Cornerstone Buys San Antonio-Area Hospice

Cornerstone Healthcare, Inc., a subsidiary of the Ensign Group (ENSG), has purchased the assets of Boerne, Tex.-based All County Home Care and Hospice for an undisclosed sum, furthering the company’s strategy of acquiring well-performing and struggling hospice and home health care providers nationwide.

With this acquisition, Cornerstone now operates 25 hospice locations in addition to 33 other home-based health care ventures across 12 states, predominantly in the West and Midwest.

“All County is a strategic addition to Cornerstone’s home health and hospice operations,” said Christopher Christensen, Ensign’s president and chief executive officer. “This acquisition supplements our vibrant skilled-nursing operations in the greater San Antonio area with a high-quality home health and hospice partner. This expanded continuum will improve outcomes for patients throughout the San Antonio area.”


Cornerstone, like other operators in the hospice market, has identified M&A as a key growth strategy for 2019, having seen their 2018 acquisitions contribute to the company’s strong financial performance. During the fourth quarter of 2018 alone, the company acquired Alpha Nursing in Washington state, Cornerstone Home Health and Hospice in Utah, as well as Sequoia Hospice in California.  

“Each of these acquisitions are small agencies that we purchased from small business owners that were looking to exit the space. We continue to see attractive growth opportunities like these and will opportunistically acquire when our leadership talent, geography and pricing align,” Christensen said.

Cornerstone’s 2018 full-year revenue reached $170.9 million, exceeding the previous year’s total by 20 percent. Income rose 32 percent to $26.1 million.


In addition to Cornerstone’s hospice and home health M&A activity, its parent company The Ensign Group last year completed a number of acquisitions to build up its other health care segments. Ensign’s independent operating subsidiaries provides a range of post-acute health care services including hospice, skilled nursing, medical transportation, home health, assisted living, and rehabilitative therapies.

Ensign’s GAAP earnings per share for 2018 was $1.70, an increase of 120.8 percent from the prior year, and adjusted earnings per share was $1.88, up 34.3 percent. Consolidated GAAP Net Income for the year was $92.4 million, up 128.2% from 2017. Consolidated adjusted net income hit $102.1 million, up 38.3 percent from the prior year.

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