St. Croix Hospice’s 2 Acquisitions Mark ‘Tremendous, Transformative’ Growth Opportunities

Minnesota-headquartered St. Croix Hospice recently acquired Hospice of Siouxland in Iowa and some of Mayo Clinic Health System’s hospice assets in its home state, two moves that stretched its widening footprint across the Midwest. Financial terms of both deals were undisclosed.

The two transactions mark important milestones in the hospice provider’s growth trajectory during a pivotal time of rising demand, according to Heath Bartness, founder and CEO of St. Croix Hospice. The hospice provider is a portfolio company of the private equity firm H.I.G. Capital.

While both transactions were small in terms of patient census volumes, each deal represented significant opportunities to increase hospice access and strengthen workforce retention, Bartness stated.

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“It wasn’t that we gained additional geography in any of these acquisitions,” Bartness told Hospice News. “It’s simply gaining the opportunity to have a closer working relationship in these communities and be able to help us gain some really phenomenal caregivers on the St. Croix Hospice team. Both the Mayo Clinic and Hospice of Siouxland have such a strong historical reputation that seamlessly fits into our general footprint and operational structure.”

Founded in 2008, St. Croix Hospice provides care to more than 5,600 patients across 75 locations in the Midwest. The hospice’s geographic footprint spans Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, South Dakota and Wisconsin.

The Mayo Clinic acquisition included the health system’s hospice assets in southwestern Minnesota. The two organizations recently entered into an agreement, which is anticipated to close in the first quarter of 2025, pending regulatory approvals.

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Mayo Clinic Health System provides a range of services, including hospice, across Minnesota and Wisconsin. St. Croix Hospice has collaborated with the nonprofit health system for the past several years through a longstanding referral relationship, according to Bartness. .

The acquisition of Mayo Clinic’s hospice program was the second most recent transaction that St. Croix Hospice has made with a health system, a trend that could be picking up steam across the industry, according to Bartness.

St. Croix also acquired Hospice of Siouxland’s program, which involved assets acquired from two health systems that served on the nonprofit’s board, he said. Based in Sioux City, Iowa, and established roughly 40 years ago, the nonprofit hospice provides care across its home state, as well as in Nebraska and South Dakota. Hospice of Siouxland is among the organizations that provide care at the inpatient facility Mitchell House, which began serving patients in 2020.

Key considerations in each transaction were the companies’ reputations for high quality services and strong organizational culture, aspects that go a long way in sustainable hospice care delivery, Bartness said.

“Both programs were under 100 patients each, so these were not transformative in terms of census,” he told Hospice News. “But it’s transformative opportunities in terms of these were our first entry into acquiring nonprofit programs that have a very, very positive historic context. I think we’re going to continue to see health systems in particular recognize that they can have confidence in other community-based care providers to provide services, specifically hospices.”

As far as its future pipeline, St. Croix Hospice will remain focused on expanding in its existing geographic regions predominantly through de novo growth, but won’t rule out the possibility of additional acquisitions, Bartness indicated.

The hospice has historically grown by establishing new locations, anticipating the addition of roughly 15 to 18 de novos in 2025 and 2026, pending regulatory approvals in certain areas, he stated.

“We don’t have a robust M&A team, we don’t budget or have a game plan for any acquisitions to take place,” Bartness said. “Our acquisitions are simply opportunistic where we’ve been fortunate enough to be engaged by others to consider acquiring their program and enhance care. Our primary driver in terms of growth is continuing with de novos. But we’ve had a history of proving we can do acquisitions, and we can do much more sizable acquisitions as well. We are looking at tremendous opportunities with tremendous organizations, but still very much focused on the Midwest.”

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