Kain Capital Forms New Hospice Holdings Company, Makes First Acquisition

Kansas City-based Hospice Care of America (HCA) was recently acquired by a newly formed holdings company established by the private equity firm Kain Capital LLC. Financial details of the transaction were undisclosed.

Kain Capital established PERA Holdings as a way to gain a foothold in the hospice market. HCA marks the company’s first purchase, acquiring a majority stake in the company through the transaction.

Established in 2004, HCA operates a group of affiliated hospice and palliative care providers in Colorado, Kansas, Missouri and Oklahoma. The hospice will accelerate its growth plans and stretch its geographic footprint through the acquisition, according to HCA CEO Phil Hill.


Leaders of hospice locations across its service regions will remain in their current roles and become equity owners in the newly acquired company.

“We needed a partner that understands our needs and can bring best practices, technology innovation and capital to take our company to the next level,” Hill said in an announcement.

PERA aims to acquire mid-sized hospice and palliative care companies. The company’s strategy hinges on integrating and partnering with local, regional and national health systems to provide those services.


PERA’s acquisition sights are set on hospices seeking additional capital, technology and management resources to grow their operations.

Operational and staffing strains have caused a growing number of hospices to shutter or halt their programs in recent years. Some hospices have been unable to sufficiently fill their ranks to keep up demand for care as long-standing workforce shortages worsened during the pandemic.

PERA brings advanced information technologies into hospice operations to improve quality and increase staffing efficiencies, the firm indicated. The company leverages technology to help hospices enhance care delivery, reduce staff time spent on administrative tasks and automate billing, compliance and other regulatory management functions.

“Our team is passionate about our calling and how we can help our partners impact patients and families at a time when they really need assistance in their journeys,” PERA CEO Kris Stice said. “The acquisition of HCA is a first step in PERA’s strategy to create a best-in-class hospice and palliative care services provider with a national footprint.”

Kain Capital launched PERA in partnership with a team of eight unnamed hospice executives to help identify best operational practices and areas of need. Through PERA, the company aims to provide smaller hospices with a set of shared resources, services and assistance aimed at growth and sustainability.

Private equity investment has been growing in the hospice space. The number of private equity hospice deals reached record highs last year, according to data from the M&A advisory firm The Braff Group. Of the estimated 60-plus transactions during 2021, at least 39, or 65%, were private-equity based, a rise from 56% in 2020.

Demographic tailwinds in a fragmented health industry have made hospice an attractive market for investors.

“We see an opportunity to serve our communities while making a positive impact in an emerging area of health care,” said Kain Capital Founder and Managing Partner Kunal Kain.

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