Legacy Hospice Acquires Safe Harbor

Legacy Hospice has expanded in Missouri by acquiring Safe Harbor Hospice for an undisclosed sum.

Safe Harbor’s 13-county service region builds on Legacy’s footprint in southeastern Missouri. All told, Legacy now operates 19 locations in seven states, predominantly in rural areas. The company is backed by the Chicago-based private equity firm Prairie Capital.  

The Safe Harbor asset, which currently has an average daily census of 55 patients, represents a substantial growth opportunity for Legacy, according to CEO Clark Blair.


“We feel the opportunity to grow Safe Harbor is tremendous. Since Feb. 2021, Legacy has organically grown our census by over 63%. We have no reason to believe this growth won’t continue,” Blair told Hospice News. “We are actively integrating our state-of-the-art technology into the Safe Harbor location, along with extensive employee education and training so they can experience the same results.”

Favorable demographics are among the factors that make Missouri an attractive market for hospices.

The proportion of seniors older than 65 in Missouri’s population is expected to reach 19.1% by 2025, up from 13.5% in 2000, according to the U.S. Census Bureau.


Hospice utilization in Missouri reached 50.2% among Medicare decedents in 2018, which is in line with that year’s national average, according to the National Hospice and Palliative Care Organization. Utah leads the nation in utilization at 60.4%.

“It is evident by Safe Harbor’s reputation within the community and among its professional relationships that it aligns with the mission, vision, and values of Legacy,” Blair said. “With the additional coverage area of Safe Harbor, Legacy can provide the hospice benefit to broader rural communities in southeastern Missouri.”

Overall, both buyers and sellers remain “bullish” on transactions in Missouri, according to Alex Veach, director of transaction services for the M&A advisory firm Agenda Health. Agenda advised Safe Harbor in the Legacy deal.

Safe Harbor began exploring a potential sale back in 2020, Veach indicated. They connected with Agenda,and the firm initiated discussions with prospective buyers as Safe Harbor worked towards meeting its growth targets.

“We began working with the Safe Harbor team in the last few years,” Veach told Hospice News. “We worked with their team to build a buyer pool of groups we felt would best satisfy what they were looking for in a transaction and ultimately felt that the Legacy team best met that goal.”

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