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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!

Read Four Seasons: A Heritage of Compassion in Western North Carolina for more on our history

Four Seasons Timeline

1979

Four Seasons (originally Hospice of Henderson County) is Formed in 1979

The 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 people in business attire have a conversation in an office. A woman sits at a desk labeled HOSP, holding papers, while three men stand or sit close by and smile warmly. Their expressions and body language convey compassion and teamwork.

1981

Four Seasons Serves First Patient in 1981

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.

A mountain landscape with dense green forest beneath a blue sky scattered with white clouds, offering a panoramic view of the valley and distant peaks.

1999

Elizabeth House Opens in 1999

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.

A sign with Elizabeth House Inpatient Residence stands before a landscaped garden meant for year-round enjoyment, with a single-story building in the background beneath a clear blue sky.

2003

Palliative Care Program is Founded in 2003

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.

Four Seasons Palliative Care with red and gold colors and decorative circular designs on each end.

2005

Greatrex Place Opens in 2005

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

A two-story brick building features tall columns, arched lower windows, an upper balcony, and neatly trimmed bushes in front, creating a welcoming atmosphere for hospice care in Henderson County.

2007

Four Seasons Hospice Home Store Opens on Main Street, Hendersonville in 2007

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.

Storefront with a sign that reads Four Seasons Hospice Home Store above large front windows, offering a warm invitation to passersby to discover the variety of items inside and reflecting the welcoming spirit of Four Seasons.

2009

Four Seasons Presented with the Circle of Life Award for Palliative Care in 2009

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.

A blue circle positioned above Circle of Life: Celebrating Innovation in Palliative and End-of-Life Care on a light background, emphasizing advancements in hospice and palliative support.

2010

Flat Rock Location Named the Jean Moulthrop Hoogstra Community Campus in 2010

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.

Four Seasons Expands to Serve More Counties in 2010

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.

 

2011

Jean Moulthrop Hoogstra Awarded the Judith Lund Person Hospice Volunteer Award in 2011

In 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 in 2011

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.

Woman with glasses, short curly hair, and a floral blouse reminiscent of the four seasons, smiling slightly in front of a plain gray background.

2014

Four Seasons Awarded Grant to Pilot Medicare Reform in 2014

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.

Rolling green mountains covered in dense forest stretch under a blue sky with scattered clouds, as seen from an elevated viewpoint, evoking a comforting feeling similar to that found in pet therapy sessions with compassionate therapists.

2016

Four Seasons Acquires Compassionate Home Care (now named Four Seasons Home Care) in 2016

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.

A rectangular red and gold sign with “FOUR SEASONS” in white above “HOME CARE” in blue, accented by decorative circular patterns on each end to emphasize the four seasons theme.

2017

Four Seasons Starts Care Navigation Program in 2017

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.

2019

Four Seasons Home Care Awarded Best of Home Care Pulse Awards in 2019

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.

2020

Hospice Home Store Opens Second Location in Arden in 2020

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 in 2020

A row of storefronts with large glass windows in a small shopping center sits in front of trees displaying vibrant seasonal colors, with an empty parking lot stretching out in front.

2021

Four Seasons Named a Top 50 Modern Healthcare Best Place to Work in 2021

Four Seasons Receives Deemed Status by the Joint Commission in 2021

Four Seasons Receives Hospice Honors in 2021

Four Seasons Home Care Awarded Home Care Pulse Awards a Third Time in 2021

Hospice Home Store Opens Third Location in Brevard in 2021

The Home Store team worked diligently to provide a warm and inviting shopping opportunity for those in Brevard and Transylvania County.

Modern Healthcare Best Places to Work 2021, with blue and yellow on a white background and yellow horizontal lines above and below, honoring outstanding providers of palliative and hospice end of life care.
The Joint Commission National Quality Approval gold seal in a circle with a stylized geometric mark at the center, representing commitment to excellence through all four seasons.
Hospice Honors in black and pink capital letters, with a pink diamond shape inside the letter S in Hospice, symbolizing excellence in hospice and palliative end of life care.
A large building with Four Seasons Hospice Home Store on a sign above glass storefront windows and an empty parking lot in front, reflecting the welcoming presence of Four Seasons in the community.

