VITAS Healthcare
VITAS Healthcare Corporation, a wholly owned subsidiary of Chemed Corporation (NYSE: CHE), is one of the largest for-profit providers of hospice and palliative care services in the United States.[1][2] Founded in 1978 in Miami, Florida, as Hospice Care Inc. by Methodist minister Hugh Westbrook and nurse Esther Colliflower, it pioneered early hospice programs focused on compassionate end-of-life care for terminally ill patients.[3] With over 12,000 employees, VITAS serves more than 22,000 patients daily across 15 states and the District of Columbia, operating 58 hospice programs that emphasize dignity, comfort, and family support.[4] VITAS delivers a range of services including routine home-based hospice care, continuous care for acute symptoms, inpatient hospice units, respite care, and palliative interventions to manage pain and improve quality of life, often incorporating integrative therapies such as music, art, and pet visits.[5][6] The company provides care in patients' homes, nursing facilities, and dedicated inpatient settings, positioning itself as a leader in addressing complex end-of-life needs with 47 years of experience.[4] It has expanded through acquisitions and maintains a focus on technological innovations in patient care delivery.[7] Among its achievements, VITAS has been recognized as a 2025 Top Workplace in Healthcare and provided $14.3 million in charity care in 2024, reflecting its scale as the nation's largest single-source end-of-life care provider.[8][4] However, as a prominent for-profit entity in the hospice sector, it has encountered significant regulatory scrutiny, including a U.S. Department of Justice False Claims Act lawsuit alleging fraudulent Medicare billings for ineligible patients and a 2022 Office of Inspector General audit estimating at least $140 million in improper Medicare reimbursements based on sampled claims.[2][9] These issues highlight ongoing debates in the industry regarding billing practices and patient eligibility determination.[9]
Company Overview
Founding and Core Mission
VITAS Healthcare was established in 1978 in Miami, Florida, as Hospice Care Inc., becoming one of the first hospice programs in the United States.[3] The initiative originated in the mid-1970s from the collaboration of Hugh A. Westbrook, an ordained United Methodist minister and educator, and Esther T. Colliflower, a registered nurse, both of whom were teachers dissatisfied with the prevailing approaches to end-of-life care.[10] [11] Drawing from the emerging hospice model inspired by European practices, particularly the work of Cicely Saunders in the UK, Westbrook and Colliflower sought to introduce a structured alternative emphasizing patient-centered care over aggressive curative treatments for terminally ill individuals.[3] The organization's name, VITAS, derives from the Latin word for "lives," reflecting its foundational intent to affirm the value of life even in its final stages.[12] At its inception, VITAS operated from modest beginnings, initially serving a small number of patients in South Florida amid limited Medicare reimbursement for hospice services, which was not formalized until 1982.[13] Westbrook and Colliflower's vision was driven by a recognition that many Americans faced inadequate support during terminal illness, often enduring prolonged hospital stays focused on futile interventions rather than comfort.[11] This led to the development of interdisciplinary teams comprising physicians, nurses, social workers, and chaplains to deliver care in patients' homes or dedicated facilities, prioritizing symptom management for conditions like pain, nausea, and emotional distress.[3] The core mission of VITAS Healthcare centers on delivering compassionate hospice and palliative care that upholds patient dignity, comfort, and quality of life during end-of-life transitions.[14] This entails a holistic approach addressing physical, emotional, spiritual, and social needs, with an emphasis on enabling patients to remain in familiar environments whenever possible and supporting families through bereavement.[10] Unlike curative models, VITAS's framework is predicated on accepting the inevitability of death in terminal cases—such as advanced cancer, heart failure, or dementia—shifting resources toward palliation to mitigate suffering rather than extending life at all costs.[6] This mission has remained consistent since founding, evolving to incorporate evidence-based practices while adhering to the principle that effective end-of-life care requires interdisciplinary coordination and family involvement.[3]Services Provided
