Charter Health Acquires Generations Hospice Care

Post-acute provider Charter Health, a portfolio company of the private equity firm Pharos Capital Group, has purchased San Antonio, Texas-based Generations Hospice Care for an undisclosed amount.

The transaction does not include the affiliated sister agencies Generations Hospice of Austin and Generations Visiting Practitioners.

“Texas, from an overall population as well as a retirement community standpoint, is continuing to grow and remains a very strategic market for Charter,” Charter President and CEO Steve Larkin told Hospice News. “We’re also seeing great opportunities and continued growth in Medicaid managed care within the state, allowing Charter to continue focusing on addressing markets with the great need for post-acute care services and partnering with at-risk providers.” 

Charter provides a range of senior care services that includes hospice, home health complex care management and palliative care. They care for more than 5,000 patients annually in six states.

Charter has been on a strong growth trajectory during 2020 and 2021. The Generations deal marks the organization’s seventh acquisition during the past two years. Most recently the company purchased Providence Home Health & Hospice, also in Texas.

Charter in February acquired Serene Care Hospice in Omaha, Neb., for an undisclosed sum. The company also purchased Omaha-based home health company Physmed from the same owner.

Last October the company purchased Vitality Home Healthcare in Denver and Salt Lake City-based Heartwood Home Health & Hospice. In March 2020, Charter acquired St. Luke’s Home Hospice in Las Vegas and Phoenix-based Arizona Select Hospice. Both of those providers were part of the VeraCare Hospice system.

Financial terms for each of these transactions were undisclosed.

“Maintaining consistency in staffing has become more important today than ever before in post-acute care,” Larkin said. “For all of our acquisitions, we’ve really tried to seek out organizations that have good longevity and tenure, low turnover, good patient outcomes, good employee outcomes and engagement in the communities they serve. We feel like Generations checked all those boxes for us.”

Demographic tailwinds have been fueling a thriving hospice market in Texas. The Lone Star State has the third largest elderly population in the nation, according to the Texas Demographic Center, a state institution. The number of Texans 65 or older grew by 49.5% between 2000 and 2014. Only California experienced a higher rate of increase among their senior population.

Texas ranks 15th among the states in hospice utilization, with 52.8% of Medicare decedents electing hospice in 2018, according to the National Hospice & Palliative Care Organization. Utah has the highest rate of utilization at 60.4%.

The company expects to complete further acquisitions during 2021.

The next six-to-eight months is going to be a very important time for Charter as we continue to expand our footprint and the communities where we can provide our continuum of high quality, post-acute care services,” Larkin said. “Our acquisition pipeline is currently full and we have a lot of pending transactions, primarily focused on continued expansion in the Southwest for the remainder of this year.”