2022

Four Seasons Expands into Madison & Rutherford Counties in 2022

This brings the total number of counties served to 13.

Four Seasons Receives Hospice Honors Again in 2022

Four Seasons Home Care Awarded Home Care Pulse Awards a Fourth Time in 2022

Hospice Honors in black and pink capital letters, with a pink diamond shape inside the letter S in Hospice, symbolizing excellence in hospice and palliative end of life care.
Three circular 2022 badges labeled Best of Home Care: Provider of Choice, Leader in Experience, and Employer of Choice.

2023

Four Seasons Hosts 1000th Veterans Pinning Ceremony in 2023

Four Seasons Becomes Living Wage Certified in 2023

Four Seasons Named Best Place to Work for Second Year- Top 10 in Nation in 2023

Four Seasons Home Care Awarded Home Care Pulse Awards a Fifth Time in 2023

Banner for Four Seasons 1000th veteran pinning ceremony featuring Bill Troutman in a wheelchair as the 1000th honoree, with a U.S. flag in the background.
A circular badge features a green plant above the words living wage certified, with a blue border reading creating sustainable livelihoods and www.justeconomicswnc.org, representing support for fair compensation throughout the year.
Modern Healthcare Best Places to Work 2023, top 10 provider in the US.
2023 Best of Home Care badge with Top 100 in Experience displayed in bold teal and white on a shield-shaped background, symbolizing trusted care throughout all four seasons.

2024

Four Seasons Achieves Level 4 We Honor Veterans Status in 2024

Four Seasons Pediatric Hospice & Palliative Care Program, Riversong, Established in 2024.

Four Seasons Home Care Awarded Home Care Pulse Awards a Sixth Time in 2024

Four Seasons Named a Best Place to Work by Modern Healthcare for 3rd time in 2024.

A blue V with a star, We Honor Veterans, and four maroon stars below representing the four seasons of service, all within a blue border.
Four Seasons Riversong Pediatric Palliative & Hospice Care, with an otter face in the word RIVERSONG and a flowing blue wave below, reflecting trusted care and warmth of Four Seasons.
Best Places to Work 2024, Modern Healthcare in blue letters, separated by a horizontal yellow line.
A badge featuring “2024 Best of Home Care Top 100 in Experience” with a teal and navy design, emphasizing prestigious awards.

2025

Four Seasons Expands to Serve McDowell County in 2025

The addition of McDowell County brings the number of counties served to 14.

Four Seasons Home Care Awarded Home Care Pulse Awards a Seventh Time in 2025

Four Seasons Named Best Place to Work for Fourth Year in 2025

Four Seasons Receives Bell Seal Award for Employee Mental Health Support in 2025

Four Seasons Receives Hospice Honors in 2025

A map of North Carolina with each county in the Four Seasons service area labeled and color-coded for the North, South, and West regions to highlight the reach of Four Seasons services.
Three circular badges celebrating awards display Provider of Choice 2025, Leader in Experience 2025, and Employer of Choice 2025, each bordered by Best of Home Care.
Modern Healthcare in blue and yellow font on a white background, highlighting the prestigious Best Places to Work 2025 recognition.

2026

Four Seasons Designated a 5 Star Hospice by Centers for Medicare and Medicaid Services in 2026

Five Stars is the highest ranking and is based on quality scores from the CAHPS survey, which is sent to families we have served. 

Four Seasons is Named Hospice Honors Elite by MatrixCare in 2026

Hospice Honors Elite is a recognition by MatrixCare based on quality scores and feedback. 

Four Seasons Receives Best Places to Work for Fifth Year in 2026

Four Seasons Home Care Awarded Home Care Pulse Awards an eighth Time in 2026

 
Five yellow stars are lined up representing Five Star Hospice awarded by CMS.
Blue geometric badge with an orange star and the words Hospice Elite Honors 2026 in white and orange.
Modern Healthcare, Best Places to Work 2026 in blue and yellow on a white background, recognized alongside renowned organizations such as Four Seasons.
A badge displays 2026 Best of Home Care Top 100 in Experience in teal, white, and dark blue, emphasizing Four Seasons Home Care’s commitment to exceptional service.
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