Bristol Acquires Texas-Based Hospice Select

Bristol Hospice has acquired Hospice Select in the Dallas-Fort Worth area for an undisclosed sum.

Bristol is a large multi-regional player that has grown seven times larger since private equity firm Webster Equity Partners purchased the company in 2017. The hospice operates more than 45 locations across 13 states, with EBITDA that exceeds $70 million, according to PE Hub.

M&A advisory firm Agenda Health represented Hospice Select in the transaction.

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“We ran our bid process for Hospice Select at the start of this year and introduced them to myriad buyers,” Alex Veach, director of operations for Agenda Health, told Hospice News. “Hospice Select felt like the folks at Bristol represented the culture that they wanted to see continued in their hospice.”

Bristol has been very active in the M&A market. The company completed nine acquisitions during 2020, two in 2021 and 16 in total since Webster purchased the agency.

In March, Bristol Hospice acquired Missouri-based Hope Hospice for an undisclosed sum in the company’s first deal of the year.

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In December 2021, the company purchased two California providers from the same owner — A Plus Hospice and NorCal Hospice. Financial terms were confidential.

Demographics are driving 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.

The Lone Star State is second in the nation when it comes to the number of hospice providers operating within its borders, according to Veach. Thus, M&A activity in the region is unlikely to slow.

“Where you have the highest amount of supply, you’re going to see the largest amount of opportunity. We saw a ramp up in 2021 in the state of Texas in some of the larger markets, Houston, Dallas, even Austin a little bit,” Veach said. “I would expect that to continue.”

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