Our History

The Four Seasons Compassion for Life 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. To build the foundations of hospice, the ten founding volunteers would develop a speaker’s bureau in 1980 to take the mission and message of hospice to groups, churches, and organizations. The Hospice of Henderson County served its first patient in 1981.

The early leaders of the hospice made a conscious decision: to design its care services around patient and family needs. It would be 1988 before the agency would apply for and receive its Medicare and Medicaid certifications – though its services would continue to be patient and family centered.

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. Greatrex Place would open its doors in December 2005, forming a center for Four Seasons’ operations. By 2007, the capacity of the Elizabeth would be expanded to 19 beds with addition the Charles W. McGrady wing.

In 2002, the board of directors made another conscious decision: to make Four Seasons one of the best hospices in the country. The board hired new leadership and physicians who brought palliative care practices with them.

As a result, Four Seasons added its 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. Two years later, in 2005, she founded Four Seasons’ nationally-recognized clinical research department with a community-based program focused on the lessening of patient suffering in a home setting.   

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’  leading-edge palliative care delivery in rural settings, involvement in collaborative research with universities, and palliative care outreach.

A global health initiative addresses the need for clinical, technical and leadership support for the development of palliative care. In 2010, Dr. Bull travelled to Zambia to partner with health leaders on a strategic plan for training, educational exchange, and workforce and capacity development. While in residence, she helped establish a center of excellence for training and mentorship of sub-Saharan African clinicians.

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.

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. In 2011, at the age of 94, she was presented with the Judith Lund Person Hospice Volunteer Award by the Carolinas Center for Hospice and End of Life Care. At the time of her death in 2012, more than 10,000 patients and their families had benefitted from her vision and determination.

Today, Four Seasons continues to set state, national and international benchmarks for palliative care.  For the past decade, it has remained a top hospice provider in western North Carolina, ranking number one nationally in client satisfaction.

Most recently, in May 2014, Four Seasons was notified they are the prospective recipients 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. The non-profit agency emerges as the sole hospice and palliative care provider nationwide chosen to implement health care reform through its innovative community care model. Nationally, the model is designed to improve outcomes, increase quality of care, decrease hospital readmissions, decrease costs for patients and families and reduce tolls on Medicare.