The nation’s largest provider of hospice care is entering the Kansas market.

Miami-based Vitas Innovative Hospice Care announced Thursday that it had received state approval to provide end-of-life care in Kansas. The company opened in Kansas City, Mo., a month ago.

The new Vitas market – with offices in Merriam and downtown Kansas City, Mo. – stretches into Kansas by serving Douglas, Franklin, Jefferson, Johnson, Leavenworth, Miami and Shawnee counties.

Vitas, a subsidiary of Chemed Corp., last year had revenues of $638 million. Vitas has 39 programs in the United States.

Mark Cohen, a Vitas spokesman, said the company would work to educate the public about the benefits of hospice care that is provided in a patient’s home, whether it’s an owner-occupied residence or a skilled nursing facility.

“Our goal, our objective, is not to take patients away from an existing provider,” he said. “It’s to find the patients who could benefit from hospice care but who are not accessing it. Our philosophy is when every provider in the market does well, everybody benefits: the patients, the families, the providers, the assisted-living communities : everybody.”

Nadereh Nasseri, director of the Midland Healing Institute in Lawrence, said the community already was well-served by existing providers. Heart of America Hospice and Southern Care Hospice are for-profit providers with offices in town, while both Midland and Douglas County Visiting Nurses Assn. operate on a not-for-profit basis.

Nasseri fears that Vitas will end up marketing heavily to nursing homes, so that it can reduce travel expenses and boost efficiencies by seeing as many patients under a single roof as possible – and leave not-for-profits with a larger share of indigent cases.

“That puts us at a financial risk, but it’s our philosophy to care for them, so we do care for them,” she said. “We also get the harder cases. We have to travel a lot more than they do, and we have to work harder for the money. To me, it’s unfair.”

Cohen called such criticisms unfair, saying that Vitas provided $9 million in charity care last year, or 1.7 percent of gross revenues.