VITAS Healthcare specializes in hospice and palliative care for patients facing serious or terminal illnesses, emphasizing symptom management, comfort, and quality of life over curative treatments. Hospice services are designed for individuals with a life expectancy of six months or less if the disease follows its typical course, while palliative care can be provided at any stage of illness, often concurrently with disease-directed therapies. Both are delivered by interdisciplinary teams comprising physicians, nurses, home health aides, social workers, chaplains, and volunteers, with care coordinated to address physical, emotional, spiritual, and practical needs.[15][16] Hospice care is primarily provided in patients' homes—whether private residences, assisted living facilities, or nursing homes—through routine home care involving scheduled visits for pain and symptom control, medication management, and support for daily activities. This includes delivery of all necessary medical equipment, supplies, and medications at no additional cost to eligible patients under Medicare or similar coverage. For crises requiring more intensive support, continuous hospice care offers around-the-clock nursing presence at home to manage acute symptoms like uncontrolled pain or respiratory distress. VITAS also facilitates inpatient hospice care in dedicated units, partner hospitals, or skilled nursing facilities when symptoms cannot be safely managed at home; this short-term option, typically lasting 3–5 days, aims to stabilize patients for discharge back to routine care, with facilities featuring family-friendly amenities such as private rooms and communal spaces. Respite care provides temporary inpatient relief for family caregivers, up to five days, to allow recovery or breaks. A 24/7 telecare line ensures constant access to clinicians for guidance or emergency dispatch.[6][17] Palliative care services focus on comprehensive symptom relief, including alleviation of pain, nausea, fatigue, and emotional distress through medications, therapies like acupuncture or nutrition counseling, and holistic support such as spiritual guidance and advance care planning. Unlike hospice, which shifts away from curative intent, palliative care aligns interventions with patient goals and can extend indefinitely, supporting decision-making and family involvement without prognosis restrictions.[16] Additional offerings include specialized support for veterans through dedicated care tailored to military service-related needs and pediatric hospice in select locations for children with life-limiting conditions. Complementary therapies, such as music therapy, pet visits, massage, and bereavement counseling, enhance emotional and spiritual well-being, with plans customized by diagnosis, cultural diversity, and individual preferences.[18][19][15]Ownership Structure and Financial Performance
VITAS Healthcare Corporation operates as a wholly owned subsidiary of Chemed Corporation, a diversified holding company publicly traded on the New York Stock Exchange under the ticker symbol CHE.[20] Chemed acquired VITAS in 2004, integrating it as one of two primary operating segments alongside Roto-Rooter, a plumbing and drain cleaning service provider.[21] This structure positions VITAS under Chemed's centralized management while allowing operational autonomy in hospice and palliative care delivery.[22] The VITAS segment has demonstrated revenue growth driven by expansions in average daily census, admissions volume, and Medicare reimbursement adjustments, though profitability has faced pressures from regulatory caps, acuity mix shifts, and external disruptions such as hurricanes.[23] In the fourth quarter of 2024, VITAS reported net revenue of $411.0 million, a 17.4% increase year-over-year, supported by a 14.6% rise in average daily census to 22,179 and contributions from the April 2024 acquisition of Covenant Health assets, which added $11–12 million in revenue.[24] Adjusted EBITDA, excluding Medicare cap effects, reached $93.2 million, up 11.8%, despite a 119 basis point negative impact from patient acuity shifts.[24] Continuing into 2025, first-quarter net revenue climbed to $407.4 million, reflecting a 15.1% year-over-year gain, fueled by an 11.9% increase in days of care and a 3.2% Medicare rate uplift, partially offset by a 112 basis point drag from acuity mix.[23] Adjusted EBITDA excluding the cap rose 15.9% to $70.3 million, with the Covenant acquisition contributing an additional $11.5–12.5 million in revenue and $2.1–2.3 million in net income.[23] Second-quarter revenue moderated to $396.2 million, up 5.8%, with a 6.1% days-of-care increase and 4.2% reimbursement boost, but operating income fell 23.5% to $38.2 million amid higher Medicare cap accruals of $16.4 million and weaker admissions in Florida.[25] Adjusted EBITDA held flat at $66.8 million, with margins contracting 163 basis points to 16.2%.[25]| Quarter | Net Revenue ($ millions) | YoY Growth | Adjusted EBITDA excl. Medicare Cap ($ millions) | YoY Growth |
|---|---|---|---|---|
| Q4 2024 | 411.0 | +17.4% | 93.2 | +11.8% |
| Q1 2025 | 407.4 | +15.1% | 70.3 | +15.9% |
| Q2 2025 | 396.2 | +5.8% | 66.8 | 0% |