Choice Health at Home Secures $190 Million Credit Facility, Completes Two Acquisitions

Texas-headquartered Choice Health at Home has closed a $190 million credit facility led by Oxford Finance, a global specialty financial firm focused on life sciences and health care investments. In conjunction with this infusion of capital, Choice has purchased Kindful Hospice and Amed Home. Financial terms were undisclosed.

AllianceBernstein and Maranon Capital served as co-syndication agents in the credit facility. Choice has been on a roll in terms of securing investments to fuel its growth, including relationships with the private equity firms Coltala Holdings and Trive Capital. As evidenced by the recent purchases, Choice will leverage the funds to pursue further acquisitions.

Kindful Hospice operates six locations in Oklahoma and Kansas, and Amed has eight offices in Texas. Amed is not affiliated with the publicly traded home health and hospice provider Amedisys (NASDAQ: AMED).

“This transaction, when you look at Amed and Kindful together, was probably one of the three largest in the country over the past quarter. We are really excited about that.” Choice Health & Home CEO David Jackson told Hospice News. “When we think really along the lines of that full continuum [of home-based care], we are developing our provider line, or home health line and hospice. We have plans in those states within the next two quarters to really expand our footprint.”

Choice’s growth strategy is focused on the Southwest, building density in its current markets in Texas, Oklahoma and Kansas with plans to branch out in the near future, including to Arizona and New Mexico.

The Kindful transaction marks Choice’s first entry into Kansas. Kansas was 12th in the nation in 2018 for hospice utilization among Medicare decedents at 53.3%. Missouri, at 50.2%, was 24th. The national average is slightly more than 50%.

The proportion of the Kansas population that is older than 60 is growing while the proportion that is under 60 is shrinking. The U.S. Census Bureau estimates that nearly 25% of Kansas residents will exceed that age by 2030, a 32% increase from 2012.

The Kindful deal also grows Choice’s presence in Oklahoma. The company moved into that market in 2021 through a series of acquisitions including Restore Home Health, Alpha Home Health and Hospice, and Angelic Hospice of Shawnee. All told, the company completed nine transactions last year.

“This was an outstanding operational move bringing us some great people,” Trina Lanier, COO of Choice and co-founder of the hospice and home health service segment, said. “Kindful has built an exceptional statewide reputation and, in concert with additional organic expansion plans, gives Choice the capability of providing hospice services to approximately 90% of the state of Oklahoma by year end 2022.”

Jackson founded Tyler, Texas-based Choice in 2008 as a rehabilitation services provider. The company entered the home health space in 2012 and moved into hospice in 2018.

Jackson, a former college athlete and physical therapist, was inspired to establish Choice Health at Home by the experiences of his two grandfathers, both of whom struggled with debilitating, life-limiting illness in their twilight years.

When the family saw complications with the home health care these patriarchs received, as well as a difficult transition to hospice, Jackson said he wanted to create a company that would provide a better patient experience. He capitalized Choice with personal funds and three credit cards.

The company’s plan for growth is not limited to acquisitions.

“The most exciting organic growth plan that we have within hospice is working with our home health organizations in every market to meet the needs of the critically ill and start conversations about their own health care and allow them more control of their own health care,” Jackson said. “That’s exciting for me as a clinician and as a CEO, to give my patients more control and more advanced planning, which is a real need in health care.”