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Through Life’s Challenging Seasons, We’re Here to Help.

Four Seasons History

The word “hospice” comes from the Latin hospitum, meaning hospitality or place of protection and rest for the weary. The concept of Hospice care was reportedly available as far back as 1065 in Malta. Modern day Hospice Care began in England in the 1950s when Dame Cicely Saunders, a physician and healthcare pioneer created the first modern hospice there in 1967. Four Seasons wasn’t far behind, establishing its roots as Hospice of Henderson County in 1979. Thank you for reading about our rich history. We are grateful to continue making history and would love for you to be a part of our next chapter as a volunteer, a member of our team or a community supporter. Contact us today if you’d like to be part of our future!

Four Seasons Timeline


Four Seasons (originally Hospice of Henderson County) is Formed

Jean Moulthrop HoogstraThe Four Seasons story begins with Jean Moulthrop Hoogstra (1916-2012), long considered the matriarch of hospice in Western North Carolina. In 1977, she relocated to Hendersonville with her then-husband, Dick Moulthrop. Their church was looking for an outreach program, so she and a small group of volunteers decided to attend a workshop on hospice. What they learned was inspiring.

“It seemed so logical,” she said, looking back in 2001, “to treat dying as a natural event, to relieve pain and suffering, and to give care and support to patients and caregivers at end of life.”

As the idea of starting a hospice took form, Jean reached out to psychologist John Esse and registered nurse Claire Burse with the shared objective of providing services to terminally ill persons who would prefer to die at home. Under the auspices of a steering committee formed in the living room of her Springside Drive residence, the Hospice of Henderson County incorporated in December 1979.


Four Seasons Serves First Patient


Four Seasons becomes Hospice Medicare Certified

Although this benefit was available in 1983, at that time it did not meet all the needs of those dealing with serious and advanced illnesses.

Innovation is truly the DNA of Four Seasons. Jean Moulthrop Hoogstra foresaw that while the Hospice Medicare benefit was innovative, Four Seasons would not enroll to become certified until it met all of our patient’s needs.


Elizabeth House Opens

Thanks to the ongoing support of the community and the generosity of donors, the Elizabeth House, a 12-bed inpatient hospice residence, opened in April 1999.


Palliative Care Program is Founded

As a result of innovative thought leaders and a progressive board of directors, Four Seasons added a Palliative Care program in 2003. Thanks in no small part to the efforts of Janet Bull, M.D., a pioneer in establishing best practices in hospice and palliative care, we continue to share our knowledge, research and mentor others on how to provide the best palliative care possible.


Greatrex Place Opens

Greatrex Place opens its doors in December 2005, forming a center for Four Seasons’ operations.


Nationally-Recognized Clinical Research Department Founded

In 2005, Dr. Janet Bull founded Four Seasons’ nationally-recognized Clinical Research department with a community-based program focused on the lessening of patient suffering in a home setting. To date, we are one of just a handful of palliative and hospice care organizations in the nation to participate in clinical research trials.


Elizabeth House Expands to Include the Charles W. McGrady Wing

By 2007, the capacity of the Elizabeth House expanded with the addition of the Charles W. McGrady wing.


Four Seasons Hospice Home Store Opens on Main Street, Hendersonville.

The Home Store originally opened in 2006 as Grandma’s Attic on Asheville Highway. The next year in 2007, the Home Store moved to its flagship location on Main Street Hendersonville.


Four Seasons Presented with the Circle of Life Award

In 2009, Four Seasons received the prestigious Circle of Life Award honoring its innovative care. The American Hospital Association and partner agencies noted Four Seasons for the leading-edge palliative care delivery in rural settings, involvement in collaborative research with universities, and Palliative Care outreach.


Four Seasons Expands to Serve More Counties

In 2010, Four Seasons began to expand into Buncombe and Transylvania counties due to people asking for our services.

Also, in 2010, Four Seasons purchased the hospice services of Highlands-Cashiers Hospital which gave Four Seasons the ability to serve Macon, Jackson, Swain, Clay, Graham, and Cherokee Counties.


Flat Rock Location Named the Jean Moulthrop Hoogstra Community Campus

For more than 30 years, Jean Moulthrop Hoogstra would volunteer with the agency she helped found, maintaining an active role its growth and development. In 2010, the agency named its Flat Rock location the Jean Moulthrop Hoogstra Community Campus.


Jean Moulthrop Hoogstra Awarded the Judith Lund Person Hospice Volunteer Award

2011, at the age of 94, Jean Moulthrop Hoogstra was awarded the Judith Lund Person Hospice Volunteer Award by the Carolinas Center for Hospice and End of Life Care. 


Four Seasons Center for Excellence Named One of the Top Ten Clinical Training Sites

The “Palliative Care Immersion Course,” an experiential program offered to clinicians from around the country, was created during this period, also due to Dr. Bull’s efforts. The Four Seasons’ Center for Excellence was named one of the top ten clinical training sites by the American Academy of Hospice and Palliative Medicine (AAHPM), and the Center to Advance Palliative Care (CAPC) in 2011.


Four Seasons Awarded Grant to Pilot Medicare Reform

In May 2014, Four Seasons was notified they were the recipient of a $9,596,123 grant award to pilot Medicare reform from the Center for Medicare and Medicaid Innovation, a program of the federal Department of Health and Human Services. Four Seasons emerged as the sole hospice and palliative care provider nationwide chosen to implement healthcare reform through its innovative community care model. Nationally, the model is designed to improve outcomes, increase quality of care, decrease hospital re-admissions, decrease costs for patients and families and reduce tolls on Medicare.


Four Seasons Acquires Compassionate Home Care (now named Four Seasons Home Care)

In 2016, Four Seasons acquired Compassionate Home Care furthering our ability to provide patients and families with a continuous care model throughout their journey. In 2019, Compassionate Home Care changed its name to reflect on the mission, vision and values of Four Seasons and is now named Four Seasons Home Care.

Four Seasons Starts Care Navigation Program

In 2017, Four Seasons introduced Care Navigation where we are able to guide families through the process of aging or being diagnosed with a serious illness. Wherever you are on this path, we are here to navigate and help you.


Four Seasons Home Care Awarded Best of Home Care Pulse Awards

Four Seasons Home Care awarded the distinguished Best of Home Care Leader in Excellence Award, Best of Home Care Provider of Choice Award, and Best of Home Care Employer of Choice Award from Home Care Pulse, the leading firm in quality assurance for home care.


Hospice Home Store Opens Second Location in Arden

The Home Store team worked diligently to provide a warm and inviting shopping opportunity for those in South Asheville/Arden Area.


Four Seasons Home Care Awarded Home Care Pulse Awards a Second Time



Four Seasons Named Top 50 Modern Healthcare Best Place to Work


Four Seasons Receives Deemed Status by the Joint Commission


Four Seasons Receives Hospice Honors


Four Seasons Home Care Awarded Home Care Pulse Awards a Third Time



Hospice Home Store Opens Third Location in Brevard

The Home Store team worked diligently to provide a warm and inviting shopping opportunity for those in South Asheville/Arden Area.



Four Seasons Expands into Madison & Rutherford Counties.

This brings the total number of counties served to 13.


Four Seasons Receives Hospice Honors Again


Four Seasons Home Care Awarded Home Care Pulse Awards a Fourth Time