St. David’s HealthCare Expands Into Hospice, Home Health with HCA-Brookdale JV Assets

Texas-based St. David’s HealthCare has expanded its services to include hospice and home health care in and around the City of Austin.

St. David’s HealthCare was formed through a partnership between hospital operator HCA Healthcare (NYSE: HCA) and two nonprofit organizations — St. David’s Foundation and Georgetown Health Foundation. The recent expansion of services has its roots in HCA’s $400 million acquisition of an 80% stake in Brookdale Senior Living’s home health and hospice segment last year.

“[Brookdale home health and hospice] provides us with a large platform that complements our local provider systems,” said HCA Healthcare CEO Samuel Hazen during an earnings call. “Additionally, we believe the home will become a more important setting for health care in the future, with continuing growth in demand.”


The transaction added 57 home health agencies, 22 hospice agencies, and 84 outpatient-therapy locations to HCA’s portfolio, which the company manages through a joint venture with Brookdale.

The JV went on to sell operations in 22 states, including 11 hospice locations to LHC Group Inc. (NASDAQ: LHCG) toward the end of 2021, retaining those that fell within HCA’s hospital footprint.

Now, the joint venture has attached former Brookdale hospice and home health locations to St. David’s, an HCA affiliate, rebranded as St. David’s HealthCare at Home and St. David’s Hospice & Family Care.


All told, the St. David’s system operates more than 180 sites of care that also include hospitals, freestanding emergency departments, urgent care clinics, and physician offices. The three partners that own the system funnel dollars from St. David’s into local community initiatives to support other health care programs.

The organization earlier this year announced a $953 million expansion initiative, involving the construction of two new hospitals, a behavioral health facility, and renovations to its existing medical centers as well as the move into home-based care.

“St. David’s HealthCare is dedicated to ensuring Central Texans have the care and support they need during every stage of life,” David Huffstutler, president and CEO of St. David’s HealthCare, said in a statement. “As the region’s leading health care provider, we have built a system around convenience and access in order to meet the needs of our patients, and home health and hospice are critical parts of this.”

Demographics are pushing up demand for hospice in Texas. Projections from the U.S. Census Bureau indicate that seniors will comprise more than 20% of the state’s population by 2030, up from 12.9% currently.

Hospice utilization among Medicare decedents in Texas runs high, reaching 52.1% in 2018, tipping above the national average of 50.3% that year, according to the National Hospice and Palliative Care Organization.