,600 volunteers.

The CON for Pinellas County opens doors to growth for Chapters that were temporarily closed last year, according to Chuck Lee, chief administrative officer and president of hospice services at Chapters Health.

“This new licensure will allow us to provide care inside Pinellas County that we couldn’t do last year,” Lee told local news. “We provide the full scope of hospice care. For every patient that we serve, we likely touch three to five other patients, family members. Our goal is to really wrap our arms around them and help them get through this process of their loved one dying and helping them get back to as normal life as possible.”

Seniors represent 21.1% of the population in Pinellas County, Florida, according to the U.S. Census Bureau. The county consists of Tampa, St. Petersburg, and Clearwater, Florida metropolitan areas.

Suncoast Hospice and Seasons Hospice & Palliative Care of Pinellas County LLC are the two existing licensed hospice programs operating in that region, according to a 2021 report from the AHCA. Hernando-Pasco Hospice, Inc. received CON approval to expand services in the county as well.

Seasons in 2020 merged with post-acute company AccentCare, a portfolio company of the private equity firm Advent International.

Suncoast Hospice is a member of Empath Health, a nonprofit integrated network of care supporting patients and families challenged by chronic and advanced illness in the Tampa Bay region. Empath Health expanded its presence in Florida at the start of this year, growing its hospice care services throughout the Hardee, Highlands, and Polk counties.

Hospice utilization runs high in Florida. The state ranked fourth nationwide for hospice utilization among Medicare decedents in 2018, reaching a rate of 57.9%, according to the National Hospice and Palliative Care Organization. Only Utah, Delaware and Arizona saw higher rates at 60.5%, 59.2%, and 58.8% respectively.

Statewide, the number of adults 65 and older is projected to swell to 6.7 million during the next two decades, a 52.1% jump from 4.4 million currently, according to Florida TaxWatch.

Rising demand is attracting other hospice providers to the Florida market.

Chemed Corporation (NYSE: CHE) VITAS Health in September expanded with three de novos in the state’s southwest region. The latest de novo will serve Glades, Hendry, and Lee counties. This came on the heels of two other new inpatient hospice facilities that VITAS opened in Broward County, Florida earlier this year.

Future growth in the Florida market will hinge in part on how certificate of need regulations evolve. The AHCA in 2021 initially indicated that it would approve four hospice certificates of need that year, but ultimately decided to issue twice as many. Some industry stakeholders saw this as paving the way for hospice M&A expansion in the Sunshine State.

The ACHA determines the number of certificates it will issue based on population data, mortality rates, hospice utilization data and the number of providers operating within a count.

A provider must demonstrate a minimum threshold of 350 patients who will have unmet hospice services without the addition of their services within a targeted service region, according to the agency.