Our History

Home Care Program started at Jewish Hospital was first west of the Mississippi









When BJC Home Care Services was started at the Jewish Hospital of St. Louis 60 years ago, it was viewed with suspicion. In those days of extended hospital stays after surgeries, how could adequate care be provided in an individual’s home? It was a new and radical idea, and the program became the first west of the Mississippi and only the third hospital-based, coordinated home care program in the country.

The year was 1953.  Dr. David Litthauer, president of Jewish Hospital, wanted to implement a home care program based on one first started at Montefiore Hospital in New York, a hospital where he had trained. He approached I. Jerome Flance, MD.

Dr. Flance became the medical director for the next 11 years. Doctors in the home care program made house calls to patients at least once every two weeks. Social workers, physical and occupational therapists, home helpers and even dentists also made calls. The Visiting Nurse Association (VNA) provided bedside care to homebound patients. The area served was restricted to the city of St. Louis and those areas east of Lindbergh Blvd. The budget the first year of operation was $19,411, with a cost per day for patient care of $2.98. Ninety percent of the care was free care.

Patients then mirrored patients typically seen today, with one exception – active tuberculosis. Dr. Flance, who was also director of the Washington University Pulmonary Service at St. Louis City Hospital, thought home care proved to be the perfect means to treat tuberculosis patients. It became the first home care program that allowed TB patients to be treated in the home rather than in a sanitarium.

Another first for the program was the concept of delivering food to their home bound patients. A program was launched through the Women’s Auxiliary, which became Meals on Wheels and spread nationwide.

By 1956, a survey conducted by the American Medical Association found 31 organized home care programs in the country. In 1961, The U.S. Public Health Service awarded a grant to Jewish Hospital’s home care program to become a training center for hospital administrators from across the country interested in starting their own home care program.

BJC Home Care Services was the brainchild of Ruth Castellano, vice president of BJC Home Care Services. Initially a staff nurse at Christian Hospital, Castellano became a referral coordinator for Christian Hospital Home Health Care in 1984, and was promoted to director of that operation in 1985. During the next 13 years, Castellano led the consolidation of eight certified home health agencies including the Jewish Hospital program, three hospice programs, a home infusion agency, one home medical equipment operation and three private duty programs into one cohesive and cost-effective agency -- BJC Home Care Services.

BJC Home Care Services is the largest and most comprehensive home care provider in the St. Louis region, touching thousands of patients in more than 25 counties in Missouri and Illinois.

Our team of physicians, nurses, pharmacists, therapists, volunteers and other health care professionals is nationally recognized for continuous quality and innovations.

Services are available 24 hours a day, seven days a week, and include: